Correlates of Past Homelessness in the National Epidemiological Survey on Alcohol and Related Conditions

Abstract

This study sought to investigate correlates of past homelessness, especially mental illness and substance abuse, using data from the National epidemiological survey on alcohol and related conditions (NESARC), a large nationally representative survey conducted in 2001–2002. Multivariate analyses showed that the factors most strongly related to past homelessness were diagnoses of behavioral health conditions which showed consistently stronger association than sociodemographic characteristics, measures of economic well being, or general health indicators. The results presented here confirm in a nationally representative sample a number of single site studies that have also demonstrated the over representation of both mental illness and substance abuse disorders in homeless populations.

This is a preview of subscription content, access via your institution.

References

  1. Breakey, W. R., Fischer, P. J., Kramer, M., Nestadt, G., Romanoski, A. J., Ross, A., et al. (1989). Health and mental health problems of homeless men and women in Baltimore. JAMA, 262, 1352–1357.

    Article  CAS  PubMed  Google Scholar 

  2. Burt, M. R. (1992). Over the edge: The growth of homelessness in the 1980s. Washington D.C: Urban Institute Press.

    Google Scholar 

  3. Burt, M., Aron, L. Y., Lee, E., & Valente, J. (2001). Helping America’s homeless: Emergency shelter or affordable housing?. Washington DC: Urban Institute.

    Google Scholar 

  4. Curtis, S. E. (2002). Social welfare as a dimension of regional development. In P. Townroe & R. Martin (Eds.), Regional development in the 1990s: The British isles in transition. Regional policy and development 4. London: Spoon.

    Google Scholar 

  5. Folsom, D., & Jeste, D. V. (2002). Schizophrenia in homeless persons: A systematic review of the literature. Acta Psychiatrica Scandinavica, 104, 1–10.

    Google Scholar 

  6. Grant, B. F., Dawson, D. A., Stinson, F. S., Chou, P., Kay, W., & Pickering, R. (2003a). The alcohol use disorder and associated disabilities interview schedule IV (AUDADIS-IV): Reliability of alcohol consumption, tobacco use, family history of depression and psychiatric diagnostic modules in a general population sample. Drug Alcohol Dependence, 71, 7–16.

    Article  Google Scholar 

  7. Grant, B. F., Hasin, D. S., Stinson, F. S., Dawson, D. A., Chou, S. P., Ruan, W. J., et al. (2005). Co-occurrence of 12-month mood and anxiety disorders and personality disorders in the US: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Psychiatric Research, 39, 1–9.

    Article  PubMed  Google Scholar 

  8. Grant, B. F., Kaplan, K., Shepard, J., & Moore, T. (2003b). Source and accuracy statement for wave 1 of the 2001–2002 National Epidemiological Survey on alcohol and rated conditions. Bethesda: National Institute on Alcohol Abuse and Alcoholism.

    Google Scholar 

  9. Grant, B. F., Stinson, F. S., Dawson, D. A., Chou, S. P., Dufour, M. C., Compton, W., et al. (2004). Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders. Archives of General Psychiatry, 61, 807–816.

    Article  PubMed  Google Scholar 

  10. Greenberg, G. A., & Roseneheck, R. A. (2009). Mental Health Correlates of Past Homelessness. Psychiatric Services. (Under Review).

  11. Greenblatt, M. (1992). Deinstitutionalization and reinstitutionalization of the mentally ill. In M. J. Robertson & M. Greenblatt (Eds.), Homelessness: A national perspective (pp. 57–67). New York: Plenum Press.

    Google Scholar 

  12. Hopper, K., & Milburn, N. (1996). Homelessness among African Americans: A historical and contemporary perspective. In J. Baumohl (Ed.), Homelessness in America (pp. 123–131). Phoenix, Arizona: Oryx Press.

    Google Scholar 

  13. Koegel, P., & Burnam, M. A. (1992). Problems in the assessment of mental illness among the homeless: An empirical approach. In M. J. Robertson & M. Greenblatt (Eds.), Homelessness: A national perspective (pp. 77–100). New York: Plenum Press.

    Google Scholar 

  14. Koegel, P., Burnam, M. A., & Baumohl, J. (1996). The causes of homelessness. In J. Baumohl (Ed.), Homelessness in America (pp. 24–33). Phoenix, Arizona: Oryx Press.

    Google Scholar 

  15. Koegel, P., Burnam, M. A., & Farr, R. K. (1988). The prevalence of specific psychiatric disorders among homeless individuals in the inner city of Los Angeles. Archives of General Psychiatry, 45, 1085–1092.

    CAS  PubMed  Google Scholar 

  16. Leavitt, J. (1992). Homelessness and the housing crisis. In M. J. Robertson MJ & M. Greenblatt (Eds.), Homelessness: A national perspective (pp. 19–34). New York: Plenum Press.

