Amy Dworsky

Homelessness During the Transition From Foster Care to Adulthood

OBJECTIVES We estimated the incidence of homelessness during the transition to adulthood and identified the risk and protective factors that predict homelessness during this transition. METHODS Using data from the Midwest Evaluation of the Adult Functioning of Former Foster Youth, a longitudinal study of youths aging out of foster care in 3 Midwestern states, and a bounds approach, we estimated the cumulative percentage of youths who become homeless during the transition to adulthood. We also estimated a discrete time hazard model that predicted first reported episode of homelessness. RESULTS Youths aging out of foster care are at high risk for becoming homeless during the transition to adulthood. Between 31% and 46% of our study participants had been homeless at least once by age 26 years. Running away while in foster care, greater placement instability, being male, having a history of physical abuse, engaging in more delinquent behaviors, and having symptoms of a mental health disorder were associated with an increase in the relative risk of becoming homeless. CONCLUSIONS Policy and practice changes are needed to reduce the risk that youths in foster care will become homeless after aging out.

Homeless Spell Exits and Returns: Substantive and Methodological Elaborations on Recent Studies

This article builds upon a series of recent studies that have examined exits from and returns to homelessness. The data come from a three‐wave panel study of homeless persons. The articles major substantive concern is the relationship between the type of housing situations to which homeless persons move upon exiting homeless spells and their likelihood of becoming homeless again. The issue of selection bias due to sample attrition, a serious methodological problem common to longitudinal research, is also addressed.

Barriers to Employment Among TANF Applicants and Their Consequences for Self-Sufficiency

This article examines the prevalence of potential barriers to employment using data from a longitudinal study of 1,075 Milwaukee County parents who applied for assistance from Wisconsins TANF program in 1999. It also examines whether those potential barriers were related to their subsequent employment and earnings. We find that many of these TANF applicants faced significant and often multiple barriers to employment. Moreover, these potential barriers were associated with both a reduction in their likelihood of being employed and lower earnings when they worked. The implications of these findings for welfare policy and practice are discussed.

Involvement of TANF Applicant Families with Child Welfare Services

Few studies examine the relationship between welfare and child welfare populations in the wake of welfare reform. This article compares child welfare services involvement between 1996 Aid to Families with Dependent Children entrants and 1999 Temporary Assistance for Needy Families (TANF) applicants in Wisconsin. Results suggest that there is considerable overlap between welfare applicant and child welfare populations, that this overlap has increased significantly since welfare reform, and that, as state TANF caseloads decline, they may be increasingly composed of families that face significant problems in balancing the demands of work and parenting.

Child welfare services involvement among the children of young parents in foster care

Despite the high rate of early parenthood among youth in foster care as well as the increased risk of child maltreatment among children whose adolescent parents have been neglected or abused, very little is known about child welfare services involvement among children whose parents were in foster care when they were born. This study uses administrative data from the Illinois Department of Children and Family Services (DCFS) to examine the occurrence of child abuse and neglect investigations, indicated reports and out of home care placements among the children of youth in foster. Thirty-nine percent of the children were the subject of at least one CPS investigation, 17 percent had at least one indicated report and 11 percent were placed in out of home care at least once before their 5th birthday. Cox proportional hazard models are also estimated to identify characteristics of parenting foster youth and their placement histories associated with the risk of child welfare services involvement. Implications of the findings for policy and practice are discussed.

