Racial and Ethnic Disparities in the Lifetime Prevalence of Homelessness in the United States
Abstract
Homelessness in the United States is often examined using cross-sectional, point-in-time samples. Any experience of homelessness is a risk factor for adverse outcomes, so it is also useful to understand the incidence of homelessness over longer periods. We estimate the lifetime prevalence of homelessness among members of the Baby Boom cohort (n = 6,545) using the 2012 and 2014 waves of the Health and Retirement Study (HRS), a nationally representative survey of older Americans. Our analysis indicates that 6.2 % of respondents had a period of homelessness at some point in their lives. We also identify dramatic disparities in lifetime incidence of homelessness by racial and ethnic subgroups. Rates of homelessness were higher for non-Hispanic blacks (16.8 %) or Hispanics of any race (8.1 %) than for non-Hispanic whites (4.8 %; all differences significant with p < .05). The black-white gap, but not the Hispanic-white gap, remained significant after adjustment for covariates such as education, veteran status, and geographic region.
Keywords
Homelessness Racial and ethnic disparities Health and retirement studyNotes
Acknowledgments
The HRS (Health and Retirement Study) is sponsored by the National Institute on Aging (grant number NIA U01AG009740) and is conducted by the University of Michigan. The authors thank external reviewers and the editors for helpful comments and suggestions.
References
- Barrow, S. M., Herman, D. B., Cordova, P., & Struening, E. L. (1999). Mortality among homeless shelter residents in New York City. American Journal of Public Health, 89, 529–534.CrossRefGoogle Scholar
- Buron, L., McCall, T., & Solari, C. D. (2016). The 2015 Annual Homeless Assessment Report (AHAR) to Congress, Part 2: Estimates of homelessness in the United States, data collection and analysis methodology. Washington, DC: U.S. Department of Housing and Urban Development, Office of Community Planning and Development.Google Scholar
- Culhane, D. P. (2008). The cost of homelessness: A perspective from the United States. European Journal of Homelessness, 2, 97–114.Google Scholar
- Culhane, D. P., & Metraux, S. (1999). One-year rates of public shelter utilization by race/ethnicity, age, sex and poverty status for New York City (1990 and 1995) and Philadelphia (1995). Population Research and Policy Review, 18, 219–236.CrossRefGoogle Scholar
- Culhane, D. P., Metraux, S., Byrne, T., Stino, M., & Bainbridge, J. (2013). The age structure of contemporary homelessness: Evidence and implications for public policy. Analyses of Social Issues and Public Policy, 13, 228–244.CrossRefGoogle Scholar
- Donovan, S., & Shinseki, E. K. (2013). Homelessness is a public health issue. American Journal of Public Health, 103(S2), S210–S211.CrossRefGoogle Scholar
- Fargo, J., Metraux, S., Byrne, T., Munley, E., Montgomery, A. E., Jones, H., H., . . . Culhane, D. (2012). Prevalence and risk of homelessness among US veterans. Preventing Chronic Disease, 9, 110112. https://doi.org/10.5888/pcd9.110112
- Fazel, S., Geddes, J. R., & Kushel, M. (2014). The health of homeless people in high-income countries: Descriptive epidemiology, health consequences, and clinical and policy recommendations. Lancet, 384, 1529–1540.CrossRefGoogle Scholar
- Folsom, D. P., Hawthorne, W., Lindamer, L., Gilmer, T., Bailey, Golshan, S., . . . Jeste, D. V. (2005). Prevalence and risk factors for homelessness and utilization of mental health services among 10,340 patients with serious mental illness in a large public mental health system. American Journal of Psychiatry, 162, 370–376.Google Scholar
- Health and Retirement Study (HRS 2012 Core Final Release) public use dataset. (2012). Produced and distributed by the University of Michigan with funding from the National Institute on Aging (Grant No. NIA U01AG009740). Ann Arbor: University of Michigan.Google Scholar
- Health and Retirement Study (HRS 2014 Core Final Release) public use dataset. (2014). Produced and distributed by the University of Michigan with funding from the National Institute on Aging (Grant No. NIA U01AG009740). Ann Arbor: University of Michigan.Google Scholar
- Henry, M., Watt, R., Rosenthal, L., & Shivji, A. (2016). The 2016 Annual Homeless Assessment Report (AHAR) to Congress, Part 1: Point-in-time estimates of homelessness. Washington, DC: U.S. Department of Housing and Urban Development, Office of Community Planning and Development.Google Scholar
