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August 28, 1996, Vol 276, No. 8 >
ARTICLE | August 28, 1996

The Characteristics and Needs of Sheltered Homeless and Low-Income Housed Mothers FREE

Ellen L. Bassuk, MD; Linda F. Weinreb, MD; John C. Buckner, PhD; Angela Browne, PhD; Amy Salomon, PhD; Shari S. Bassuk
[+] Author Affiliations

Reprints: Ellen L. Bassuk, MD, The Better Homes Fund, 181 Wells Ave, Newton, MA 02159.


JAMA. 1996;276(8):640-646. doi:10.1001/jama.1996.03540080062031
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Published online
Article
References

Objective.  —To compare characteristics of homeless and low-income housed mothers across economic, psychosocial, and physical health domains.

Design.  —Case-control study.

Setting.  —Community of Worcester, Mass.

Participants.  —A cross-sectional sample of 220 sheltered homeless mothers and 216 low-income housed (never homeless) mothers receiving welfare.

Main Outcome Measures.  —Income, housing, life events, social support, history of abuse and assault, and mental and physical health.

Results.  —Comparison of homeless and housed mothers revealed some important similarities and differences. The proportion of homeless mothers with annual incomes of less than $7000 was 46% vs 17% for housed mothers (P<.01). Homeless mothers experienced more residential instability than the housed mothers (3.8 moves vs 1.8 moves; P<.001) and had smaller support networks (P<.001). More homeless mothers reported severe physical and sexual assault over the lifespan than housed mothers (91.6% vs 81.1%; P<.003). No significant differences were found between the groups in mental and physical health. However, the lifetime prevalence of major depressive disorder, posttraumatic stress disorder, and substance use disorders was overrepresented compared to the general female population. Both groups had lower physical functioning compared to the general population and a higher prevalence of chronic health conditions.

Conclusion.  —Sheltered homeless mothers had fewer economic resources and social supports and higher cumulative rates of violent abuse and assault over their lifespans than their housed counterparts. However, both groups faced extreme adversity that compromised family well-being. Practitioners and social policymakers need to be cognizant of the multiple economic, psychosocial, and physical health needs of these mothers in providing treatment and developing program interventions.

