Skip to main content

Prospective Associations of Childhood Housing Insecurity With Anxiety and Depression Symptoms During Childhood and Adulthood.

Publication ,  Journal Article
Keen, R; Chen, JT; Slopen, N; Sandel, M; Copeland, WE; Tiemeier, H
Published in: JAMA Pediatr
August 1, 2023

IMPORTANCE: Childhood housing insecurity has dramatically increased in the US in recent decades, but whether an association with adverse mental health outcomes exists after adjusting for repeated measures of childhood poverty is unclear. OBJECTIVE: To test whether childhood housing insecurity is associated with later anxiety and depression symptoms after adjusting for time-varying measures of childhood poverty. DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study included individuals aged 9, 11, and 13 years at baseline from the Great Smoky Mountains Study in western North Carolina. Participants were assessed up to 11 times from January 1993 to December 2015. Data were analyzed from October 2021 to October 2022. EXPOSURE: Participants and their parents reported social factors annually when participants were 9 to 16 years of age. A comprehensive measure of childhood housing insecurity was constructed based on frequent residential moves, reduced standard of living, forced separation from home, and foster care status. MAIN OUTCOMES AND MEASURES: Between ages 9 and 16 years, the Child and Adolescent Psychiatric Assessment was used up to 7 times to evaluate childhood anxiety and depression symptoms. Adult anxiety and depression symptoms were assessed at ages 19, 21, 26, and 30 years using the Young Adult Psychiatric Assessment. RESULTS: Of the 1339 participants (mean [SD] age, 11.3 [1.63] years), 739 (55.2%; 51.1% weighted) were male; 1203 individuals assessed up to 30 years of age were included in the adulthood outcome analyses. Standardized mean (SD) baseline anxiety and depression symptom scores were higher among children who experienced housing insecurity than among those who never experienced housing insecurity (anxiety: 0.49 [1.15] vs 0.22 [1.02]; depression: 0.20 [1.08] vs -0.06 [0.82]). Individuals who experienced childhood housing insecurity had higher anxiety symptom scores (fixed effects: standardized mean difference [SMD], 0.21; 95% CI, 0.12-0.30; random effects: SMD, 0.25; 95% CI, 0.15-0.35) and higher depression symptom scores (fixed effects: SMD, 0.18; 95% CI, 0.09-0.28; random effects: SMD, 0.26; 95% CI, 0.14-0.37) during childhood. In adulthood, childhood housing insecurity was associated with higher depression symptom scores (SMD, 0.11; 95% CI, 0.00-0.21). CONCLUSIONS AND RELEVANCE: In this cohort study, housing insecurity was associated with anxiety and depression during childhood and with depression during adulthood. Because housing insecurity is a modifiable, policy-relevant factor associated with psychopathology, these results suggest that social policies that support secure housing may be an important prevention strategy.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

JAMA Pediatr

DOI

EISSN

2168-6211

Publication Date

August 1, 2023

Volume

177

Issue

8

Start / End Page

818 / 826

Location

United States

Related Subject Headings

  • Young Adult
  • Prospective Studies
  • Pediatrics
  • Male
  • Humans
  • Housing Instability
  • Female
  • Depression
  • Cohort Studies
  • Child
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Keen, R., Chen, J. T., Slopen, N., Sandel, M., Copeland, W. E., & Tiemeier, H. (2023). Prospective Associations of Childhood Housing Insecurity With Anxiety and Depression Symptoms During Childhood and Adulthood. JAMA Pediatr, 177(8), 818–826. https://doi.org/10.1001/jamapediatrics.2023.1733
Keen, Ryan, Jarvis T. Chen, Natalie Slopen, Megan Sandel, William E. Copeland, and Henning Tiemeier. “Prospective Associations of Childhood Housing Insecurity With Anxiety and Depression Symptoms During Childhood and Adulthood.JAMA Pediatr 177, no. 8 (August 1, 2023): 818–26. https://doi.org/10.1001/jamapediatrics.2023.1733.
Keen R, Chen JT, Slopen N, Sandel M, Copeland WE, Tiemeier H. Prospective Associations of Childhood Housing Insecurity With Anxiety and Depression Symptoms During Childhood and Adulthood. JAMA Pediatr. 2023 Aug 1;177(8):818–26.
Keen, Ryan, et al. “Prospective Associations of Childhood Housing Insecurity With Anxiety and Depression Symptoms During Childhood and Adulthood.JAMA Pediatr, vol. 177, no. 8, Aug. 2023, pp. 818–26. Pubmed, doi:10.1001/jamapediatrics.2023.1733.
Keen R, Chen JT, Slopen N, Sandel M, Copeland WE, Tiemeier H. Prospective Associations of Childhood Housing Insecurity With Anxiety and Depression Symptoms During Childhood and Adulthood. JAMA Pediatr. 2023 Aug 1;177(8):818–826.

Published In

JAMA Pediatr

DOI

EISSN

2168-6211

Publication Date

August 1, 2023

Volume

177

Issue

8

Start / End Page

818 / 826

Location

United States

Related Subject Headings

  • Young Adult
  • Prospective Studies
  • Pediatrics
  • Male
  • Humans
  • Housing Instability
  • Female
  • Depression
  • Cohort Studies
  • Child