Perceived Housing Discrimination and Self-Reported Health: How Do Neighborhood Features Matter?

School Racial Composition as a Moderator of the Effect of Discrimination on Mental Health and Substance use Among American Indian Adolescents

PURPOSE

To examine the relationships between individual-level perceived racial/ethnic discrimination and mental health and substance use outcomes by school-level racial composition among American Indian (AI) adolescents.

METHOD

Self-reported survey data on individual-level variables come from a sample of AI adolescents (n = 510) living in or near the Cherokee Nation during the fall of 2021. School-level data come from publicly available databases. Multilevel linear and logistic regression analyses were performed to test for and examine the interaction between perceived racial/ethnic discrimination and school racial composition in relation to symptoms of anxiety and depression, past 30-day use of alcohol and marijuana, and misuse of prescription opioids.

RESULTS

Adjusted analyses showed a significant interaction effect between discrimination and racial composition on anxiety symptoms, such that the effect of discrimination was more pronounced at lower % AI (10th percentile) than at more equivalently mixed (50th percentile) or higher % AI (90th percentile) school settings. No significant interactions were observed with depressive symptoms or substance use outcomes.

DISCUSSION

School racial compositions of higher percentage AI may buffer the adverse effect of racial/ethnic discrimination on anxiety symptoms among AI adolescents.

A systematic review and meta-analysis of the relationship between economic inequality and prosocial behaviour

How does economic inequality relate to prosocial behaviour? Existing theories and empirical studies from multiple disciplines have produced mixed results. Here we conduct a systematic review and meta-analysis to systematically synthesize empirical studies. Results from 192 effect sizes and over 2.5 million observations in 100 studies show that the relationship varies from being negative to positive depending upon the study (95% prediction interval -0.450 to 0.343). However, on average, there is a small, negative relationship between economic inequality and prosocial behaviour (r = -0.064, P = 0.004, 95% confidence interval -0.106 to -0.021). There is generally no evidence that results depend upon characteristics of the studies, participants, the way prosocial behaviour and inequality were assessed, and the publication discipline. Given the prevalence of economic inequality and the importance of prosocial behaviour, this systematic review and meta-analysis provides a timely study on the relationship between economic inequality and prosocial behaviour.

Racialized Housing Discrimination and Population Health: a Scoping Review and Research Agenda

Racial residential segregation is considered a fundamental cause of racial health disparities, with housing discrimination as a critical driver of residential segregation. Despite this link, racial discrimination in housing is far less studied than segregation in the population health literature. As a result, we know little about how discrimination in housing is linked to health beyond its connection to segregation. Furthermore, we need to understand how health impacts differ across different types of housing discrimination. This review aims to assess the state of the population health literature on the conceptualization, measurement, and health implications of housing discrimination. We used PRISMA guidelines for scoping reviews and presented the data on 32 articles that met our inclusion criteria published before January 1, 2022. Nearly half of the articles do not define housing discrimination explicitly. Additionally, there is considerable variation in how housing discrimination is operationalized across studies. Compared to studies using administrative data for housing discrimination exposures, studies using survey data were more likely to report a detrimental association with health outcomes. Synthesizing and comparing the results of these studies helps bridge methodological approaches to this research. Our review helps inform the debate on how racism impacts population health. Given the changing nature of racial discrimination over time and place, we discuss how population health researchers can approach studying various forms of housing discrimination.

Housing and Cancer Care and Outcomes: A Systematic Review

BACKGROUND

Access to stable and affordable housing is an important social determinant of health in the United States. However, research addressing housing and cancer care, diagnosis, and outcomes has not been synthesized.

METHODS

We conducted a systematic review of studies examining associations of housing and cancer care and outcomes using PubMed, Embase, Scopus, and CINAHL. Included studies were conducted in the United States and published in English between 1980 and 2021. Study characteristics and key findings were abstracted and qualitatively synthesized.

