The prevalence and economic value of doubling up

Empty chairs at the dinner table: Black-white disparities in exposure to household member deaths

As a result of Black-White inequities in life expectancy, recent research has indicated that Black individuals are disproportionately exposed to the deaths of multiple family members compared to White individuals. Black individuals are also more likely to live in coresident households-that is, households that extend beyond the nuclear family. However, it is unclear the degree to which this population may be disproportionately exposed to the loss of deaths marked by the geographic closeness of the household. In this study, I use data from the Panel Study of Income Dynamics to provide the first nationally representative estimates of Black-White disparities in exposure to household member deaths. I find that Black people are significantly more likely than White individuals to have experienced the death of a household member. Based on these findings, I argue the dual inequities of racial disparities in life expectancy and racial disparities in coresidence are an overlooked, salient source of racial disparities in exposure to death. By illuminating a broader range of network sources that contribute to racial inequities in exposure to death, this study sets forth a new conceptual unit of analysis-that of the household-to investigate the intergenerational reproduction of inequality in health and socioeconomic status due to exposure to death.

The Effects of the 2021 Child Tax Credit on Housing Affordability and the Living Arrangements of Families With Low Incomes

Access to safe and stable housing is important for child and adult well-being. Yet many low-income households face severe challenges in maintaining stable housing. In this article, we examine the impact of the 2021 temporary expansion to the Child Tax Credit (CTC) on housing affordability and the living arrangements of families with low incomes. We employ a parameterized difference-in-differences method and leverage national data from a sample of parents who are receiving or recently received Supplemental Nutrition Assistance Program benefits (N = ∼20,500), many of whom became newly eligible for the CTC. We find that the monthly CTC reduced parents' past-due rent/mortgages (both amounts and incidence) and their reports of potential moves due to difficulties affording rent/mortgages. The CTC increased the likelihood that parents reported a change in their living arrangements and reduced their household size, both effects driven by fewer mothers living with a partner (and not a reduction in doubling up). We find some differences in effects by race and ethnicity and earnings. Our findings illustrate that the monthly credit improved low-income parents' ability to afford housing, gain residential independence from partners, and reduce the number of people residing in their household.

The Affordable Rental Housing Crisis and Population Health Equity: a Multidimensional and Multilevel Framework

The US is facing a severe affordable rental housing crisis that contributes to multiple forms of housing insecurity including homelessness, crowded and poor quality housing conditions, unstable housing arrangements, and cost burdens. A considerable body of evidence finds that housing insecurity is an important determinant of health. However, the existing literature may fall short of conceptualizing and measuring the full impact of housing insecurity on population health and on racial health equity. In this paper, we seek to expand the conceptualization of housing as a determinant of population health equity by considering housing insecurity as a manifestation of structural racism that intersects with other manifestations and impacts of structural racism to affect, not only the health of housing insecure individuals, but also the health of the networks and communities in which these individuals live. First, we situate the current housing crisis within larger systems of structural racism. We extend prior work documenting the confluence of ways that racist policies and practices have created unequal burdens of housing insecurity to also discuss the ways that the meanings and impacts of housing insecurity may be shaped by racism. Next, we consider how the health impacts of this unequal burden of housing insecurity can extend beyond individual households to affect networks and communities. Ultimately, we provide a multilevel framework that can inform research, policy, and practice to address housing and health equity.

Household Instability and Girls' Teen Childbearing

More than one third of U.S. children spend part of their childhood living with extended family members. By age 18, nearly 40% of U.S. children experience a household change involving a nonparent. Research has found that having extended family or nonrelatives join or leave children's households negatively affects children's educational attainment. I argue that we need new ways of theorizing, conceptualizing, and measuring household changes and their effects on children. I use the Panel Study of Income Dynamics and marginal structural models with inverse probability of treatment weighting to estimate the association between household changes involving parents and nonparents and teen childbearing among girls. I find that experiencing household changes involving nonparents and parents during childhood is associated with a significantly higher probability of having a child as a teenager than experiencing no changes. In addition, the association between changes involving parents and teen childbearing is statistically indistinguishable from the association between changes involving nonparents and teen childbearing, suggesting that household composition shifts involving nonparents can be as disruptive to girls as those involving parents.

