Neighborhoods have a profound impact on healthy child development and well-being, particularly among Black and Latinx children and adolescents. Neighborhoods provide unique social and physical environments that impact child health by determining access to resources that are (or not) available to them. In the United States (US), neighborhoods have been structurally designed to restrict non-white racialized populations from upward mobility particularly through racist housing policies. The US has a long history of discriminatory housing policies and practices that have subsequently forced Black and Latinx families into precarious housing situations. Housing instability is prevalent among non-white racialized populations and has consequences for the health and well-being of children and adolescents. Using a Public Health Critical Race praxis framework, this dissertation examines how structural racism, defined and exhibited through historical and contemporary discriminatory housing policy, in the US affects neighborhood opportunities, housing instability, measured through residential mobility, and their association with health in children and adolescents who live in metropolitan areas. In study 1, I used the Delphi method to develop a framework exploring how structural racism influences neighborhood opportunities and the immediate factors that exist between these opportunities and healthy child development and well-being, particularly among Black children. Findings from the conceptual framework in study 1 emphasize the effects of structural racism and housing as an upstream determinant of health that influences child health and health inequities. To further examine some of the pathways between housing instability and child health, I used the Future of Families and Child Wellbeing dataset to investigate the associations between housing instability, gender, and internalizing and externalizing behaviors in children and adolescents, in study 2. Here I found that for every move a child experienced by ages 9 and 15 the standard deviation of their internalizing behavior scores increased, meaning children exhibited worse internal and external behaviors during this developmental period. Gender did not modify the association between residential mobility and internalizing and externalizing behaviors in children and adolescents. From here, to further explore the role of structural racism manifested through housing instability, using the same dataset as study 2, in study 3 I examined if race modifies the association between housing instability and internalizing externalizing behaviors in children and adolescents. Findings showed that race modified the association between residential mobility and child and adolescent behavior. Black and Hispanic/Latinx children exhibited fewer internalizing behaviors compared to white children. Finally, findings show that race did not modify the association between residential mobility and externalizing behaviors in children or adolescents. The research in this dissertation has important implications for future work in structural racism, housing instability, and child health inequities and well-being. Additionally, it emphasizes the importance of using the Public Health Critical Race praxis when exploring health inequities in racialized populations, particularly when it comes to the relationship between housing and child and adolescent health.PhDHealth Behavior & Health EducationUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/177895/1/kbess_1.pd
