The Association Between Exposure to Maternal Depression During Year 2 of a Child's Life and Future Child Problem Behavior.

INTRODUCTION: We examined the association of exposure to maternal depression during year 2 of a child's life with future child problem behavior. We conducted a secondary analysis to investigate whether race/ethnicity is a moderator of this relationship. METHODS: We used Fragile Families and Child Well-Being Study data (age 3 N = 3288 and 49% Black, 26% Hispanic, 22% non-Hispanic White; age 5 N = 3001 and 51% Black, 25% Hispanic, 21% non-Hispanic White; age 9 N = 3630 and 50% Black, 25% Hispanic, 21% non-Hispanic White) and ordinal logistic regression to model problem behavior at ages 3, 5, and 9 on maternal depression status during year 2. RESULTS: At age 9, children whose mother was depressed during year 2 were significantly more likely to have higher internalizing (AOR = 1.92, 95% CI: 1.42,2.61) and externalizing (AOR = 1.65, 95% CI: 1.10,2.48) problem behavior scores. In our secondary analysis, race/ethnicity did not have moderating effects, potentially due to a limitation of the data that required use of maternal self-reported race/ethnicity as a proxy for child race/ethnicity. DISCUSSION: Exposure to maternal depression after the prenatal and perinatal periods may have a negative association with children's behavioral development through age 9. Interventions that directly target maternal depression during this time should be developed. Additional research is needed to further elucidate the role of race/ethnicity in the relationship between maternal depression and child problem behavior.

Food Insecurity and Housing Instability Partially Mediate the Association Between Maternal Depression and Child Problem Behavior.

Maternal depression is a risk factor for the development of problem behavior in children. Although food insecurity and housing instability are associated with adult depression and child behavior, how these economic factors mediate or moderate the relationship between maternal depression and child problem behavior is not understood. The purpose of this study was to determine whether food insecurity and housing instability are mediators and/or moderators of the relationship between maternal depression when children are age 3 and children's problem behaviors at age 9 and to determine whether these mechanisms differ by race/ethnicity. We used data from the Fragile Families and Child Wellbeing Study. Food insecurity and housing instability at age 5 were tested as potential mediators and moderators of the relationship between maternal depression status at age 3 and problem behavior at age 9. A path analysis confirmed our hypothesis that food insecurity and housing instability partially mediate the relationship between maternal depression when children are age 3 and problem behavior at age 9. However, housing instability was only a mediator for externalizing problem behavior and not internalizing problem behavior or overall problem behavior. Results of the moderation analysis suggest that neither food insecurity nor housing instability were moderators. None of the mechanisms explored differed by race/ethnicity. While our findings stress the continued need for interventions that address child food insecurity, they emphasize the importance of interventions that address maternal mental health throughout a child's life. Given the central role of maternal health in child development, additional efforts should be made to target maternal depression.

A Longitudinal Examination of Housing Hardships Among Urban Fathers.

Stable housing is widely recognized as a prerequisite for the functioning of individuals and families. However, the housing stability of fathers is under-studied, particularly for fathers living apart from their children. This analysis measures the extent and nature of fathers' housing insecurity using the Fragile Families and Child Wellbeing Study, a national longitudinal survey of urban families. Housing insecurity affects a substantial portion of fathers, with 25 percent experiencing insecurity at least once in their child's first nine years. However, few fathers report persistent insecurity that spans consecutive waves. Data also indicate significant differences in rates of housing insecurity between fathers living with, and apart from, the mothers of their children, with nonresident fathers far less likely to report secure housing and more likely to experience incarceration. The nature of insecurity experienced by nonresident fathers is also qualitatively different than that experienced by their coresident counterparts.

Housing Instability and Children's Health Insurance Gaps.

