Lifetime and 1-year prevalence of homelessness in the US population: results from the National Epidemiologic Survey on Alcohol and Related Conditions-III

Background Homelessness remains a major public health problem in the USA but there have been few recent epidemiological studies in the general population. Methods Using data from structured interviews with a nationally representative sample of 36 299 US adults from the 2012-13 Wave 3 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III), this study examined the lifetime and 1-year prevalence of homelessness, and its correlates. Results Lifetime and 1-year prevalence of homelessness in the US population was found to be 4.2 and 1.5%, respectively. Low income, debt, borderline personality disorder (PD), past-year tobacco use disorder, any history of suicidal attempts and being a victim of crime in the past year were all independently strongly associated with past-year homelessness (all OR > 1.5). Low income, debt, history of incarceration, antisocial PD and any history of suicidal attempts were all independently strongly associated with lifetime homelessness (all OR > 1.5). Conclusions These findings provide an update to the original NESARC, suggesting a possible increase in lifetime homelessness (2.7-4.2%) in the past decade. Along with known economic and behavioral health conditions, special attention should be paid to PDs in efforts to prevent and end homelessness.