Prevalence and Correlates of Youth Homelessness in the United States

Purpose Unaccompanied youth homelessness is a serious concern. Response, however, has been constrained by the absence of credible data on the size and characteristics of the population and reliable means to track youth homelessness over time. We sought to address these gaps. Methods Using a nationally representative phone-based survey (N = 26,161), we solicited household and individual reports on different types of youth homelessness. We collected household reports on adolescents aged 13–17 and young adults aged 18–25, as well as self-reports from young adults aged 18–25. Follow-up interviews with a subsample (n = 150) provided additional information on youth experiences and enabled adjustment for inclusion errors. Results Over a 12-month period, approximately 3.0% of households with 13- to 17-year-olds reported explicit youth homelessness (including running away or being asked to leave) and 1.3% reported experiences that solely involved couch surfing, resulting in an overall 4.3% household prevalence of any homelessness, broadly defined. For 18- to 25-year-olds, household prevalence estimates were 5.9% for explicitly reported homelessness, 6.6% for couch surfing only, and 12.5% overall. The 12-month population prevalence estimates, available only for 18- to 25-year-olds, were 5.2%, 4.5%, and 9.7%, respectively. Incidence rates were about half as high as prevalence rates. Prevalence rates were similar across rural and nonrural counties. Higher risk of homelessness was observed among young parents; black, Hispanic, and lesbian, gay, bisexual, or transgender (LGBT) youth; and those who did not complete high school. Conclusions The prevalence and incidence of youth homelessness reveal a significant need for prevention and youth-centric systems and services, as well as strategies to address disproportionate risks of certain subpopulations.

Health Insurance Coverage and Use of Family Planning Services among Current and Former Foster Youth: Implications of the Health Care Reform Law

This research uses data from a longitudinal study to examine how two provisions in the Patient Protection and Affordable Care Act could affect health insurance coverage among young women who have aged out of foster care. It also explores how allowing young people to remain in foster care until age twenty-one affects their health insurance coverage, use of family planning services, and information about birth control. We find that young women are more likely to have health insurance if they remain in foster care until their twenty-first birthday and that having health insurance is associated with an increase in the likelihood of receiving family planning services. Our results also suggest that many young women who would otherwise lack health insurance after aging out of foster care will be eligible for Medicaid under the health care reform law. Because having health insurance is associated with use of family planning services, this increase in Medicaid eligibility may result in fewer unintended pregnancies among this high-risk population.

Psychosocial Pathways to Sexually Transmitted Infection Risk Among Youth Transitioning Out of Foster Care: Evidence From a Longitudinal Cohort Study

PURPOSE To test the fit of a theoretically driven conceptual model of pathways to sexually transmitted infection (STI) risk among foster youth transitioning to adulthood. The model included (1) historical abuse and foster care experiences; (2) mental health and attachment style in late adolescence; and (3) STI risk in young adulthood. METHODS We used path analysis to analyze data from a longitudinal study of 732 youth transitioning out of foster care. Covariates included gender, race, and an inverse probability weight. We also performed moderation analyses comparing models constrained and unconstrained by gender. RESULTS Thirty percent reported they or a partner had been diagnosed with an STI. Probability of other measured STI risk behaviors ranged from 9% (having sex for money) to 79% (inconsistent condom use). Overall model fit was good (Standardized Root Mean Square Residual of .026). Increased risk of oppositional/delinquent behaviors mediated an association between abuse history and STI risk, via increased inconsistent condom use. There was also a borderline association with having greater than five partners. Having a very close relationship with a caregiver and remaining in foster care beyond age 18 years decreased STI risk. Moderation analysis revealed better model fit when coefficients were allowed to vary by gender versus a constrained model, but few significant differences in individual path coefficients were found between male and female-only models. CONCLUSIONS Interventions/policies that (1) address externalizing trauma sequelae; (2) promote close, stable substitute caregiver relationships; and (3) extend care to age 21 years have the potential to decrease STI risk in this population.

Applicants' Understanding of Wisconsin's TANF Program and Its Relationship to Other Programs for Low Income Families

Abstract This paper uses data from the Milwaukee TANF Applicant Study to examine what a sample of 1,075 TANF applicants from Milwaukee County knew about Wisconsins TANF program and its relationship to other programs for low-income families. The data suggest that there were significant gaps in knowledge about the program both at the time of application and approximately 18 months later. Although there was a positive relationship between knowledge about the program and participation, even those who participated in the program were frequently confused. This confusion could also account for some of the discrepancies we found when we compared applicant self-reports to State administrative data.