Prevalence of Food and Housing Insecurity among Direct Support Professionals in New York

Background. Low earnings are associated with household insecurity. Direct Support Professionals (DSPs) provide support for people with intellectual and developmental disabilities, typically for wages close to state minimums, and may experience insecurity. Objective. The purpose of the study was to evaluate the prevalence of food and housing insecurity among DSPs. Methods. We conducted a statewide, cross-sectional survey of DSPs in New York State (2022-2023). Measures included detailed questions about food and housing insecurity. We used chi-square analyses and logistic regressions to examine relationships between insecurity and demographic characteristics as proxies for social determinants of health. A total of 4,503 DSPs responded to the survey. The analytic sample contained 2,766 respondents with complete data for all relevant variables. Results. Overall, 62.6% experienced food and/or housing insecurity, with over half of those respondents experiencing both. Insecurity was highest among DSPs with a disability (76.2%), DSPs of color (75.7%), and those with lower income (72.4%), but over 50% of DSPs across demographic groups experienced insecurity. Conclusions. The widespread insecurity this study demonstrates is an occupational hazard that reduces worker welfare. At the macro-level, household insecurity is a critical threat to the stability of the care and support delivery system. The human services sector is projected to grow rapidly in the future. If growth continues along low wage lines, it implies an equally rapid expansion of worker insecurity. Government action to raise pay and interventions that enhance food and housing security are needed to support workers in the care delivery system for people with intellectual and developmental disabilities.