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

Int J Environ Res Public Health. 2020 May 21;17(10):3631. doi: 10.3390/ijerph17103631.


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.

Keywords: alcohol dependence; alcohol use; drinking behaviors; food insecurity; homeless; sex.