Doubled-Up Households, Self-Management Behaviors, Diabetes Preventive Care Services, and Hospital Use in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) 2015-2020

OBJECTIVE

We investigated associations of living in a doubled-up household (i.e., adults living with adult children, other related adults, or other unrelated adults) with diabetes self-management behaviors, occurrence of diabetes preventive care services, and hospital use by Hispanic/Latino adults with diabetes.

RESEARCH DESIGN AND METHODS

We analyzed data from the second clinical visit (2014-2017) through subsequent annual follow-up interviews completed through January 2020 of all participants with diabetes in the Hispanic Community Health Study/Study of Latinos. Multivariable regression was used to test associations between doubled-up status with diabetes self-management behaviors (i.e., checking blood glucose level, checking feet for sores), diabetes preventive care services done by a doctor (i.e., dilated-eye examination, feet checked, hemoglobin A1c measured, urine analysis for kidney function), and hospital use (i.e., emergency department [ED] visits and hospitalizations).

RESULTS

Hispanic/Latino adults living doubled up were less likely to have their urine checked by a doctor for kidney disease compared with adults not in doubled-up households. Doubled-up status was not associated with diabetes self-management behaviors. Adults living doubled up in a household with other related adults had a 33% increased risk of ED visits compared with adults living doubled up in a household with adult children.

CONCLUSIONS

Health care settings where Hispanic/Latino adults with diabetes receive trusted care should add housing characteristics such as doubled-up status to social-needs screening to identify residents in need of connecting with housing or social services and more targeted diabetes management services.

Association of Promoting Housing Affordability and Stability With Improved Health Outcomes: A Systematic Review

IMPORTANCE

Housing insecurity-that is, difficulty with housing affordability and stability-is prevalent and results in increased risk for both homelessness and poor health. However, whether interventions that prevent housing insecurity upstream of homelessness improve health remains uncertain.

OBJECTIVE

To review evidence characterizing associations of primary prevention strategies for housing insecurity with adult physical health, mental health, health-related behaviors, health care use, and health care access.

EVIDENCE REVIEW

Pairs of independent reviewers systematically searched PubMed, Web of Science, EconLit, and the Social Interventions Research and Evaluation Network for quantitative studies published from 2005 to 2021 that evaluated interventions intended to directly improve housing affordability and/or stability either by supporting at-risk households (targeted primary prevention) or by enhancing community-level housing supply and affordability in partnership with the health sector (structural primary prevention). Risk of bias was appraised using validated tools, and the evidence was synthesized using modified Grading of Recommendations Assessment, Development, and Evaluation criteria.

FINDINGS

A total of 26 articles describing 3 randomized trials and 20 observational studies (16 longitudinal designs and 4 cross-sectional quasi-waiting list control designs) were included. Existing interventions have focused primarily on mitigating housing insecurity for the most vulnerable individuals rather than preventing housing insecurity outright. Moderate-certainty evidence was found that eviction moratoriums were associated with reduced COVID-19 cases and deaths. Certainty of evidence was low or very low for health associations of other targeted primary prevention interventions, including emergency rent assistance, legal assistance with waiting list priority for public housing, long-term rent subsidies, and homeownership assistance. No studies evaluated health system-partnered structural primary prevention strategies.

CONCLUSIONS AND RELEVANCE

This systematic review found mixed and mostly low-certainty evidence that interventions that promote housing affordability and stability were associated with improved adult health outcomes. Existing interventions may need to be paired with other efforts to address the structural determinants of health. As health care systems and insurers respond to increasing opportunities to invest in housing as a determinant of health, further research is needed to clarify where along the housing insecurity pathway interventions should focus for the most effective and equitable health impact.

The Accumulation of Economic Disadvantage: The Influence of Childbirth and Divorce on the Income and Poverty Risk of Single Mothers

This study examines how motherhood earnings penalties in combination with the cost of partner absence affect single mothers' economic well-being. Using longitudinal data from the Panel Study of Income Dynamics for 1990-2015 and fixed-effects models with individual-specific slopes reveals that when needs are controlled for, the transition to parenthood is as strongly linked to reduced family income as partner absence is. I consider different routes to single motherhood and predict that income penalties will differ for women entering single motherhood at a first child's birth and for women who were married at first childbirth but later separated. I show that previously married mothers face larger income penalties than those who were single at first childbirth because they see larger declines in their earnings following childbirth. The results illustrate how marriage and parenthood, alongside partner absence, shape the economic prospects of single-mother families. These findings highlight the importance of reducing gender inequalities in the labor market to improve single mothers' economic well-being.

