Substance abuse and homelessness: direct or indirect effects?
OBJECTIVE
To investigate whether substance abuse is a direct factor in the explanation of homelessness or one that operates indirectly through disaffiliation and human capital processes to place individuals at greater risk of the condition.


METHODS
Analyses were conducted using data on substance abuse and homeless experiences from a random probability sample of 481 homeless persons and those at risk of homelessness in Cook County, Illinois. Covariance structure models were used to assess substance abuse, human capital, and disaffiliation as potential precursors of homelessness, with particular attention paid to the direct and indirect role of substance abuse in the loss of domicile.


RESULTS
Analysis of several nested models of homelessness links substance abuse only indirectly to loss of domicile, primarily through its impact on social and institutional affiliations. Contrary to expectations, substance abuse did not impact homelessness indirectly by diminishing the accumulation of human capital.


CONCLUSIONS
The role of disaffiliation as a proximate cause of homelessness was confirmed. This locates the phenomenon within the context of society itself, as a direct result of a breakdown in the social bonds necessary for human community. Substance abuse plays a critical role in this breakdown, negatively influencing social as well as institutional relationships.
Vangeest
Jonathan B
JB
Medicine and Public Health, American Medical Association, Survey Research Laboratory, College of Urban Planning and Public Affairs, University of Illinois at Chicago, Chicago, IL 60610, USA.
Johnson
Timothy P
TP
D000328:Adult; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology*; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D008297:Male; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology*