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Thesis
The impact of pre-injury socioeconomic status on post-injury housing instability: a TBI model systems study
Master of Science (M.S.), Drexel University
Jun 2025
DOI:
https://doi.org/10.17918/00011027
Abstract
Housing instability is a significant public health issue that encompasses a range of inadequate living conditions, from marginal housing to complete homelessness. Individuals at greater risk for housing instability include those who have sustained a traumatic brain injury (TBI). TBI prevalence is disproportionately higher amongst those who are marginally housed and experiencing homelessness. The existing literature suggests that socioeconomic status (SES) can significantly impact post-TBI outcomes for survivors. However, limited research comprehensively examines the relationship between SES before injury and housing instability after injury. This retrospective study utilized data from the Traumatic Brain Injury Model Systems (TBIMS), and the Social Deprivation Index (SDI) to investigate the association between pre-injury SES and post-injury housing instability among TBI survivors. In addition, this study explored how age, race/ethnicity, and sex can influence housing instability outcomes. Results were as follows. A bivariate point-biserial correlation revealed that pre-injury SES was not significantly associated with post-injury housing instability, r(4,999) = .013, p = .182, 95% CI [−0.010, 1.000]. Similarly, in a weighted binary logistic regression model controlling for prior housing status and TBI severity, pre-injury SES was not a significant predictor, OR = 1.00, p = .965. Of the factors examined, prior housing was the strongest predictor. Individuals with prior unstable housing were more likely to experience post-injury housing instability, OR = 16.63, p < .001. For the demographic variables, chi-square tests showed that age group was the only demographic factor that was significantly associated with post-injury housing instability, [chi]²(2, N = 4,993) = 26.42, p < .001, with older adults (5.3%) and middle-aged adults (3.7%) experiencing higher rates of instability than young adults (2.4%). Race/ethnicity, [chi]²(4, N = 4,926) = 3.96, p = .411, and sex, [chi]²(1, N = 4,995) = 1.55, p = .213, were not significantly associated with post-injury housing outcomes. When a follow-up logistic regression analysis controlling for prior housing and TBI severity was completed, age remained a significant predictor. Middle-aged adults (OR = 1.70, p = .034) and older adults (OR = 2.72, p < .001) were more likely to experience housing instability relative to young adults. Although the hypothesized relationship between pre-injury SES and post-injury housing instability was not observed, the current study identified important demographic factors to be considered when supporting individuals following a TBI. Specifically, these results underscore the importance of prior housing history and age to post-injury housing outcomes. Taken together, the results identify important patient characteristics that may be important to consider when developing targeted interventions to support TBI survivors who are most at risk for poor outcomes, including housing instability.
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Details
- Title
- The impact of pre-injury socioeconomic status on post-injury housing instability
- Creators
- Kamaria Taara Tucker
- Contributors
- Nancy Raitano Lee (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Master of Science (M.S.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- viii, 39 pages
- Resource Type
- Thesis
- Language
- English
- Academic Unit
- Psychological and Brain Sciences (Psychology); College of Arts and Sciences; Drexel University
- Other Identifier
- 991022058937104721