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AJPH First Look, published online ahead of print Aug 30, 2005
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October 2005, Vol 95, No. 10 | American Journal of Public Health 1753-1759
© 2005 American Public Health Association
DOI: 10.2105/AJPH.2005.063321

RESEARCH AND PRACTICE

Risk Factors for Long-Term Homelessness: Findings From a Longitudinal Study of First-Time Homeless Single Adults

Carol L. M. Caton, PhD, Boanerges Dominguez, MS, Bella Schanzer, MD, Deborah S. Hasin, PhD, Patrick E. Shrout, PhD, Alan Felix, MD, Hunter McQuistion, MD, Lewis A. Opler, MD, PhD and Eustace Hsu, BA

Carol L. M. Caton, Boanerges Dominguez, Bella Schanzer, Deborah S. Hasin, Alan Felix, and Eustace Hsu are with the Department of Psychiatry and Mailman School of Public Health, College of Physicians and Surgeons, Columbia University New York, NY. Patrick E. Shrout is with the Department of Psychology, New York University, New York, NY. Hunter McQuistion is with the City of New York Department of Health and Mental Hygiene. Lewis A. Opler is with the New York State Office of Mental Health, Albany, NY.

Correspondence: Requests for reprints should be sent to Carol L. M. Caton, PhD, Mailman School of Public Health, Columbia University, 600 W 168th St, New York, NY 10032 (e-mail: clc3{at}columbia.edu).

Objectives. We examined risk factors for long-term homelessness among newly homeless men and women who were admitted to New York City shelters in 2001 and 2002.

Methods. Interviews were conducted with 377 study participants upon entry into the shelter and at 6-month intervals for 18 months. Standardized assessments of psychiatric diagnosis, symptoms, and coping skills; social and family history; and service use were analyzed. Kaplan—Meier survival analysis and Cox regression were used to examine the association between baseline assessments and duration of homelessness.

Results. Eighty-one percent of participants returned to community housing during the follow-up period; the median duration of homelessness was 190 days. Kaplan—Meier survival analysis showed that a shorter duration of homelessness was associated with younger age, current or recent employment, earned income, good coping skills, adequate family support, absence of a substance abuse treatment history, and absence of an arrest history. Cox regression showed that older age group P<.05) and arrest history (P<.01) were the strongest predictors of a longer duration of homelessness.

Conclusions. Identification of risk factors for long-term homelessness can guide efforts to reduce lengths of stay in homeless shelters and to develop new preventive interventions.




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