Addressing racial and ethnic disparities in premature exits from permanent supportive housing among residents with substance use disorders
Abstract Background Permanent supportive housing (PSH) is an evidence-based practice for reducing homelessness that subsidizes permanent, independent housing and provides case management—including linkages to health services. Substance use disorders (SUDs) are common contributing factors towards pre...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-024-21169-2 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832571213028786176 |
|---|---|
| author | Talia J. Panadero Sonya Gabrielian Marissa J. Seamans Lillian Gelberg Jack Tsai Taylor Harris |
| author_facet | Talia J. Panadero Sonya Gabrielian Marissa J. Seamans Lillian Gelberg Jack Tsai Taylor Harris |
| author_sort | Talia J. Panadero |
| collection | DOAJ |
| description | Abstract Background Permanent supportive housing (PSH) is an evidence-based practice for reducing homelessness that subsidizes permanent, independent housing and provides case management—including linkages to health services. Substance use disorders (SUDs) are common contributing factors towards premature, unwanted (“negative”) PSH exits; little is known about racial/ethnic differences in negative PSH exits among residents with SUDs. Within the nation’s largest PSH program at the Department of Veterans Affairs (VA), we examined relationships among SUDs and negative PSH exits (for up to five years post-PSH move-in) across racial/ethnic subgroups. Methods We used VA administrative data to identify a cohort of homeless-experienced Veterans (HEVs) (n = 2,712) who were housed through VA Greater Los Angeles’ PSH program from 2016–2019. We analyzed negative PSH exits by HEVs with and without SUDs across racial/ethnic subgroups (i.e., African American/Black, Non-Hispanic White, Hispanic/Latino, and Other/Mixed [Asian, American Indian or Alaskan Native, and Native Hawaiian or Other Pacific Islander, and mixed race/ethnicity]) in controlled models and accounting for competing risk of death. Results In competing risk models, HEVs with at least one SUD had 1.3 times the hazard of negative PSH exits compared to those without SUDs (95% CI: 1.00, 1.61). When stratifying by race/ethnicity, Other/Mixed race residents with at least one SUD had 6.4 times the hazard of negative PSH exits compared to their peers without SUDs (95% CI: 1.61–25.50). Hispanic/Latino residents with at least one SUD had 1.9 times the hazard compared to those without SUDs; however, this association was not statistically significant (95% CI: 0.85–4.37). African American/Black residents with at least one SUD had 1.2 times the hazard compared to those without SUDs (95% CI: 0.85–1.64), indicating no evidence of an association with negative PSH exits. Non-Hispanic White residents with at least one SUD had 1.1 times the hazard compared to those without SUDs (95% CI: 0.75–1.66), similarly indicating no evidence to suggest an association with negative PSH exits. Conclusions These findings suggest relationships between SUDs and negative PSH exits differ between racial/ethnic groups and suggest there may be value in culturally specific tailoring and implementation of SUD services for these subgroups. |
| format | Article |
| id | doaj-art-0b1d2a40c13c466ebe5dd0364e8c1b0f |
| institution | Kabale University |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-0b1d2a40c13c466ebe5dd0364e8c1b0f2025-02-02T12:45:54ZengBMCBMC Public Health1471-24582025-01-0125111010.1186/s12889-024-21169-2Addressing racial and ethnic disparities in premature exits from permanent supportive housing among residents with substance use disordersTalia J. Panadero0Sonya Gabrielian1Marissa J. Seamans2Lillian Gelberg3Jack Tsai4Taylor Harris5Center for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP), Department of Veteran Affairs (VA) Greater Los AngelesCenter for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP), Department of Veteran Affairs (VA) Greater Los AngelesDepartment of Epidemiology, UCLA Fielding School of Public HealthCenter for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP), Department of Veteran Affairs (VA) Greater Los AngelesDepartment of Veteran Affairs Central Office, National Center On Homelessness Among VeteransCenter for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP), Department of Veteran Affairs (VA) Greater Los AngelesAbstract Background Permanent supportive housing (PSH) is an evidence-based practice for reducing homelessness that subsidizes permanent, independent housing and provides case management—including linkages to health services. Substance use disorders (SUDs) are common contributing factors towards premature, unwanted (“negative”) PSH exits; little is known about racial/ethnic differences in negative PSH exits among residents with SUDs. Within the nation’s largest PSH program at the Department of Veterans Affairs (VA), we examined relationships among SUDs and negative PSH exits (for up to five years post-PSH move-in) across racial/ethnic subgroups. Methods We used VA administrative data to identify a cohort of homeless-experienced Veterans (HEVs) (n = 2,712) who were housed through VA Greater Los Angeles’ PSH program from 2016–2019. We analyzed negative PSH exits by HEVs with and without SUDs across racial/ethnic subgroups (i.e., African American/Black, Non-Hispanic White, Hispanic/Latino, and Other/Mixed [Asian, American Indian or Alaskan Native, and Native Hawaiian or Other Pacific Islander, and mixed race/ethnicity]) in controlled models and accounting for competing risk of death. Results In competing risk models, HEVs with at least one SUD had 1.3 times the hazard of negative PSH exits compared to those without SUDs (95% CI: 1.00, 1.61). When stratifying by race/ethnicity, Other/Mixed race residents with at least one SUD had 6.4 times the hazard of negative PSH exits compared to their peers without SUDs (95% CI: 1.61–25.50). Hispanic/Latino residents with at least one SUD had 1.9 times the hazard compared to those without SUDs; however, this association was not statistically significant (95% CI: 0.85–4.37). African American/Black residents with at least one SUD had 1.2 times the hazard compared to those without SUDs (95% CI: 0.85–1.64), indicating no evidence of an association with negative PSH exits. Non-Hispanic White residents with at least one SUD had 1.1 times the hazard compared to those without SUDs (95% CI: 0.75–1.66), similarly indicating no evidence to suggest an association with negative PSH exits. Conclusions These findings suggest relationships between SUDs and negative PSH exits differ between racial/ethnic groups and suggest there may be value in culturally specific tailoring and implementation of SUD services for these subgroups.https://doi.org/10.1186/s12889-024-21169-2Permanent supportive housingSubstance use disorderHomelessnessHealth disparities |
| spellingShingle | Talia J. Panadero Sonya Gabrielian Marissa J. Seamans Lillian Gelberg Jack Tsai Taylor Harris Addressing racial and ethnic disparities in premature exits from permanent supportive housing among residents with substance use disorders BMC Public Health Permanent supportive housing Substance use disorder Homelessness Health disparities |
| title | Addressing racial and ethnic disparities in premature exits from permanent supportive housing among residents with substance use disorders |
| title_full | Addressing racial and ethnic disparities in premature exits from permanent supportive housing among residents with substance use disorders |
| title_fullStr | Addressing racial and ethnic disparities in premature exits from permanent supportive housing among residents with substance use disorders |
| title_full_unstemmed | Addressing racial and ethnic disparities in premature exits from permanent supportive housing among residents with substance use disorders |
| title_short | Addressing racial and ethnic disparities in premature exits from permanent supportive housing among residents with substance use disorders |
| title_sort | addressing racial and ethnic disparities in premature exits from permanent supportive housing among residents with substance use disorders |
| topic | Permanent supportive housing Substance use disorder Homelessness Health disparities |
| url | https://doi.org/10.1186/s12889-024-21169-2 |
| work_keys_str_mv | AT taliajpanadero addressingracialandethnicdisparitiesinprematureexitsfrompermanentsupportivehousingamongresidentswithsubstanceusedisorders AT sonyagabrielian addressingracialandethnicdisparitiesinprematureexitsfrompermanentsupportivehousingamongresidentswithsubstanceusedisorders AT marissajseamans addressingracialandethnicdisparitiesinprematureexitsfrompermanentsupportivehousingamongresidentswithsubstanceusedisorders AT lilliangelberg addressingracialandethnicdisparitiesinprematureexitsfrompermanentsupportivehousingamongresidentswithsubstanceusedisorders AT jacktsai addressingracialandethnicdisparitiesinprematureexitsfrompermanentsupportivehousingamongresidentswithsubstanceusedisorders AT taylorharris addressingracialandethnicdisparitiesinprematureexitsfrompermanentsupportivehousingamongresidentswithsubstanceusedisorders |