Revolving doors: imprisonment among the homeless and marginally housed population

Am J Public Health. 2005 Oct;95(10):1747-52. doi: 10.2105/AJPH.2005.065094.


Objectives: We studied a sample of homeless and marginally housed adults to examine whether a history of imprisonment was associated with differences in health status, drug use, and sexual behaviors among the homeless.

Methods: We interviewed 1426 community-based homeless and marginally housed adults. We used multivariate models to analyze factors associated with a history of imprisonment.

Results: Almost one fourth of participants (23.1%) had a history of imprisonment. Models that examined lifetime substance use showed cocaine use (odds ratio [OR]=1.67; 95% confidence interval [CI]=1.04, 2.70), heroin use (OR=1.51; 95% CI=1.07, 2.12), mental illness (OR=1.41; 95% CI=1.01, 1.96), HIV infection (OR=1.69; 95% CI=1.07, 2.64), and having had more than 100 sexual partners were associated with a history of imprisonment. Models that examined recent substance use showed past-year heroin use (OR = 1.65; 95% CI = 1.14, 2.38) and methamphetamine use (OR=1.49; 95% CI=1.00, 2.21) were associated with lifetime imprisonment. Currently selling drugs also was associated with lifetime imprisonment.

Conclusions: Despite high levels of health risks among all homeless and marginally housed people, the levels among homeless former prisoners were even higher. Efforts to eradicate homelessness also must include the unmet needs of inmates who are released from prison.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Educational Status
  • Female
  • Health Services Needs and Demand
  • Health Status*
  • Housing / statistics & numerical data*
  • Humans
  • Ill-Housed Persons / statistics & numerical data*
  • Income / statistics & numerical data
  • Male
  • Mental Disorders / epidemiology
  • Middle Aged
  • Multivariate Analysis
  • Poverty / statistics & numerical data
  • Prisoners / education
  • Prisoners / statistics & numerical data*
  • Risk Factors
  • Risk-Taking
  • San Francisco / epidemiology
  • Sexual Behavior / statistics & numerical data
  • Substance-Related Disorders / epidemiology
  • Surveys and Questionnaires