Alcohol and Homeless Women's Use of Health Services

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DESCRIPTION (provided by applicant): Alcohol abuse/dependence and physical health problems are quite common among the homeless and their general health-care needs often go unmet. However, much of the existing research is based on samples comprised largely of homeless men. To date, there has been no population-based study of the association between alcohol abuse/dependence and utilization of general health care among homeless women. This study will employ secondary data to analyze the association between alcohol abuse/dependence and use of general health care (inpatient, ambulatory, and preventive) in a community-based probability sample of 974 homeless women in Los Angeles County. We will identify factors that appear to impede or facilitate the use of general health care among homeless women with lifetime alcohol abuse/ dependence. The proposed study directly addresses policy questions prominent in NIAAA's agenda for research on health services and special populations including women, minorities, and victims of violence. First, the majority of homeless women are members of ethnic minority groups and have been victims of violence. Second, homeless women are likely to have multiple health problems requiring general health care. Because homeless women may view such problems as more important than alcohol problems, effective access to general health services may facilitate utilization of and success in alcohol treatment as well. This study will test hypotheses regarding a wide range of predisposing and enabling factors (such as case management, health insurance, and access to public benefits) potentially associated with access to general health services by homeless women with alcohol problems. By documenting the nature and extent of health problems affecting alcohol-using homeless women, their use of general health services, and the extent to which their need for care goes unmet, this study will inform alcohol treatment providers on the value and content of screening/assessment procedures they might employ and the types of general health services for which more effective linkage is needed.