Gender and crime victimization modify neighborhood effects on adolescent mental health.
OBJECTIVE
Leverage an experimental study to determine whether gender or recent crime victimization modify the mental health effects of moving to low-poverty neighborhoods.


METHODS
The Moving to Opportunity (MTO) study randomized low-income families in public housing to an intervention arm receiving vouchers to subsidize rental housing in lower-poverty neighborhoods or to controls receiving no voucher. We examined 3 outcomes 4 to 7 years after randomization, among youth aged 5 to 16 years at baseline (n = 2829): lifetime major depressive disorder (MDD), psychological distress (K6), and Behavior Problems Index (BPI). Treatment effect modification by gender and family's baseline report of recent violent crime victimization was tested via interactions in covariate-adjusted intent-to-treat and instrumental variable adherence-adjusted regression models.


RESULTS
Gender and crime victimization significantly modified treatment effects on distress and BPI (P < .10). Female adolescents in families without crime victimization benefited from MTO treatment, for all outcomes (Distress B = -0.19, P = .008; BPI B = -0.13, P = .06; MDD B = -0.036, P = .03). Male adolescents in intervention families experiencing crime victimization had worse distress (B = 0.24, P = .004), more behavior problems (B = 0.30, P < .001), and nonsignificantly higher MDD (B = 0.022, P = .16) versus controls. Other subgroups experienced no effect of MTO treatment. Instrumental variable estimates were similar but larger.


CONCLUSIONS
Girls from families experiencing recent violent crime victimization were significantly less likely to achieve mental health benefits, and boys were harmed, by MTO, suggesting need for cross-sectoral program supports to offset multiple stressors.
Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, 360 Huntington Ave, Robinson 316, Boston, MA 02115, USA. tosypuk@neu.edu
Theresa L
TL
Osypuk
Nicole M
NM
Schmidt
Lisa M
LM
Bates
Eric J
EJ
Tchetgen-Tchetgen
Felton J
FJ
Earls
M Maria
MM
Glymour
D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D002675:Child, Preschool; D003415:Crime; D019548:Crime Victims / Q000523:psychology*; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D011204:Poverty Areas; D000297:Psychology, Adolescent; D011638:Public Housing; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology