Housing instability patterns among low-income, urban Black young adults in California and associations with mental health outcomes: baseline data from a randomized waitlist-controlled trial

IF 3.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH BMC Public Health Pub Date : 2024-09-13 DOI:10.1186/s12889-024-19948-y
Michelle K. Nakphong, D. Jovon Bright, Ala Koreitem, A. Rain Mocello, Nadra E. Lisha, Hannah H. Leslie, Itzel Estrada, Margaret K. Libby, Sheri A. Lippman, Marguerita A. Lightfoot
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Abstract

Deep-rooted racial residential segregation and housing discrimination have given rise to housing disparities among low-income Black young adults in the US. Most studies have focused on single dimensions of housing instability, and thus provide a partial view of how Black young adults experience multiple, and perhaps overlapping, experiences of housing instability including homelessness, frequent moves, unaffordability, or evictions. We aimed to illuminate the multiple forms of housing instability that Black young adults contend with and examine relationships between housing instability and mental health outcomes. Using baseline data from the Black Economic Equity Movement (BEEM) guaranteed income trial with 300 urban low-income Black young adults (aged 18–24), we conducted a three-stage latent class analysis using nine housing instability indicators. We identified distinct patterns by using fit indices and theory to determine the optimal number of latent classes. We then used multinomial logistic regression to identify subpopulations disproportionately represented within unstable housing patterns. Finally, we estimated associations between housing experience patterns and mental health outcomes: depression, anxiety, and hope. We found high prevalence of housing instability with 27.3% of participants reporting experiences of homelessness in the prior year and 39.0% of participants reporting multiple measures of housing instability. We found the 4-class solution to be the best fitting model for the data based on fit indices and theory. Latent classes were characterized as four housing experience patterns: 1) more stably housed, 2) unaffordable and overcrowded housing, 3) mainly unhoused, and 4) multiple dimensions of housing instability. Those experiencing unaffordable and overcrowded housing and being mainly unhoused were more than four times as likely to have symptoms of depression (Unaffordable: aOR = 4.57, 95% CI: 1.64, 12.72; Unhoused: aOR = 4.67, 95% CI:1.18, 18.48) and more than twice as likely to report anxiety (Unaffordable: aOR = 2.28, 95% CI: 1.03, 5.04; Unhoused: aOR = 3.36, 95% CI: 1.12, 10.05) compared to the more stably housed pattern. We found that hope scores were similarly high across patterns. High prevalence of housing instability and mental health challenges among low-income Black young adults demands tailored interventions to reduce instability, given widening racial disparities and implications for future well-being into adulthood.
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加利福尼亚州低收入城市黑人青年的住房不稳定模式及其与心理健康结果的关系:随机候选对照试验的基线数据
根深蒂固的种族居住隔离和住房歧视造成了美国低收入黑人青年在住房方面的差异。大多数研究都集中在住房不稳定的单一方面,因此只能片面地了解黑人年轻人如何经历多重、甚至重叠的住房不稳定经历,包括无家可归、频繁搬迁、负担不起或被驱逐。我们的目标是揭示黑人青壮年所面临的多种形式的住房不稳定性,并研究住房不稳定性与心理健康结果之间的关系。我们利用黑人经济平等运动(BEEM)保障收入试验的基线数据,对 300 名城市低收入黑人青年(18-24 岁)进行了三阶段潜类分析,使用了九个住房不稳定指标。我们利用拟合指数和理论来确定潜类的最佳数量,从而识别出不同的模式。然后,我们使用多项式逻辑回归来确定在不稳定住房模式中比例过高的亚人群。最后,我们估算了住房经历模式与心理健康结果(抑郁、焦虑和希望)之间的关联。我们发现,住房不稳定的发生率很高,27.3% 的参与者报告了上一年无家可归的经历,39.0% 的参与者报告了多种住房不稳定的情况。根据拟合指数和理论,我们发现 4 类解决方案是最适合数据的模型。潜在类别被描述为四种住房经验模式:1)较稳定的住房;2)负担不起和过度拥挤的住房;3)主要无房;4)住房不稳定的多个维度。住房负担不起和住房拥挤以及主要无房的人出现抑郁症状的可能性是普通人的四倍多(负担不起:aOR = 4.57,95% CI:1.64, 12.72;无房:aOR = 4.67,95% CI:1.18, 18.48),报告焦虑的可能性是居住更稳定者的两倍多(负担不起:aOR = 2.28,95% CI:1.03, 5.04;无居所:aOR = 3.36,95% CI:1.12, 10.05)。我们发现,各种模式的希望得分都很高。鉴于不断扩大的种族差异以及对未来成年后幸福生活的影响,低收入黑人青年中住房不稳定和心理健康挑战的高发率需要有针对性的干预措施来降低不稳定性。
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来源期刊
BMC Public Health
BMC Public Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.50
自引率
4.40%
发文量
2108
审稿时长
1 months
期刊介绍: BMC Public Health is an open access, peer-reviewed journal that considers articles on the epidemiology of disease and the understanding of all aspects of public health. The journal has a special focus on the social determinants of health, the environmental, behavioral, and occupational correlates of health and disease, and the impact of health policies, practices and interventions on the community.
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