OBJECTIVE: To assess the extent to which housing instability is associated with gaps in health insurance coverage of preschool-age children. METHODS: Secondary analysis of data from the Early Childhood Longitudinal Study-Birth Cohort, a nationally representative study of children born in the United States in 2001, was conducted to investigate associations between unstable housing-homelessness, multiple moves, or living with others and not paying rent-and children's subsequent health insurance gaps. Logistic regression was used to adjust for potentially confounding factors. RESULTS: Ten percent of children were unstably housed at age 2, and 11% had a gap in health insurance between ages 2 and 4. Unstably housed children were more likely to have gaps in insurance compared to stably housed children (16% vs 10%). Controlling for potentially confounding factors, the odds of a child insurance gap were significantly higher in unstably housed families than in stably housed families (adjusted odds ratio 1.27; 95% confidence interval 1.01-1.61). The association was similar in alternative model specifications. CONCLUSIONS: In a US nationally representative birth cohort, children who were unstably housed at age 2 were at higher risk, compared to their stably housed counterparts, of experiencing health insurance gaps between ages 2 and 4 years. The findings from this study suggest that policy efforts to delink health insurance renewal processes from mailing addresses, and potentially routine screenings for housing instability as well as referrals to appropriate resources by pediatricians, would help unstably housed children maintain health insurance.

Public housing agency preferences for the homeless as a policy lever: Examining county-level housing subsidy receipt and maltreatment rates.

This study examines the relationship between county Public Housing Agency (PHA) practices that prioritize families experiencing homelessness and county-level child maltreatment rates. Using data from a survey of PHAs and the National Child Abuse and Neglect Data System (NCANDS) with a sample of 534 counties, we find that policies which give preference to homeless households for housing assistance are associated with reduced victimization and substantiation rates, while policies that reduce barriers to assistance eligibility are associated with reporting rates. Our findings suggest that beyond prioritizing homeless families for housing assistance as a means of ending homelessness, providing families with more expedient access to a valuable public subsidy may have important positive externalities, such as reduced CPS involvement. Additional partnerships between child welfare agencies and housing providers, particularly those that provide housing subsidies, may be worthy of additional investment and evaluation.

Child Support Receipt, Mobility, and Housing Quality.

This study uses administrative records for the state of Wisconsin as well as Zillow Real Estate data on median house values to examine the associations between the regularity of child support receipt on moves and changes in housing values following moves. Our sample consists of 13 329 custodial mothers with new orders from 2002 to 2006. Across several measures of child support and specifications of moves, regular receipt is negatively associated with any moves and with more than one move a year, holding constant the value of the child support received. In models examining associations between regularity and changes in housing quality after a move, an additional month of child support within 25 per cent of the order amount is associated with an $890 increase in housing value. These results imply that policy-makers concerned with housing stability consider both the regularity and absolute value of child support when considering family well-being.

Maternal depression as a risk factor for children's inadequate housing conditions.

Depression among mothers with young children is an important public health issue that not only has implications for their own well-being, but can also potentially affect their children's health and developmental trajectories. This study explored the extent to which maternal depression is a risk factor for inadequate housing conditions related to utilities, a noteworthy risk factor for poor child health. Using data on 2965 mothers and children from a national urban cohort of U.S. births in 1998-2000, we estimated multivariate logistic regression models of associations between maternal depression during the postpartum year and a U.S. Department of Housing and Urban Development (HUD) measure of severely inadequate housing due to heating issues, as well as a broader measure of energy insecurity that encompasses various types of utility problems. We also considered outcomes that incorporated housing instability and food insecurity in conjunction with housing inadequacy. Mothers who experienced depression had about 60% higher odds of experiencing severely inadequate housing due to heat (OR: 1.57) and 70% higher odds of experiencing energy insecurity (OR: 1.69) compared to mothers who did not experience depression. Maternal depression was even more strongly associated with multiple hardships in the forms of housing inadequacy plus housing instability and/or food insecurity than it was with housing inadequacy. This study provides robust evidence that maternal depression is a risk factor for inadequate housing and multiple hardships during a critical period of children's development. The findings suggest that policy efforts should not occur in mental health, housing, and food security silos.

Maternal depression as a risk factor for family homelessness.

