Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, USA.
Department of Veterans Affairs (VA) New England Mental Illness Research, Education, and Clinical Center, West Haven, CT 06516, USA.
J Public Health (Oxf). 2018 Mar 1;40(1):65-74. doi: 10.1093/pubmed/fdx034.
Homelessness remains a major public health problem in the USA but there have been few recent epidemiological studies in the general population.
Using data from structured interviews with a nationally representative sample of 36 299 US adults from the 2012-13 Wave 3 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III), this study examined the lifetime and 1-year prevalence of homelessness, and its correlates.
Lifetime and 1-year prevalence of homelessness in the US population was found to be 4.2 and 1.5%, respectively. Low income, debt, borderline personality disorder (PD), past-year tobacco use disorder, any history of suicidal attempts and being a victim of crime in the past year were all independently strongly associated with past-year homelessness (all OR > 1.5). Low income, debt, history of incarceration, antisocial PD and any history of suicidal attempts were all independently strongly associated with lifetime homelessness (all OR > 1.5).
These findings provide an update to the original NESARC, suggesting a possible increase in lifetime homelessness (2.7-4.2%) in the past decade. Along with known economic and behavioral health conditions, special attention should be paid to PDs in efforts to prevent and end homelessness.
在美国,无家可归仍是一个主要的公共卫生问题,但近期针对普通人群的流行病学研究较少。
本研究利用来自全国代表性样本的 36299 名美国成年人在 2012-13 年国家酒精与相关状况流行病学调查(NESARC-III)第三波的结构化访谈数据,调查了美国人口终生和 1 年无家可归的发生率及其相关因素。
发现美国人口终生和 1 年无家可归的发生率分别为 4.2%和 1.5%。低收入、债务、边缘型人格障碍(PD)、过去一年的烟草使用障碍、过去一年的自杀企图史和过去一年的犯罪受害者,均与过去一年的无家可归史独立高度相关(所有 OR > 1.5)。低收入、债务、监禁史、反社会 PD 和过去的自杀企图史,均与终生无家可归史独立高度相关(所有 OR > 1.5)。
这些发现为原始 NESARC 提供了更新,表明在过去十年中,终生无家可归(2.7%-4.2%)的可能性有所增加。除了已知的经济和行为健康状况外,在预防和结束无家可归方面,应特别关注 PD。