REFERENCES

1 +
Karoly LA.  Anatomy of the US income distribution: two decades of change . Oxford Rev Econ Policy . 1996;;12( (1) ):77-96.
2 +
Blank RM, Card D.  Poverty, income distribution, and growth: are they still connected? Brookings Papers Econ Activity . 1993;;2:285-339.
3 +
Cook JT, Brown JL. Asset Development Among America's Poor: Trends in the Distribution of Income and Wealth . Boston, Mass: Center on Hunger, Poverty and Nutrition Policy, Tufts University; December 1995;. Research in Progress Working Paper CHPNP-WP AD-121595.
4 +
McLanahan S.  Problems of mother-only families . In: Garfinkel I, McLanahan S, eds. Single Mothers and Their Children: A New American Dilemma . Washington, DC: The Urban Institute; 1986;:11-43.
5 +
May R. 1993 Poverty and Income Trends . Washington, DC: Center on Budget and Policy Priorities; March 1995;.
6 +
Bassuk EL.  Lives in jeopardy: women and homelessness . In: Willie C, Rieker PP, Kramer BM, Brown BS, eds. Mental Health, Racism and Sexism . Pittsburgh, Pa: University of Pittsburgh Press; 1995;:237-252.
7 +
Handler JF. The Poverty of Welfare Reform . New Haven, Conn: Yale University Press; 1995;.
8 +
Jencks C. Rethinking Social Policy: Race, Poverty and the Underclass . Cambridge, Mass: Harvard University Press; 1992;.
9 +
Belle D, ed. Lives in Stress: Women and Depression . Beverly Hills, Calif: Sage Publications; 1982;.
10 +
Stack C. All Our Kin: Strategies for Survival in a Black Community . New York, NY: Harper & Row; 1974;.
11 +
Link B, Susser E, Steve A, Phelan J, Moore R, Struening E.  Lifetime and five-year prevalence of homelessness in the United States . Am J Public Health . 1994;;84:1907-1912.
12 +
US Conference of Mayors. A Status Report on Hunger and Homelessness in America's Cities: 1995 . Washington, DC: US Conference of Mayors; 1995;.
13 +
Bassuk EL, Rubin L, Lauriat A.  Characteristics of sheltered homeless families . Am J Public Health . 1986;;76:1097-1101.
14 +
Bassuk EL, Rosenberg L.  Why does family homelessness occur? a case-control study . Am J Public Health . 1988;;78:783-788.
15 +
Molnar J, Rath WR, Klein TP, Lowe C, Hartmann A. Ill Fares the Land: The Consequences of Homelessness and Chronic Poverty for Children and Families in New York City . New York, NY: Bank Street College of Education; 1991;.
16 +
Knickman JR, Weitzman BC. A Study of Homeless Families in New York City: Forecasting Models to Target Families at High Risk of Homelessness Vol 3 . New York, NY: New York University Health Research Program; 1989;. Final report.
17 +
Wood D, Valdez RB, Hayashi T, Shen A.  Homeless and housed families in Los Angeles: a study comparing demographic, economic and family function characteristics . Am J Public Health . 1990;;80:1049-1052.
18 +
Goodman L.  The relationship between social support and family homelessness: a comparison study of homeless and housed mothers . J Community Psychol . 1991;;19:321-332.
19 +
Shinn M, Knickman JR, Weitzman BC.  Social relationships and vulnerability to becoming homeless among poor families . Am Psychol . 1991;;46:1180-1187.
20 +
Goodman LA.  The prevalence of abuse among homeless and housed poor mothers: a comparison study . Am J Orthopsychiatry . 1991;;61:489-500.
21 +
Wagner JK, Perrine RM.  Women at risk for homelessness: comparison between housed and homeless women . Psychol Rep . 1994;;75:1671-1678.
22 +
McKinney Homeless Assistance Act of 1987.42 USC 11301 et seq; 1987, amended 1988.
23 +
Worcester Dept of Public Welfare. Characteristics . Worcester, Mass: Worcester Dept of Public Aid; August 1990;.
24 +
Rog D, McCombs-Thornton K, Gilbert-Mongelli A, Brito MC, Holupka CS.  Implementation of the homeless families program, 2: characteristics, strengths and needs of participating families . Am J Orthopsychiatry . 1995;;65:514-528.
25 +
US Bureau of the Census. Dynamics of Economic Well-being: Poverty 1991 to 1993: Survey of Income and Program Participation. Washington, DC: US Government Printing Office; 1994. Series P 70-45.
26 +
US Bureau of the Census. 1990 Census of Population: Metropolitan Areas. Washington, DC: US Government Printing Office; 1990.
27 +
