Adults aged 50 and older make
up half of individuals experiencing homelessness and have high rates of
morbidity and mortality. They may have different life trajectories and reside
in different environments than do younger homeless adults. Although the
environmental risks associated with homelessness are substantial, the
environments in which older homeless individuals live have not been well
characterized.
We classified living environments and identified associated factors in a sample of older homeless adults. From July 2013 to June 2014, we recruited a community-based sample of 350 homeless men and women aged fifty and older in Oakland, California. We administered structured interviews including assessments of health, history of homelessness, social support, and life course. Participants used a recall procedure to describe where they stayed in the prior six months. We performed cluster analysis to classify residential venues and used multinomial logistic regression to identify individual factors prior to the onset of homelessness as well as the duration of unstable housing associated with living in them.
We generated four residential groups describing those who were unsheltered, cohabited unstably with friends and family, resided in multiple institutional settings (shelters, jails, transitional housing), or lived primarily in rental housing (recently homeless).
Compared to those who were unsheltered, having social support when last stably housed was significantly associated with cohabiting and institution use. Cohabiters and renters were significantly more likely to be women and have experienced a shorter duration of homelessness. Cohabiters were significantly more likely than unsheltered participants to have experienced abuse prior to losing stable housing.
Pre-homeless social support appears to protect against street homelessness while low levels of social support may increase the risk for becoming homeless immediately after losing rental housing.
Our findings may enable targeted interventions for those with different manifestations of homelessness.
We classified living environments and identified associated factors in a sample of older homeless adults. From July 2013 to June 2014, we recruited a community-based sample of 350 homeless men and women aged fifty and older in Oakland, California. We administered structured interviews including assessments of health, history of homelessness, social support, and life course. Participants used a recall procedure to describe where they stayed in the prior six months. We performed cluster analysis to classify residential venues and used multinomial logistic regression to identify individual factors prior to the onset of homelessness as well as the duration of unstable housing associated with living in them.
We generated four residential groups describing those who were unsheltered, cohabited unstably with friends and family, resided in multiple institutional settings (shelters, jails, transitional housing), or lived primarily in rental housing (recently homeless).
Compared to those who were unsheltered, having social support when last stably housed was significantly associated with cohabiting and institution use. Cohabiters and renters were significantly more likely to be women and have experienced a shorter duration of homelessness. Cohabiters were significantly more likely than unsheltered participants to have experienced abuse prior to losing stable housing.
Pre-homeless social support appears to protect against street homelessness while low levels of social support may increase the risk for becoming homeless immediately after losing rental housing.
Our findings may enable targeted interventions for those with different manifestations of homelessness.
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- 1Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Division of General Internal Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA. Electronic address: christopher_lee@post.harvard.edu.
- 2Division of General Internal Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA.
- 3Division of HIV/AIDS, University of California San Francisco, San Francisco General Hospital, San Francisco, CA, USA.
- 4Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Division of General Internal Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA.
- Soc Sci Med. 2016 Feb 10;153:131-140. doi: 10.1016/j.socscimed.2016.02.004.
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