Acute care utilization and housing hardships in American children

Millions of families in the United States are economically vulnerable: one shock can lead to hardship. We use data from the Fragile Families and Child Wellbeing Study to examine the association between acute healthcare utilization - emergency room visits or hospitalizations - and subsequent housing hardships, such as being evicted for financial reasons. Further, we explore whether this association differs by who in the family utilized the care and whether perceived social support protects against hardship when these experiences occur. Using lagged dependent variable regression models, we find that families that visited the emergency room or were hospitalized, regardless if it was a child or parent with this experience, were five percentage points more likely to experience any housing hardship than families that did not use acute care. Among families in which a child utilized acute care, perceived social support buffered the impact of using acute care. That perceived social support is associated with a lower likelihood of housing hardship among families that experienced acute care utilization for a child, but not parent, suggests that social support may be able to offset the challenges arising from children's, but not adults', use of acute care. In the face of economic precarity, informal safety nets may be insufficient to reduce the impact of acute care utilization on housing hardships.

Material Hardship and the Living Arrangements of Older Americans

This study investigates the extent to which the household living arrangements of older adults influences their experiences of material hardship. Using data from the 2014 Panel of the Survey of Income and Program Participation, we run linear probability models with individual fixed effects to estimate the likelihood that a change in living arrangements predicts a change in food insecurity, housing hardship and utility hardship. Although household living arrangements are associated with reports of material hardship for older adults, individual fixed effect models point to a reduced role for the change in living arrangements on the change in the probability of experiencing material hardship. For older adults, we find that moving into a non-family household increases the risk of housing hardship. This study illustrates how the risk of material hardship related to family living arrangements changes over the life course. We call for increased attention to the risk of material hardship for older adults living alone, those in multigenerational living arrangements, and non-family households.

Under Whose Roof? Understanding the Living Arrangements of Children in Doubled-Up Households

A growing literature in family demography examines children's residence in doubled-up (shared) households with extended family members and nonkin. This research has largely overlooked the role of doubling up as a housing strategy, with "hosts" (householders) providing housing support for "guests" living in their home. Yet, understanding children's experiences in doubled-up households requires attention to host/guest status. Using the American Community Survey and Survey of Income and Program Participation, we identify the prevalence of children doubling up as hosts and guests in different household compositions (multigenerational, extended family, nonkin), show how this varies by demographic characteristics, and examine children's patterns of residence across these household types. We find large variation by demographic characteristics. More disadvantaged children have higher rates of doubling up as guests than hosts, whereas more advantaged children have higher rates of doubling up as hosts than guests. Additionally, compared with hosts, guests more often use doubling up as a longer-term strategy; a greater share of guests live consistently doubled up over a three-year period, but those who do transition between household types experience more transitions on average than do hosts. Our findings show the importance of attending to both housing status and household composition when studying children living in doubled-up households.

Housing insecurity and adolescent well-being: Relationships with child welfare and criminal justice involvement

BACKGROUND

Housing insecurity is endemic among low-income, marginalized families throughout the United States. Unstably housed families face increased likelihood of coming into contact with various social systems that upend family routines and norms, but the roles of these contacts in linking housing insecurity with long-term adolescent outcomes are unknown.

OBJECTIVE

The present study tested whether family contacts with the criminal justice and child welfare systems mediated links between housing insecurity and adverse adolescent outcomes.

PARTICIPANTS AND SETTING

Data came from at-risk families with children born 1998-2000 in 20 large American cities followed over 15 years (N = 2,892).

METHODS

Structural equation modeling estimated a measurement model using confirmatory factor analysis and a structural model testing direct and indirect pathways from housing insecurity to adolescent depression and delinquency via contact with the criminal justice and child welfare systems.

