Ronald G. Thompson Jr, Melanie M. Wall, and Deborah S. Hasin are with the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY. Melanie M. Wall, Eliana Greenstein, and Deborah S. Hasin are with the New York State Psychiatric Institute, New York. Bridget F. Grant is with the Laboratory of Epidemiology and Biometry, Division of Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD.
Am J Public Health. 2013 Dec;103 Suppl 2(Suppl 2):S282-8. doi: 10.2105/AJPH.2013.301302. Epub 2013 Oct 22.
We examined whether substance-use disorders and poverty predicted first-time homelessness over 3 years.
We analyzed longitudinal data from waves 1 (2001-2002) and 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions to determine the main and interactive effects of wave 1 substance use disorders and poverty on first-time homelessness by wave 2, among those who were never homeless at wave 1 (n = 30,558). First-time homelessness was defined as having no regular place to live or having to live with others for 1 month or more as a result of having no place of one's own since wave 1.
Alcohol-use disorders (adjusted odds ratio [AOR] = 1.34), drug-use disorders (AOR = 2.51), and poverty (AOR = 1.34) independently increased prospective risk for first-time homelessness, after adjustment for ecological variables. Substance-use disorders and poverty interacted to differentially influence risk for first-time homelessness (P < .05), before, but not after, adjustment for controls.
This study reinforces the importance of both substance-use disorders and poverty in the risk for first-time homelessness, and can serve as a benchmark for future studies. Substance abuse treatment should address financial status and risk of future homelessness.
我们研究了物质使用障碍和贫困是否在 3 年内预测首次无家可归。
我们分析了来自全国酒精相关情况流行病学调查的第 1 波（2001-2002 年）和第 2 波（2004-2005 年）的纵向数据，以确定第 1 波物质使用障碍和贫困对第 2 波首次无家可归的主要和交互作用，前提是第 1 波时从未无家可归的人（n=30558）。首次无家可归被定义为自第 1 波以来由于没有自己的住所而没有定期住所或必须与他人同住 1 个月或以上。
在调整了生态变量后，酒精使用障碍（调整后的优势比 [AOR]=1.34）、药物使用障碍（AOR=2.51）和贫困（AOR=1.34）独立增加了首次无家可归的前瞻性风险。物质使用障碍和贫困在调整了对照后，交互作用对首次无家可归的风险有不同的影响（P<0.05）。
这项研究强调了物质使用障碍和贫困在首次无家可归风险中的重要性，可以作为未来研究的基准。物质滥用治疗应该解决财务状况和未来无家可归的风险。
