title: Substance-use disorders and poverty as prospective predictors of first-time homelessness in the United States.
abstract: OBJECTIVE
  We examined whether substance-use disorders and poverty predicted first-time homelessness over 3 years.
  
  
  METHODS
  We analyzed longitudinal data from waves 1 (2001-2002) and 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions to determine the main and interactive effects of wave 1 substance use disorders and poverty on first-time homelessness by wave 2, among those who were never homeless at wave 1 (n = 30,558). First-time homelessness was defined as having no regular place to live or having to live with others for 1 month or more as a result of having no place of one's own since wave 1.
  
  
  RESULTS
  Alcohol-use disorders (adjusted odds ratio [AOR] = 1.34), drug-use disorders (AOR = 2.51), and poverty (AOR = 1.34) independently increased prospective risk for first-time homelessness, after adjustment for ecological variables. Substance-use disorders and poverty interacted to differentially influence risk for first-time homelessness (P < .05), before, but not after, adjustment for controls.
  
  
  CONCLUSIONS
  This study reinforces the importance of both substance-use disorders and poverty in the risk for first-time homelessness, and can serve as a benchmark for future studies. Substance abuse treatment should address financial status and risk of future homelessness.
authors.affiliation: Ronald G. Thompson Jr, Melanie M. Wall, and Deborah S. Hasin are with the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY. Melanie M. Wall, Eliana Greenstein, and Deborah S. Hasin are with the New York State Psychiatric Institute, New York. Bridget F. Grant is with the Laboratory of Epidemiology and Biometry, Division of Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD.
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Thompson
authors.forename: Melanie M
authors.initials: MM
authors.lastname: Wall
authors.forename: Eliana
authors.initials: E
authors.lastname: Greenstein
authors.forename: Bridget F
authors.initials: BF
authors.lastname: Grant
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Hasin
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011203:Poverty / Q000706:statistics & numerical data*; D012307:Risk Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult