Sociodemographic Shifts in Childhood Housing Instability in the United States, 2022-2024.

OBJECTIVE: To evaluate recent national trends in childhood housing instability, overall and across sociodemographic subgroups. METHODS: We conducted a serial cross-sectional analysis of children aged 0-17 years using the 2022-2024 National Survey of Children's Health (NSCH). Our primary outcome was housing instability, a NSCH-defined composite of caregiver-reported inability to pay rent or mortgage on time in the past 12 months, lifetime experience of homelessness or living in a shelter, and frequent residential mobility in the past 12 months. We conducted survey-weighted regression models with an interaction term between sociodemographic subgroups and survey year to estimate within-group trends, adjusting for age and sex and accounting for the complex sampling design. RESULTS: Approximately 12 million U.S. children (17%) experienced housing instability annually. Overall housing instability prevalence did not significantly change from 2022 to 2024. However, housing instability increased among children in households at 200%-399% of the family poverty level (adjusted risk ratio [aRR]: 1.11 per year; 95% CI: 1.05, 1.17), those with private insurance (aRR: 1.06; 95% CI: 1.00, 1.11), and those whose highest-educated caregiver held a college degree or higher (aRR: 1.07; 95% CI: 1.02, 1.12). Absolute prevalence remained highest among children identifying as American Indian or Alaska Native, Black or African American, Hispanic, Native Hawaiian or Pacific Islander, those publicly insured, and those in low-income households. CONCLUSIONS: Childhood housing instability is expanding in higher-income populations that are not traditionally targeted by federal assistance programs, while remaining concentrated among historically marginalized groups. Increased response strategies are needed from cross-sector collaboration among pediatricians, policymakers, and health systems.