Maternal Depression and Urban Homelessness

Homelessness is a significant and often glaring social problem in the United States, particularly in urban areas (Lee et al., 2010).  A 2012 point-in-time measure found over 600,000 homeless in the U.S., with individuals in families with children comprising 38% of the homeless (U.S. Department of Housing and Urban Development, 2011).  In 2011, over 500,000 individuals in families had used emergency housing at least once, representing an increase of almost 14% since 2007 (U.S. Department of Housing and Urban Development, 2011).  Although most homeless individuals are single male adults, children and families make up a larger percentage of homeless individuals today than in the past (Lee et al., 2010).

Numerous studies have found positive associations between mental illness and homelessness (Culhane et al., 2001; Boa et al., 2000; Fitzpatrick et al., 2007; Winkleby et al., 1992; Bassuk et al., 1997; Phinney et al., 2007) including some focusing on women with children.   Additionally, studies have found an increase in mental illness among homeless mothers in the 1980s and 1990s (Weinreb et al., 2006; North et al., 2004).

The data are clear that homelessness and mental illness are strongly associated.  However, the nature and direction of the links between these two psychosocial problems have not been established.  Recent studies provide important longitudinal evidence that mental illness predicts subsequent homelessness among poor families (Fertig & Reingold, 2008; Phinney et al., 2007), but it is very difficult to rule out that the observed associations reflect unobserved confounding factors.  In this study, we take an important step in elucidating the links between mental illness and homelessness by estimating  the effects of a mental illness that often comes as a shock and has known timing of onset—depression during the postpartum year—on subsequent homelessness in a national sample of urban, mostly low-income, childbearing women.

Using data from the Fragile Families and Child Wellbeing (FFCWB) Study, we estimate effects of postpartum depression on two measures of homelessness three years after the birth of the focal child. The FFCWB is a longitudinal study of births to mostly unmarried women in 20 U.S. cities, with the initial interviews conducted between 1998 to 2000 right after their children were born. We include measures from the medical records from the hospital of birth concerning prenatal mental and physical health of the mother, as well as health conditions of the newborn.  In addition, the FFCBW data allow us to include a rich set of covariates from the mothers’ interviews.  We use a variety of strategies to test for and address the potential endogeneity of postpartum depression.  Preliminary findings indicate that onset of depression during the postpartum year increases the likelihood that the family will become homeless within three years.