RESULTS

Housing insecurity was associated with increased contact with both the criminal justice and child welfare systems. Housing insecurity at age 5 was directly associated with adolescent depression at age 15 (β = 0.09, p < 0.05) and indirectly associated with adolescent delinquency via mothers' criminal justice (β = 0.04, p < 0.05) and child welfare (β = 0.07, p < 0.05) contacts.

CONCLUSIONS

Families with high needs may face stigma or seek assistance that increases surveillance of families and thus likelihood for sanctioning by the criminal justice and child welfare systems. Providers and systems working with low-income, insecurely housed families must consider stigma faced by clients to avoid further marginalizing underserved populations.

Eviction, Health Inequity, and the Spread of COVID-19: Housing Policy as a Primary Pandemic Mitigation Strategy

The COVID-19 pandemic precipitated catastrophic job loss, unprecedented unemployment rates, and severe economic hardship in renter households. As a result, housing precarity and the risk of eviction increased and worsened during the pandemic, especially among people of color and low-income populations. This paper considers the implications of this eviction crisis for health and health inequity, and the need for eviction prevention policies during the pandemic. Eviction and housing displacement are particularly threatening to individual and public health during a pandemic. Eviction is likely to increase COVID-19 infection rates because it results in overcrowded living environments, doubling up, transiency, limited access to healthcare, and a decreased ability to comply with pandemic mitigation strategies (e.g., social distancing, self-quarantine, and hygiene practices). Indeed, recent studies suggest that eviction may increase the spread of COVID-19 and that the absence or lifting of eviction moratoria may be associated with an increased rate of COVID-19 infection and death. Eviction is also a driver of health inequity as historic trends, and recent data demonstrate that people of color are more likely to face eviction and associated comorbidities. Black people have had less confidence in their ability to pay rent and are dying at 2.1 times the rate of non-Hispanic Whites. Indigenous Americans and Hispanic/Latinx people face an infection rate almost 3 times the rate of non-Hispanic whites. Disproportionate rates of both COVID-19 and eviction in communities of color compound negative health effects make eviction prevention a critical intervention to address racial health inequity. In light of the undisputed connection between eviction and health outcomes, eviction prevention, through moratoria and other supportive measures, is a key component of pandemic control strategies to mitigate COVID-19 spread and death.

Mitigating Poverty through the Formation of Extended Family Households: Race and Ethnic Differences

In times of hardship, moving in with family is one strategy for alleviating economic deprivation and uncertainty. The ability of the family to buffer against poverty may vary by the resources available to and the economic needs of individuals. I assess how the formation of extended-family households is associated with a move into or out of poverty and how this association varies by race and ethnicity, since economic resources and norms around extended-family households differ. Using longitudinal data that span four years, I estimate linear fixed effects regression models to assess how changes in living arrangements are related to changes in poverty. I find that moving into an extended-family household reduces poverty, especially for the joining family unit. Most of this poverty reduction occurs through a family safety net, with a non-poor family taking in poor family units.

Is Housing Hardship Associated with Increased Adolescent Delinquent Behaviors?

Housing-related hardships, ranging from an inability to pay full housing costs to being evicted, are common experiences for families in the U.S. Despite the frequency of these hardships, little is known about their relationships with adolescent behaviors. The current paper uses longitudinal data on births in large U.S. cities from all six waves of the Fragile Families and Child Well-being Study to explore the association between childhood experiences of housing hardships and delinquent behaviors in adolescence. About 60% of the sample experiences housing hardship at one or more waves. Inabilities to meet housing costs are common among the sample: over 40% are unable to pay their full rent or mortgage payment. Results from multivariate regression and residualized change models indicate that children who experience any housing hardship are more likely to engage in delinquent behaviors than children who do not experience hardship. Exposure to higher average levels of hardship and more waves of hardship are both associated with increased delinquency. Childhood poverty does not moderate the relationship between housing hardship and delinquency suggesting that housing hardship is associated with delinquent behaviors for poor and non-poor children alike. This research builds on existing literature highlighting the importance of examining hardship as a measure of family wellbeing. It also suggests that preventing common housing-related hardships can be beneficial for youth behavioral outcomes.

