Health and adverse childhood experiences among homeless youth
Abstract Background 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...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-04-01
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| Series: | BMC Pediatrics |
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| Online Access: | https://doi.org/10.1186/s12887-021-02620-4 |
| _version_ | 1818329488349462528 |
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| author | Andrew J. Barnes Amy L. Gower Mollika Sajady Katherine A. Lingras |
| author_facet | Andrew J. Barnes Amy L. Gower Mollika Sajady Katherine A. Lingras |
| author_sort | Andrew J. Barnes |
| collection | DOAJ |
| description | Abstract Background 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. Experiencing homelessness, whether unaccomapnied or with family, is associated with increased health risk, and every additional ACE increases this risk. Clinicians and health systems should advocate for policies that include stable housing as a protective factor. |
| first_indexed | 2024-12-13T12:48:51Z |
| format | Article |
| id | doaj.art-6b4de6580560473d98a93465a6134bda |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-12-13T12:48:51Z |
| publishDate | 2021-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-6b4de6580560473d98a93465a6134bda2022-12-21T23:45:24ZengBMCBMC Pediatrics1471-24312021-04-0121111010.1186/s12887-021-02620-4Health and adverse childhood experiences among homeless youthAndrew J. Barnes0Amy L. Gower1Mollika Sajady2Katherine A. Lingras3Developmental-Behavioral Pediatrics, Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of MinnesotaDepartment of Pediatrics, University of Minnesota Medical SchoolChildren’s Minnesota Developmental PediatricsDepartment of Psychiatry and Behavioral Sciences, University of MinnesotaAbstract Background 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. Experiencing homelessness, whether unaccomapnied or with family, is associated with increased health risk, and every additional ACE increases this risk. Clinicians and health systems should advocate for policies that include stable housing as a protective factor.https://doi.org/10.1186/s12887-021-02620-4Developmental origins of health and diseaseAdverse childhood experiencesHomelessness |
| spellingShingle | Andrew J. Barnes Amy L. Gower Mollika Sajady Katherine A. Lingras Health and adverse childhood experiences among homeless youth BMC Pediatrics Developmental origins of health and disease Adverse childhood experiences Homelessness |
| title | Health and adverse childhood experiences among homeless youth |
| title_full | Health and adverse childhood experiences among homeless youth |
| title_fullStr | Health and adverse childhood experiences among homeless youth |
| title_full_unstemmed | Health and adverse childhood experiences among homeless youth |
| title_short | Health and adverse childhood experiences among homeless youth |
| title_sort | health and adverse childhood experiences among homeless youth |
| topic | Developmental origins of health and disease Adverse childhood experiences Homelessness |
| url | https://doi.org/10.1186/s12887-021-02620-4 |
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