Homeless mentally ill veterans: Race, service use, and treatment outcomes.

Rosenheck, Robert A.; Leda, Catherine; Frisman, Linda K.; Gallup, Peggy

doi:10.1037/h0080260

Cited by 24 publications

(14 citation statements)

References 19 publications

(18 reference statements)

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“…Several studies, based on local samples or small longitudinal studies, have documented differences between racial groups of homeless adults with respect to both socio-demographic factors and behavioural problems. 7–10 For example, black homeless adults have been reported in some studies to be younger, less likely to be married or to have completed a high school diploma than white adults 7 ; while others suggest they have higher levels of drug abuse but lower rates of alcohol abuse or psychiatric problems. 8–10 No studies, however, have used nationally representative survey data to examine the differences between black adults with experiencing lifetime homelessness or not, and compare these to the differences observed between white adults with experiencing lifetime homelessness or not, a first step in identifying particular risk factors that can account for the high levels of lifetime homelessness among black adults.…”

Section: Introductionmentioning

confidence: 99%

Why are black adults over-represented among individuals who have experienced lifetime homelessness? Oaxaca-Blinder decomposition analysis of homelessness among US male adults

Rhee

Rosenheck

2020

J Epidemiol Community Health

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BackgroundNon-Hispanic black adults experience homelessness at higher rates than non-Hispanic white adults in many studies. We aim to identify factors that could account for this disparity.MethodsWe used national survey data on non-Hispanic black and white men with complete data from the National Epidemiological Survey on Alcohol and Related Conditions Wave III. Using the Oaxaca-Blinder decomposition analysis, we examined race-based disparities in correlates of risk for lifetime homelessness.ResultsIn our analysis, 905 of 11 708 (7.7%) respondents, representing 6 million adults nationwide, reported lifetime homelessness. Black adults were 1.41 times more likely to have been homeless than white adults (95% CI 1.14 to 1.73; p=0.002). Overall, 81.6% of race-based inequality in lifetime homelessness were explained by three main variables with black adults having: lower incomes, greater incarceration histories since age of 18 and a greater risk of traumatic events (p<0.01 for each). They also had more antisocial personality disorder, younger age and parental drug use (p<0.05 for each).ConclusionAlthough previous studies suggested that black homeless men have higher rates of drug abuse than white homeless men, our findings highlight the fact that black–white disparities in lifetime homeless risk are associated with socio-structural factors (eg, income and incarceration) and individual adverse events (eg, traumatic events), and not associated with psychiatric or substance use disorders.

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Section: Introductionmentioning

confidence: 99%

Why are black adults over-represented among individuals who have experienced lifetime homelessness? Oaxaca-Blinder decomposition analysis of homelessness among US male adults

Rhee

Rosenheck

2020

J Epidemiol Community Health

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“…Hispanic incarcerated veterans were more likely to be chronically homeless than those in other ethnic groups (Tsai, Rosenheck, Kasprow, & McGuire, 2013 [n ¼ 30,834]). Black homeless, mentally ill veterans had more felony arrests than white homeless, mentally ill veterans (Rosenheck et al, 1997 [n ¼ 381]). Non-white youth more likely than white youth to be arrested for a more serious offense; white females more likely than non-white females to be arrested for a less serious offense (Yoder, Muñoz, Whitbeck, Hoyt, & McMorris, 2005 [n ¼ 602]).…”

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confidence: 99%

Does Race Matter in Addressing Homelessness? A Review of the Literature

Jones¹

2016

World Medical &Amp; Health Policy

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Since the 1980s, black persons have been overrepresented in the United States homeless population. Given that morbidity and mortality is elevated among both the black population and the homeless population in comparison to the general U.S. population, this overrepresentation has important implications for health policy. However, the racial demographics of homelessness have received little attention from policymakers. This article reviews published social and behavioral science literature that addresses the relationship between race and contemporary homelessness in the United States. This literature points to substantial differences between racial subgroups of the U.S. homeless population in vulnerabilities, health risks, behaviors, and service outcomes. Such observed differences suggest that policies and programs to prevent and end homelessness must explicitly consider race as a factor in order to be of maximum effectiveness. The limited scope of these findings also suggests that more research is needed to better understand these differences and their implications.

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“…Studies that only examined the relation between patient characteristics and outcome, with no direct comparison between competing treatments or health policy strategies (e.g. Rosenheck et al, 1997), were excluded, as were reports of routine outcomes measurement in practice, with no direct report of comparative service or treatment evaluations based on the data.…”

Section: Methodsmentioning

confidence: 99%