Evidence map›Paper›PMID 41159066›Full record

ArticleAJPM focus2026

Hardship-Free Households Are Associated With Optimal Caregiver and Child Health.

Richard Sheward, Stephanie Ettinger de Cuba, Diana B Cutts, Deborah A Frank, Ana Poblacion, Eduardo Ochoa, Félice Lê-Scherban, Maureen M Black, Sharon M Coleman, Timothy C Heeren and 1 more

Abstract read
In one paragraph

Article in AJPM focus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Richard ShewardDepartment of Pediatrics, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts.
Stephanie Ettinger de CubaDepartment of Pediatrics, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts.
Diana B CuttsDepartment of Pediatrics, Hennepin Healthcare, Minneapolis, Minnesota.
Deborah A FrankDepartment of Pediatrics, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts.
Ana PoblacionDepartment of Pediatrics, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts.
Eduardo OchoaDepartment of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Félice Lê-ScherbanUrban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania.
Maureen M BlackDepartment of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland.
Sharon M ColemanBiostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts.
Timothy C HeerenDepartment of Biostatistics, Boston University School of Public Health, Boston, Massachusetts.
Megan SandelDepartment of Pediatrics, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Families living with low incomes experience a higher risk of material hardships associated with poor health. To understand the potentially protective role of hardship-free households, the authors examined associations between the absence of material hardships among families with low incomes and child health and healthcare utilization and caregiver health outcomes. Methods: Researchers interviewed a sentinel sample of caregivers of publicly insured children aged <4 years in hospital settings in 5 U.S. cities (2012-2017). Exposure to material hardships (food insecurity, housing instability, healthcare hardship, and energy insecurity) was categorized as 0, 1, or ≥2 hardships. Outcome measures included child health (overall and oral health), anthropometrics, developmental risk, lifetime hospitalizations, composite well-child measure, caregiver health, and depressive symptoms. Multivariable logistic regression models examined the associations between hardships and child and caregiver health. Results: Among 16,320 families, 41.0% experienced 0 hardships, 28.2% experienced 1 hardship, and 30.8% experienced ≥2 hardships. After covariate control, children from hardship-free households experienced lower adjusted odds of lifetime hospitalizations, fair/poor health, fair/poor oral health, developmental risk, and higher odds of wellness than children from household that experienced ≥2 hardships, and caregivers had lower odds of fair/poor health and depressive symptoms. Children and their caregivers from households with 1 hardship showed lower adjusted odds of lifetime hospitalizations, fair/poor health, fair/poor oral health, and higher odds of wellness than those from household that experienced ≥2 hardships, and caregivers had lower odds of fair/poor health and depressive symptoms. Conclusions: Living without material hardships may contribute to positive physical and developmental/behavioral health among children and caregivers. Findings support the importance of policies to decrease material hardships among families with low incomes.

Indexed as

Child healthFood insecurityHealth disparitiesLow-income familiesMaterial hardshipsSocial determinants of health

Identifiers

PMID41159066
PMCPMC12557588

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.