Quantifying Doubled-Up Homelessness: Presenting a New Measure Using U.S. Census Microdata

Association of Housing Instability With Firearm Homicides in Major US Cities.

A growing and severe shortage of affordable housing in the U.S. has led to an increase in cost-burdened households and housing insecurity nationwide. The U.S. Department of Housing and Urban Development (HUD) provides rental assistance through programs such as Housing Choice Vouchers and public or project-based housing to increase access to affordable housing. However, available funding for these programs limits their supply, creating extensive waitlists for rental assistance. While the physical and mental health consequences of housing insecurity and cost burdens are well documented, less is known about how the experience of waiting for rental assistance may contribute to these adverse outcomes. This paper examines qualitative data from a longitudinal mixed-methods study about rental assistance and diabetes self-management. Through thematic analysis of 116 semi-structured interviews collected from 30 unique participants, we describe how the uncertainty of one’s waitlist status, an obligation to wait, and a sense of powerlessness in the waiting process contribute to poor mental health among rental assistance applicants. Our findings suggest that the experience of waiting and specific features of the waiting process may exacerbate stressors associated with housing insecurity to the detriment of applicants’ psychological wellbeing.

ABSTRACTEach year, over 600 youth under the age of 25 experience literal homelessness in Austin, Texas. Of these youth, 76% have a history of involvement with foster care or the juvenile justice system—far exceeding the rates of system involvement observed among homeless youth in other large communities in the United States (approximately 54%; Voices of Youth Count, 2017). Recently, Austin was selected by the U.S. Department of Housing & Urban Development as one of ten communities nationwide to participate in the Youth Homelessness Demonstration Program (YHDP), a federal initiative designed to effectively end youth homelessness by 2020. Youth with lived experience are central players in the development and implementation of Austin's response to the youth homelessness crisis. A group of twelve of these youth (the “Austin Youth Collective to End Youth Homelessness,” or AYC) serve as key decision-making partners within the Austin YHDP team. Representatives of the AYC are deeply involved at every level of the community planning process, from the development of youth-centric housing options to system redesign efforts to ensure that youth do not exit the foster care or juvenile justice systems to homelessness. The article provides an overview of the development and contributions of the AYC—including their programmatic recommendations and advocacy work—as well as key recommendations for communities looking to leverage youth voice at the systems level.

This study sought to investigate the rates and correlates of homelessness, especially mental illness, among adult jail inmates. Data from a national survey of jail inmates (N=6,953) were used to compare the proportion of jail inmates who had been homeless in the previous year with the proportion of persons in the general population who had been homeless in the previous year, after standardization to the age, race and ethnicity, and gender distribution of the jail sample. Logistic regression was then used to examine the extent to which homelessness among jail inmates was associated with factors such as symptoms or treatment of mental illness, previous criminal justice involvement, specific recent crimes, and demographic characteristics. Inmates who had been homeless (that is, those who reported an episode of homelessness anytime in the year before incarceration) made up 15.3% of the U.S. jail population, or 7.5 to 11.3 times the standardized estimate of 1.36% to 2.03% in the general U.S. adult population. In comparison with other inmates, those who had been homeless were more likely to be currently incarcerated for a property crime, but they were also more likely to have past criminal justice system involvement for both nonviolent and violent offenses, to have mental health and substance abuse problems, to be less educated, and to be unemployed. Recent homelessness was 7.5 to 11.3 times more common among jail inmates than in the general population. Homelessness and incarceration appear to increase the risk of each other, and these factors seem to be mediated by mental illness and substance abuse, as well as by disadvantageous sociodemographic characteristics.

Housing insecurity is associated with poor health outcomes. Characterization of chronic disease outcomes among adults with and without housing assistance would enable housing programs to better understand their population's health care needs. We used National Health and Nutrition Examination Survey (NHANES) data from 2005 through 2018 linked to US Department of Housing and Urban Development (HUD) administrative records to estimate the prevalence of obesity, diabetes, and hypertension and to assess the independent associations between housing assistance and chronic conditions among adults receiving HUD assistance and HUD-assistance-eligible adults not receiving HUD assistance at the time of their NHANES examination. We estimated propensity scores to adjust for potential confounders among linkage-eligible adults who had an income-to-poverty ratio less than 2 and were not receiving HUD assistance. Sensitivity analysis used 2013-2018 NHANES cycles to account for disability status. Adults not receiving HUD assistance had a significantly lower adjusted prevalence of obesity (42.1%; 95% CI, 40.4%-43.8%) compared with adults receiving HUD assistance (47.5%; 95% CI, 44.8%-50.3%), but we found no differences for diabetes and hypertension. We found significant associations between housing assistance and obesity (adjusted odds ratio = 1.29; 95% CI, 1.12-1.47), but these were not significant in the sensitivity analysis with and without controlling for disability status. We found no significant associations between housing assistance and diabetes or hypertension. Based on data from a cross-sectional survey, we observed a higher prevalence of obesity among adults with HUD assistance compared with HUD-assistance-eligible adults without HUD assistance. Results from this study can help inform research on understanding the prevalence of chronic disease among adults with HUD assistance.

