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Adverse childhood experiences: are they risk factors for adult homelessness?

D B Herman, E S Susser, E L Struening and B L Link

New York State Psychiatric Institute, NY, USA.

OBJECTIVES: We tested the hypothesis that adverse childhood experiences are risk factors for adult homelessness. METHODS: We interviewed a nationally representative sample of 92 US household members who had previously been homeless and a comparison group of 395 individuals with no prior homelessness. We assessed childhood adversity with a structured protocol that included a previously validated scale indicating lack of care from parents and single-item measures of physical and sexual abuse. RESULTS: Lack of care from a parent during childhood sharply increased the likelihood of subsequent homelessness (odds ratio [OR] = 13), as did physical abuse (OR = 16). Sexual abuse during childhood was associated with a nonsignificant trend toward homelessness (OR = 1.7). The risk of subsequent homelessness among individuals who experienced both lack of care and either type of abuse was dramatically increased compared with subjects reporting neither of these adversities (OR = 26). CONCLUSIONS: Adverse childhood experiences are powerful risk factors for adult homelessness. Effectively reducing child abuse and neglect may ultimately help prevent critical social problems including homelessness.

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