Adverse effects caused by the Covid-19 pandemic could have lasting implications for children under five who are living in temporary accommodation in London, finds a new study led by UCL researchers.
The research, published in the International Journal of Environmental Research and Public Health, examined the impact of not having a fixed address during the Covid-19 pandemic on the healthcare access and health outcomes of children under five living in the London Borough of Newham.
Living in temporary accommodation is a form of homelessness and, according to the Office of National Statistics, it "may be provided while an assessment decision is being made or while homeless households are waiting for longer-term accommodation".
During the pandemic, the number of families in temporary accommodation across England significantly increased. And, according to the Ministry of Housing Communities & Local Government, in 2021, the London Borough of Newham reported the highest local rate of homelessness in the country. In 2020 and 2021, one in 11 children were living in temporary accommodation and one in two were living in poverty.
The team interviewed 16 professionals who work with under-fives and their families in the borough, including health visitors, health professionals, non-profit organisations, and the local authority.
They found that the pandemic had negatively affected the health of under-fives in temporary accommodation - including delay and regression in developmental milestones and behaviours, including toileting, feeding skills, emotional regulation, and social communication skills.
Lead author, PhD candidate and Early Career Researcher Diana Margot Rosenthal (UCL Great Ormond Street Institute of Child Health), said: "The first five years of life is a critical development period. However, there is now a generation of under-fives in temporary accommodation who have experienced potentially severe effects on their health and development, which will likely have life-long consequences. These adversities could include detrimental effects on education, employment, and relationships."
Among families living in temporary accommodation, professionals reported barriers including poor mental health, unsuitable housing, no social support, mistrust of services, immigration administration and financial insecurity.
These barriers were exacerbated by the reduction of in-person services and digital poverty - such as not having access to the internet, not being technologically savvy, and not feeling comfortable speaking or writing in English - which made it harder to schedule and access online appointments. Consequently, resolving issues linked to housing, benefits, or health became more difficult.
Ms Rosenthal said: "Our findings indicate that Covid-19 greatly affected the lives of under-fives in temporary accommodation and further reduced the ability of professionals to deliver care to under-fives in temporary accommodation.
"In order to tackle this, we need integrated care systems (i.e., housing and health) and tailored cross-sector strategies, that take into account both public health and policy and focus on early development, mental health support, employment training and opportunities for parents and carers."
The qualitative study found that key professionals, such as community facilitators, had tried to mitigate problems linked with healthcare access and health outcomes by improving communication with families. This included contacting them about missed and follow-up appointments and delivering services to children within the community.
The researchers now hope to examine the impact of the pandemic on under-fives in temporary accommodation in other UK regions and places of high homelessness around the world.
Ms Rosenthal said: "While the study was carried out in Newham, the findings may still be generalisable to other populations in England - given the high prevalence of child homelessness in temporary accommodation and the fact that many of the professionals had also worked outside of the borough."
Recruitment difficulties due to the unpredictability of lockdowns and an increasing workload for professionals meant there was a lack of representation from the London Borough of Newham Housing department.