Tatjana Meschede

Accessing Housing: Exploring the Impact of Medical and Substance Abuse Services on Housing Attainment for Chronically Homeless Street Dwellers

This mixed-methods study addresses transitions out of homelessness associated with medical and substance abuse service use for a unique cohort of 174 chronically homeless street dwellers at risk of death. Multi-nominal and survival analyses indicate that high-risk women, white street dwellers, older individuals, and those with health insurance coverage had greater odds of leaving the streets. Thouh high-risk street dwellers used health services extensively, medical and substance abuse treatments did not impact positive housing outcomes, except for extended stays at homeless respite care. Policy implications include the need for increasing affordable housing options and integrating housing services into any type of health services for chronically homeless street dwellers.

Post-Traumatic Stress Disorder in Adults with Serious Mental Illness and Substance Abuse

ABSTRACT Post-Traumatic Stress Disorder continues to be under-diagnosed among individuals with severe mental illness and substance abuse. In a convenience sample of 64 patients with severe mental disorders being treated at an urban outpatient clinic, 24% met full criteria for PTSD based upon a comprehensive assessment protocol while only 3% were diagnosed with PTSD by clinicians in the medical record (Cochrans Q = 11.267, df 1, p <.001). In contrast, there was a high rate of diagnostic agreement for psychotic and affective illnesses as well as substance abuse. More attention needs to be given to systematically assessing PTSD among severely mentally ill and dually diagnosed individuals because even highly skilled diagnosticians miss the complex presentation of symptoms with which these patients present for treatment.

The Widening Racial Wealth Gap: Why Wealth Is Not Color Blind

Researchers began to explore the wealth holdings of households by race in the mid-1980s, when data became available for the first time. The magnitude and implications of these early findings were shocking: most found that, on average, black households owned only a dime for each dollar of wealth owned by white households (Lui, Robles, and Leondar- Wright 2006). This difference was much larger than the prevailing income gap of 60 cents-to-the-dollar. More alarmingly, the racial wealth gap has increased further since it was first analyzed. Our analysis reveals an increase of

From Street Life to Housing: Consumer and Provider Perspectives on Service Delivery and Access to Housing

151,000 in the absolute racial wealth gap between 1984 and 2009. This chapter empirically examines the main reasons behind the rise in the racial wealth gap over the past 25 years, deepening the analytic and policy understanding and narrative required to effectively disrupt and reverse this trend.

Home for now: A mixed-methods evaluation of a short-term housing support program for homeless families.

The goal of this qualitative study was to demonstrate the achievements and failures of services that attempt to reach those most likely to be left out of the homeless-services delivery model - the chronically homeless street population. In 36 interviews with current and former chronically homeless street dwellers and the people who serve them, this study analyzed the service needs of chronically homeless street dwellers and the successes and failures of street-based medical and substance abuse services intersecting with the predominant continuum-of-care (CoC) model for homeless individuals, thus connecting chronically homeless street dwellers with services and housing. Using Grounded Theory as the guiding principle for analysis (Strauss and Corbin, 1998), the results of this study emphasize important differences between providers’ and consumers’ perceptions and theories on homelessness, service needs of homeless street dwellers, and service provision. Program and policy recommendations for ending chronic homelessness include the need to increase the affordable housing stock, enhance support systems for successful transition to housing and continuous support, and reduce bureaucratic barriers to housing.

“Family Achievements?”: How a College Degree Accumulates Wealth for Whites and Not For Blacks

The use of short-term rental subsidy vouchers offers a new approach to addressing the housing needs of families facing homelessness. In Massachusetts, the Family Home pilot program placed homeless families in housing instead of shelter, providing two years of rental subsidy plus support services with the goal of enabling families to maintain market rate housing. This mixed-method case study complements staff and participant interview data with participant survey and administrative data to evaluate the implementation and short-term outcomes of Family Home in one region. Data point to improved family well-being in housing but also persistent barriers to achieving longer-term housing and economic stability. Of the families who had exited the program at the end of the study, one quarter were able to retain their housing at market rate, only 9% returned to shelter, and one in five moved in with families/friends. Lack of affordable housing in a high rental cost region and jobs that pay living wages were among the major reasons that families struggled to maintain housing. This research points to the need for integrating supportive services from the programs start, including targeted workforce development, to plan for the end of the short-term rental subsidy.

Retirement Security for Households of Color: Disparities During the Lifecourse Compounded in Old Age

A college education has been linked to higher life-time earnings and better economic achievements, so the expectation would be that it is also linked to higher net wealth for everybody. However, recent analyses challenge this hypothesis and find that the expectation holds true for White college-educated households but not for Black college-educated households. To examine this finding further and investigate the role of family financial transfers in household net wealth, the authors perform a mixed-method study using data from the Panel Study of Income Dynamics for a 24-year period, 1989-2013, and qualitative data from the Institute on Assets and Social Policy Levering Mobility study. Their results confirm that White college-educated households amass wealth, whereas the wealth of their Black counterparts declines. The authors also estimate the impact of just inheritance or large financial gifts and find that they decrease the existing racial wealth gap by nearly

The Roots of the Widening Racial Wealth Gap: Explaining the Black-White Economic Divide

40,000, or 20 percent. Further analyses demonstrate that White college graduates are significantly and substantially more likely to provide and receive financial support for education and/or a home purchase, while Black college graduates are significantly more likely to financially support their parents. Multivariate regression analysis identifies receipt of financial support for education and a home purchase as a positive contributor to net wealth and financial help for parents as a negative contributor to net wealth, disadvantaging Black college-educated households, who are less likely to receive and more likely to give financial support. Longitudinal interview data collected in the Institute on Assets and Social Policy Leveraging Mobility study illustrate the mechanisms of family financial transfers and their relationship to wealth accumulation, contrasting the White and Black households’ experiences. The discussion underscores the need to better understand intergenerational wealth and wealth sharing within families when studying wealth outcomes and highlights the role of family financial wealth transfers in creating opportunities for those who benefit the most—mostly White college-educated households.

Distress, suicidal thoughts, and social support among homeless adults

The later stages in each person’s life depend on what came before, reflecting previous life events and experiences, both successes and challenges. This is true for all aspects of life from health to work, from social relations to economic security. But different groups in society experience these lifecourse realities rather differently. Race and ethnicity is one type of group association that plays a role in this process. In particular, elders of color, whose economic security is often threatened from an early age, find that those barriers are compounded in old age, frequently leading to substantial economic vulnerability in later life. Though seniors of color1 today have seen much progress toward increasing opportunity for minorities in their lifetimes due to laws that prohibit discrimination against people of color, significant economic disparities between white and non-white households remain. These disparities are especially notable for seniors because many of today’s older adults of color were born into a pre-Civil Rights US society characterized by explicit discrimination and racism that shaped the economic realities of their work lives.