Transitions between Housing States among Urban Homeless Adults: a Bayesian Markov Model
Transitions between Housing States among Urban Homeless Adults: a Bayesian Markov Model
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DOI：
10.1007/s11524-018-0236-8
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发表时间：
2018-06-01
影响因子：
6.6
通讯作者：
Pollio, David E.
中科院分区：
文献类型：
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作者：
Alexander-Eitzman, Ben;North, Carol S.;Pollio, David E.
本研究的目的是探讨边缘化、药物滥用和服务利用如何影响城市无家可归成年人在两年的时间内在街道、庇护所和住房状态之间的转变。每年对 400 名无家可归的成年人进行三年一次访谈的调查结果与从地区卫生、心理健康和住房服务提供商收集的行政服务数据进行了匹配。为了估计住房、街道和住房状态之间的转换率，在贝叶斯框架内开发了多状态马尔可夫模型。然后将这些转变率回归到一组衡量人口统计、边缘化、药物滥用和服务利用的自变量。从住房到避难所或街道的过渡与非本地人、没有朋友或家人可以依靠以及失业有关。未决指控和近期被抢劫的历史与庇护所到街道的过渡有关。留在街头与从事“影子工作”有着独特的联系，令人惊讶的是，它与日常服务的大量使用有关。这些发现描绘了不同类型的住房过渡的独特且独立的过程。这些结果强调了将干预措施重点关注这些独特的住房转型需求的重要性，特别关注以前的住房模式、药物滥用以及无家可归的成年人在我们社会中被边缘化的不同方式。
The purpose of this study is to explore how marginalization, substance abuse, and service utilization influence the transitions between streets, shelters, and housed states over the course of 2 years in a population of urban homeless adults. Survey responses from three yearly interviews of 400 homeless adults were matched with administrative services data collected from regional health, mental health, and housing service providers. To estimate the rates of transition between housed, street, and shelter status, a multi-state Markov model was developed within a Bayesian framework. These transition rates were then regressed on a set of independent variables measuring demographics, marginalization, substance abuse, and service utilization. Transitions from housing to shelters or streets were associated with not being from the local area, not having friends or family to count on, and unemployment. Pending charges and a recent history of being robbed were associated with the shelters-to-streets transition. Remaining on the streets was uniquely associated with engagement in "shadow work" and, surprisingly, a high use of routine services. These findings paint a picture of unique and separate processes for different types of housing transitions. These results reinforce the importance of focusing interventions on the needs of these unique housing transitions, paying particular attention to prior housing patterns, substance abuse, and the different ways that homeless adults are marginalized in our society.