RESULTS

A total of 31 studies were identified. Housing-related measures were reported at the individual level in 20 studies (65%) and area level in 11 studies (35%). Study populations and housing measures were heterogeneous. The most common housing measures were area-level housing discrimination (8 studies, 26%), individual-level housing status (8 studies, 26%), and individual-level housing concerns (7 studies, 23%). The most common cancer outcomes were screening (12 studies, 39%) and mortality (9 studies, 29%). Few studies assessed multiple dimensions of housing. Most studies found that exposure to housing insecurity was statistically significantly associated with worse cancer care (11 studies) or outcomes (10 studies).

CONCLUSIONS

Housing insecurity is adversely associated with cancer care and outcomes, underscoring the importance of screening for housing needs and supporting systemic changes to advance equitable access to care. Additional research is needed to develop and test provider- and policy-level housing interventions that can effectively address the needs of individuals throughout the cancer care continuum.

Inequitable Housing Practices and Youth Internalizing Symptoms: Mediation Via Perceptions of Neighborhood Cohesion

Disordered urban environments negatively impact mental health symptoms and disorders. While many aspects of the built environment have been studied, one influence may come from inequitable, discriminatory housing practices such as redlining, blockbusting, and gentrification. The patterns of disinvestment and reinvestment that follow may be an underlying mechanism predicting poor mental health. In this study, we examine pathways between such practices and internalizing symptoms (i.e., anxiety and depression) among a sample of African American youth in Baltimore, Maryland, considering moderation and mediation pathways including neighborhood social cohesion and sex. In our direct models, the inequitable housing practices were not significant predictors of social cohesion. In our sex moderation model, however, we find negative influences on social cohesion: for girls from gentrification, and for boys from blockbusting. Our moderated mediation model shows that girls in gentrifying neighborhoods who experience lower social cohesion have higher levels of internalizing symptoms. Likewise for boys, living in a formerly blockbusted neighborhood generates poorer social cohesion, which in turn drives higher rates of internalizing symptoms. A key implication of this work is that, in addition to standard measures of the contemporary built environment, considering other invisible patterns related to discriminatory and inequitable housing practices is important in understanding the types of neighborhoods where anxiety and depression are more prevalent. And while some recent work has discussed the importance of considering phenomena like redlining in considering long-term trajectories of neighborhoods, other patterns such as blockbusting and gentrification may be equally important.

A qualitative investigation of the professional and social experiences of occupational groups working with individuals with disabilities and their attitudes: An example from Finland

Working with individuals with disabilities affects the professional and social experiences and attitudes of professional groups. Accordingly, this study aimed to understand the professional and social experiences and attitudes of occupational groups working with individuals with disabilities. A qualitative, descriptive design based on thematic analysis approach was used in this study. The data were collected from 11 staff at the Center for Disability Empowerment in Finland. The results obtained from the study were thematized and eight main themes were established. Some of these main themes are as follows: Opinions about and attitudes toward individuals with disabilities, the effect on personal/inner and spiritual development, satisfaction with occupational performance and key points in working with disabled groups. Working with individuals with disabilities had a positive impact on the attitude and development of the employees from both an occupational and a social perspective. Moreover, it contributed to the professional and personal development of the employees.

The Impact of Racially Motivated Housing Discrimination on Allostatic Load among Indigenous University Students

Allostatic load (AL) is an aggregate measure of wear and tear on the body due to the chronic activation of the stress response system. The goal of this study was to examine the association between racially motivated housing discrimination (HD) and AL score within a sample of Indigenous university students. Data for this cross-sectional study were collected from Indigenous adults attending university in a small city in western Canada between 2015 and 2017 (N = 104; mean age = 27.8 years). An item adapted from the Experience of Discrimination Scale was to assess racially motivated HD in the past 12 months. AL was measured as a composite of 7 biomarkers assessing neuroendocrine, cardiovascular, metabolic, and immune system function. Bias-corrected and accelerated bootstrapped linear regression models were used to examine associations adjusting for age, income, parenthood, and other situations in which discrimination had been experienced. Indigenous university students who experienced racially motivated HD in the past year (16.8% of the sample) had an average AL score of approximately 4, which was almost double that of their peers who had not. In an adjusted model, racially motivated HD was associated with a 1.5 point increase in AL score. This model explained 35% of the adjusted variance in AL score, of which racially motivated HD explained 24%. These results suggest Indigenous adults who experienced racially motivated HD in the past year had early and more pronounced wear and tear on neuroendocrine, cardiovascular, metabolic, and immune system functioning in young and middle adulthood than Indigenous peers who did not. These findings combine with others to highlight the need for increased efforts to prevent racially motivated HD in urban centers.