A growing number of older adults live in unaffordable and unstable housing; however, whether programs designed to counter housing insecurity contribute to earlier-stage cancer diagnosis remains largely unknown. To examine the association between the receipt of federal housing assistance, which limits household spending on rent and utilities, and cancer stage at diagnosis among older adults in the US. This comparative cohort study used the Surveillance, Epidemiology, and End Results cancer registry program and Medicare database linked with data from the US Department of Housing and Urban Development (HUD). Participants were individuals aged 66 to 95 years who received new diagnoses of breast cancer, colorectal cancer, non-small cell lung cancer (NSCLC), or prostate cancer between 2007 and 2019. Data were acquired in 2023, and the data analysis was performed from June 2023 through March 2025. Receipt of federal housing assistance. The primary outcome was stage at cancer diagnosis, defined as in situ (for breast cancer only), localized, regional, or distant. Odds ratios (ORs) for the association between having HUD assistance at diagnosis and cancer stage at diagnosis were estimated using multinomial (nonproportional odds) regression. Individuals with HUD assistance were propensity score matched to individuals without housing assistance. A total of 52 532 individuals (mean [SD] age at diagnosis, 76.3 [6.8] years; 33 608 women [64.0%]) with housing assistance at diagnosis were included: 16 064 had breast cancer, 10 807 had colorectal cancer, 17 156 had NCSLC, and 8505 had prostate cancer; 38 183 (72.7%) were enrolled in Medicaid, and 38 539 (73.4%) had Part D low-income cost sharing. Compared with matched controls, fewer individuals with housing assistance received a diagnosis of distant breast cancer (1071 patients [6.7%] vs 3485 patients [7.2%]; adjusted OR [aOR], 0.85; 95% CI, 0.82- 0.90), distant colorectal cancer (2398 patients [22.2%] vs 7562 patients [23.3%]; aOR, 0.90; 95% CI, 0.83-0.98), and distant NSCLC (8810 patients [51.4%] vs 27 901 patients [54.2%]; aOR, 0.83; 95% CI, 0.79-0.86) compared with localized cancers. Housing assistance was not significantly associated with stage at diagnosis for individuals with prostate cancer. The association between housing assistance and stage at cancer diagnosis varied across the different types of housing assistance, including the Housing Choice voucher program, multifamily housing, and public housing. The findings of this cohort study of older adults with cancer suggest that federal housing assistance was associated with earlier-stage diagnosis of breast cancer, colorectal cancer, and NSCLC, highlighting its potential role in mitigating the adverse associations of housing insecurity with cancer outcomes.

Using data from a population-based cross-sectional survey, we aim to measure the prevalence, risk factors, and impact of COVID-19 on household food insecurity, housing insecurity, and the double burden of experiencing both. Data were collected from July to November 2022. We used simple and multivariable logistic regression models to investigate the factors contributing to food insecurity, housing insecurity, and the double burden. Additionally, we computed the relative excess risk due to interaction (RERI) to determine whether any significant interactions contributed to the increased risk of experiencing the double burden. Around 27% of our study participants were food insecure, 54% were housing insecure, and 22% were food and housing insecure (double burden). Respondents' gender, age, ethnicity, education, and income were associated with experiencing the double burden of food and housing insecurity. Additionally, this study found a significant statistical interaction between residence location and employment status, with both employed and unemployed individuals in urban areas facing higher odds of experiencing the double burden of food and housing insecurity compared to retired individuals in either urban or rural areas; the relative excess risk due to interaction analysis suggests that increasing employment opportunities may have a more substantial impact on reducing this burden in urban areas. Findings from this study provide important insights into addressing the issue of food and housing insecurity, especially through improving employment opportunitiesfor vulnerable populations in Canada. Comprehensive systems-oriented intersectoral policies are much needed to improve households' experience of multiple need insecurities.