OBJECTIVES: We estimated the effects of maternal depression during the postpartum year, which is often an unexpected event, on subsequent homelessness and risk of homelessness in a national sample of urban, mostly low-income mothers. METHODS: We used logistic regression models to estimate associations between maternal depression during the postpartum year and both homelessness and risk of homelessness 2 to 3 years later, controlling for maternal and family history of depression, prenatal housing problems, and other covariates. Risk factors for homelessness included experiencing evictions or frequent moves and moving in with family or friends and not paying rent. RESULTS: We found robust associations between maternal depression during the postpartum year and subsequent homelessness and risk of homelessness, even among mothers who had no history of mental illness, whose own mothers did not have a history of depressive symptoms, and who had no previous housing problems. CONCLUSIONS: This study provides robust evidence that maternal mental illness places families with young children at risk for homelessness, contributes to the scant literature elucidating directional and causal links between mental illness and homelessness, and contributes to a stagnant but important literature on family homelessness.

Life shocks and homelessness.

We exploited an exogenous health shock-namely, the birth of a child with a severe health condition-to investigate the effect of a life shock on homelessness in large cities in the United States as well as the interactive effects of the shock with housing market characteristics. We considered a traditional measure of homelessness, two measures of housing instability thought to be precursors to homelessness, and a combined measure that approximates the broadened conceptualization of homelessness under the 2009 Homeless Emergency Assistance and Rapid Transition to Housing Act (2010). We found that the shock substantially increases the likelihood of family homelessness, particularly in cities with high housing costs. The findings are consistent with the economic theory of homelessness, which posits that homelessness results from a conjunction of adverse circumstances in which housing markets and individual characteristics collide.

A Sort of Homecoming: Incarceration and the housing security of urban men.

While individuals returning from prison face many barriers to successful re-entry, among the most serious are the challenges they face in securing housing. Housing has long been recognized as a prerequisite for stable employment, access to social services, and other aspects of individual and family functioning. The formerly incarcerated face several administrative and de facto restrictions on their housing options; however, little is known about the unique instabilities that they face. We use a longitudinal survey of urban families to examine housing insecurity among nearly 3,000 urban men, including over 1,000 with incarceration histories. We find that men recently incarcerated face greater housing insecurity, including both serious hardships such as homelessness, and precursors to homelessness such as residential turnover and relying on others for housing expenses. Their increased risk is tied both to diminished annual earnings and other factors, including, potentially, evictions from public housing supported by Federal "one-strike" policies.

The effect of incarceration on urban fathers' health.

This study examines the effects of incarceration on the health of urban fathers. Using the Fragile Families and Child Well-Being Study, which surveys parents in 20 large U.S. cities across the country, the relationship between fathers' incarceration patterns and health status was examined while controlling for poor preexisting health and individual impulsivity. Findings indicate that fathers who have previously been incarcerated at some time are markedly more likely to rely on medications for physical or mental health problems, whereas recently incarcerated repeat offenders have reduced odds of being in poor health relative to those who have never been to prison. Improvements in health among recently incarcerated repeat offenders relative to those who have not been incarcerated may be related to prison health care and the overall disadvantaged circumstances of these fathers.

Effects of child health on housing in the urban U.S.

This study exploits an exogenous health shock-the birth of a child with a severe health condition that is considered by the medical community to be random-to investigate the effect of that shock on the family's housing situation. We use population-based data from an urban birth cohort study in the U.S. that oversampled non-marital births, resulting in a relatively disadvantaged sample that may be particularly susceptible to the effects of adverse life events. The health conditions were recorded in the infants' hospital medical records and coded by a pediatric consultant to capture conditions that are considered both severe and random. Seven different housing outcomes in the domains of quality, crowding, and stability were assessed from maternal interviews and in-home assessments when the children were 3 years old. We found that poor child health increases the likelihood of both overcrowding and homelessness and that it may also increase the likelihood of having inadequate utilities and generally poor housing quality. The effect sizes ranged from 1 to 17 percentage points, depending on the measure of poor child health and housing outcome.

Fertility Timing of Unmarried and Married Mothers: Evidence on Variation Across U.S. Cities from the Fragile Families and Child Wellbeing Study.

In this paper, we examine the determinants of fertility timing of unmarried and married mothers using a rich new birth cohort study, the Fragile Families and Child Wellbeing Study, drawn from 20 medium and large U.S. cities. We find considerable variation in the time to next birth among comparable mothers who live in different cities. Some of this variation is explained by variation in labor markets, housing costs and availability, and welfare policies. City variation is particularly important for unmarried women who already have two or more children, whose fertility is more sensitive to these contextual variables than is the fertility of married women, or unmarried women with just one child.