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Newborns in Shelter
The Newborns in Shelter research project is a collaboration between the Mayor’s Office Center for Innovation through Data Intelligence (CIDI), Department of Health and Mental Hygiene (DOHMH), Department of Homeless Services (DHS), Department of Social Services (DSS), and Administration for Children’s Services (ACS). Using several sources of matched administrative data from 2008-2015, the team analyzed the characteristics and health of infants and of their mothers residing in NYC DHS shelters to examine birth outcomes and healthcare utilization for this population.
Each agency has its own role in the collaboration. CIDI acts as the clearinghouse for the research and convenes a multi-agency workgroup to review research questions and results to ensure action-oriented findings. CIDI also leads the analyses related to shelter utilization for parents and infants residing in shelter.
DOHMH’s Bureau of Epidemiology Services (BES) conducted the administrative data matching and also leads analyses regarding health outcomes for mothers and infants using Medicaid, hospital records, and Vital Statistics data. The Bureau of Maternal, Infant and Reproductive Health (BMIRH) within DOHMH collaborates on analyses and operates a number of home visiting programs for mothers and infants, including the Newborn Home Visiting Program that is specifically tailored for families living in DHS shelters. These analyses will inform the programming of the home visiting programs and the design of the evaluation of the New Family Home Visits Initiative, which is being conducted by BMIRH.
DHS has been working to understand patterns of shelter utilization and health outcomes for this population and to develop programming in shelters and other models to support their needs. This research will inform their ongoing work.
Our first brief from this dataset contributes to the understanding of the health of mothers and infants experiencing homelessness in NYC.
KEY TAKEAWAYS:
- Structural racism in the United States has resulted in inequities that disproportionately burden people of color, and particularly Black communities, with the experience of homelessness further impacting their health and well-being.
- Mothers who spent time in shelter while pregnant were slightly less likely to experience gestational diabetes and slightly more likely to experience gestational hypertension as compared to those in the NYC Medicaid and overall NYC populations.
- Mothers who spent time in shelter while pregnant were less likely to obtain on-time prenatal care than those in the Medicaid and overall NYC populations.
- Infants whose mothers spent time in shelter while pregnant were more likely to experience certain adverse birth outcomes, such as preterm birth, low birthweight, being small for gestational age and admission to the neonatal intensive care unit, as compared to those in the NYC Medicaid and overall NYC populations.
- Entering shelter earlier in pregnancy and having a longer and more continuous shelter stay were associated with higher rates of on-time prenatal care access and WIC enrollment.
- These findings are descriptive in nature and do not indicate whether or not shelter usage is the cause of adverse health outcomes for mothers and infants. We know many factors at the structural and individual level play role in health. Further analysis is needed to better understand how to support positive maternal and infant health outcomes among mothers in shelter in New York City.
These findings will be used to support the development and evaluation of NYC agency programs for mothers and infants accessing social services. It also will inform programs and policies focused on improving well-being and health outcomes among this population, such as the New Family Home Visits Initiative, Newborn Home Visiting Program, and Nurse-Family Partnership.
Work is underway to update analysis with more recent data including the years 2016-2021.
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