Changes in maternal health and health behaviors as a function of homelessness: A five-year follow-up of low-income mothers in 20 American cities

While studies consistently find that a considerable proportion of homeless families suffer from acute and chronic physical and mental health problems, it is unclear to what extent homelessness contributes to the health and health behavior problems among homeless families. By parsing out homeless-specific effects on maternal health and health behaviors, this study provides evidence to develop strategies that address health outcomes for families who are currently homeless and at risk for homelessness.

This prospective cohort study followed nearly 5,000 parents with children born between 1998 and 2000 in 20 large U.S. cities. The final sample comprised 2,631 mothers and their households. Descriptive and logit analyses with GEE estimation were conducted.

Over five years, 9.8 percent of households experienced at least one homeless spell and 25.4 percent experienced at least one doubled-up episode. Women who eventually experienced homelessness have poorer health outcomes both before and after homelessness. Multivariate analyses show that mothers who became homeless had a greater likelihood of depression (OR=2.01, p<.001), anxiety (OR=1.97, p<.05), and drug/alcohol problem (OR=2.45, p<.05) and mothers in the doubled-up group were more likely to display depressive symptoms (OR=1.54, p<.001).

Mothers of young, low-income families who present health problems, particularly behavioral health problems, are promising targets for interventions designed towards preventing or diverting homelessness. Homelessness also represents an important marker of health and health-related behavioral problems, pointing out the importance of assessment and treatment of health risks at the time of initial homeless episodes.