Private Sector-led Urban Development Projects. Management, Partnerships and Effects in the Netherlands and the UK

This dissertation analyzes the differences among homeless rates in urban and suburban “continuums of care” (service areas for homelessness in the United States) over the period of 2014-2018. The purpose is to determine which variables are useful to predict the rates of two definitions of homelessness: the more extreme “Category One” homelessness as defined by the U.S. Department of Housing and Urban Development (HUD): those unsheltered or living in homeless shelters; and the broader Department of Education definition of homelessness: families with children that are homeless, including those in Category One but also those living in hotels, staying temporarily with other families, or in other inadequate housing that is not their own. Comparing these two forms of homelessness helps to provide insight into the overall spectrum of homelessness in U.S. cities. This study finds that housing affordability is a significant predictor of both Category One and school-reported homelessness. A comparison of the data for both forms of homelessness indicates that less affordable communities tend to have higher ratios of Category One homelessness compared to school-reported homelessness. The model for Category One homelessness also suggests that continuums of care networks have lower rates of homelessness when they devote a greater share of resources to rapid rehousing programs. The findings of this study do not support the popular belief that the homeless tend to migrate to areas that are warmer or have better homeless services.

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The Nordic countries have relatively equal employment participation between men and women, but some differences between countries exist in labour market participation. The aim was to examine the association between employment status and health among women and men in Denmark, Finland, Norway, and Sweden, and analyse whether this association is modified by marital status and parental status. The data come from nationally representative cross-sectional surveys carried out in Denmark (n = 2,209), Finland (n = 4,604), Norway (n = 1,844) and Sweden (n = 5,360) in 1994-95. Women and men aged 25-49 were included. Employment status was categorized into full-time employed, part-time employed, unemployed, and housewives among women and into employed and unemployed among men. Health was measured by perceived health and limiting longstanding illness. Logistic regression analysis was used, adjusting for age and education. Marital status and parental status were analysed as modifying factors. The non-employed were more likely to report perceived health as below good and limiting longstanding illness than the employed among both women and men. The association between employment status and perceived health remained unchanged when marital status and parental status were adjusted for among all men and Finnish women, but the association was slightly strengthened among Danish and Swedish women, with the housewives becoming more likely to report ill health than employed women. The association between employment status and limiting longstanding illness was slightly strengthened among women, and slightly weakened among Norwegian men when marital and parental status were adjusted for. Non-employment was associated with poorer health in all countries, although there are differences in the employment patterns between the countries. Among women marital status and parental status showed a modest or no influence on the association between employment status and health. Among men there was no such influence.

This study of 207 school counselors revealed significant relationships between types of counselors' training, number of students in counselors' schools experiencing homelessness, and counselors' perceived knowledge and provision of services regarding students experiencing homelessness. In-service training and professional development, but not graduate training, were related to counselors' knowledge of the McKinney-Vento Homeless Assistance Act and their advocacy for and provision of services to students experiencing homelessness. Differences also existed by school level and school setting. Implications of these findings are discussed.Keywords: school counselors, homelessness, McKinney-Vento Homeless Assistance Act, advocacy, professional developmentHomeless, although a difficult term to clearly define, refers to those who a fixed, regular, and adequate nighttime residence (U.S. Department of Education, 2004, p. 2). Families with children are the fastest growing homeless population in the United States, comprising one third of the homeless population (National Coalition for the Homeless, 2009). Twenty-two percent of all sheltered persons experiencing homelessness are under the age of 18, with over half of this group under the age of 6 (U.S. Department of Housing and Urban Development, 2010). Some live doubled-up with other families, in transitional housing such as shelters or in inhumane conditions (U.S. Department of Education, 2004). In 2012, the National Center for Homeless Education (NCHE) reported that 1,065,794 children in schools experienced homelessness, an increase of over 50% since 2007. The rapidly increasing figures, due in part to the economic recession in the United States, are cause for grave concern because homelessness is detrimental to the emotional, social and cognitive development and well-being of children (Coker et al., 2009; Grothaus, Lorelle, Anderson, & Knight, 2011).Families who experience homelessness are more likely to experience separation from each other, violence and serious health conditions (National Center on Family Homelessness, 2011). Children experiencing homelessness may face high rates of abuse, neglect and mental health issues, as well as barriers that make it nearly impossible for them to succeed academically and emotionally without additional systemic supports (Buckner, Bassuk, Weinreb, & Brooks, 1999; Gewirtz, Hart-Shegos, & Medhanie, 2008; Swick, 2008; U.S. Department of Education, 2004). Due to the challenges of homelessness, students can be worse off academically and socially than their middle-class peers (Obradovic et ah, 2009; Shinn et ah, 2008). Unlike most of their peers, they may lack supports such as before- and after-school services, mentors, transportation to and from school, and attendance support (Hicks-Coolick, Bumside-Eaton, & Peters, 2003; Miller, 2009; U.S. Department of Education, 2004). Higher levels of mobility and absenteeism make it difficult for homeless students to acquire a consistent education (Hicks-Coolick et ah, 2003; Miller, 2009; Rafferty, Shinn, & Weitzman, 2004; U.S. Department of Education, 2004). Students experiencing homelessness, and those who are highly mobile, have lower reading and math scores from second through seventh grade than students living in poverty (Obradovic et al., 2009). Further, relative to their peers, students experiencing homelessness are less likely to aspire to postsecondary education (Rafferty et al., 2004).In response to the growing crisis among children experiencing homelessness, policymakers designed the McKinney-Vento Homeless Assistance Act (U.S. Department of Education, 2004) to provide access to education and remove barriers in order to ensure that schools address the unique needs of students experiencing homelessness. The provisions of the act require that school districts provide transportation to and from the school of origin for students experiencing homelessness, even when the students relocate to an area outside of their home school. …

