Emotional Health Among Youth Experiencing Family Homelessness

Barnes, Andrew J.; Gilbertson, Jace; Chatterjee, Debanjana

doi:10.1542/peds.2017-1767

Cited by 31 publications

(22 citation statements)

References 28 publications

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“…The survey assessed self-injury with the question, "During the last 12 months, how many times did you do something to purposely hurt or injure yourself without wanting to die, such as cutting, burning, or bruising yourself on purpose?" Drawing on a previously established approach to the nonnormal distribution of this variable, 26 we classified students as having self-injurious behavior if they answered as having done so 1 or more times.…”

Section: Mental Health Outcomesmentioning

confidence: 99%

“…We used student report of receiving free or reduced-price lunch as an indicator of poverty. 26,31 Four dichotomous (yes or no) questions assessed different types of intrafamilial and extrafamilial abuse. Students indicated whether they had ever experienced verbal or physical abuse by a parent or other adult in their household, sexual abuse by an older or stronger member of their family, or sexual abuse by an adult or other person outside their family.…”

Section: Sociodemographicsmentioning

confidence: 99%

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Mental Health Outcomes Among Homeless, Runaway, and Stably Housed Youth

et al. 2020

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BACKGROUND AND OBJECTIVES: Runaway youth and homeless youth are at risk for adverse mental health outcomes. These 2 populations are frequently pooled together in both research and interventions yet may have unique health needs. We sought to assess differences in mental health outcomes among these populations. METHODS:We conducted a secondary data analysis of ninth-and 11th-graders in the 2016 minnesota Student Survey (n = 68 785). We categorized youth into 4 subgroups based on housing status in the previous year: (1) unaccompanied homeless youth (0.5%), (2) runaway youth (4%), (3) youth who had both run away and been homeless (0.6%), and (4) stably housed youth (95%). We performed multivariable logistic regression to compare 4 mental health outcomes (self-injury, suicidal ideation, suicide attempts, and depressive symptoms) across groups, controlling for demographics and abuse history.RESULTS: Unstably housed youth had poorer mental health outcomes when compared with their stably housed peers (P , .05). For example, 11% of homeless youth, 20% of runaways, and 33% of youth who had experienced both had attempted suicide in the previous year compared with 2% of stably housed youth (adjusted odds ratios 2.4, 4.9, and 7.1, respectively). Other outcomes showed a similar pattern.CONCLUSIONS: Our findings suggest that runaway and homeless youth represent unique populations with high levels of mental health needs who would benefit from targeted clinical and community interventions. Pediatric clinicians represent one potential point of screening and intervention.

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Section: Mental Health Outcomesmentioning

confidence: 99%

Section: Sociodemographicsmentioning

confidence: 99%

Mental Health Outcomes Among Homeless, Runaway, and Stably Housed Youth

et al. 2020

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“…Furthermore, although MSS items assessing health and housing status have established associations with various outcomes in other studies, 19,36 these items are self-reported and have not yet been assessed for reliability and external validity. Furthermore, these items do not assess other aspects of housing such as duration or frequency of homelessness, rent instability, or housing safety.…”

Section: Discussionmentioning

confidence: 99%

“…16 Likewise, public schools identified over 1.3 million homeless youth in 2016 (91% of whom were homeless with family) -an increase of 4% over 2 years. 17 Youth experiencing family homelessness report more mental health problems than housed youth, 18 including suicide attempts, 19 even when controlling for family income. In addition, youth experiencing unaccompanied homelessness are at high risk of victimization, substance abuse, infectious diseases, and mental health problems.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, youth experiencing unaccompanied homelessness are at high risk of victimization, substance abuse, infectious diseases, and mental health problems. 20 While factors such as positive parenting relationships and increased parent responsiveness can moderate trauma symptoms and emotional-behavioral concerns in children experiencing homelessness, 19,21 it remains unclear how housing contexts might be associated with health among youth at high psychosocial risk due to ACEs.…”

Section: Introductionmentioning

confidence: 99%

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Health and Adverse Childhood Experiences Among Homeless Youth

Barnes

Gower

Sajady

et al. 2020

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Background and Objectives Homelessness is associated with health problems and with adverse childhood experiences (ACEs). The risk of chronic health conditions for homeless compared to housed youth, and how this risk interacts with ACEs remains unclear. This study investigated the relationship between ACEs, housing, and child health, and whether: 1) ACEs and health vary by housing context; 2) ACEs and homelessness confer independent health risks; and 3) ACEs interact with housing with regard to adolescent health. Methods Using data from 119,254 8th-11th graders, we tested independent and joint effects of ACEs and past-year housing status (housed, family homelessness, unaccompanied homelessness) on overall health and chronic health conditions, controlling for sociodemographic covariates. Results The prevalence of ACEs varied by housing status, with 34.1% of housed youth experiencing ≥1 ACE vs. 56.3% of family-homeless and 85.5% of unaccompanied-homeless youth. Health status varied similarly. Homelessness and ACEs were independently associated with low overall health and chronic health conditions, after adjusting for covariates. Compared to housed youth, both family-homeless youth and unaccompanied-homeless youth had increased odds of low overall health and chronic physical and/or mental health conditions. All ACE x housing-status interactions were significant (all p<0.001), such that ACE-related health risks were moderated by housing status. Conclusions ACEs and housing status independently predict health status during adolescence beyond other sociodemographic risks. Being homeless unaccompanied is also riskier than being homeless with family, and every additional ACE increases this risk. Clinicians and health systems should advocate for policies that include stable housing as a protective factor.

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