Structural and Personal Factors Related to Access to Housing and Housing Stability among Urban Drug Users in Hartford, Connecticut

Early researchers studying the causes of homelessness often focused on individual pathologies, such as chronic substance abuse or mental illness (Lamb, 1984; Baum & Burnes, 1993), e.g. the risky person model (Aidala, 2006). Others have argued that structural factors, most often conceptualized as socioeconomic changes in the inner-city, are the causes of the increase in homelessness over the past two decades (Harrington, 1984; Blau, 1992). More recent research has argued that both personal and structural factors must be considered. Substance abuse and mental illness do not cause homelessness but make individuals with these disorders more vulnerable to becoming homeless in increasingly competitive housing markets (Burt, 1992; Cohen & Thompson, 1992; Koegel & Burnam, 1992; Shinn, 1992; Koegel, Melamid & Burnam, 1995; Booth, Sullivan, Koegel & Burnam, 2002). Structural factors determine why pervasive homelessness exists in this historical time, while individual factors explain who is least able to compete for scarce affordable housing (Burt, 1992; Cohen & Thompson, 1992; Koegel & Burnam, 1992; Shinn, 1992; Koegel, Melamid, et al., 1995; Booth, Sullivan, et al., 2002).Drug use as cause or consequence is another frequently argued question. Research has shown that substance use problems afflict anywhere from 28 to 67% of homeless individuals (Fischer & Breakey, 1991; Lehman & Cordrey, 1993; Stahler, Shipley, Bartelt, Wescott, Griffith & Shandler, 1993; Dennis, Bray & lachan, 1998; Royse, Leukefeld, Logan, Dennis, Weschberg, Hoffman, et al., 2000) and that substance abuse increases individuals' vulnerability to homelessness (Spinner & Leaf, 1992; Winkleby, Rockhill, Jatulis & Fortman, 1992; Johnson, Freels, Parsons & Vangeest, 1997). In contrast, other researchers have argued that drug abuse is more likely to be a consequence of homelessness, as drugs are used to cope with the stresses of homelessness. Johnson and colleagues (1997) found support for both positions and argue that a multidirectional model is more appropriate. In their study, drug use was associated with first homeless episode. Also, prior homeless experiences were found to be predictive of first symptoms of drug abuse. Other research has compared the personal characteristics of drug using with non-drug using homeless (Galaif, Nyamathi & Stein, 1999; Booth, Sullivan, et al., 2002). Homeless individuals with a lifetime or recent diagnosis of substance dependence reported more severe homeless history, more childhood/ adolescent vulnerabilities for homelessness, repeated homelessness, indications of poorer quality recent shelter (more days outdoors, fewer nights in places meant for sleeping, more victimization) (Booth, Sullivan, et al., 2002), and less positive social support (Galaif, Nyamathi, et al., 1999).However, little research has examined the criminalization of drug use and housing policy as potential structural factors that may contribute to the association between substance abuse and homelessness. Many federal policies and laws criminalizing drug use may limit drug users' access to housing, housing subsidies, welfare benefits, and employment. The federal "One Strike and You're Out" law (PL. 104-120, Sec.9), passed in 1996, allows federal housing authorities to consider drug and alcohol abuse and convictions by people and their family members when making decisions to evict them from or deny them access to federally subsidized housing, although states may opt out of this law. Other policies which have impacted drug users' access to housing include the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, in particular the elimination of the SSI Addiction Disability and a ban on receiving welfare benefits for convicted drug offenders (Anderson, Shannon, Schyb, Goldstein, et al., 2002; Crane, Quirk & van der Straten, 2002; Baumohl, Speiglman, Swartz & Stahl, 2003; Drug Policy Alliance, 2003; Hunt & Baumohl, 2003a; Hunt & Baumohl, 2003b; Norris, Scott, Speiglman & Green, 2003). …