UMass Chan Affiliations
Center for Health Law and EconomicsDepartment of Quantitative Health Sciences
Department of Family Medicine and Community Health
Commonwealth Medicine
Document Type
Journal ArticlePublication Date
2019-01-01Keywords
pregnancyhomelessness
health risks
emergency shelters
mental illness
substance use disorders
pregnancy complications
Health conditions
Access and use
Drug use
Emergency departments
Behavioral health care
Depression
Health care providers
Medicaid
Medical education
Behavioral Medicine
Female Urogenital Diseases and Pregnancy Complications
Health Services Administration
Health Services Research
Maternal and Child Health
Mental Disorders
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Show full item recordAbstract
Homelessness during pregnancy poses significant health risks for mothers and infants. As health care providers increase their emphasis on social determinants of health, it is important to understand how unstable housing contributes to complications during pregnancy. We linked data about emergency shelter enrollees with Massachusetts Medicaid claims for the period January 1, 2008-June 30, 2015 to compare health care use and pregnancy complications for 9,124 women who used emergency shelter with those for 8,757 similar women who did not. Rates of mental illness and substance use disorders were significantly higher among homeless women. Adjusted odds of having nine pregnancy complications were also significantly higher for homeless women and remained substantially unchanged after we adjusted for behavioral health disorders. Emergency shelter users also had fewer ambulatory care visits and more months without billable care and were more likely to visit an emergency department. Homelessness and behavioral health disorders appear to be independent factors contributing to pregnancy complications and should be addressed simultaneously.Source
Clark RE, Weinreb L, Flahive JM, Seifert RW. Homelessness Contributes To Pregnancy Complications. Health Aff (Millwood). 2019 Jan;38(1):139-146. doi: 10.1377/hlthaff.2018.05156. PubMed PMID: 30615521.
DOI
10.1377/hlthaff.2018.05156Permanent Link to this Item
http://hdl.handle.net/20.500.14038/26988PubMed ID
30615521Related Resources
ae974a485f413a2113503eed53cd6c53
10.1377/hlthaff.2018.05156
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