Defining the Problem


Too many children across North Carolina do not have a safe and stable place to sleep at night. Some families may be living in shelters, others in their cars, or, still, others may be temporarily living with friends or relatives, which can be unpredictable. Unstable housing is stressful, especially for families with young children.1 Young children who experience unstable housing are at a higher risk for poor physical health, and mental health and behavioral problems.2-4 They are also at risk for delayed language and literacy skills, attention difficulties, and poor self-regulation.3, 5,6 They may also struggle in school with relationships with their classmates and their teachers.7 Children living in unsafe or unstable conditions also often face greater challenges at home and in their communities, such as family and neighborhood violence, maltreatment, food insecurity, chronic illness, and lack of proper healthcare.8-10 They may face unhealthy home environments that expose them to things such as lead, pests, poor ventilation, or mold, that could lead to health problems such as asthma, or physical dangers that could lead to injury. Further, caregivers of young children who experience homelessness often report poor health, signs of maternal depression or other mental illness, putting them at risk for low confidence in parenting and using harsh parenting practices.11

The North Carolina Early Childhood Action Plan focuses on decreasing rates of homelessness for all young children across the state, and particularly among those children participating in high-quality early learning programs. There are also other measures that focus on safe living environments, such as reducing emergency care for asthma and tracking elevated blood lead levels, both of which may be caused by harmful environmental exposure.

Goal 4 Target

26,198 

 Number of children under age six experiencing homelessness in NC

Number of Children K – 3rd Grade Enrolled in North Carolina Public Schools Experiencing Homelessness

Data Source: NC Department of Public Instruction (NCDPI) 

Sub-Targets

Sub-Target 1: High Housing Cost Burden 

Percent of Households with Children Ages 0 – 8 Facing High Housing Cost Burden in North Carolina  

Data Source: American Community Survey (ACS), U.S. Census Bureau 

*Technical note: High housing cost burden is defined as a household that pays more than 30 percent of its income on housing.

Percent of Households with Children Ages 0 – 8 Facing High Housing Cost Burden in North Carolina by Race, Ethnicity, 2016

Data Source: American Community Survey (ACS), U.S. Census Bureau 

*Technical note: High housing cost burden is defined as a household that pays more than 30 percent of its income on housing.

Sub-Target 2: Children Facing Homelessness and Participating in Education Programs  

Number of Children K – 3rd Grade Facing Homelessness Enrolled in Public Schools in North Carolina 

Data Source:  NC Department of Public Instruction (NCDPI)

Data Source: Division of Child Development and Early Education (DCDEE), NC Department of Health and Human Services (NCDHHS)

*Note: Data collection for this data source began in October 2017. Counts of children identified with homeless priority are expected to increase as identification methods improve for this data source.

Sub-Target 3: Rates of Emergency Department Visits for Asthma Care  

Rates of Emergency Department Visits for Asthma Care per 1,000 Children Ages 0 – 8 in North Carolina

Data Source: NC DETECT (North Carolina Disease Event Tracking and Epidemiologic Collection Tool): ED Visit Data. Analysis by NC DPH Injury and Violence Prevention Branch.

*Technical note: Case definitions for asthma diagnoses include ICD9 CM Asthma first listed diagnosis 493 and IDC10 CM Asthma first listed diagnosis: J45. Counties with no shading have undergone cell suppression rules.

*Disclaimer: “The North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) is an advanced, statewide public health surveillance system. NC DETECT is funded with federal funds by North Carolina Division of Public Health (NC DPH), Public Health Emergency Preparedness Grant (PHEP), and managed through a collaboration between NC DPH and the University of North Carolina at Chapel Hill Department of Emergency Medicine's Carolina Center for Health Informatics (UNC CCHI). The NC DETECT Data Oversight Committee does not take responsibility for the scientific validity or accuracy of methodology, results, statistical analyses, or conclusions presented. The NC DETECT Data Oversight Committee (DOC) includes representatives from the NC DPH, UNC NC DETECT Team and NC Hospital Association.” The NC DETECT Data Oversight Committee (DOC) includes representatives from the NCDPH, UNC NC DETECT Team and NC Hospital Association.

Rates of Emergency Department Visits for Asthma Care per 1,000 Children Ages 0 – 8 in North Carolina by County 

Data Source: NC DETECT (North Carolina Disease Event Tracking and Epidemiologic Collection Tool): ED Visit Data. Analysis by NC DPH Injury and Violence Prevention Branch.

*Technical note: Case definitions for asthma diagnoses include ICD9 CM Asthma first listed diagnosis 493 and IDC10 CM Asthma first listed diagnosis: J45. Counties without shading have undergone cell suppression rules.

*Disclaimer: “The North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) is an advanced, statewide public health surveillance system. NC DETECT is funded with federal funds by North Carolina Division of Public Health (NC DPH), Public Health Emergency Preparedness Grant (PHEP), and managed through a collaboration between NC DPH and the University of North Carolina at Chapel Hill Department of Emergency Medicine's Carolina Center for Health Informatics (UNC CCHI). The NC DETECT Data Oversight Committee does not take responsibility for the scientific validity or accuracy of methodology, results, statistical analyses, or conclusions presented. The NC DETECT Data Oversight Committee (DOC) includes representatives from the NC DPH, UNC NC DETECT Team and NC Hospital Association.” The NC DETECT Data Oversight Committee (DOC) includes representatives from the NCDPH, UNC NC DETECT Team and NC Hospital Association.


Sub-Target 4: Children Receiving Lead Screening with Elevated Lead Levels  

Percent of Young Children in North Carolina Receiving Lead Screening with Confirmed Elevated Blood Lead Levels 

Data Source: NCLEAD Surveillance System, Children’s Environmental Health, Division of Public Health (DPH), NC Department of Health and Human Services (NCDHHS) 

*Technical note: Starting in 2013, children are counted as being "tested" for lead poisoning until they are confirmed to have a lead level ≥5 micrograms per deciliter (µg/dL).  After a child has a "confirmed" lead level, the child is no longer counted as "tested" during subsequent years. Blood lead tests after lead level confirmation are considered "follow-up" test results and are not counted in the surveillance tables. Children are counted as having "confirmed" lead levels when they have two consecutive blood lead test results ≥ 5 µg/dL within a six-month period, up until December 31, 2017. The second test result must be a diagnostic test, preferably a venous sample, sent to an outside reference laboratory for analysis. The majority of children are tested by their second birthday, but the larger age range of children ages 0-6 years is also shown.


Sub-Target 5: Poverty 

Percent of Families in North Carolina with Children Aged 0 - 8 Living at or Below 200% of the Federal Poverty Level

Data Source: American Community Survey (ACS), U.S. Census Bureau

Percent of Families in North Carolina with Children Aged 0 - 8 Living at or Below 200% of the Federal Poverty Level by Race, Ethnicity

Data Source: American Community Survey (ACS), U.S. Census Bureau