Search Results (15)

This study focuses on the current service/care difficulties and challenges that social institutions in Hungary are facing during their daily operations; how they can react to them utilizing their internal resources, mechanisms, and capacities; and what concrete, tangible needs and demands are emerging in terms of methodological professional support, potential forms, interventions, and direction for professional development. A total of 24 general and 55 specific service and operational problems were identified and assessed in eight different service areas (family and child welfare services, family and child welfare centers, respite care for children, care for the homeless, addiction intervention, care for people with disabilities, care for psychiatric patients, specialized care for the elderly, and basic services for the elderly). The empirical base of the study uses a database of 201 online questionnaires completed by a professional target group working for social service providers in two counties (Győr-Moson-Sopron and Veszprém), representing 166 social service providers. The questionnaires were completed between November and December of 2022. The findings will be used to develop a professional support and development problem map. Social institutions face complex and serious service/care difficulties and challenges in their daily operations. Three distinctive basic problems clearly stand out in both severity and significance from the complex set of factors assessed. The biggest problem in the social care system is clearly the complex challenge of low wages, followed by the administrative burdens in the ranking of operational difficulties, and the third key factor was the psycho-mental workload of staff. Full article

Homelessness for families in Alberta, Canada, is a growing concern despite an abundance of research and continued support for Housing First programs, and the consequences can be severe. This study used a descriptive qualitative design to examine the experiences of families currently living in or that have a history of homelessness with the goal of developing recommendations to improve system coordination. Participants included parents who had at least one dependent child while homeless (n = 15) and staff who were currently working at a homeless support service (n = 18). Interviews were analyzed using a thematic inductive approach and integrated using functional narrative analysis. Four themes emerged: (1) Housing as a Foundation for Success in Other Domains; (2) Challenges with System Navigation: A Door Within a Door Within a Door; (3) Services’ Contributions to Trauma; and (4) Exposure to Social Bias and Stigma Within Services. We posit several recommendations for policy and service delivery which focus on finding “homes” and building community connections, enhancing Housing First program models, expanding on existing trauma-informed approaches, and prioritizing system-level change. Full article

In recent years, researchers and policymakers have called attention to the importance of child and adolescent trauma for understanding adult health status. The primary aim of this study is to describe the adverse childhood events reported in a sample of runaway and homeless youths and examine their impact on these youths’ current health status. We utilize survey data collected from a community sample of runaway and homeless youths gathered in metro Atlanta. Using the Adverse Childhood Experiences Scale (ACEs scale), we examined the relationship between ACEs and several health status measures using OLS and logistic regression. We found that runaway and homeless youths endorsed experiencing many ACEs, especially sexual minority youths, youths who had prior involvement with child-serving social service systems, and youths who were homeless for more than a year. Black/African American youths were slightly less likely to report many adverse childhood experiences. Runaway and homeless youths who reported more ACEs had increased odds of experiencing significant current mental health and/or substance abuse problems. Our study suggests ACEs are an important factor shaping these youths’ health and underscores the potential value of trauma-informed care for youths experiencing homelessness. Full article

Child removals are increasing in England and Wales. Family court involvement is particularly common among women with multiple disadvantages, and the rates are higher in economically marginalised areas. This article aims to explore women’s narratives of child removal within life stories of homelessness and examines how stigma, power and State surveillance manifest in their experiences. Data drawn from qualitative interviews with 14 mothers in the north-east of England who had experienced the removal of their children through the family courts are explored within the wider context of a neoliberal political agenda of “troubled families”, and in particular, “deviant mothers”. The participants describe how stigma structured their interactions with social services. Despite the known poor outcomes associated with child removal for both mothers and children, professional involvement often tapers off afterwards, with little support for mothers. Drawing on women’s accounts, we seek to illuminate their experiences of child removal and enhance our understanding of how stigma plays out in statutory settings, further entrenching social exclusion and ultimately increasing health inequalities. Full article

Youth homelessness is a significant problem in most United States communities. Health problems are both a contributor to and a consequence of homelessness. Responses to youth homelessness are typically fragmentary. Different agencies deal with various causes and consequences of the problem. Stakeholders in Connecticut sought a more coherent approach. This article describes the development and use of a system dynamics simulation model as a decision-support tool that: (1) brings stakeholders together from diverse service sectors and allows them to see the system as a whole, (2) enables them to explore how delivery systems interact to affect homeless and unstably housed youth, (3) lets them test the impact of different intervention alternatives on reducing the problem, and (4) helps develop insights about coherent approaches to youth homelessness. The model’s development is described as a phased process including stakeholder engagement, causal mapping, and creation of the quantitative simulation model. The resulting model is presented along with an interface that enables stakeholders to use the model in a Learning Lab setting. Results of an initial set of Learning Labs are presented, including types of insights gained by participants from using the simulation model. Conclusions include limitations of the model and plans for its future use. Full article

Background: Children < 5 years living in temporary accommodation (U5TA) are vulnerable to poor health outcomes. Few qualitative studies have examined service provider perspectives in family homelessness; none have focused on U5TA with a cross-sector approach. This study explored professionals’ perspectives of the barriers and facilitators, including pandemic-related challenges, experienced by U5TA in accessing healthcare and optimising health outcomes, and their experiences in delivering services. Methods: Sixteen semi-structured online interviews were conducted. Professionals working in Newham (London) with U5TA families were recruited from non-profit organisations, the health sector, and Local Authority. A thematic analysis was conducted. Findings: Professionals described barriers including poor parental mental health; unsuitable housing; no social support; mistrust of services; immigration administration; and financial insecurity. Digital poverty, language discordance, and the inability to register and track U5TA made them even less visible to services. Professionals tried to mitigate barriers with improved communication, and through community facilitators. Adverse pandemic effects on U5TA health included delay and regression in developmental milestones and behaviours. In-person services were reduced, exacerbating pre-existing barriers. Interpretation: COVID-19 further reduced the ability of professionals to deliver care to U5TA and significantly impacted the lives of U5TA with potential life-long risks. Innovative and tailored cross-sector strategies are needed, including co-production of public health services and policies focusing on early development, mental health support, employment training, and opportunities for parents/carers. Full article

Diet, screen time, physical activity, and sleep combine into lifestyle patterns with synergistic effects on health. This study aimed to identify lifestyle patterns in children without housing and assess their associations with physical and mental health and family socio-ecological factors. In the 2013 ENFAMS cross-sectional survey (children aged 6–12 experiencing homelessness, Greater Paris area, n = 235), parents reported socio-ecological factors, children’s behaviours, and mental health (the latter was also child-reported). Nurses measured children’s haemoglobin concentrations and body mass index. Principal component analysis was used to derive sex-specific lifestyle patterns. Hierarchical linear regressions and “outcome-wide” analyses assessed, respectively, these patterns’ relations to health and family socio-ecological factors. A rather healthy lifestyle pattern—similarly characterized by diverse diet and high sleep time—was identified, with slight differences by sex. Scores for this pattern were higher for children in food-secure or higher-income households, whose parents were proficient in French, who slept longer, or who received more social support compared to their counterparts, with some nuances by sex. Higher scores for this pattern were associated with higher prosocial behaviour scores (girls) and lower anxiety and hyperactivity–inattention symptoms scores (boys), but not with physical health. For this underserved and understudied population, the results highlight the importance of family socio-ecological factors in shaping the lifestyles and mental health of children. Full article

The first five years of life are critical for optimal growth, health, and cognitive development. Adverse childhood experiences, including experiencing homelessness, can be a risk factor for multiple health issues and developmental challenges. There is a dearth of data collected with and by families with children under age five living in temporary accommodation due to experiencing homelessness (U5TA) describing indoor environmental barriers that prevent U5TA from achieving and maintaining optimal health. The aim of this study was to address this current gap using a citizen science approach. Fifteen participants, who were mothers of U5TA living in a deprived area of London, and the lead researcher collected data in late 2019/early 2020 using: (I) a housing survey conducted via a mobile app; (II) house visits; and (III) collaborative meetings. Data were analyzed using thematic analysis. Key themes included: overcrowding/shared facilities, dampness/mold growth, poor/inadequate kitchen/toilet facilities, infestations/vermin, structural problems/disrepair, unsafe electrics, excessively cold temperatures, and unsafe surfaces that risk causing trips/falls, with all participants experiencing multiple concurrent indoor environmental barriers. The citizen science approach was successfully used to collect meaningful data demonstrating the need for child-centered housing policies meeting the needs of current and future generations of families living in TA. Full article

