Children growing up in homeless families are disproportionately more likely to experience health and psychological problems. Our objective was to describe social, environmental, individual and family characteristics associated with emotional and behavioral difficulties among homeless children living in the Paris region.

Face-to-face interviews with a representative sample of homeless families were conducted by bilingual psychologists and interviewers between January and May 2013 (n = 343 children ages 4-13 years). Mothers reported children’s emotional and behavioral difficulties (Strength and Difficulties Questionnaire [SDQ]), family socio-demographic characteristics, residential mobility, and parents’ and children’s physical and mental health. Children were interviewed regarding their perception of their living arrangements, friendships and school experiences. We studied children’s SDQ total score in a linear regression framework.

Homeless children had higher SDQ total scores than children in the general population of France, (mean total score = 11.3 vs 8.9, P < 0,001). In multivariate analyses, children’s difficulties were associated with parents’ region of birth (beta = 1.74 for Sub-Saharan Africa, beta = 0.60 for Eastern Europe, beta = 3.22 for other countries, P = 0.020), residential mobility (beta = 0.22, P = 0.012), children’s health (beta = 3.49, P < 0.001) and overweight (beta = 2.14, P = 0.007), the child’s sleeping habits (beta = 2.82, P = 0.002), the mother’s suicide risk (beta = 4.13, P < 0.001), the child’s dislike of the family’s accommodation (beta = 3.59, P < 0.001) and the child’s experience of bullying (beta = 3.21, P = 0.002).

Children growing up homeless experience high levels of psychological difficulties which can put them at risk for poor mental health and educational outcomes long-term. Access to appropriate screening and medical care for this vulnerable yet underserved group are greatly needed.

Haiti remains the poorest country in the Americas and one of the poorest in the world. Children in Haiti face many health concerns, some of which were exacerbated by the 2010 earthquake. This systematic review summarizes published research conducted since the 2010 earthquake, focusing on health outcomes for children in Haiti, including physical, psychological, and socioeconomic well-being.

A literature search was conducted identifying articles published from January 2010 through May 2016 related to pediatric health outcomes in Haiti. Two reviewers screened articles independently. Included research articles described at least one physical health, psychological health, or socioeconomic outcome among children less than 18 years of age in Haiti since the January 2010 earthquake.

Fifty-eight full-length research articles were reviewed, covering infectious diseases (non-cholera [N=12] and cholera [N=7]), nutrition (N=11), traumatic injuries (N=11), mental health (N=9), anemia (N=4), abuse and violence (N=5), and other topics (N=3). Many children were injured in the 2010 earthquake, and care of their injuries is described in the literature. Infectious diseases were a significant cause of morbidity and mortality among children following the earthquake, with cholera being one of the most important etiologies. The literature also revealed that large numbers of children in Haiti have significant symptoms of posttraumatic stress disorder (PTSD), peri-traumatic stress, depression, and anxiety, and that food insecurity and malnutrition continue to be important issues.

Future health programs in Haiti should focus on provision of clean water, sanitation, and other measures to prevent infectious diseases. Mental health programming and services for children also appear to be greatly needed, and food insecurity/malnutrition must be addressed if children are to lead healthy, productive lives. Given the burden of injury after the 2010 earthquake, further research on long-term disabilities among children in Haiti is needed.

DubeA, MoffattM, DavisonC, BartelsS. Health Outcomes for Children in Haiti Since the 2010 Earthquake: A Systematic Review. Prehosp Disaster Med. 2018;33(1):77–88.