US Bureau of the Census. Statistical Brief: Mothers Who Receive AFDC Payments—Fertility and Socioeconomic Characteristics. Washington, DC: US Government Printing Office; 1995.
28 +
Barrow S, Hellman F, Lovell A, et al. Personal History Form . New York: New York State Psychiatric Institute; 1985;.
29 +
Dunst CJ, Trivette CM. Personal Assessment of Social Support Scale . Morganton, NC: Family, Infant and Preschool Program, Western Carolina Center; 1988;.
30 +
Dunst CJ, Leet HE.  Measuring the adequacy of resources in households with young children . Child Care Health Dev . 1987;;13:111-125.
31 +
Miller BA, Downs WR, Gondoli DM, Keil A.  The role of childhood sexual assault in the development of alcoholism in women . Violence Vict . 1987;;2:157-172.
32 +
Straus MA.  Measuring intrafamily conflict and violence: the Conflict Tactics (CT) Scales . J Marriage Fam . 1979;;14:75-88.
33 +
Spitzer RL, Williams JBW, Gibben M, First MB. Structured Clinical Interview for DSM-III-R Non-Patient Edition (SCID-NP, Version 1.0) . Washington, DC: American Psychiatric Press; 1990;.
34 +
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised . Washington, DC: American Psychiatric Association; 1987;.
35 +
Ware JE, Sherbourne CD.  The MOS 36-Item Short Form Health Status Survey; I: conceptual framework and item selection . Med Care . 1992;;30:473-483.
36 +
National Institute of Mental Health. Epidemiologic Catchment Area Study: Public Use Wave 1 Code Book . Rockville, Md: National Institute of Mental Health; 1988;.
37 +
National Center for Health Statistics. Vital Statistics of the United States, Series 1 (13-16): National Health and Nutrition Examination Survey II (1978-81) . Hyattsville, Md: US Dept of Health and Human Services; 1983;.
38 +
Walter SD.  Determination of significant relative risks and optimal sampling procedures in prospective and retrospective comparative studies of various sizes . Am J Epidemiol . 1977;;105:387-397.
39 +
Kessler RC, McGonagle KA, Zhaos S, et al.  Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey . Arch Gen Psychiatry . 1994;;51:8-19.
40 +
Resnick HS, Kilpatrick DG, Dansky BS, Saunders BE, Best CL.  Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women . J Consult Clin Psychol . 1993;;61:984-991.
41 +
Ware J, Snow K, Kosinski M, Gandek B. SF-36 Health Survey: Manual and Interpretation Guide . Boston, Mass: The Health Institute, New England Medical Center; 1993;.
42 +
National Center for Health Statistics. Vital Statistics of the United States, Series 10 (No. 190): Current Estimates From the National Health Interview Survey, 1993 . Hyattsville, Md: US Dept of Health and Human Services, Public Health Service; 1994;.
43 +
Bassuk EL.  Homeless families . Sci Am . 1991;;265:66-74.
44 +
Hobfoll SE, Vaux A.  Social support: social resources and social context . In: Goldberger L, Breznitz S, eds. Handbook of Stress: Theoretical and Clinical Aspects . 2nd ed. New York, NY: The Free Press; 1993;.
45 +
Baum AS, Burnes DW. A Nation in Denial . San Francisco, Calif: Westview Press; 1993;.
46 +
Council on Scientific Affairs, American Medical Association.  Violence against women: relevance for medical practitioners . JAMA . 1992;;267:3184-3189.
47 +
Browne A.  Family violence and homelessness: the relevance of trauma histories in the lives of homeless women . Am J Orthopsychiatry . 1993;;63:370-384.
48 +
Browne A.  Violence against women by male partners: prevalence, outcomes, and policy implications . Am Psychol . 1993;:48:1077-1087.
49 +
Miller BA, Downs WR, Testa M.  Interrelationships between victimization experiences and women's alcohol use . J Stud Alcohol . 1993;;( (suppl 11) ):109-117.
50 +
Davidson JRT, Foa EM, eds. Posttraumatic Stress Disorder: DSM-IV and Beyond . Washington, DC: American Psychiatric Press; 1993;.
51 +
Herman J. Trauma and Recovery . New York, NY: Basic Books; 1992;.
52 +
Chomitz V, Cheung L, Lieberman E.  The role of life style in preventing low birth weight . Future Child . 1995;;5:121-138.
53 +
Dearborn PM.  The state-local fiscal outlook from a federal perspective . Intergovern Perspect . (Spring) 1994;:20-24.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Karoly LA.  Anatomy of the US income distribution: two decades of change . Oxford Rev Econ Policy . 1996;;12( (1) ):77-96.
