Factors Associated with Incarceration in Older Adults Experiencing Homelessness: Results from the HOPE HOME Study

Abstract

Background In the US, the median age of adults experiencing homelessness and incarceration is increasing. Little is known about risk factors for incarceration among older adults experiencing homelessness. To develop targeted interventions, there is a need to understand their risk factors for incarceration. Objective To examine the prevalence and risk factors associated with incarceration in a cohort of older adults experiencing homelessness. Design Prospective, longitudinal cohort study with interviews every 6 months for a median of 5.8 years. Participants We recruited adults ≥50 years old and homeless at baseline (n=433) via population-based sampling. Main Measures Our dependent variable was incident incarceration, defined as one night in jail or prison per 6-month follow-up period after study enrollment. Independent variables included socioeconomic status, social, health, housing, and prior criminal justice involvement. Key Results Participants had a median age of 58 years and were predominantly men (75%) and Black (80%). Seventy percent had at least one chronic medical condition, 12% reported heavy drinking, and 38% endorsed moderate-severe use of cocaine, 8% of amphetamines, and 7% of opioids. At baseline, 84% reported a lifetime history of jail stays; 37% reported prior prison stays. During follow-up, 23% spent time in jail or prison. In multivariable models, factors associated with a higher risk of incarceration included the following: having 6 or more confidants (HR=2.13, 95% CI=1.2–3.7, p=0.007), remaining homeless (HR=1.72, 95% CI=1.1–2.8, p=0.02), heavy drinking (HR=2.05, 95% CI=1.4–3.0, p<0.001), moderate-severe amphetamine use (HR=1.89, 95% CI=1.2–3.0, p=0.006), and being on probation (HR=3.61, 95% CI=2.4–5.4, p<0.001) or parole (HR=3.02, 95% CI=1.5–5.9, p=0.001). Conclusions Older adults experiencing homelessness have a high risk of incarceration. There is a need for targeted interventions addressing substance use, homelessness, and reforming parole and probation in order to abate the high ongoing risk of incarceration among older adults experiencing homelessness.

Letter to the Editor: Results from the HOPE HOME Study

“…In the HOPE HOME Study, the early (age < 50) and late (age > 50) onset of homeless individuals is approximately equal. 1 Although the onset of homelessness did not contribute to the incarceration in the present study, from the imprisonment problem, pathways to late-onset homelessness is known that these individuals are more likely to have housing hampered by one-time charges (i.e., one drug charge) than early-onset homelessness. 2 We can speculate that drug use may be more "globally disruptive" across life domains, interfering not only with one's financial stability but also with one's social functioning and physical and mental health.…”

“…We have read with interest the HOPE HOME Study by Garcia-Grossman et al 1 that evaluates factors associated with incarceration in homeless older adults and found that both individual and structural risk factors cause high prevalence of incarceration. In the HOPE HOME Study, the early (age < 50) and late (age > 50) onset of homeless individuals is approximately equal.…”

Community Supervision, Housing Insecurity, and Homelessness

“…Older adults and those experiencing accelerated aging present higher levels of chronic illness, geriatric syndromes, and functional impairment; and homeless older adults are at risk of experiencing violent victimization (Tong et al 2019). Older homeless adults who have been chronically homeless throughout their adulthood experience higher rates of mental health and substance use issues than people who first become homeless late in life (Brown et al 2012; Garcia-Grossman et al 2021).…”

“…The simultaneous rise in incarceration and homelessness is no coincidence because each phenomenon exacerbates the other: homelessness is a risk factor for criminal justice involvement (including incarceration), and criminal justice involvement (including a history of incarceration) is a risk factor for homelessness (Garcia-Grossman et al 2021). Formerly incarcerated people are ten times more likely than the general population to be homeless (Couloute 2018), due to the scarcity of affordable housing options and housing assistance (National Low Income Housing Coalition 2021b), public housing bans for certain criminal records (National Housing Law Project, n.d.…”

“…), barriers to employment at reentry (Couloute and Kopf 2018), restrictions from living with family or friends in public housing (National Academies of Sciences, Engineering, and Medicine 2020), private housing market tenant screening procedures that trigger discrimination against tenants with criminal backgrounds (Evans, Blount-Hill, and Cubellis 2019), discrimination against Black applicants who are disproportionately more likely to have criminal histories due to racially biased policies and policing/court practices (Turner et al 2013), and overly restrictive community supervision conditions (Travis and Stacey 2010). Researchers estimate that people experiencing homelessness in the U.S. have high lifetime rates of incarceration, with estimates ranging from 20 to 70 percent (Garcia-Grossman et al 2021).…”