- Hopper, K. (1995). Definitional quandaries and other hazards in counting the homeless: An invited commentary. American Journal of Orthopsychiatry, 63, 340–346.CrossRefGoogle Scholar
- Hopper, K., Shinn, M., Laska, E., Meisner, M., & Wanderling, J. (2008). Estimating the numbers of unsheltered homeless people through plant-capture and postcount survey methods. American Journal of Public Health, 98, 1438–1442.CrossRefGoogle Scholar
- Kuhn, R., & Culhane, D. P. (1998). Applying cluster analysis to test a typology of homelessness by pattern of shelter utilization: Results from the analysis of administrative data. American Journal of Community Psychology, 26, 207–232.CrossRefGoogle Scholar
- Larkin, H., Henwood, B., Fogel, S. J., Aykanian, A., Briar-Lawson, K. H., Donaldson, P., . . . Streeter, C. L. (2016). Responding to the grand challenge to end homelessness: The national homelessness social work initiative. Families in Society: The Journal of Contemporary Social Services, 97, 153–159.Google Scholar
- Lee, B. A., Tyler, K. A., & Wright, J. D. (2010). The new homelessness revisited. Annual Review of Sociology, 36, 501–521.CrossRefGoogle Scholar
- Link, B. G., Phelan, J., Bresnahan, M., Stueve, A., Moore, R., & Susser, E. (1995). Lifetime and five-year prevalence of homelessness in the United States: New evidence on an old debate. American Journal of Orthopsychiatry, 65, 347–354.CrossRefGoogle Scholar
- Link, B. G., Susser, E., Stueve, A., Phelan, J., Moore, R. E., & Struening, E. (1994). Lifetime and five-year prevalence of homelessness in the United States. American Journal of Public Health, 84, 1907–1912.CrossRefGoogle Scholar
- McAllister, W., Lennon, M. C., & Kuang, L. (2011). Rethinking research on forming typologies of homelessness. American Journal of Public Health, 101, 596–601.CrossRefGoogle Scholar
- Metraux, S., Eng, N., Bainbridge, J., & Culhane, D. P. (2011). The impact of shelter use and housing placement on mortality hazard for unaccompanied adults and adults in family households entering New York City shelters: 1990–2002. Journal of Urban Health, 88, 1091–1104.CrossRefGoogle Scholar
- Montgomery, A. E., Dicter, M. E., Thomasson, A. M., Fu, X., & Roberts, C. B. (2015). Demographic characteristics associated with homelessness and risk among female and male veterans accessing VHA outpatient care. Women's Health Issues, 25, 42–48.CrossRefGoogle Scholar
- Montgomery, A. E., Szymkowiak, D., Marcus, J., Howard, P., & Culhane, D. P. (2016). Homelessness, unsheltered status, and risk factors for mortality: Findings from the 100 000 Homes Campaign. Public Health Reports, 131, 765–772.CrossRefGoogle Scholar
- O’Connell, J. J. (2005). Premature mortality in homeless populations: A review of the literature (Report). Nashville, TN: National Health Care for the Homeless Council.Google Scholar
- Oppenheimer, S. C., Nurius, P. S., & Green, S. (2016). Homelessness history impacts on health outcomes and economic and risk behavior intermediaries: New insights from population data. Families in Society, 43, 576–585.Google Scholar
- Phelan, J. C., & Link, B. G. (1999). Who are “the homeless”? Reconsidering the stability and composition of the homeless population. American Journal of Public Health, 89, 1334–1338.CrossRefGoogle Scholar
- Schneider, M., Brisson, D., & Burnes, D. (2016). Do we really know how many are homeless? An analysis of the point-in-time homelessness count. Families in Society: The Journal of Contemporary Social Services, 97, 321–329.Google Scholar
- Shelton, K. H., Taylor, P. J., Bonner, A., & van den Bree, M. (2009). Risk factors for homelessness: Evidence from a population-based study. Psychiatric Services, 60, 465–472.CrossRefGoogle Scholar
- Sonnega, A., Faul, J. D., Ofstedal, M. B., Langa, K. M., Phillips, J. W., & Weir, D. R. (2014). Cohort profile: The Health and Retirement Study (HRS). International Journal of Epidemiology, 43, 576–585.CrossRefGoogle Scholar
- U.S. Department of Housing and Urban Development. (2017). An introductory guide to the Annual Homeless Assessment Report. Washington, DC: U.S. Department of Housing and Urban Development. Retrieved from https://www.hudexchange.info/resources/documents/Introductory-Guide-to-the-2017-AHAR.pdf
- Williams, D. R. (2005). The health of U.S. racial and ethnic populations. Journals of Gerontology. Series B: Psychological Sciences and Social Sciences, 60(Special Issue 2), S53–S62.Google Scholar
- Wright, J. D., & Devine, J. A. (1995). Housing dynamics of the homeless: Implications for a count. American Journal of Orthopsychiatry, 63, 320–329.CrossRefGoogle Scholar