Mental Health Correlates of Past Homelessness in Latinos and Asians

Background and Purpose. Mental illness and addiction are strongly associated with homelessness, yet few studies have shown how these relationships vary across ethnic categories that are underrepresented in the homeless population. This study examines mental health and substance abuse disorders, as well as cultural and institutional factors, that impact risk for homelessness amongst Latinos and Asians living in the United States

Methods. Data from the National Latino and Asian American Survey (NLAAS), a nationally representative sample of Asian and Latino households (n=4649), were used to examine the relationships between mental health problems and homelessness amongst Latino and Asian respondents. The main dependent variable –homelessness– was defined as being homeless for one week or more since the age of 18. The main independent variables reflected the lifetime endorsement of substance use disorder, anxiety disorder, mood disorder, and impulse disorder. Health status, age, gender, marital status, education, citizenship status, employment status, welfare status, and religious service attendance were included as covariates. Multivariable logistic regression was used to calculate odds ratios for each independent variable.

Results. Approximately 4% of Latinos and 1% of Asians in the sample reported a history of homelessness. Clinical and institutional factors associated with homelessness varied by ethnicity. Substance abuse was a strong and significant predictor for homelessness across both ethnic categories (Latinos OR=3.98, CI:2.08-7.64; Asians OR=4.50, CI:2.12-8.14). Among Latinos, conduct disorder (OR=2.69, CI:1.41-5.14) and intermittent explosive disorder (OR=2.50, CI:1.11-5.60) were risk factors for homelessness, while attending a religious service at least once a week was a protective factor (OR=0.44, CI:0.24-0.82). Among Asians, mood disorder was a risk factor (OR=3.57, CI:1.41-9.01) as were health problems (OR=3.05, CI:1.09-8.52) and receiving welfare in the past (OR=4.57, CI:1.57-13.31).

Conclusion. Findings from this analysis show that while Latinos and Asians share substance abuse as a risk factor, they still seem to possess distinctive relationships with homelessness with respect to other disorders and institutional factors. For Latinos, psychiatric disorders that involve behavioral problems (such as oppositional defiance disorder and conduct disorder) increased the likelihood of being homeless. The association between religious service attendance and decreased likelihood of reporting a history of homelessness may suggest that Latinos utilize the church as a source of social capital, whereas Asians do not. For Asians, the main class of mental health conditions associated with increased likelihood of past homelessness was mood disorder. Additionally, a history of receiving welfare services was highly predictive of homelessness, which aligns with prior studies that examined the same relationship using black and white respondents. Also, health problems were predictive of homelessness in Asians, but not in Latinos. Findings suggest that services oriented toward homeless Latino Americans should address different issues than those oriented towards homeless Asians. Limitations of the analysis include the cross-sectional nature of the data, which undercuts any causal claims, as well as the fact that the survey was administered to households in the general population, which excludes those currently homeless. Despite limitations in establishing causality, understanding ethnicity-specific correlates of homelessness may guide culturally competent social work practice with homeless individuals.