Characterizing Alcohol Use Behaviors among Homeless Men and Women

Neisler, Julie; Shree, Sonakshee; Reitzel, Lorraine R.; Chen, Tzu-An; Kendzor, Darla E.; Obasi, Ezemenari M.; Wrighting, Quentaxia; Businelle, Michael S.

doi:10.5993/ajhb.43.1.4

Cited by 22 publications

(26 citation statements)

References 39 publications

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“…A recent Oklahoma City–based outreach survey found that 39.7% of homeless individuals self-reported a history of alcohol problems, and a Toronto-based survey showed that 27% of the homeless population reported recent cocaine use. 10 , 11…”

Section: Introductionmentioning

confidence: 99%

Outcomes Among Homeless Patients With Non–Small-Cell Lung Cancer: A County Hospital Experience

Concannon

Thayer

et al. 2020

JCO Oncology Practice

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PURPOSE: Lung cancer remains the leading cause of cancer death in the United States, with outcomes likely worsened by the presence of poorer outcomes among vulnerable populations such as the homeless. We hypothesized that homeless patients experience delays in biopsy, decreased appointment adherence, and increased overall mortality rates. METHODS: We conducted a retrospective electronic medical record–based review of all patients with non–small-cell lung cancer (NSCLC; N = 133) between September 2012 and September 2018 at an academic county hospital in Seattle, Washington. RESULTS: Of the 133 patients treated for NSCLC, 22 (17%) were homeless at the time of their treatment. Among homeless patients with localized lung cancer, the mean time from radiographic finding to biopsy was 248 days, compared with 116 days among housed patients ( P = .37). Homeless patients with advanced disease missed a mean of 26% of appointments in the year after diagnosis, compared with 16% among housed patients ( P = .03). Homeless patients with advanced NSCLC had a median survival of 0.58 years, versus 1.30 years in housed patients ( P = .48). CONCLUSION: To our knowledge, this is the first US study comparing outcomes among homeless and housed patients with NSCLC within the same institution; we found homeless patients had longer delays to biopsy, increased rates of missed appointments, and a trend toward decreased survival. This study shows potential areas where interventions could be implemented to improve lung cancer outcomes in this patient population.

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Section: Introductionmentioning

confidence: 99%

Outcomes Among Homeless Patients With Non–Small-Cell Lung Cancer: A County Hospital Experience

Concannon

Thayer

et al. 2020

JCO Oncology Practice

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“…Individuals who are homeless face numerous challenges to maintain or improve their health, and as a result suffer disproportionate rates of morbidity and mortality [2][3][4]. Two prevalent health risk factors among homeless adults include food insecurity, which is the inability to acquire adequate nutritious food due to insufficient money or other means to enable sufficient food access [5,6], and alcohol use problems [7]. Although these constructs have been shown to be associated among domiciled samples [8][9][10][11][12], their association among homeless samples has not been extensively researched.…”

Section: Introductionmentioning

confidence: 99%

“…Problematic alcohol use, including heavy alcohol use and alcohol dependency/abuse, are about 10 times more prevalent among homeless individuals than their domiciled counterparts [23][24][25]. Studies indicate alcohol dependence disorder rates of 8.1% to 58.5% [23], and at-risk drinking rates from 31% to 39% [7,26]. The lifetime prevalence of alcohol use disorders is about 60%, and the current prevalence rate is about 40%, among individuals who are homeless [27,28].…”

Section: Introductionmentioning

confidence: 99%

“…In general, substance use is more common among men [40,41], which may be due to greater impulsivity and higher rates of externalizing behaviors among men as a result of exposure to social stressors [42,43]. However, at least one study among homeless men and women indicated that women have equivalent rates of alcohol use problems relative to men [7]. Research among domiciled women indicates that they are more likely to be affected by food insecurity than men [44].…”

Section: Introductionmentioning

confidence: 99%

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Association of Problematic Alcohol Use and Food Insecurity among Homeless Men and Women

Reitzel

Chinamuthevi

Daundasekara

et al. 2020

IJERPH

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Food insecurity results from unreliable access to affordable and nutritious food. Homeless adults are particularly vulnerable to both food insecurity and problematic alcohol use. The current study examined the link between problematic alcohol use and food insecurity among homeless adults. Participants (N = 528; 62.7% men; Mage = 43.6 ± 12.2) were recruited from homeless-serving agencies in Oklahoma City. Problematic alcohol use was measured using the Alcohol Quantity and Frequency Questionnaire and the Patient Health Questionnaire. The latter used DSM-IV diagnostic criteria to assess probable alcohol use dependence/abuse. Heavy drinking was considered >7 drinks (women) and >14 drinks (men) per week. Food insecurity was measured with the USDA Food Security Scale-Short Form. The link between alcohol problems and food insecurity was examined with logistic regression analyses controlling for sex, age, education, income, and months homeless. Overall, 28.4% of the sample had probable alcohol dependence, 25% were heavy drinkers, and 78.4% were food insecure. Probable alcohol dependence and heavy drinking were correlated at 0.53 (p < 0.001). Results indicated that heavy drinking (OR = 2.12, CI.95 = 1.21, 3.73) and probable alcohol dependence/abuse (OR = 2.72, CI.95 = 1.55, 4.77) were each associated with increased odds of food insecurity. Food insecurity and problematic alcohol use are major issues among homeless populations; this study suggests they are associated. Future research is needed to shed light on potential causal mechanisms and on whether alcohol may take precedence over eating or food purchases.

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“…For example, previous research among domiciled populations has shown that women were more likely than men to rate their health as poor, which may lead to more frequent utilization of hospital care [38]. Further, homeless women have higher rates of severe mental illness and chronic medical illness, and similar rates of alcohol use behaviors when compared to homeless men [3,4,15,39]. Homeless women also lack access to preventive care such as prenatal care [40], mammograms, and Pap tests [41] and experience sexual assault at higher rates than homeless men [42], which may lead to increased need for emergency treatment.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Overnight and Emergency Treatment among Homeless Adults

Iwundu

Agrawal

Businelle

et al. 2020

IJERPH

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High usage of emergency treatment and hospitalization has been reported among homeless individuals. Hence, this study aimed to identify the sociodemographic predictors associated with overnight and emergency hospital treatment among a sample of homeless adults. Participants were recruited from a shelter in Dallas, Texas (N = 354; Mage = 43.7 ± 11.7) and were predominantly uninsured, low-income men from various racial groups. The outcome variables were: (a) stayed overnight for treatment in a hospital; and (b) treated in a hospital emergency room. In logistic regression models, sex emerged as the only predictor of overnight treatment in a hospital (OR = 2.68, 95% CI = 1.61–4.47), and treatment in an emergency room (OR = 2.21, 95% CI = 1.34–3.65), such that women were more likely than men to be treated overnight and use emergency care. Targeted interventions and policies are needed to address homeless women’s primary care needs and reduce costlier treatment.

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Characterizing Alcohol Use Behaviors among Homeless Men and Women

Cited by 22 publications

References 39 publications

Outcomes Among Homeless Patients With Non–Small-Cell Lung Cancer: A County Hospital Experience

Outcomes Among Homeless Patients With Non–Small-Cell Lung Cancer: A County Hospital Experience

Association of Problematic Alcohol Use and Food Insecurity among Homeless Men and Women

Predictors of Overnight and Emergency Treatment among Homeless Adults

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