As suggests by the Minorities' Diminished Returns (MDR) theory, education attainment and other socioeconomic status (SES) indicators have a smaller impact on the health and well-being of non-White than White Americans. To test whether MDR also applies to happiness, in the present study, Blacks and Whites were compared in terms of the effect of education attainment on the level of happiness among American adults. General Social Survey (1972-2016) is a series of national surveys that are performed in the United States. The current analysis included 54,785 adults (46,724 Whites and 8,061 Blacks). The years of schooling (i.e., education attainment) and happiness were the main independent variable and the main dependent variable of interest, respectively. In addition, other parameters such as gender, age, employment status, marital status, and the year of the survey were the covariates and race was the focal effect modifier. Finally, the logistic regression model was used to analyze the data. Based on the results, high education attainment was associated with higher odds of happiness in the pooled sample. Further, a significant interaction was found between race and education attainment on the odds of happiness, showing a larger gain for Whites compared to Blacks. Race-specific models also confirmed this finding (i.e., a larger magnitude of the effect of education for Whites compared to Blacks). Overall, the MDR theory also applies to the effect of education attainment on happiness. Blacks' disadvantage in comparison to the Whites in gaining happiness from their education may be due to the structural, institutional, and interpersonal racism and discrimination in the US. Therefore, there is a need for economic and public policies that can minimize the Blacks' diminished returns of education attainment and other SES resources.

Background:Educational attainment is widely regarded as a key predictor of economic and social outcomes in later life, including the likelihood of receiving Social Security Disability Insurance (SSDI). According to the Minorities’ Diminished Returns (MDRs) theory, however, the benefits of education may be less pronounced for racial and ethnic minorities compared to non-Latino Whites. This study investigates whether the effects of education on the likelihood of receiving SSDI differ by race and ethnicity, focusing on Black and Latino Americans.Objective:The primary aim of this study was to examine the relationship between educational attainment (measured in years of schooling) and the likelihood of receiving SSDI, with a specific focus on exploring how this relationship varies by race and ethnicity, in line with the MDRs framework.Methods:Data were drawn from the Understanding America Study (UAS), a nationally representative, internet-based panel survey. The sample included Black, Latino, and non-Latino White U.S. adults. Our sample size was 12,975 adults over the age of 18. Logistic regression models were used to assess the association between educational attainment and receiving SSDI, adjusting for demographic variables such as age, sex, employment status, and marital status. Interaction terms between race/ethnicity and educational attainment were included to explore whether the returns on education varied across racial and ethnic groups.Results:Higher educational attainment was significantly associated with a lower likelihood of receiving SSDI in the overall sample. However, consistent with the MDRs framework, the protective effect of education was significantly weaker for both Black and Latino individuals compared to non-Latino Whites. Black and Latino participants with similar levels of education as their non-Latino White counterparts were more likely to receive SSDI, reflecting diminished returns on educational attainment for these groups.Conclusion:This study provides strong evidence supporting the MDRs theory, demonstrating that the protective effects of education on the likelihood of receiving SSDI are not equally distributed across racial and ethnic groups. Black and Latino Americans experience weaker returns on their education when it comes to avoiding SSDI, likely due to structural inequalities and systemic barriers. These findings highlight the need for policies that address not only educational disparities but also the broader societal factors that limit the benefits of education for racial and ethnic minorities.

The pace of decline in fertility rates in sub-Saharan Africa appears to have slowed or stalled in the last few decades. This study examines the socioeconomic associated with cumulative fertility in Ghana. Negative binomial regression models were used to estimate determinants of cumulative fertility using data from the Ghana Demographic and Health Surveys of 2003, 2008, and 2014. The composition of children ever born by women did not change considerably over the study periods. Socioeconomic disparities in educational attainment, household wealth, employment, and employer status are significantly associated with cumulative fertility risks in Ghana. The current age of women, age at sexual debut, and marital status, among others, are also linked to cumulative fertility levels. Place and region of residence are also linked to fertility in Ghana. Cumulative fertility levels in Ghana are underscored by considerable socioeconomic disparities among women of reproductive age. Fertility regulation policies should hinge on improving the socio-economic wellbeing of women in Ghana.