Does Opportunity Skip Generations? Reassessing Evidence From Sibling and Cousin Correlations

Sibling (cousin) correlations are empirically straightforward: they capture the degree to which siblings' (cousins') socioeconomic outcomes are similar. At face value, these quantities seem to summarize something about how families constrain opportunity. Their meaning, however, is complicated. One empirical set of sibling and cousin correlations can be generated from a multitude of distinct theoretical processes. I illustrate this problem in the context of multigenerational mobility: the relationship between the incomes of an ancestor and a descendant separated by several generations in a family. When cousins' outcomes are similar (an empirical fact), prior authors have favored the particular theoretical interpretation that extended kin affect life chances through pathways not involving the parents of the focal individual. I show that this evidence is consistent with alternative theories of latent transmission (measurement error) or dynamic transmission (a parent-to-child transmission process that changes over generations). Theoretical assumptions are required to lend meaning to a point estimate. Further, I show that point estimates alone may be misleading because they can be highly uncertain. To facilitate uncertainty estimation for the key test statistic, I develop a Bayesian procedure to estimate sibling and cousin correlations. I conclude by outlining how future research might use sibling and cousin correlations as effective descriptive quantities while remaining cognizant that these quantities could arise from a variety of distinct theoretical processes.

Cumulative Effects of Doubling Up in Childhood on Young Adult Outcomes

Living in a doubled-up, or shared, household is a common experience. Nearly one-half of children in the United States double up at some point during childhood, yet we know little about the cumulative effects of these households on children. This study estimates the effects on young adult health and educational attainment of childhood years spent in three doubled-up household types: (1) those formed with children's grandparent(s), (2) those formed with children's adult sibling(s), and (3) those formed with other extended family or non-kin adults. Using marginal structural models and inverse probability of treatment weighting-methods that account for the fact that household composition is both a cause and consequence of other family characteristics-I find that doubling up shapes children's life chances, but the effects vary depending on children's relationships with household members. Childhood years spent living with nongrandparent extended family or non-kin adults are associated with worse young adult outcomes, but coresidence with grandparents is not significantly associated with young adult outcomes after selection into these households is accounted for, and coresidence with adult siblings may be beneficial in some domains. By studying the effects of coresidence with adults beyond the nuclear family, this research contributes to a fuller understanding of the implications of family complexity for children.

The Effect of the Earned Income Tax Credit on Housing and Living Arrangements

As rents have risen and wages have not kept pace, housing affordability in the United States has declined over the last 15 years, impacting the housing and living arrangements of low-income families. Housing subsidies improve the housing situations of low-income families, but less than one in four eligible families receive a voucher. In this article, we analyze whether one of the largest anti-poverty programs in the United States-the Earned Income Tax Credit (EITC)-affects the housing (eviction, homelessness, and affordability) and living arrangements (doubling up, number of people in the household, and crowding) of low-income families. Using the Current Population Survey, the American Community Survey/decennial census, and the Fragile Families and Child Wellbeing Study, we employ a parameterized difference-in-differences strategy to examine whether policy-induced expansions to the EITC affect the housing and living arrangements of single mothers. Results suggest that a $1,000 increase in the EITC improves housing by reducing housing cost burdens, but it has no effect on eviction or homelessness. Increases in the EITC also reduce doubling up (living with additional, nonnuclear family adults)-in particular, doubling up in someone else's home-and reduce three-generation/multigenerational coresidence, suggesting that mothers have a preference to live independently. We find weak evidence for a reduction in overall household size, yet the EITC does reduce household crowding. Although the EITC is not an explicit housing policy, expansions to the EITC are generally linked with improved housing outcomes for single mothers and their children.

Estimating Children's Household Instability Between Birth and Age 18 Using Longitudinal Household Roster Data

Previous descriptions of the composition and stability of children's households have focused on the presence of parents and the stability of mothers' marital and cohabiting relationships. We use data available in the 2008 Survey of Income and Program Participation to expand the description of children's household composition and stability. We find that one in five children lives with nonnuclear household members. These other household members are a source of substantial household instability. In addition, during the period of observation (2008-2013), children experienced considerable residential instability. Thus, children's experience of household instability is much more common and frequent than previously documented. Moreover, levels of both residential and compositional instability are higher for children with less-educated mothers and for racial/ethnic minorities.

