My heart grieves for the children

This morning on NPR there was a story about a US program to move single mothers (mostly African-American) out of high poverty neighborhoods into more affluent ones using vouchers (so they could chose where to live). The kids were all under 8 when they moved, and most were under 3. The study focused on mental health outcomes.

They found that while the little girls thrived and had good long-term outcomes, the little boys did not. In fact, the male children were worse than controls who did not receive vouchers. When asked to explain why, the lead author said that the study wasn’t designed to ask why (I was impressed with his reluctance to extend his results). He said they had some data from workers who were in the neighborhoods, interviewing the families. There was some evidence that little girls were accepted but that the boys were seen “as a threat” and not accepted.

When we will learn that black males are not a threat? That 3 and 5 and 8 year old black males are children whose color does not make them a threat? That safe and stable neighborhoods make a difference to human beings? (see also this paper by the same group).

Here is the link to PUBMED. Here is the abstract of the paper:

Associations of Housing Mobility Interventions for Children in High-Poverty Neighborhoods With Subsequent Mental Disorders During Adolescence

Ronald C. Kessler, PhD1; Greg J. Duncan, PhD2; Lisa A. Gennetian, PhD3; Lawrence F. Katz, PhD3,4; Jeffrey R. Kling, PhD3,5; Nancy A. Sampson, BA1; Lisa Sanbonmatsu, PhD3; Alan M. Zaslavsky, PhD1; Jens Ludwig, PhD3,6
JAMA. 2014;311(9):937-948. doi:10.1001/jama.2014.607.

Importance  Youth in high-poverty neighborhoods have high rates of emotional problems. Understanding neighborhood influences on mental health is crucial for designing neighborhood-level interventions.

Objective  To perform an exploratory analysis of associations between housing mobility interventions for children in high-poverty neighborhoods and subsequent mental disorders during adolescence.

Design, Setting, and Participants  The Moving to Opportunity Demonstration from 1994 to 1998 randomized 4604 volunteer public housing families with 3689 children in high-poverty neighborhoods into 1 of 2 housing mobility intervention groups (a low-poverty voucher group vs a traditional voucher group) or a control group. The low-poverty voucher group (n=1430) received vouchers to move to low-poverty neighborhoods with enhanced mobility counseling. The traditional voucher group (n=1081) received geographically unrestricted vouchers. Controls (n=1178) received no intervention. Follow-up evaluation was performed 10 to 15 years later (June 2008-April 2010) with participants aged 13 to 19 years (0-8 years at randomization). Response rates were 86.9% to 92.9%.

Main Outcomes and Measures  Presence of mental disorders from the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) within the past 12 months, including major depressive disorder, panic disorder, posttraumatic stress disorder (PTSD), oppositional-defiant disorder, intermittent explosive disorder, and conduct disorder, as assessed post hoc with a validated diagnostic interview.

Results  Of the 3689 adolescents randomized, 2872 were interviewed (1407 boys and 1465 girls). Compared with the control group, boys in the low-poverty voucher group had significantly increased rates of major depression (7.1% vs 3.5%; odds ratio (OR), 2.2 [95% CI, 1.2-3.9]), PTSD (6.2% vs 1.9%; OR, 3.4 [95% CI, 1.6-7.4]), and conduct disorder (6.4% vs 2.1%; OR, 3.1 [95% CI, 1.7-5.8]). Boys in the traditional voucher group had increased rates of PTSD compared with the control group (4.9% vs 1.9%, OR, 2.7 [95% CI, 1.2-5.8]). However, compared with the control group, girls in the traditional voucher group had decreased rates of major depression (6.5% vs 10.9%; OR, 0.6 [95% CI, 0.3-0.9]) and conduct disorder (0.3% vs 2.9%; OR, 0.1 [95% CI, 0.0-0.4]).

Conclusions and Relevance  Interventions to encourage moving out of high-poverty neighborhoods were associated with increased rates of depression, PTSD, and conduct disorder among boys and reduced rates of depression and conduct disorder among girls. Better understanding of interactions among individual, family, and neighborhood risk factors is needed to guide future public housing policy changes.

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One thought on “My heart grieves for the children

  1. Pingback: Links 3/16/14 | Mike the Mad Biologist

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