2 +
Blank RM, Card D.  Poverty, income distribution, and growth: are they still connected? Brookings Papers Econ Activity . 1993;;2:285-339.
3 +
Cook JT, Brown JL. Asset Development Among America's Poor: Trends in the Distribution of Income and Wealth . Boston, Mass: Center on Hunger, Poverty and Nutrition Policy, Tufts University; December 1995;. Research in Progress Working Paper CHPNP-WP AD-121595.
4 +
McLanahan S.  Problems of mother-only families . In: Garfinkel I, McLanahan S, eds. Single Mothers and Their Children: A New American Dilemma . Washington, DC: The Urban Institute; 1986;:11-43.
5 +
May R. 1993 Poverty and Income Trends . Washington, DC: Center on Budget and Policy Priorities; March 1995;.
6 +
Bassuk EL.  Lives in jeopardy: women and homelessness . In: Willie C, Rieker PP, Kramer BM, Brown BS, eds. Mental Health, Racism and Sexism . Pittsburgh, Pa: University of Pittsburgh Press; 1995;:237-252.
7 +
Handler JF. The Poverty of Welfare Reform . New Haven, Conn: Yale University Press; 1995;.
8 +
Jencks C. Rethinking Social Policy: Race, Poverty and the Underclass . Cambridge, Mass: Harvard University Press; 1992;.
9 +
Belle D, ed. Lives in Stress: Women and Depression . Beverly Hills, Calif: Sage Publications; 1982;.
10 +
Stack C. All Our Kin: Strategies for Survival in a Black Community . New York, NY: Harper & Row; 1974;.
11 +
Link B, Susser E, Steve A, Phelan J, Moore R, Struening E.  Lifetime and five-year prevalence of homelessness in the United States . Am J Public Health . 1994;;84:1907-1912.
12 +
US Conference of Mayors. A Status Report on Hunger and Homelessness in America's Cities: 1995 . Washington, DC: US Conference of Mayors; 1995;.
13 +
Bassuk EL, Rubin L, Lauriat A.  Characteristics of sheltered homeless families . Am J Public Health . 1986;;76:1097-1101.
14 +
Bassuk EL, Rosenberg L.  Why does family homelessness occur? a case-control study . Am J Public Health . 1988;;78:783-788.
15 +
Molnar J, Rath WR, Klein TP, Lowe C, Hartmann A. Ill Fares the Land: The Consequences of Homelessness and Chronic Poverty for Children and Families in New York City . New York, NY: Bank Street College of Education; 1991;.
16 +
Knickman JR, Weitzman BC. A Study of Homeless Families in New York City: Forecasting Models to Target Families at High Risk of Homelessness Vol 3 . New York, NY: New York University Health Research Program; 1989;. Final report.
17 +
Wood D, Valdez RB, Hayashi T, Shen A.  Homeless and housed families in Los Angeles: a study comparing demographic, economic and family function characteristics . Am J Public Health . 1990;;80:1049-1052.
18 +
Goodman L.  The relationship between social support and family homelessness: a comparison study of homeless and housed mothers . J Community Psychol . 1991;;19:321-332.
19 +
Shinn M, Knickman JR, Weitzman BC.  Social relationships and vulnerability to becoming homeless among poor families . Am Psychol . 1991;;46:1180-1187.
20 +
Goodman LA.  The prevalence of abuse among homeless and housed poor mothers: a comparison study . Am J Orthopsychiatry . 1991;;61:489-500.
21 +
Wagner JK, Perrine RM.  Women at risk for homelessness: comparison between housed and homeless women . Psychol Rep . 1994;;75:1671-1678.
22 +
McKinney Homeless Assistance Act of 1987.42 USC 11301 et seq; 1987, amended 1988.
23 +
Worcester Dept of Public Welfare. Characteristics . Worcester, Mass: Worcester Dept of Public Aid; August 1990;.
24 +
Rog D, McCombs-Thornton K, Gilbert-Mongelli A, Brito MC, Holupka CS.  Implementation of the homeless families program, 2: characteristics, strengths and needs of participating families . Am J Orthopsychiatry . 1995;;65:514-528.
25 +
US Bureau of the Census. Dynamics of Economic Well-being: Poverty 1991 to 1993: Survey of Income and Program Participation. Washington, DC: US Government Printing Office; 1994. Series P 70-45.
26 +
US Bureau of the Census. 1990 Census of Population: Metropolitan Areas. Washington, DC: US Government Printing Office; 1990.
27 +