    Google Scholar 

  17. Leginski, W. (2007). Historical and contextual influences on the U.S. response to contemporary homelessness. In D. Dennis, G. Locke, & J. Khadduri (Eds.), The 2007 National Symposium on Homelessness Research. Toward Understanding Homelessness. Washington, DC: U.S. Department of Housing and Urban Development Office of Policy Development and Research. Available online: http://aspe.hhs.gov/hsp/homelessness/symposium07/index.htm.

  18. Link, B. G., Susser, E., Stueve, A., Phelan, A., Moore, R. E., & Struening, E. (1994). Lifetime and five-year prevalence of homelessness in the United States. American Journal of Public Health, 84(12), 1907–1912.

    Article  CAS  PubMed  Google Scholar 

  19. Martens, W. H. J. (2001). A review of physical and mental health in homeless persons. Public Health Review, 29(1), 13–33.

    CAS  Google Scholar 

  20. Morse, G. A. (1992). Causes of homelessness. In M. J. Robertson & M. Greenblatt (Eds.), Homelessness: A national perspective (pp. 3–18). New York: Plenum Press.

    Google Scholar 

  21. Morse, G. A., & Calsyn, R. (1992). Mental health and other human service needs and homeless people. In M. J. Robertson & M. Greenblatt (Eds.), Homelessness: A national perspective (pp. 117–132). New York: Plenum Press.

    Google Scholar 

  22. Park, J. Y. S. (2000). Increased homelessness and low rent housing vacancy rates. Journal of Housing Economics, 9, 76–103.

    Article  Google Scholar 

  23. Rosenheck, R., & Fontana, A. (1994). A model of homelessness among male veterans of the Vietnam War generation. American Journal of Psychiatry, 151, 421–427.

    CAS  PubMed  Google Scholar 

  24. Rossi, P. H. (1989). Down and out in America: The origins of homelessness. Chicago: University of Chicago Press.

    Google Scholar 

  25. Rossi, P. H., & Wright, J. D. (1987). The determinants of homelessness. Health Affairs, 6, 19–32.

    Article  CAS  PubMed  Google Scholar 

  26. Roth, D., Toomey, B. G., & First, R. J. (1992). Gender, racial, and age variation among homeless persons. In M. J. Robertson & M. Greenblatt (Eds.), Homelessness: A national perspective (pp. 199–206). New York: Plenum Press.

    Google Scholar 

  27. Schutt, R. K., & Garrett, G. R. (1992). The homeless alcoholic: Past and present. In M. J. Robertson & M. Greenblatt (Eds.), Homelessness: A national perspective (pp. 177–186). New York: Plenum Press.

    Google Scholar 

  28. Scott, J. (1993). Homelessness and mental illness. British Journal of Psychiatry, 162, 314–324.

    Article  CAS  PubMed  Google Scholar 

  29. Sullivan, G., Burnam, A., & Koegel, P. (2000). Pathways to homelessness among the mentall ill. Social Psychiatry and Psychiatric Epidemiology, 35, 444–450.

    Article  CAS  PubMed  Google Scholar 

  30. Susser, E., Moore, R., & Link, B. (1993). Risk factors for homelessness. American Journal of Epidemiology, 15(2), 546–556.

    CAS  PubMed  Google Scholar 

  31. Susser, E., Struening, E. L., & Conover, S. (1989). Psychiatric problems in homeless men: Lifetime psychosis, substance use, and current distress in new arrivals at New York City shelters. Archives of General Psychiatry, 46, 845–850.

    CAS  PubMed  Google Scholar 

  32. Tompsett, C. J., Toro, P. A., Guzicki, M., Manrique, M., & Zatakia, J. (2006). Homelessness in the United States: Assessing changes in prevalence and public opinion, 1993–2001. American Journal of Community Psychology, 37, 47–61.

    Article  PubMed  Google Scholar 

  33. Toro, P. (2007). International perspectives on homelessness in developed nations. Journal of Social Issues, 63(3), 461–482.

    Article  Google Scholar 

  34. Toro, P. A., Tompsett, C. J., Lombardo, S., Philipott, P., Nachtegael, H., Galand, B., et al. (2007). Homelessness in Europe and the United States: A comparison of prevalence and public opinion. Journal of Social Issues, 63(3), 505–524.

    Article  Google Scholar 

  35. U.S. Department of Housing, Urban Development Office of Community Planning, Development (HUD). (2008). The 2007 annual homeless assessment report: A summary of findings. Washington DC: HUD.

    Google Scholar 

  36. Ware, J. E., Kosinski, M., Turner-Bowker, D. M., & Gandek, B. (2002). How to score version 2 of the SF-12 health survey. Lincoln, RI: Quality Metrics.

    Google Scholar 

  37. Ware, J. E., Koskinski, M., & Keller, S. D. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220–233.

    Article  PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Greg A. Greenberg.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Greenberg, G.A., Rosenheck, R.A. Correlates of Past Homelessness in the National Epidemiological Survey on Alcohol and Related Conditions. Adm Policy Ment Health 37, 357–366 (2010). https://doi.org/10.1007/s10488-009-0243-x

Download citation

Keywords

  • Homelessness
  • Mental health
  • Substance abuse