Early developmental success and school readiness strongly influence future skill development, occupational opportunities, and health. Therefore, it is critical to identify and address early determinants of school readiness for supporting children’s overall well-being and success. In this retrospective cohort study, we examined the effects of pre-birth household challenges, such as homelessness or experiences of intimate partner violence, on children’s early school readiness. We linked data from the Alaska 2009–2011 Pregnancy Risk Assessment Monitoring System (PRAMS) to administrative and education records through 2019. Education records included kindergarten developmental scores, third grade reading assessments, and attendance records. Generalized linear models with Quasi-Poisson distributions for each outcome of interest examined the predictive value of pre-birth household challenges on the risks of not meeting school readiness expectations. We found that experiencing higher numbers of pre-birth household challenges was related to higher risk of the child not meeting developmental and reading proficiency and having chronic absenteeism. These results suggest that it is imperative support systems for pregnant persons and their families be introduced as soon as possible in pre-natal care routines to address current pre-birth household stressors and prevent future challenges. Such early prevention efforts are needed to ensure the best possible developmental start for children. Full article

Background: Adolescent inpatients with substance use disorder (SUD) and a history of child maltreatment (CM) present a vulnerable population at considerable risk of poor health and social outcomes. The aims of this study were to explore the proportion of adolescent inpatients with SUD and a history of CM and to compare these patients to inpatients with SUD and no history of CM. Methods: In this retrospective chart review, we explored adolescent patients who were consecutively admitted to a regional child and adolescent inpatient unit for psychiatric care and met DSM (5th ed) criteria for SUD. A standardized form was created and used to extract clinical information and psychosocial histories. Results: From 1 September 2019 to 28 February 2020, 126 adolescents were admitted with SUD, and for 80 (63.3%) patients, a history of CM was recorded in the medical charts. Patients with a history of CM were significantly more likely to be female (p = 0.02), have longer lengths of stay (p = 0.04), to be readmitted (p = 0.03), be diagnosed with trauma/stress-related (p = 0.04) and eating disorders (p = 0.05), to have a parent with a mental illness (p = 0.01), experienced physical (p < 0.01) and sexual (p < 0.01) assaults and homelessness (p < 0.01), and to engage in self-harming behaviors (p < 0.01) than inpatients with SUD but no history of CM. Conclusions: Almost two-thirds of adolescent inpatients with an SUD reported a history of CM. Addressing their specific clinical and psychosocial vulnerabilities through comprehensive treatment and discharge plans may reduce readmission and improve quality of life. Full article

Poverty creates social conditions that increase the likelihood of homelessness. These include exposure to traumatic life experiences; social disadvantages such as poor educational experiences; being raised in a broken family, care homes or foster care; physical, emotional, and sexual abuse; and neglect at an early age. These conditions reduce people’s ability to negotiate through life challenges. This cross-sectional study documents the clustering and frequency of adverse social conditions among 152 homeless people from four cities in North West England between January and August 2020. Two-step cluster analysis showed that having parents with a criminal record, care history, and child neglect/abuse history was predictive of homelessness. The cluster of indicator variables among homeless people included sexual abuse (χ2 (N = 152) = 220.684, p < 0.001, Cramer’s V = 0.7), inappropriate sexual behaviour (χ2 (N = 152) = 207.737, p < 0.001, Cramer’s V = 0.7), emotional neglect (χ2 (N = 152) = 181.671, p < 0.001, Cramer’s V = 0.7), physical abuse by step-parent (χ2 (N = 152) = 195.882, p < 0.001, Cramer’s V = 0.8), and physical neglect (χ2 (N = 152) = 205.632, p < 0.001, Cramer’s V = 0.8). Poverty and homelessness are intertwined because of the high prevalence of poverty among the homeless. Poverty sets up a chain of interactions between social conditions that increase the likelihood of unfavourable outcomes: homelessness is at the end of the interaction chain. Interventions supporting families to rise out of poverty may also reduce entry into homelessness. Full article