US Bureau of the Census. Statistical Brief: Mothers Who Receive AFDC Payments—Fertility and Socioeconomic Characteristics. Washington, DC: US Government Printing Office; 1995.
28 +
Barrow S, Hellman F, Lovell A, et al. Personal History Form . New York: New York State Psychiatric Institute; 1985;.
29 +
Dunst CJ, Trivette CM. Personal Assessment of Social Support Scale . Morganton, NC: Family, Infant and Preschool Program, Western Carolina Center; 1988;.
30 +
Dunst CJ, Leet HE.  Measuring the adequacy of resources in households with young children . Child Care Health Dev . 1987;;13:111-125.
31 +
Miller BA, Downs WR, Gondoli DM, Keil A.  The role of childhood sexual assault in the development of alcoholism in women . Violence Vict . 1987;;2:157-172.
32 +
Straus MA.  Measuring intrafamily conflict and violence: the Conflict Tactics (CT) Scales . J Marriage Fam . 1979;;14:75-88.
33 +
Spitzer RL, Williams JBW, Gibben M, First MB. Structured Clinical Interview for DSM-III-R Non-Patient Edition (SCID-NP, Version 1.0) . Washington, DC: American Psychiatric Press; 1990;.
34 +
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised . Washington, DC: American Psychiatric Association; 1987;.
35 +
Ware JE, Sherbourne CD.  The MOS 36-Item Short Form Health Status Survey; I: conceptual framework and item selection . Med Care . 1992;;30:473-483.
36 +
National Institute of Mental Health. Epidemiologic Catchment Area Study: Public Use Wave 1 Code Book . Rockville, Md: National Institute of Mental Health; 1988;.
37 +
National Center for Health Statistics. Vital Statistics of the United States, Series 1 (13-16): National Health and Nutrition Examination Survey II (1978-81) . Hyattsville, Md: US Dept of Health and Human Services; 1983;.
38 +
Walter SD.  Determination of significant relative risks and optimal sampling procedures in prospective and retrospective comparative studies of various sizes . Am J Epidemiol . 1977;;105:387-397.
39 +
Kessler RC, McGonagle KA, Zhaos S, et al.  Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey . Arch Gen Psychiatry . 1994;;51:8-19.
40 +
Resnick HS, Kilpatrick DG, Dansky BS, Saunders BE, Best CL.  Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women . J Consult Clin Psychol . 1993;;61:984-991.
41 +
Ware J, Snow K, Kosinski M, Gandek B. SF-36 Health Survey: Manual and Interpretation Guide . Boston, Mass: The Health Institute, New England Medical Center; 1993;.
42 +
National Center for Health Statistics. Vital Statistics of the United States, Series 10 (No. 190): Current Estimates From the National Health Interview Survey, 1993 . Hyattsville, Md: US Dept of Health and Human Services, Public Health Service; 1994;.
43 +
Bassuk EL.  Homeless families . Sci Am . 1991;;265:66-74.
44 +
Hobfoll SE, Vaux A.  Social support: social resources and social context . In: Goldberger L, Breznitz S, eds. Handbook of Stress: Theoretical and Clinical Aspects . 2nd ed. New York, NY: The Free Press; 1993;.
45 +
Baum AS, Burnes DW. A Nation in Denial . San Francisco, Calif: Westview Press; 1993;.
46 +
Council on Scientific Affairs, American Medical Association.  Violence against women: relevance for medical practitioners . JAMA . 1992;;267:3184-3189.
47 +
Browne A.  Family violence and homelessness: the relevance of trauma histories in the lives of homeless women . Am J Orthopsychiatry . 1993;;63:370-384.
48 +
Browne A.  Violence against women by male partners: prevalence, outcomes, and policy implications . Am Psychol . 1993;:48:1077-1087.
49 +
Miller BA, Downs WR, Testa M.  Interrelationships between victimization experiences and women's alcohol use . J Stud Alcohol . 1993;;( (suppl 11) ):109-117.
50 +
Davidson JRT, Foa EM, eds. Posttraumatic Stress Disorder: DSM-IV and Beyond . Washington, DC: American Psychiatric Press; 1993;.
51 +
Herman J. Trauma and Recovery . New York, NY: Basic Books; 1992;.
52 +
Chomitz V, Cheung L, Lieberman E.  The role of life style in preventing low birth weight . Future Child . 1995;;5:121-138.
53 +
Dearborn PM.  The state-local fiscal outlook from a federal perspective . Intergovern Perspect . (Spring) 1994;:20-24.

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