Program to move families out of high-poverty neighborhoods helps girls, harms boys’ mental health

A program designed to move families out of high-poverty neighborhoods resulted in reduced rates of depression and conduct disorder among girls, but increased rates of depression, post-traumatic stress disorder (PTSD) and conduct disorder among boys, according to a study published in the March 5 issue of JAMA.

Prof. Jens Ludwig, one of the study’s authors, said this was a follow-up long-term analysis of families participating in the Moving to Opportunity residential-mobility demonstration sponsored by the U.S. Department of Housing and Urban Development. Ludwig is the McCormick Foundation Professor of Social Service Administration, Law, and Public Policy at the University of Chicago; director of the UChicago Crime Lab; and co-director of the University of Chicago Urban Education Lab.

“The major surprise was the size of the findings,” Ludwig said. “Moving out of high-poverty areas had very different effects on boys and girls, and both effects are large. For boys, the increase in PTSD is comparable to what you see from combat exposure among military veterans, while the reduction in depression among girls is equally massive.”

Moving to Opportunity was designed to use housing vouchers to move families out of very distressed public housing projects into less disadvantaged neighborhoods with lower poverty and crime rates, with the goal of improving educational achievement and economic self-sufficiency. Between 1994 and 1998 the HUD program enrolled 4,604 volunteer low-income public housing families in five cities (Baltimore, Boston, Chicago, Los Angeles and New York) and randomly assigned some but not others to receive housing vouchers.

The follow-up evaluations were conducted 10 to 15 years later, which meant participants who were in early childhood at the time of the randomization were in adolescence when researchers were evaluating long-term associations of the housing mobility program with mental disorders. Ludwig’s co-researchers on the study include lead author Ronald C. Kessler from Harvard Medical School as well as other colleagues from Harvard, University of California-Irvine, the National Bureau of Economic Research and the Congressional Budget Office.

The researchers found that girls whose families had the chance to move through Moving to Opportunity had much lower rates of major depression compared to the control group (6.5 percent versus 10.9 percent) and conduct disorder (0.3 percent versus 2.9 percent). On the other hand, boys whose families had the chance to move through Moving to Opportunity had significantly elevated rates of major depression (7.1 percent vs. 3.5 percent) and elevated rates of PTSD (6.2 percent versus 1.9 percent, respectively) and conduct disorder (6.4 percent vs. 2.1 percent). 

“Qualitative evidence suggested these differences were due to girls profiting more than boys from moving to better neighborhoods because of sex differences in both neighborhood experiences and in the social skills needed to capitalize on new opportunities presented by their improved neighborhoods,” the study authors wrote.

For Ludwig, the study reinforces the need for scientific-based evidence for public policy decisions. “This work demonstrates that the effects of housing mobility interventions are more complicated than one might expect,” he said. “Equally important, the project shows the importance of the randomized experimental design of Moving to Opportunity for highlighting these effects, which had never before been detected by other research in this area.”