Home Is Missing From the Maternal and Infant Health Conversation

These aren’t rare, extreme cases. In more than two decades of working alongside state and community leaders on the earliest years of life, I’ve come to believe housing instability is one of the most under-recognized threats to a healthy start for babies and the parents raising them — and it’s far more common than most people realize.

What the Data Shows 
More than 500,000 infants and toddlers in the U.S. experienced homelessness during the 2023–24 school year (this is a modeled estimate from SchoolHouse Connection and the University of Michigan’s Poverty Solutions initiative, since infants and toddlers aren’t counted through school enrollment the way older children are). Separately, an estimated 1.2 million women experience homelessness in the U.S. each year, and nearly half of homeless young women ages 18 to 25 are pregnant or parenting.

The health consequences are severe and well documented: homeless mothers are roughly twice as likely to experience depression, three times more likely to have PTSD, and two-and-a-half times more likely to face substance dependence than housed mothers. Layer in the racial disparities that already define maternal and infant health in this country — Black infants die at more than twice the rate of white infants, 10.9 vs. 4.5 per 1,000 live births in 2022, and Black women are three times more likely to die from a pregnancy-related cause than white women — and the picture gets even harder to look away from.

Why BUILD Is Working on This 
We talk often in early childhood circles about toxic stress and the importance of a steady, nurturing environment for infant brain development. But we don’t always connect that language to the family living out of a car, doubled up on a relative’s couch, or cycling through motel rooms. Homelessness doesn’t disrupt only a family’s address — it disrupts prenatal and postpartum care, deepens maternal mental health challenges at the exact moment new parents most need stability, and strains the foundation early childhood systems exist to protect.

That’s why the BUILD Initiative has made family homelessness a priority within our Prenatal-to-Three Capacity-Building Hub. Through a cross-state learning community, we’re helping early childhood, housing, and health leaders stop working in separate lanes and start aligning around the same families. The solutions already exist: integrated models like Warren Village in Denver pair stable housing with mental health support, employment services, and trauma-informed, no-wrong-door care. The barrier isn’t knowing what works — it’s building the cross-sector systems, and the will, to make that the standard of care everywhere, not the exception in a handful of well-resourced places.

Read More 

• No Place to Grow: Rethinking Homelessness Through a Whole-Child, Whole-Family Lens 
• Connecting the Dots: Holistic Help for Women and Children Experiencing Homelessness Learn more with BUILD on September 30 
  We’re continuing this conversation on September 30 at 2:00 PM ET during the webinar, Held and Housed: Protecting Maternal and Infant Well-Being from the Harms of Homelessness. We’ll explore how housing instability disrupts the perinatal journey — and, more importantly, what states and communities are actually doing about it. Register here.Every parent deserves the care to recover and grow strong. Every baby deserves a healthy, supported start. Housing doesn’t exist on the sidelines of maternal and infant health discussions — it’s often the precursor to so many perinatal issues. Fixing it takes housing, health, and early childhood systems working from the same playbook, not three separate ones.