Why are black adults over-represented among individuals who have experienced lifetime homelessness? Oaxaca-Blinder decomposition analysis of homelessness among US male adults.

BACKGROUND: Non-Hispanic black adults experience homelessness at higher rates than non-Hispanic white adults in many studies. We aim to identify factors that could account for this disparity.
METHODS: We used national survey data on non-Hispanic black and white men with complete data from the National Epidemiological Survey on Alcohol and Related Conditions Wave III. Using the Oaxaca-Blinder decomposition analysis, we examined race-based disparities in correlates of risk for lifetime homelessness.
RESULTS: In our analysis, 905 of 11 708 (7.7%) respondents, representing 6 million adults nationwide, reported lifetime homelessness. Black adults were 1.41 times more likely to have been homeless than white adults (95% CI 1.14 to 1.73; p=0.002). Overall, 81.6% of race-based inequality in lifetime homelessness were explained by three main variables with black adults having: lower incomes, greater incarceration histories since age of 18 and a greater risk of traumatic events (p<0.01 for each). They also had more antisocial personality disorder, younger age and parental drug use (p<0.05 for each).
CONCLUSION: Although previous studies suggested that black homeless men have higher rates of drug abuse than white homeless men, our findings highlight the fact that black-white disparities in lifetime homeless risk are associated with socio-structural factors (eg, income and incarceration) and individual adverse events (eg, traumatic events), and not associated with psychiatric or substance use disorders. © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.