Browsing by Author "Davis, Laurel"

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    Health and Care Utilization among Youth with a History of Parental Incarceration and Homelessness
    (Families, Systems, & Health, 2023-07-28) So, Marvin; Davis, Laurel; Barnes, Andrew; Freese, Rebecca; Atella, Julie; Shlafer, Rebecca
    Introduction. Despite widespread recognition of the health and social risks posed by parental incarceration and homelessness, these challenges are rarely considered in unison. We sought to (1) assess the experiences of homelessness among youth with and without a history of parental incarceration (PI), and (2) compare the health and health care utilization among youth with a combined history of PI and homelessness. Methods. Examining data from eighth, ninth, and eleventh grade public school participants in the 2019 Minnesota Student Survey (N=110,904), we calculated univariate and multivariate analyses to characterize the health status and care utilization of youth who have experienced PI, past-year homelessness, or both. Results. We observed higher prevalence of homelessness among youth with a history of PI compared to those without. The group with dual PI-homelessness experience had a higher proportion of youth that were younger, male, and non-white; and living in poverty or urban areas compared to youth with PI history only. Even after accounting for demographic factors, the dual PI-homelessness group evidenced higher expected odds for several physical health conditions (e.g., asthma, diabetes), and differences in care utilization indicators relative to individual PI and homelessness groups. Discussion. Findings suggest that PI may be over-represented among recently homeless youth and that youth with such dual experience possess distinct, and often elevated, health service needs. Health, education, housing, and other systems may need intersectoral strategies to better identify and support this at-risk subset of youth through clinical and policy approaches.
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    Positive Early Childhood Experiences and School Readiness among United States Preschoolers
    (Journal of Pediatrics, 2023-07-31) So, Marvin; Woodward, Krista P; Shlafer, Rebecca J; Testa, Alexander; Davis, Laurel; Jackson, Dylan B
    Objectives: To characterize the relationship between positive early childhood experiences (PECEs) and school readiness, and assess whether the PECEs-school readiness relationship was robust to and/or differed across levels of adverse childhood experiences (ACEs). Methods: We analyzed national data on children ages 3-5 from 2016-2020 (N = 26,871) to examine associations between key PECE domains (nurturing relationships, home learning opportunities, safe and stable environments, and family routines) with being on-track for school readiness, defined using a pilot, multidimensional measure called “Healthy and Ready to Learn.” Weighted univariate, bivariate, and multivariable analyses were conducted to generate nationally representative estimates. Multivariable models adjusted for sociodemographic factors and were assessed both with and without cumulative ACE exposure. Results: Two-fifths of children were healthy and ready to learn. Exposure to PECEs was associated with higher school readiness, irrespective of relative ACE exposure. Compared with those with low PECEs, children with moderate (adjusted odds ratio [aOR]: 2.19, 95% confidence interval [CI]: 1.86, 2.58) and high (aOR: 4.37, 95% CI: 3.58, 5.34) PECEs had greater odds for being healthy and ready to learn, net of both sociodemographic factors and ACE exposure. Significant associations were robust across demographic groups (eg, race and ethnicity), ACE levels, and ACE types (eg, parental incarceration). Conclusions: Increasing PECEs correspond with greater likelihood of possessing capacities key for school functioning, even amidst ACEs. In concert with efforts to ameliorate early life trauma, caregivers, health care providers, educators, and systems can consider boosting PECEs to foster healthy development in childhood and beyond.