| Literature DB >> 33920892 |
Charvonne N Holliday1,2, Kristin Bevilacqua1, Karen Trister Grace1,3, Langan Denhard4, Arshdeep Kaur1, Janice Miller5, Michele R Decker1,6.
Abstract
Survivors' considerations for re-housing following intimate partner violence (IPV) are understudied despite likely neighborhood-level influences on women's safety. We assess housing priorities and predictors of re-housing location among recent IPV survivors (n = 54) in Rapid Re-housing (RRH) in the Baltimore-Washington Metropolitan Area. Choropleth maps depict residential location relative to census tract characteristics (neighborhood deprivation index (NDI) and residential segregation) derived from American Community Survey data (2013-2017). Linear regression measured associations between women's individual, economic, and social factors and NDI and segregation. In-depth interviews (n = 16) contextualize quantitative findings. Overall, survivors re-housed in significantly more deprived and racially segregated census tracts within their respective regions. In adjusted models, trouble securing housing (B = 0.74, 95% CI: 0.13, 1.34), comfortability with proximity to loved ones (B = 0.75, 95% CI: 0.02, 1.48), and being unsure (vs unlikely) about IPV risk (B = -0.76, 95% CI: -1.39, -0.14) were significantly associated with NDI. Economic dependence on an abusive partner (B = -0.31, 95% CI: -0.56, -0.06) predicted re-housing in segregated census tracts; occasional stress about housing affordability (B = 0.39, 95% CI: 0.04, 0.75) predicted re-housing in less segregated census tracts. Qualitative results contextualize economic (affordability), safety, and social (familiarity) re-housing considerations and process impacts (inspection delays). Structural racism, including discriminatory housing practices, intersect with gender, exacerbating challenges among survivors of severe IPV. This mixed-methods study further highlights the significant economic tradeoffs for safety and stability, where the prioritization of safety may exacerbate economic devastation for IPV survivors. Findings will inform programmatic policies for RRH practices among survivors.Entities:
Keywords: health consequences; homeless persons; housing insecurity; housing instability; intimate partner violence; neighborhood deprivation; rapid rehousing; residential segregation; social determinants of health
Mesh:
Year: 2021 PMID: 33920892 PMCID: PMC8071223 DOI: 10.3390/ijerph18084177
Source DB: PubMed Journal: Int J Environ Res Public Health ISSN: 1660-4601 Impact factor: 3.390
Figure 1Hypothesized pathways among broad social and structural factors, environmental conditions, and housing outcomes among recent IPV survivors. Adapted from Massey, 1999 [15].
Characteristics of female housing intervention participants, recent intimate partner violence (IPV) survivors, in the Baltimore-Washington Metropolitan Areas, n = 54.
| % ( | |
|---|---|
| DEMOGRAPHIC CHARACTERISTICS | |
| Age | |
| Less than 35 years | 63 (34) |
| 35 years or older | 37 (20) |
| Race | |
| White | 2 (1) |
| Black | 76 (41) |
| Hispanic | 7 (4) |
| Asian/Other | 6 (3) |
| Multiracial | 9 (5) |
| ECONOMIC CHARACTERISTICS | |
| Education | |
| Some HS | 7 (4) |
| HS Graduate | 35 (19) |
| At least some college | 57 (31) |
| Income | |
| $0–$16,000 | 33 (17) |
| $16,001–$24,000 | 29 (15) |
| $24,001–$32,000 | 13 (7) |
| $32,001 or more | 25 (13) |
| Past month employment (Yes) | 65 (35) |
| Financial ability | |
| Meets needs independently | 6 (3) |
| Meets needs with assistance | 47 (25) |
| Partially meets needs with assistance | 38 (20) |
| Cannot meet needs | 9 (5) |
| Food stress | |
| Always or usually | 40 (21) |
| Sometimes | 28 (15) |
| Rarely/never | 32 (17) |
| Economically dependent on partner | 57 (31) |
| HOUSING CHARACTERISTICS | |
| Trouble getting housing, past 3 m | 59 (29) |
| Recent difficulty with landlord | 23 (12) |
| Housing affordability stress | |
| Always | 59 (31) |
| Sometimes | 28 (15) |
| Rarely/Never | 13 (7) |
| HEALTH CHARACTERISTICS | |
| PTSD Symptoms | 78 (42) |
| Unable to access necessary healthcare, past 12 m | 17 (9) |
| Depression symptoms | 39 (21) |
| SOCIAL/COMMUNITY CONTEXT | |
| Intimate partner violence, past 3 m | 54 (28) |
| Feels safe at home | 87 (47) |
| Co-parenting with abusive partner | 70 (38) |
| Comfortable with proximity to family/friends | 58 (31) |
| Comfortable with proximity to abuser | 72 (38) |
Neighborhood deprivation index by individual, interpersonal, economic, and social factors among female housing intervention participants, recent IPV survivors, Baltimore, Maryland, and District of Columbia Metropolitan Areas, n = 54. Bold text signifies statistical significance.
| Neighborhood Deprivation Index | ||||
|---|---|---|---|---|
| % ( | M (SD) | Unadjusted | Adjusted | |
| Range across four regions (847 census tracts) | - | - | −1.25, 4.30 | - |
| Range across sample (43 census tracts) | - | - | −0.88, 3.53 | - |
| Demographic Characteristics | ||||
| Age (ref: <35 years) | 63 (34) | 1.00 (1.09) | - | - |
| 35 years or older | 37 (20) | 1.04 (1.24) | 0.04 (−0.62, 0.71) | - |
| Race | - | - | 0.20 (−0.55, 0.15) | - |
| Black | 76 (41) | 1.15 (1.13) | - | - |
| White | 2 (1) | 1.24 (.) | - | - |
| Hispanic | 7 (4) | 0.36 (0.88) | - | - |
| Asian/other | 6 (3) | 0.04 (1.04) | - | - |
| Multiracial | 9 (5) | 0.92 (1.42) | - | - |
| Economic Demographic Characteristics | ||||
| Education (Ref: At least some college) | 57 (31) | 0.91 (1.17) | - | - |
| Some HS | 7 (4) | 0.59 (1.24) | −0.32 (−1.51, 0.87) | - |
| HS Graduate | 35 (19) | 1.26 (1.08) | 0.35 (−0.30, 1.00) | - |
| Income (Ref: $0–$16,000) | 33 (17) | 2.00 (1.17) | - | - |
| $16,001–$24,000 | 29 (15) | 1.07 (1.14) | −0.13 (−0.96, 0.70) | −0.12 (−1.06, 0.81) |
| $24,001–$32,000 | 13 (7) | 1.50 (1.26) | 0.30 (−0.79, 1.39) | 0.30 (−0.77, 1.37) |
| $32,001 or more | 25 (13) | 0.24 (0.51) |
| −0.46 (−1.30, 0.38) |
| Past month employment (Yes) | 65 (35) | 1.03 (1.21) | 0.06 (−0.56, 0.68) | - |
| Financial Ability (Ref: Cannot meet needs) | 9 (5) | 0.04 (0.96) | - | - |
| Meets needs independently | 6 (3) | 1.16 (0.46) |
| 0.88 (−0.87, 2.63) |
| Meets needs with assistance | 47 (25) | 0.99 (1.11) |
| 0.82 (−0.70, 2.34) |
| Partially meets needs with assistance | 38 (20) | 1.15 (1.14) |
| 0.81(−0.82, 2.44) |
| Economically dependent on partner | 57 (31) | 1.23 (1.29) | 0.52 (−0.06, 1.10) * | 0.31 (−0.25, 0.88) |
| Food stress (Ref: Always) | 40 (21) | 1.11 (1.35) | - | - |
| Sometimes | 28 (15) | 0.78 (0.90) | −0.33 (−1.08, 0.43) | - |
| Rarely/never | 32 (17) | 0.96 (0.95) | −0.15 (−0.91, 0.60) | - |
| Housing Characteristics | ||||
| Trouble getting housing, past 3 m | 59 (29) | 1.30 (1.28) |
|
|
| Recent difficulty with landlord | 23 (12) | 1.14 (1.57) | 0.17 (−0.77, 1.11) | - |
| Housing affordability stress (Ref: Always) | 59 (31) | 1.00 (1.17) | - | - |
| Sometimes | 28 (15) | 0.78 (1.10) | −0.22(−0.93, 0.49) | - |
| Rarely/never | 13 (7) | 1.23 (0.79) | 0.23 (−0.48, 0.95) | - |
| Social/Community Context | ||||
| Feels safe at home | 87 (47) | 1.07 (1.10) | 0.45 (−0.61, 1.52) | - |
| Child(ren) with abusive partner | 70 (38) | 0.91 (1.11) | −0.33 (−1.03, 0.36) | - |
| Comfortable with proximity to family/friends | 58 (31) | 1.24 (1.00) | 0.58 (−0.06, 1.22) * |
|
| Comfortable with proximity to abuser | 72 (38) | 1.12 (1.11) | 0.44 (−0.26, 1.16) | - |
| Social cohesion (Ref: Neutral) | 50 (27) | 0.84 (0.99) | - | - |
| Yes | 39 (21) | 1.21 (1.32) | 0.38 (−0.33, 1.078) | - |
| No | 11 (6) | 1.01 (1.09) | 0.24 (−0.68, 1.16) | - |
| Intimate Partner Violence, past 3 m | 54 (28) | 1.12 (1.11) | 0.23 (−0.42, 0.87) | - |
| Perceived risk of IPV, next 3 m (Ref: Unlikely) | 69 (37) | 1.20 (1.17) | - | - |
| Unsure | 24 (13) | 0.61 (0.91) | −0.59 (−1.22, 0.05) * |
|
| Likely | 7 (4) | 0.55 (1.30) | −0.65 (−1.84, 0.54) | −0.40 (−1.46, 0.66) |
| Constant | - | - | - | −0.59 (−2.30, 1.12) |
* p < 0.10, ** p < 0.05.
Residential segregation by individual, interpersonal, economic, and social factors among female housing intervention participants, recent IPV survivors, Baltimore, Maryland, and District of Columbia Metropolitan Areas, n = 54. Bold text signifies statistical significance.
| Residential Segregation | ||||
|---|---|---|---|---|
| % ( | M (SD) | Unadjusted | Adjusted | |
| Range across four regions (847 census tracts) | - | - | 0.99, −1 | - |
| Range across sample (43 census tracts) | - | - | 0.66, −1 | - |
| Demographic Characteristics | ||||
| Age (ref: <35 years) | 63 (34) | −0.53 (0.48) | - | - |
| 35 years or older | 37 (20) | −0.49 (0.51) | 0.05 (−0.22, 0.33) | - |
| Race | - | - | - | - |
| Black | 76 (41) | −0.59 (0.46) | - | - |
| White | 2 (1) | −0.43 (.) | - | - |
| Hispanic | 7 (4) | −0.09 (0.68) | - | - |
| Asian/other | 6 (3) | −0.27 (0.25) | - | - |
| Multiracial | 9 (5) | −0.42 (0.57) | - | - |
| Economic Demographic Characteristics | ||||
| Education (Ref: At least some college) | 57 (31) | −0.43 (0.48) | - | - |
| Some HS | 7 (4) | −0.73 (0.30) | −0.30 (−0.62, 0.02) * |
|
| HS Graduate | 35 (19) | −0.61 (0.51) | −0.19 (−0.48, 0.10) | −0.26 (−0.57, 0.04) * |
| Income (Ref: $0–$16,000) | 33 (17) | −0.44 (0.62) | - | - |
| $16,001–$24,000 | 29 (15) | −0.47 (0.48) | −0.04 (−0.42, 0.36) | 0.01 (−0.36, 0.37) |
| $24,001–$32,000 | 13 (7) | −0.80 (0.14) |
| −0.32 (−0.67, 0.02) * |
| $32,001 or more | 25 (13) | −0.48 (0.41) | −0.05 (−0.43, 0.33) | −0.09 (−0.49, 0.31) |
| Past month employment (Yes) | 65 (35) | −0.52 (0.45) | −0.01 (−0.30, 0.29) | |
| Financial Ability (Ref: Cannot meet needs) | 9 (5) | −0.39 (0.47) | - | |
| Meets needs independently | 6 (3) | −0.82 (0.11) |
| −0.46 (−1.16, 0.25) |
| Meets needs with assistance | 47 (25) | −0.46 (0.53) | −0.07 (−0.52, 0.38’) | −0.22 (−0.72, 0.27) |
| Partially meets needs with assistance | 38 (20) | −0.55 (0.46) | −0.15 (−0.60, 0.29) | −0.31 (−0.80, 0.19) |
| Economically dependent on partner | 57 (31) | −0.61 (0.43) | −0.23 (−0.50, 0.03) * |
|
| Food stress (Ref: Always) | 40 (21) | −0.60 (0.41) | - | |
| Sometimes | 28 (15) | −0.36 (0.58) | 0.24 (−0.11, 0.59) | - |
| Rarely/never | 32 (17) | −0.52 (0.47) | 0.08 (−0.21, 0.37) | - |
| Housing Characteristics | ||||
| Trouble getting housing, past 3 m | 59 (29) | −0.53 (0.52) | −0.05 (−0.33, 0.23) | - |
| Recent difficulty with landlord | 23 (12) | −0.59 (0.32) | −0.11 (−0.36, 0.13) | - |
| Housing affordability stress (Ref: Always) | 59 (31) | −0.57 (0.44) | - | - |
| Sometimes | 28 (15) | −0.28 (0.57) | 0.29 (−0.05, 0.63) * |
|
| Rarely/never | 13 (7) | −0.69 (0.32) | −0.12 (−0.40, 0.17) | −0.07 (−0.47, 0.31) |
| Social/Community Context | ||||
| Feels safe at home | 87 (47) | −0.54 (0.46) | −0.21 (−0.67, 0.24) | - |
| Child(ren) with abusive partner | 70 (38) | −0.51 (0.49) | 0.02 (−0.27, 0.31) | - |
| Comfortable with proximity to family/friends | 58 (31) | −0.60 (0.45) | −0.23 (−0.49, 0.05) | - |
| Comfortable with proximity to abuser | 72 (38) | −0.55 (0.42) | −0.15 (−0.50, 0.20) | - |
| Social cohesion (Ref: Neutral) | 50 (27) | 0.52 (0.52) | - | - |
| Yes | 39 (21) | −0.48 (0.44) | 0.05 (−0.23, 0.33) | - |
| No | 11 (6) | −0.61 (0.52) | −0.08 (−0.53, 0.37) | - |
| Intimate Partner Violence, past 3 m | 54 (28) | −0.55 (0.45) | −0.11 (−0.38, 0.17) | - |
| Perceived risk of IPV, next 3 m (Ref: Unlikely) | 69 (37) | −0.57 (0.43) | - | - |
| Unsure | 24 (13) | 0.37 (0.63) | 0.20 (−0.18, 0.57) | - |
| Likely | 7 (4) | −0.46 (0.39) | 0.11 (−0.27, 0.49) | - |
| Constant | - | - | - | 0.01 (−0.60, 0.62) |
* p < 0.10, ** p < 0.05.
Figure 295% confidence intervals for mean neighborhood deprivation index (NDI) and residential segregation, comparing region-wide means and region-specific census tracts of the study sample (recently re-housed IPV survivors). N represents the number of census tracts in each location. * mean difference between the full region and study sample is statistically significant at p < 0.05.
Figure 3Spatial distribution of recently housed IPV survivors in Rapid Re-Housing by neighborhood deprivation and residential segregation quintiles. High residential segregation reflects a high concentration of Black residents relative to White, whereas low residential segregation reflects a high concentration of White residents relative to Black.