Cash benefits are associated with lower risk behavior among the homeless and marginally housed in San Francisco.
To address the widespread debate about the role of public assistance to the urban poor, the authors determined characteristics of individuals receiving cash assistance and explored the link between cash subsidies and risk behavior. From 1999 to 2000, a representative sample of homeless and marginally housed (HMH) adults living in San Francisco was recruited and interviewed about subsidies, shelter, jail, and drug use. Among 1,156 adults, 87% were ever homeless, 22% currently injected drugs, and 14% were HIV positive. Sixty percent of participants reported that most of their income came from subsidies [mostly subsidized (MS)]. The MS had lower odds of receiving any income from selling drugs or trading sex. Adjusting for HIV infection, the MS had higher odds of sleeping in a hotel [odds ratio (OR) = 2.39] or shelter (OR = 1.61) compared to the street. The MS had lower odds of injection drug use (OR = 0.69) and recent incarceration (OR = O.77). Among San Francisco's homeless, being MS was positively associated with having shelter and negatively associated with injection drug use and incarceration. These data suggest that government subsidies are associated with positive health behaviors among the urban poor.
Riley
Elise D
ED
University of California, San Francisco General Hospital, Epidemiology and Prevention Interventions Center, San Francisco, California 94110, USA. eriley@epi-center.ucsf.edu
Moss
Andrew R
AR
Clark
Richard A
RA
Monk
Sandra L
SL
Bangsberg
David R
DR
D000328:Adult; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control; D006703:Ill-Housed Persons / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011203:Poverty / Q000523:psychology*; D011632:Public Assistance / Q000706:statistics & numerical data*; D011638:Public Housing / Q000706:statistics & numerical data*; D040242:Risk Reduction Behavior; D012495:San Francisco / Q000453:epidemiology; D012946:Social Welfare / Q000191:economics; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000517:prevention & control; D014505:Urban Population
Psychiatr Serv. 2000 Jan;51(1):116-8
10647145
J Gen Intern Med. 2000 Oct;15(10):731-8
11089717
Psychiatr Serv. 2000 Dec;51(12):1549-54
11097652
J Health Soc Policy. 2001;13(2):61-73
11190657
Am J Public Health. 2004 Jul;94(7):1207-17
15226145
Am J Drug Alcohol Abuse. 1991;17(4):415-22
1746503
N Engl J Med. 1995 Sep 21;333(12):777-83
7643886
Psychiatr Serv. 1995 Sep;46(9):922-6
7583504
N Engl J Med. 1996 Mar 7;334(10):664; author reply 665
8592537
Am J Public Health. 1997 Feb;87(2):241-8
9103104
Psychiatr Serv. 1997 Jun;48(6):792-5
9175187
Am J Community Psychol. 1997 Dec;25(6):755-69
9534218
J Urban Health. 1998 Mar;75(1):170-83
9663975
Am J Public Health. 1998 Nov;88(11):1651-7
9807531
J Health Polit Policy Law. 1999 Feb;24(1):91-114
10342256
N Engl J Med. 1999 Jul 8;341(2):93-8
10395634