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Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study.

Brown RT, Goodman L, Guzman D, Tieu L, Ponath C, Kushel MB - PLoS ONE (2016)

Bottom Line: We used a structured modeling approach to identify experiences associated with first adult homelessness before age 50 versus at age 50 or older.Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment) and lower attainment of adult milestones (i.e., marriage, full-time employment) compared to individuals with later onset.Prevention and service interventions should be adapted to meet different needs.

View Article: PubMed Central - PubMed

Affiliation: Division of Geriatrics, University of California, San Francisco, San Francisco, California, United States of America.

ABSTRACT
Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (<18 years), young adulthood (ages 18-25), and middle adulthood (ages 26-49). We used a structured modeling approach to identify experiences associated with first adult homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment) and lower attainment of adult milestones (i.e., marriage, full-time employment) compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs.

No MeSH data available.


Related in: MedlinePlus

Flow-chart of recruitment of 350 older homeless adults.This figure shows the number of individuals approached, assessed for eligibility, and enrolled in the study (N = 350), noting specific reasons for inability to enroll. Values represent the number of individuals in each group. *Participants who declined after being approached (N = 335) declined before being assessed for eligibility. Therefore, the number of participants who were ineligible for the study may have been higher than the numbers presented in this figure.
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pone.0155065.g001: Flow-chart of recruitment of 350 older homeless adults.This figure shows the number of individuals approached, assessed for eligibility, and enrolled in the study (N = 350), noting specific reasons for inability to enroll. Values represent the number of individuals in each group. *Participants who declined after being approached (N = 335) declined before being assessed for eligibility. Therefore, the number of participants who were ineligible for the study may have been higher than the numbers presented in this figure.

Mentions: Individuals who declined participation or did not attend the interview were similar to enrolled participants by sex, but were more likely to be African-American by observed race/ethnicity (82.3% vs. 79.7%, P = .04) and more likely to be recruited from meal programs (55.3% vs. 49.1%) and from unsheltered areas or recycling centers (20.1% vs. 15.7%, overall P value for comparison = 0.003) (Fig 1).


Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study.

Brown RT, Goodman L, Guzman D, Tieu L, Ponath C, Kushel MB - PLoS ONE (2016)

Flow-chart of recruitment of 350 older homeless adults.This figure shows the number of individuals approached, assessed for eligibility, and enrolled in the study (N = 350), noting specific reasons for inability to enroll. Values represent the number of individuals in each group. *Participants who declined after being approached (N = 335) declined before being assessed for eligibility. Therefore, the number of participants who were ineligible for the study may have been higher than the numbers presented in this figure.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4862628&req=5

pone.0155065.g001: Flow-chart of recruitment of 350 older homeless adults.This figure shows the number of individuals approached, assessed for eligibility, and enrolled in the study (N = 350), noting specific reasons for inability to enroll. Values represent the number of individuals in each group. *Participants who declined after being approached (N = 335) declined before being assessed for eligibility. Therefore, the number of participants who were ineligible for the study may have been higher than the numbers presented in this figure.
Mentions: Individuals who declined participation or did not attend the interview were similar to enrolled participants by sex, but were more likely to be African-American by observed race/ethnicity (82.3% vs. 79.7%, P = .04) and more likely to be recruited from meal programs (55.3% vs. 49.1%) and from unsheltered areas or recycling centers (20.1% vs. 15.7%, overall P value for comparison = 0.003) (Fig 1).

Bottom Line: We used a structured modeling approach to identify experiences associated with first adult homelessness before age 50 versus at age 50 or older.Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment) and lower attainment of adult milestones (i.e., marriage, full-time employment) compared to individuals with later onset.Prevention and service interventions should be adapted to meet different needs.

View Article: PubMed Central - PubMed

Affiliation: Division of Geriatrics, University of California, San Francisco, San Francisco, California, United States of America.

ABSTRACT
Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (<18 years), young adulthood (ages 18-25), and middle adulthood (ages 26-49). We used a structured modeling approach to identify experiences associated with first adult homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment) and lower attainment of adult milestones (i.e., marriage, full-time employment) compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs.

No MeSH data available.


Related in: MedlinePlus