Gender differences in mental health after moving from poverty

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1. Adolescent boys have increased rates of depression, PTSD, and conduct disorder after moving out of poverty.

2. Adolescent girls have decreased rates of depression and conduct disorder after moving out of poverty.

Evidence Rating Level: 2 (Good)       

Study Rundown: Observational findings indicate that high-poverty neighborhoods adversely affect the mental health of adolescents, but the effects of housing interventions are unclear. This study evaluated the long-term effects of housing mobility on the mental health of adolescents after 10 to 15 years. Families in public or subsidized housing were randomized to move out of poverty (low-poverty voucher group), unrestricted areas (traditional voucher group), or had no intervention (controls). Boys in the low-poverty group experienced higher rates of major depression, PTSD, and conduct disorder compared to boys in the control group. Girls in the traditional voucher group experienced decreased rates of major depression and conduct disorder compared to girls in the control group.

Strengths of the study include the study design, longevity of follow-up time, and large sample size. The study was limited by the poor enrollment of families offered vouchers, no mental health evaluations of children at baseline, and inability to assess the change in magnitude of associations over time. Although further research is needed, the study hints the need to account for gender differences on mental health in adolescents when considering policy guidelines that target housing mobility.

Click to read the study in JAMA

Relevant Reading: Differential mental health effects of neighborhood relocation among youth in vulnerable families: results from a randomized trial.

In-Depth [randomized study]: 4604 families with 3689 children living in high-poverty public housing were randomized in The Moving to Opportunity Demonstration program into low-poverty (n=1430), traditional (n=1081), and control (n=1178) groups across 5 major cities. Children were 0 to 8 years old at the time of study implementation and 13 to 19 years old at the time of long-term follow-up. The most common disorders were intermittent explosive disorder, oppositional-defiant disorder, and major depressive disorder. Across both genders, the low-poverty group had significantly higher rates of PTSD compared to the control group. Boys in the low-poverty group compared to control group experienced 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]). Girls in the traditional group compared to control group experienced lower 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]).

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