Housing as a determinant of health equity: A conceptual model

Housing is a major pathway through which health disparities emerge and are sustained over time. However, no existing unified conceptual model has comprehensively elucidated the relationship between housing and health equity with attention to the full range of harmful exposures, their cumulative burden and their historical production. We synthesized literature from a diverse array of disciplines to explore the varied aspects of the relationship between housing and health and developed an original conceptual model highlighting these complexities. This holistic conceptual model of the impact of housing on health disparities illustrates how structural inequalities shape unequal distribution of access to health-promoting housing factors, which span four pillars: 1) cost (housing affordability); 2) conditions (housing quality); 3) consistency (residential stability); and 4) context (neighborhood opportunity). We further demonstrate that these four pillars can lead to cumulative burden by interacting with one another and with other structurally-rooted inequalities to produce and reify health disparities. We conclude by offering a comprehensive vision for healthy housing that situates housing's impact on health through a historical and social justice lens, which can help to better design policies and interventions that use housing to promote health equity.

Severe housing-cost burden and obesity among preschool-aged low-income children in Los Angeles County

Despite high rates of housing-cost burden in the United States, little is known regarding its impact on childhood obesity. In this article, we determine whether low-income 2–5-year-olds living in housing-cost burdened households are more likely to be obese and examine the potential moderators and behavioral and psychosocial mediators of this relationship. We used data from a triennial survey (2011, 2014) of a random sample of Los Angeles County participants of the Special Supplemental Nutrition Program for Women, Infants and Children (n = 2307). Logistic regression was used to examine the association between child's obesity status (Body Mass Index for age and sex ≥ 95th percentile) and severe housing-cost burden (finding it very difficult to pay for housing). Mother's depressive symptoms and child's diet and screen time were tested for mediation. We found that 16% of children lived in severe housing-cost burdened households. Severe housing-cost burden was associated with an increase in the odds of childhood obesity [aOR (95%CI) = 1.33 (1.00, 1.78)] and household size moderated this relationship. Child's diet and screen time and mother's depressive symptoms were not mediators. Given the high and vacillating rates of early childhood obesity and the increasing burden of housing costs in low-income populations, there is an urgency to better understand the role of housing-cost burden in epidemiologic investigations of early childhood obesity.

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Children in severe housing-cost burdened households had more chronic stressors.

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Severe housing-cost burden was associated with greater odds of childhood obesity.

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Child's behavior and mother's mental well-being were not mediators of the relationship.

Beyond the Nuclear Family: Trends in Children Living in Shared Households

Using data from the 1996–2008 panels of the Survey of Income and Program Participation and the 2009–2016 American Community Survey, we examine trends in U.S. children living in shared households (living with adults beyond their nuclear (parent/parent’s partner/sibling) family). We find that although the share of children who lived in a shared household increased over this period, the rise was nearly entirely driven by an increase in three-generation/multigenerational households (coresident grandparent(s), parent(s), and child). In 1996, 5.7 % of children lived in a three-generation household; by 2016, 9.8 % did likewise—more than a 4 percentage point increase. More economically advantaged groups (older, more educated mothers, married households) experienced the largest percentage increase in three-generation coresidence, although correlates of coresidence remained largely stable. Decomposition analyses suggest that the rise in Social Security receipt and changes in parental relationship status (less marriage, more single parenthood) most strongly explained the increase in three-generation households. Given the dramatic rise in three-generation households, more research is needed to understand the consequences of these living arrangements for children, their parents, and their grandparents.

Redistributional Policy in Rich Countries: Institutions and Impacts in Nonelderly Households

We review research on institutions of redistribution operating in high-income countries. Focusing on the nonelderly, we invoke the concept of the household income package, which includes income from labor, from related households, and from the state. Accordingly, we assess three institutional arenas: predistribution (rules and regulations that govern paid work), private redistribution (interhousehold transfers), and conventional public redistribution (operating via cash transfers and direct taxes). In each arena, we assess underlying policy logics, identify current policy controversies, summarize contemporary cross-national policy variation, and synthesize existing findings on policy effects. Our assessment of redistributional effects focuses on three core socioeconomic outcomes: low pay, child poverty, and income inequality. We close by assessing how the three institutional arenas perform collectively and by calling for further work on how these institutions change over time and how they affect subgroups differentially.

