Homelessness, Substance Misuse, and Access to Public Entitlements in a Soup Kitchen Population

Abstract

The study examined the effects of homelessness on access to public entitlements (Medicaid and food stamp programs) in a soup kitchen population. Data were collected between 1997 and 1999 from a sample of 343 adults at two soup kitchen sites in New York City. Five hypotheses, focusing on the effects of housing status (literal homelessness, unstable housing, and domiciled), frequency of drug/heavy alcohol use, drug/alcohol-user treatment history and childcare responsibilities on access to Medicaid and food stamp programs were tested. Multiple logistic regression analysis indicated that both literal homelessness and unstable housing were associated with less access to Medicaid and food stamps. Other significant findings were: current drug/alcohol-user treatment experience was associated with greater access to both Medicaid and food stamps, frequency of drug/heavy alcohol use was associated with less access to Medicaid only, and caring for children was associated with greater access to food stamps only. These findings support the crucial role of housing status in mediating access to entitlements, and the importance of drug/alcohol-user treatment involvement as a cue to seeking entitlements. The need to reduce health disparities through active and sustained outreach programs designed to enhance homeless persons’ access to Medicaid and food stamp programs was discussed.

• Literal homelessness
• Unstable housing
• Marginal homelessness
• Substance misuse
• Entitlements
• Medicaid
• Food stamps
• Soup kitchen
• Service utilization

Additional information

Notes on contributors

Peter C. Nwakeze

Peter C. Nwakeze, Ph.D., is Director of Research and Evaluation at Hunter College Center on AIDS, Drugs and Community Health. He worked as a project director at National Development and Research Institutes on several research projects prior to joining the Hunter College Center. His research interests are in urban social problems, substance user treatment outcomes, HIV prevention research, and service outreach to underserved populations.

Stephen Magura

Stephen Magura, Ph.D., C.S.W., is Deputy Director of National Development and Research Institutes, Inc. He has designed and directed drug-dependency clinical trials, treatment outcome studies, health services research, social epidemiology studies, HIV prevention research, and policy analysis. He has been the principal investigator of numerous studies sponsored by the National Institutes of Health and private foundations. He has published over 100 articles and authored/edited several books and special journal issues.

Andrew Rosenblum

Andrew Rosenblum, Ph.D., is the Director of the Institute for Treatment and Services Research at the National Development and Research Institutes, Inc. He has served as principal investigator, coinvestigator, and project director on several research projects on substance use including innovative interventions for the treatment of cocaine dependence, outreach to homeless populations, and an evaluation of a treatment linkage model for street-based sex workers.

Herman Joseph

Herman Joseph, Ph.D., is currently affiliated with the Office of Alcoholism and Substance Abuse Services (OASAS) in New York, NY.