Racially-motivated housing discrimination experienced by Indigenous postsecondary students in Canada: impacts on PTSD symptomology and perceptions of university stress

OBJECTIVES

To examine the impacts of housing discrimination experienced by Indigenous postsecondary students on post-traumatic stress disorder (PTSD) symptomology and perceptions of university stress.

STUDY DESIGN

Cross-sectional study.

METHODS

Data were gathered via in-person surveys completed by 142 Indigenous students between 2015 and 2017. Associations were analyzed using phi coefficients and linear regression models adjusted for confounders. Qualitative data were examined using thematic analyses.

RESULTS

Indigenous students who had children (almost 50% of the sample), were living with a romantic partner, and/or were between the ages of 25-44 years experienced significantly more racially-motivated housing discrimination than other Indigenous students in the sample. The frequency of housing discrimination in the past 12 months was significantly associated with increased PTSD symptoms; particularly, intrusive recollection and more perceived stress at university in linear regression models adjusted for confounders. Every 1-point increase in the frequency of housing discrimination on a 4-point scale resulted in a 5.4-point increase in PTSD score. Although living with a romantic partner resulted in more housing discrimination, it also served as a resilience factor, buffering the impact of housing discrimination on PTSD symptomology. Qualitative data indicated students faced Racially-motivated housing discrimination that was blunt and deliberate and highlighted the resourceful ways students sought to resist it.

CONCLUSIONS

Racially-motivated housing discrimination exacerbated PTSD symptomology among Indigenous students and adversely impacted perceptions of their university experience. Efforts are needed to address housing discrimination directly, as well as provide greater family-focused housing and mental wellness supports to Indigenous students to reduce potential impacts of this public health problem on postsecondary success and degree completion.

Housing Discrimination and Health: Understanding Potential Linking Pathways Using a Mixed-Methods Approach

Few studies have examined the impact of housing discrimination on health. This study explores potential pathways linking housing discrimination and health using concept mapping, a mixed-method approach. Participants included employees from twenty Fair Housing Organizations nationwide who participated in two online sessions, brainstorming, and structuring. Responses were generated representing biological, social, economic, and physical connections between housing discrimination and health. Using hierarchical cluster analysis, five clusters were identified: (1) Access and barriers; (2) Opportunities for growth; (3) Neighborhood and communities; (4) Physical effects of housing discrimination; and (5) Mental health. Clusters 1 (4.09) and 2 (4.08) were rated as most important for health, while clusters 2 (3.93) and 3 (3.90) were rated as most frequently occurring. These findings add to the limited evidence connecting housing discrimination to health and highlight the need for studies focusing on the long-term health effects of housing discrimination on individuals and neighborhoods.

Differential investments and opportunities: How do neighborhood conditions moderate the relationship between perceived housing discrimination and social capital?

Though the adverse consequences of perceived housing discrimination have been documented, little is known about whether such experience undermines one's social capital in a neighborhood and even less is about whether and how this relationship is altered by neighborhood features. We proposed a framework that simultaneously considers within-individual and between-neighborhood processes. We applied multilevel structural equation models to data from Philadelphia (n = 9987) and found that (a) perceived housing discrimination was negatively associated with one's social capital even after other confounders were considered, (b) this negative association could be partly explained by the proliferated daily stress and anxiety mechanisms, (c) differential exposures to neighborhood social disadvantage accounted for the variation in social capital across neighborhoods, and (d) the adverse association between perceived housing discrimination and social capital could be attenuated by neighborhood stability. The findings suggested that appropriate interventions should buffer the negative association of perceived housing discrimination with social capital.