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.
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Add Health prompts respondents with criteria defining homelessness, including staying in a place not meant for sleeping, staying in a shelter, or lacking a fixed residence (Shelton et al. 2009).
Supplemental analysis of HRS data shows that individuals who have ever been homeless are in worse health than those who have not; they are twice as likely to be in fair or poor health and are significantly more likely to report heart disease, lung disease, or having ever had cancer or a stroke. These results hold both with and without adjustment for characteristics including gender, race, ethnicity, education, and age.
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.
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.
Culhane, D. P. (2008). The cost of homelessness: A perspective from the United States. European Journal of Homelessness, 2, 97–114.
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.
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.
Donovan, S., & Shinseki, E. K. (2013). Homelessness is a public health issue. American Journal of Public Health, 103(S2), S210–S211.
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.
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.
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.
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.
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.
Hopper, K. (1995). Definitional quandaries and other hazards in counting the homeless: An invited commentary. American Journal of Orthopsychiatry, 63, 340–346.
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.
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.
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.
Lee, B. A., Tyler, K. A., & Wright, J. D. (2010). The new homelessness revisited. Annual Review of Sociology, 36, 501–521.
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.
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.
McAllister, W., Lennon, M. C., & Kuang, L. (2011). Rethinking research on forming typologies of homelessness. American Journal of Public Health, 101, 596–601.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Wright, J. D., & Devine, J. A. (1995). Housing dynamics of the homeless: Implications for a count. American Journal of Orthopsychiatry, 63, 320–329.
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.
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Fusaro, V.A., Levy, H.G. & Shaefer, H.L. Racial and Ethnic Disparities in the Lifetime Prevalence of Homelessness in the United States. Demography 55, 2119–2128 (2018). https://doi.org/10.1007/s13524-018-0717-0
- Racial and ethnic disparities
- Health and retirement study