The peer-reviewed academic journal Pediatrics has published a study showing a link between families who struggle to make their rent and poor health for both the adults and children in those families.

Doctors and researchers from Boston, Philadelphia, Baltimore, Minneapolis, and Little Rock analyzed surveys of more than 22,000 families of renters with children age 4 or younger at five urban medical centers between 2009 and 2015. They looked at how many families had experienced any of three forms of housing instability: being late on rent, moving multiple times in a year, and experiencing homelessness. The study, first reported by Pacific Standard, also looked at the health of the caregivers in those families (mostly biological mothers) and their children.

Of the families interviewed, 34 percent had at least one of the housing experiences. Being behind on rent was the most common. Caregivers who had been behind on rent were almost twice as likely to report fair or poor health and children in households that had been behind on rent were about 40 percent more likely to have fair or poor health.

Caregivers in those households also had higher odds of maternal depressive symptoms and their children had higher odds of hospitalizations.

Past research has linked an inability to pay rent to homelessness and risk for depression, but has not linked being behind on rent to children's health, the researchers write.

The researchers found similar results in the health outcomes of families who were currently experiencing homelessness or had a recent history of homelessness. All three forms of housing instability were also associated with higher odds of "material hardships" like food insecurity, and either foregoing health care because of its cost or being unable to pay other bills because of the cost of healthcare.

Researchers surveyed predominantly low-income families and compared them to a control group of people who had stable housing. A third of low-income renter households had experienced at least one of the three types of housing instability and two-thirds were at risk of being behind on rent, according to the study. That's notable for "underscoring this circumstance as a previously unrecognized form of unstable housing that is meaningful for caregiver and child health," the researchers write.

So, does this mean stress about rent is directly causing poor health outcomes? Not quite. The researchers write that they can demonstrate "association, not causation."

But, they write, the three types of housing instability including trouble paying rent "have important clinical implications for all practitioners who work with young children and families." Asking about these issues during health screening may help determine what services families need.

Read the full study here.