Active Case
Housing Instability & Child Health
Training note: ask about breathing right now and about medicine on hand before discussing housing referrals. Housing work happens alongside clinical care, never before it.
Step 1 of 7: Review the case
Read what the case states, what it does not state, and what this practice case is asking you to learn.
Fictional resident
Ms. Yolanda Torres
34 years old · Parent of an 8-year-old living with asthma
ZIP code
78228
Preferred language
Spanish; requests a qualified interpreter for clinical visits
Coverage
Child covered by Medicaid
What is happening
Ms. Torres received an eviction notice 30 days ago and is staying with her sister's household. Her son Marcus, 8, has coughed at night since the move and has used his rescue inhaler more often. He has been seen in the emergency department twice in the past month. She reports that someone smokes indoors and that the room where Marcus sleeps is heavily dusty. She is hesitant to ask for help because she worries about being reported.
What you are practicing here
- Work out what has to be known about the child's breathing and medicines before any referral is chosen.
- Distinguish what the parent has actually observed at home from what would need an inspection or a clinician.
- Decide what runs in parallel and what genuinely has to wait.
The detailed learning objectives for this case name the intended answers, so they are shown in the debrief after you submit. The safety note on the case page is different: it states the intended emergency response deliberately, because safety information is never withheld to make an exercise harder.
What the resident says matters most
- Keeping Marcus out of the emergency department
- Finding somewhere stable before the month ends
- Understanding what information gets shared and with whom
Strengths already present
- Recognized the change in Marcus's symptoms and tracked it
- Family willing to share space during the gap
- Medicaid coverage for Marcus already active
- Asked questions about privacy rather than disengaging
Stated in the case
- Eviction notice received 30 days ago; no plan after this month
- Staying temporarily with her sister's household
- Night coughing and increased rescue-inhaler use since the move
- Two emergency department visits in the past month
- Parent reports indoor tobacco smoke and heavy dust in the room where Marcus sleeps
- Worry about being reported limits help-seeking
- She asks for a qualified Spanish interpreter whenever clinical instructions are explained
Not known — would need asking
- How Marcus is breathing at this moment and whether warning signs are present
- Whether he has a controller medicine and current refills
- What specifically seems to trigger symptoms in the current home
- Whether she consents to information being shared, and with which program
Social determinants in this case
Some domains are stated in the case; others are only possible mechanisms to consider and are not established here. The full five-domain framework is mapped on the Methods page.
- Neighborhood and Built Environment stated in this caseReported indoor smoke and heavy dust where Marcus sleeps, in temporary housing.
- Health Care Access and Quality stated in this caseThe rescue inhaler is nearly empty and the refill lapsed during the move, and she asks for a qualified Spanish interpreter whenever clinical instructions are explained.
- Economic Stability stated in this caseAn eviction notice with no plan after this month.
- Social and Community Context stated in this caseShe says fear of being reported is limiting her help-seeking.
- Education Access and Quality possible mechanism, not establishedNot established here. Night symptoms and moves can affect attendance and learning, which is worth asking about.
Why this is structural: A child's asthma is managed partly by where the family can afford to live. Eviction moves a family into whatever space is available, and that space may carry more triggers. Legal aid capacity and rental supply, not parenting effort, determine how long the exposure lasts.