INTRODUCTION: Housing is an important determinant of health that is amenable to intervention. While the negative health effect of living in unaffordable, insecure, and unsuitable housing has been well-established for adults, little is known of the causal effect of housing disadvantage in childhood and health across the life course. This review aims to synthesise evidence from longitudinal studies on housing disadvantage in childhood and health.

METHODS: Longitudinal studies (2000-2025) were systematic reviewed to examine the impact of insecure, unaffordable, or poor-quality housing experienced during childhood (ages 0-18 years) on subsequent physical, mental, or behavioural health outcomes. Risk of bias was assessed with ROBINS-E, and evidence graded using causal criteria including study design, temporality, confounder control, and measurement validity.

RESULTS: Sixty-three studies were included, spanning 16 countries and follow-up periods ranging from one to 68 years. Registry and quasi-experimental studies provided the strongest evidence, showing that insecure housing was associated with later mental illness, substance misuse, and premature mortality. Poor housing quality was linked to respiratory outcomes and general health, with suggestive causal signals in studies with extended follow-up and robust adjustment. Evidence for effects of overcrowding and housing affordability was inconsistent, limited by measurement error and confounding.

DISCUSSION: Living in disadvantaged housing in childhood may impact health later in life. While some studies offer suggestive causal signals, many lacked formal life-course modelling or designs that enable causal inference. Greater methodological integration and longitudinal investment will be critical to clarify pathways and inform policy responses.