Subjective versus Objective Definitions of Homelessness: Are there Differences in Risk Factors among Heavy-Drinking Women?

Investigations with homeless populations have focused on those living on the streets or in shelters; few have examined phenomena based on respondents' self-definitions as homeless or not. This investigation examined similarities and differences among risk factors (including mental health, substance abuse, religion/spirituality, social support, and risky sexual behaviors) using two definitions of homelessness: one where place of residence defined individuals as homeless (the `objective', or traditional, definition) and another where respondents defined themselves as homeless (the `subjective' definition). Data come from the baseline survey of the NIAAA-funded "Sister-to-Sister" study (n=339) of heavy-drinking women. Subjectively-defined homelessness was associated with higher rates of mental health and substance use disorders, lower rates of condom use, higher rates of trading sex for food, and less social support. Objectively-defined homelessness was associated with higher rates of drinking in abandoned buildings, on the streets, and in public restrooms, more new sexual partners, and higher rates of trading sex for heroin and speedballs. Investigations failing to ask for subjective information may misattribute some factors to homelessness which may overestimate the effect of various factors on homelessness. Investigators should ask respondents to define their homelessness, or they lose an important dimension of the concept of homelessness.