Comparison of risk factors for ill health in a sample of homeless and nonhomeless poor

Abstract

This cross-sectional survey was undertaken to examine whether the homeless poor have a higher prevalence of risk factors for ill health than the nonhomeless poor. Seventy-one adults in four age groups who attended a free-meal program in northern California were recruited during a 1-month period in 1987. The majority of the respondents lived on the streets, in vehicles, or in substandard housing located in an area undergoing rapid urban redevelopment. Regardless of employment or government assistance, the income of 100 percent of the respondents fell below the Federal poverty level. Overall, the sociodemographic profile of the study population was remarkably similar to that of the general population of California adults. Sixty-six percent had completed high school, 78 per cent had lived in the city for 5 or more years and, at most, 23 percent reported serious alcohol or emotional problems. When compared with the nonhomeless poor, the homeless poor were slightly less educated, more mobile, and more likely to report alcohol and emotional problems. Larger differences were evident for health-related variables, with the homeless poor being significantly less likely to have health insurance coverage, to receive preventive health care, and to be nonsmokers than the nonhomeless poor (P values less than .05). There were also large differences in access to heated rooms, running hot water, and cooking facilities, with approximately 90 percent of the homeless poor reporting no access to these fundamental necessities.