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      Intimate Partner Violence, Economic Insecurity, and Health Outcomes Among American Indian and Alaska Native Men and Women: Findings From a National Sample

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          Abstract

          Limited data are available on experiences of intimate partner violence (IPV) and sexual violence (SV) and health outcomes among American Indian and Alaska Native (AIAN) populations. This study explores the relationship between IPV and SV, food insecurity, housing insecurity, healthcare access, and self-reported physical and mental health status in a nationally representative sample of AIAN adults ( N = 3,634). IPV and SV were associated with poorer physical and mental health at the bivariate level, but not in multivariate analyses. Economic inequalities are a salient predictor of health and may be compounded by demographic and geographic contexts.

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            The lasting impact of childhood health and circumstance.

            We quantify the lasting effects of childhood health and economic circumstances on adult health, employment and socioeconomic status, using data from a birth cohort that has been followed from birth into middle age. Controlling for parental income, education and social class, children who experience poor health have significantly lower educational attainment, poorer health, and lower social status as adults. Childhood health and circumstance appear to operate both through their impact on initial adult health and economic status, and through a continuing direct effect of prenatal and childhood health in middle age. Overall, our findings suggest more attention be paid to health as a potential mechanism through which intergenerational transmission of economic status takes place: cohort members born into poorer families experienced poorer childhood health, lower investments in human capital and poorer health in early adulthood, all of which are associated with lower earnings in middle age-the years in which they themselves become parents.
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              Housing instability and food insecurity as barriers to health care among low-income Americans.

              Homelessness and hunger are associated with poor health outcomes. Housing instability and food insecurity describe less severe problems securing housing and food. To determine the association between housing instability and food insecurity and access to ambulatory health care and rates of acute health care utilization. Secondary data analysis of the National Survey of American Families. 16,651 low-income adults. Self-reported measures of past-year access: (1) not having a usual source of care, (2) postponing needed medical care, or (3) postponing medication; and past-year utilization: (1) not having an ambulatory care visit, (2) having emergency department (ED) visits, or (3) inpatient hospitalization. 23.6% of subjects had housing instability and 42.7% had food insecurity. In multivariate logistic regression models, housing instability was independently associated with not having a usual source of care (adjusted odds ratio [AOR] 1.31, 95% confidence interval [CI] 1.08 to 1.59), postponing needed medical care (AOR 1.84, 95% CI 1.46 to 2.31) and postponing medications (AOR 2.16, 95% CI 1.70 to 2.74), increased ED use (AOR: 1.43, 95% CI 1.20 to 1.70), and hospitalizations (AOR 1.30, 95% CI 1.01 to 1.67). Food insecurity was independently associated with postponing needed medical care (AOR 1.74, 95% CI 1.38 to 2.21) and postponing medications (AOR 2.15, 95% CI 1.62 to 2.85), increased ED use (AOR 1.39, 95% CI 1.17 to 1.66), and hospitalizations (AOR 1.42, 95% CI 1.09 to 1.85). Housing instability and food insecurity are associated with poor access to ambulatory care and high rates of acute care. These competing life demands may lead to delays in seeking care and predispose to acute care.
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                Author and article information

                Contributors
                Journal
                Violence Against Women
                Violence Against Women
                SAGE Publications
                1077-8012
                1552-8448
                September 2023
                September 27 2022
                September 2023
                : 29
                : 11
                : 2060-2079
                Affiliations
                [1 ]School of Social Work, University of Michigan, Ann Arbor, MI, USA
                [2 ]Department of Criminal Justice and School of Social Work, University of Central Florida, Orlando, FL, USA
                [3 ]Center for Human Identification at the University of North Texas Health Science Center, Fort Worth, TX, USA
                [4 ]College of Health, University of Alaska Anchorage, Anchorage, AK, USA
                Article
                10.1177/10778012221127725
                f95889b5-12e6-4ef9-bb86-8468ab6f8578
                © 2023

                http://journals.sagepub.com/page/policies/text-and-data-mining-license

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