Predictors of Reported Current and Lifetime Substance Abuse Problems Among a National Sample of U.S. Homeless

Dietz, Tracy L.

doi:10.1080/10826080701212360

Cited by 19 publications

(13 citation statements)

References 27 publications

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“…The current study provides a comprehensive perspective of homelessness in an older adult population by including recruiting venues through which homeless people transition. Because Oakland has a higher proportion of African-Americans than the country as a whole, our sample has a larger proportion of African-Americans (Dietz, 2007; Hahn et al, 2006; Kushel et al, 2002), although the relative proportions (3–4 times the general population of the region) are similar. Similar to other studies of older homeless adults, we found a higher rate of chronic illness (Hahn et al, 2006), cognitive impairments (Buhrich et al, 2000; Fischer et al, 1986), and a lower rate of active illicit drug use than younger samples (Gelberg et al, 1990).…”

Section: Discussionmentioning

confidence: 99%

Residential patterns in older homeless adults: Results of a cluster analysis

Lee

Guzman

Ponath

et al. 2016

Social Science & Medicine

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Adults aged 50 and older make up half of individuals experiencing homelessness and have high rates of morbidity and mortality. They may have different life trajectories and reside in different environments than do younger homeless adults. Although the environmental risks associated with homelessness are substantial, the environments in which older homeless individuals live have not been well characterized. We classified living environments and identified associated factors in a sample of older homeless adults. From July 2013 to June 2014, we recruited a community-based sample of 350 homeless men and women aged fifty and older in Oakland, California. We administered structured interviews including assessments of health, history of homelessness, social support, and life course. Participants used a recall procedure to describe where they stayed in the prior six months. We performed cluster analysis to classify residential venues and used multinomial logistic regression to identify individual factors prior to the onset of homelessness as well as the duration of unstable housing associated with living in them. We generated four residential groups describing those who were unsheltered (n=162), cohabited unstably with friends and family (n=57), resided in multiple institutional settings (shelters, jails, transitional housing) (n=88), or lived primarily in rental housing (recently homeless) (n=43). Compared to those who were unsheltered, having social support when last stably housed was significantly associated with cohabiting and institution use. Cohabiters and renters were significantly more likely to be women and have experienced a shorter duration of homelessness. Cohabiters were significantly more likely than unsheltered participants to have experienced abuse prior to losing stable housing. Pre-homeless social support appears to protect against street homelessness while low levels of social support may increase the risk for becoming homeless immediately after losing rental housing. Our findings may enable targeted interventions for those with different manifestations of homelessness.

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Section: Discussionmentioning

confidence: 99%

Residential patterns in older homeless adults: Results of a cluster analysis

Lee

Guzman

Ponath

et al. 2016

Social Science & Medicine

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“…Most health problems are distributed unevenly within the homeless population (see, e.g., Dietz 2007, Lee & Greif 2008). Problems that vary by race, gender, or age in housed samples usually do so among the homeless.…”

Section: Life Chancesmentioning

confidence: 99%

The New Homelessness Revisited

2010

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The ‘new homelessness’ has drawn sustained attention from scholars over the past three decades. Definitional inconsistencies and data limitations rendered early work during this period largely speculative in nature. Thanks to conceptual, theoretical, and methodological progress, however, the research literature now provides a fuller understanding of homelessness. Contributions by sociologists and other social scientists since the mid-1990s differentiate among types of homelessness, provide credible demographic estimates, and show how being homeless affects a person's life chances and coping strategies. Agreement also exists about the main macro- and micro-level causes of homelessness. Active lines of inquiry examine public, media, and governmental responses to the problem as well as homeless people's efforts to mobilize on their own behalf. Despite the obstacles faced when studying a stigmatized population marked by high turnover and weak anchors to place, recent investigations have significantly influenced homelessness policy. A greater emphasis on prevention should further strengthen the research-policy nexus.

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“…These disorders are common among homeless persons, with prevalence estimates of 40% to 60%. 25,26 These individuals generally have significantly greater health care needs, for treatment of, for example, psychiatric disorders, HIV and other sexually transmitted infections, hepatitis, liver disease, lung disease, and wound and skin infections. 27–30 The premature mortality rate is significantly higher for homeless individuals than for the general population, 27,31 and homeless people with substance use disorders are even more disproportionately affected.…”

mentioning

confidence: 99%

Medicaid Expansion Initiative in Massachusetts: Enrollment Among Substance-Abusing Homeless Adults

Zur

Mojtabai

2013

Am J Public Health

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Objectives We assessed whether homeless adults entering substance abuse treatment in Massachusetts were less likely than others to enroll in Medicaid after implementation of the MassHealth Medicaid expansion program in 1997. Methods We used interrupted time-series analysis in data on substance abuse treatment admissions from the Treatment Episode Data Set (1992–2009) to evaluate Medicaid coverage rates in Massachusetts and to identify whether trends differed between homeless and housed participants. We also compared Massachusetts data with data from 17 other states and the District of Columbia combined. Results The percentage of both homeless and housed people entering treatment with Medicaid increased approximately 21% after expansion (P = .01), with an average increase of 5.4% per year over 12 years (P = .01). The increase in coverage was specific to Massachusetts, providing evidence that the MassHealth policy was the cause of this increase. Conclusions Findings provide evidence in favor of state participation in the Medicaid expansion in January 2014 under the Affordable Care Act and suggest that hard-to-reach vulnerable groups such as substance-abusing homeless adults are as likely as other population groups to benefit from this policy.

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Predictors of Reported Current and Lifetime Substance Abuse Problems Among a National Sample of U.S. Homeless

Cited by 19 publications

References 27 publications

Residential patterns in older homeless adults: Results of a cluster analysis

Residential patterns in older homeless adults: Results of a cluster analysis

The New Homelessness Revisited

Medicaid Expansion Initiative in Massachusetts: Enrollment Among Substance-Abusing Homeless Adults

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