Introduction: Housing insecurity is increasingly commonplace among disadvantaged women and children. We measured the individual- and population-level impact of severe housing insecurity during pregnancy on adverse birth and infant outcomes. Methods: We analyzed data from 3428 mother–infant dyads enrolled in the Fragile Families and Child Wellbeing Study, a prospective cohort study representing births in 20 large U.S. cities from 1998 to 2000. Severe housing insecurity was defined as threatened eviction or homelessness during pregnancy. Outcomes included low birth weight and/or preterm birth, admission to a neonatal intensive care unit (NICU) or stepdown facility, extended hospitalization after delivery, and infant health and temperament. We estimated exposure–outcome associations with risk ratios adjusted for pre-pregnancy maternal sociodemographic and heath factors and calculated a population attributable fraction (PAF) of outcomes attributable to severe housing insecurity. Results: We found statistically significant associations between severe housing insecurity during pregnancy and low birth weight and/or preterm birth (risk ratio (RR] 1.73, 95% confidence interval (CI) 1.28, 2.32), NICU or stepdown stay (RR 1.64, CI 1.17, 2.31), and extended hospitalization (RR 1.66, CI 1.28, 2.16). Associations between housing insecurity and infant fair or poor health (RR 2.62, CI 0.91, 7.48) and poor temperament (RR 1.52, CI 0.98, 2.34) were not statistically significant. PAF estimates ranged from 0.9–2.7%, suggesting that up to three percent of adverse birth and infant outcomes could be avoided by eliminating severe housing insecurity among low-income, pregnant women in US cities. Conclusions: Results suggest that housing insecurity during pregnancy shapes neonatal and infant health in disadvantaged urban families. Full article

Few studies examined the impact of maternal socioeconomic status and of its combined effects with environmental exposures on birthweight. Our goal was to examine the impact of maternal homelessness (mothers ever homeless or who lived in shelters during pregnancy) and participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) during pregnancy in conjunction with air pollution exposure on birthweight in the Boston-based Children’s HealthWatch cohort from 2007 through 2015 (n = 3366). Birthweight was obtained from electronic health records. Information on maternal homelessness and WIC participation during pregnancy were provided via a questionnaire. Prenatal fine particulate matter (PM_2.5) exposures, estimated at the subject’s residential address, were calculated for each trimester. We fit linear regression models adjusting for maternal and child characteristics, seasonality, and block-group-level median household income and examined the interactions between PM_2.5 and each covariate. Prenatal maternal homelessness was associated with reduced birthweight (−55.7 g, 95% CI: −97.8 g, −13.7 g), while participating in WIC was marginally associated with increased birthweight (36.1 g, 95% CI: −7.3 g, 79.4 g). Only average PM_2.5 during the second trimester was marginally associated with reduced birthweight (−8.5 g, 95% CI: −19.3, 2.3) for a 1 µg/m³ increase in PM_2.5. The association of PM_2.5 during the second trimester with reduced birthweight was stronger among non-Hispanic Black mothers and trended toward significance among immigrants and single mothers. Our study emphasizes the independent and synergistic effects of social and environmental stressors on birthweight, particularly the potentially protective effect of participating in WIC for vulnerable populations. Full article

It used to be taken for a given fact that children’s literature is written by adults for children. This assumption is contested by the emergence of “another children’s literature”, namely literature about, for, and by children. Facilitated by digital platforms, this alternative type of children’s literature is gathering momentum, compelling us to rethink the (im)possibilities of children’s creative agency. As research into children’s literature is largely premised upon the asymmetry between adult authorship and juvenile readership, we need to rethink some fundamental tenets of this academic field in order to come to terms with child authorship. This article reviews leading publications on the topic, to address the question of how we can best acknowledge, facilitate, and appreciate children’s creative agency as an indispensable dimension of their emergent citizenship. Methodological deliberations are illustrated with references to primary works by child authors about topical societal issues such as ethnic conflict, homelessness, and migration. Its aim is not so much to provide a complete survey of all available publications on the topic, but rather to stake out representative publications that exemplify more and less fruitful approaches to the problem at hand. Full article

Children in homeless families have high levels of adversity and are at risk for behavior problems and chronic health conditions, however little is known about the relationship between cognitive-emotional self-regulation and health among school-aged homeless children. Children (n = 86; mean age 10.5) living in shelters were assessed for health, family stress/adversity, emotional-behavioral regulation, nonverbal intellectual abilities, and executive function. Vision problems were the most prevalent health condition, followed by chronic respiratory conditions. Cumulative risk, child executive function, and self-regulation problems in children were uniquely related to child physical health. Homeless children experience problems with cognitive, emotional, and behavioral regulation as well as physical health, occurring in a context of high psychosocial risk. Several aspects of children’s self-regulation predict physical health in 9- to 11-year-old homeless children. Health promotion efforts in homeless families should address individual differences in children’s self-regulation as a resilience factor. Full article