Examining Housing Instability Among Females Who Are System-Involved: Comparing Females With and Without Histories of Commercial Sexual Exploitation

Females involved in child welfare (CW) or juvenile justice (JJ) systems are at-risk for commercial sexual exploitation (CSE). This study used administrative data from CW and JJ agencies in Los Angeles County to examine out-of-home care experiences and identify the types of homes that were associated with housing instability for females who experienced CSE. Demographic and case characteristics of females with a history of CSE and a matched sample without a reported history of CSE were compared using χ2 analyses and t-tests. Females with a history of CSE experienced significantly more housing instability compared to their matched counterparts. Housing instability was associated with leaving care without permission (LCWOP), and females were most likely to move because of LCWOP from group homes. These findings highlight the extremely unstable living situations for females with histories of CSE. Recommendations align with new federal policy, which aims to reduce reliance on group homes.

Risk Factors for Veteran Food Insecurity: Findings from a National US Department of Veterans Affairs Food Insecurity Screener

Objective: Food insecurity is associated with numerous adverse health outcomes. The US Veterans Health Administration (VHA) began universal food insecurity screening in 2017. This study examined prevalence and correlates of food insecurity among Veterans screened. Design: Retrospective cross-sectional study using VHA administrative data. Multivariable logistic regression models were estimated to identify sociodemographic and medical characteristics associated with a positive food insecurity screen. Setting: All US VA medical centers (n=161). Participants: All Veterans screened for food insecurity since screening initiation (July 2017-December 2018). Results: Of 3,304,702 Veterans screened for food insecurity, 44,298 were positive on their initial screen (1.3% of men; 2.0% of women). Food insecurity was associated with identifying as non-Hispanic Black or Hispanic. Veterans who were non-married/partnered, low-income Veterans without VA disability-related compensation, and those with housing instability had higher odds of food insecurity, as did Veterans with a BMI<18.5, diabetes, depression, and post-traumatic stress disorder. Prior military sexual trauma was associated with food insecurity among both men and women. Women screening positive, however, were eight times more likely than men to have experienced military sexual trauma (48.9% vs 5.9%). Conclusions: Food insecurity was associated with medical and trauma-related comorbidities as well as unmet social needs including housing instability. Additionally, Veterans of color and women were at higher risk for food insecurity. Findings can inform development of tailored interventions to address food insecurity such as more frequent screening among high-risk populations, onsite support applying for federal food assistance programs, and formal partnerships with community-based resources.

Living in a block group with a higher eviction rate is associated with increased odds of preterm delivery

BackgroundHousing instability is associated with adverse pregnancy outcomes. Recent studies indicate that eviction, which may affect a larger segment of the population than other forms of housing instability, is also associated with adverse pregnancy outcomes. However, these studies evaluate eviction across large areas, such as counties, so it remains unclear whether these patterns extend to individual-level pregnancy outcomes.MethodsWe used data on a cohort of all singleton live births at a single Chicago hospital between March 2008 and March 2018 to investigate the associations between block-group eviction rates and individual adverse pregnancy outcomes. Eviction data were obtained from the Eviction Lab at Princeton University. Generalised estimating equations were used to estimate associations and account for correlations among individuals living in the same block groups.ResultsIndividuals living in block groups in the highest quartile for eviction filing rate were 1.17 times as likely to deliver preterm (95% CI: 1.08 to 1.27) and 1.13 times as likely to deliver a small for gestational age infant (95% CI: 1.03 to 1.25) as compared with individuals living in block groups in the lowest quartile. Further, tests for linear trend indicated that for each quartile increase in eviction filing rate, there was a corresponding increase in odds of adverse outcomes (p<0.05). Results were strongest in magnitude for those with low neighbourhood and individual socioeconomic status, who are most likely to be renters and affected by local eviction policies.ConclusionOur results suggest that individuals living in block groups with higher eviction rates are more likely to deliver preterm. Future research should explore associations of individual experience with eviction on adverse pregnancy outcomes and examine whether policies to improve tenant protections also impact pregnancy outcomes.

Housing Instability and Depression among US Mothers Following a Nonmarital Birth

Mothers who had a nonmarital birth experience multiple risk factors for depression, including housing instability. Yet, important questions remain about the extent of long-term housing instability and its association with future depression among at-risk mothers. Using the Fragile Families and Child Wellbeing Study data, we examine cumulative housing instability over a 15-year period following nonmarital birth and its association with maternal depression. Based on a sample of 2279 mothers who had a nonmarital birth in 20 major US cities between 1998–2000, we examined their 15-year residential moves and housing arrangements. Then, we tested the associations between the cumulative residential moves and major depressive episodes (MDE) in Year 15 using logistic regression analysis. One in every four mothers had six or more residential moves in 15 years following a nonmarital birth. For each additional move, mothers reported up to 27.9% higher odds of having a past-year MDE in Year 15, translating into the prevalence increases from 6.0% (zero move) to 20.6% (10 moves). Our findings suggest that greater attention should be paid to housing needs among mothers following a nonmarital birth, including temporary housing assistance and more fundamental programs to reduce housing instability as preventive mental health services.