The Economic Organization of Extended Family Households by Race/Ethnicity and Socioeconomic Status

This study examines differences in the amount of economic support or mutual benefit derived from extended family living arrangements by studying differences in monetary contributions to essential household expenditures across family units in extended family households. Using the 2008 Survey of Income and Program Participation, multivariate regression and selection models are estimated to assess racial differences in family contributions toward household expenses in extended family households. Extended family households have very unequal monetary contributions towards household rent and utilities, although Hispanics have less unequal monetary contributions compared to other racial groups. Hispanic and Asians extended family households experience decreasing inequality in financial contributions as the income of each family increases whereas no relationship between financial contributions and income is found for whites or blacks. This suggests a different cultural orientation to extended family living arrangements for Asians and Hispanics compared to non-Hispanic whites.

Factors associated with residential mobility during pregnancy

Our objective was to determine the factors associated with residential moving during pregnancy, as it may increase stress during pregnancy and affect birth outcomes. Data were obtained from the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) study. Participants were recruited from December 2006 to June 2011 and included 1,448 pregnant women. The average gestational age at enrollment was 23 weeks. The primary outcome of residential mobility was defined as any change in address during pregnancy. Multivariate regression was used to assess the adjusted associations of factors with residential mobility. Out of 1,448 participants, approximately 9 percent moved between baseline (enrollment) and delivery. After adjusting for covariates, mothers with lower educational attainment [less than high school (adjusted odds ratio [aOR] = 3.74, 95% confidence interval [CI] = 1.78, 7.85) and high school/technical school (aOR = 3.57, 95% CI = 2.01, 6.32) compared to college degree or higher], and shorter length of residence in neighborhood were more likely to have moved compared to other mothers. Length of residence was protective of mobility (aOR = 0.91, 95% CI = 0.86, 0.96 per year). Increased understanding of residential mobility during pregnancy may help improve the health of mothers and their children.

Giving Unto Others: Private Financial Transfers and Hardship Among Families with Children

Prior research shows that financial assistance from family and friends is an important source of support for families with children. However, research on financial transfers has largely focused on the recipients of transfers. In this study, using longitudinal data from the Fragile Families and Child Wellbeing Study (n~16,000 person-waves), we examine the association between the provision of financial assistance to family and friends and material hardship. Results from pooled regression and fixed effects models indicate that providing financial transfers is associated with an increased risk of hardship. The most economically disadvantaged groups, single mothers, those in the bottom income tertile, and black mothers, are the most likely to experience hardship after giving a transfer. These findings have important implications for understanding why families may have difficulty meeting basic and essential needs, and how social networks may exacerbate the challenges of escaping poverty and establishing economic self-sufficiency.

Housing Assistance and Housing Insecurity: A Study of Renters in Southeastern Michigan in the Wake of the Great Recession

This article examines the factors shaping longitudinal patterns of housing insecurity in the wake of the Great Recession, with a focus on whether housing assistance helped renters who received it. We use data from the first two waves (2009-10 and 2011) of the Michigan Recession and Recovery Study, a population-representative sample of working-aged adults from Southeast Michigan. We use detailed reports from renters and other non-homeowners to construct measures of instability and cost-related housing problems at both waves, and we compare the changes in these over follow-up between housing assistance recipients and their income-eligible but non-recipient counterparts. Our findings suggest that receiving housing assistance reduced the chance of experiencing housing insecurity problems over follow-up regardless of baseline housing insecurity.

Risk Models for Returns to Housing Instability Among Families Experiencing Homelessness

This study developed risk models for returns to housing instability (that is, homelessness and unstable doubling-up situations) among families exiting emergency shelter. Participants included 446 families randomly assigned to receive priority offers of long-term housing subsidies and 578 families randomly assigned to usual care in the Family Options Study, a multisite experiment designed to test the impact of various housing and service interventions for homeless families. Relationships between family features recorded at shelter entry and returns to housing instability 20 months later were examined empirically. Correlation, hierarchical logistic regression, and receiver operating characteristic curves were used to combine family features into predictive risk models. Results indicated that few observable family features beyond previous housing instability offered predictive utility. Access to long-term housing subsidies appears to reduce housing instability. Further research should examine whether disability benefits, reliable employment, or effective substance dependence treatment reduce housing instability.

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.