Homelessness: Risk Factors Associated With Homelessness Homelessness, by official definition is a state of people who use shelter care services provided by the state for any period of time- night shelter or extended periods. In America at any given period around the year, about two to three million are homeless accounting for 1% of the population (Lehmann et al., 2001). About 10% of these people are observed to use these services for much longer times and are the biggest consumers of the shelter care provisions (Kuhn & Culhane, 1998; Culhane et al., 1999; Caton et al. 2005). This social problem is a significant public health issue.

Homelessness is rampant amongst the drugs and alcohol abusers. When studied from the point of economic and social perspectives the use of intoxicants such as chemical substances, alcohol and other drugs, proved to be the primary cause of homelessness for over the last fifty years (Johnson et al. 1997; O'Toole et al. 2004; Caton et al. 2005; Fazel et al. 2008). The problem was initially reported only in white and single men, but now affects a wider cross section of the society and has cut across barriers of age and gender. Data collected thrice by North et al. (2004) over a two-decade (1980-2000) period in St. Louis shows that abuse of chemical substances and alcoholism is on the increase amongst the homeless with over 84% men and 58% women found to be addicted (McQuistion et al., 2014).

The focus of this paper is recurring cases and causes of homelessness. The aims, hence are: (1) to explain the clinical, social and demographic features of the homeless; (2) to analyze the correspondence between family, demography, psychiatric and physical illness, and use of shelter service domains causative of homelessness; and (3) identification of key reasons causative of recurrent homelessness. Towards the same, it is necessary to examine the risk factor causing this social malaise (McQuistion et al., 2014).

Methodology

Participants

Caton et al. (2005) carried out the survey on 445 (comprising of 225 men and 220 women) homeless from 6 assessment shelters in New York City. The age group focus was 16 to 65 years. Expectedly there were far more men than women homeless (Burt et al., 2001); respondents were accessed on a two-week rotation all round the year to account for seasonal fluctuations and figures. The criteria for sampling was that the person was to be homeless, without shelter for at least two weeks before afforded the shelters provided by the administration. From the Homeless History Form the researchers confirmed that these seekers were first timers- had no way of knowing where to reside or even sleep at night other than that provided by the state (Link et al., 1995). The interviewers were assigned such cases of homelessness and asked to approach them at a six-month interval at 6, 12 and 18 months from the first instant (Caton et al. 2005).

Curtis et al., (2014), approached the issue from the viewpoint of Fragile Families and Child Wellbeing. They hence sought the inmates at 75 hospitals of 20 cities (a population of at least 200,000) in America. The criterion used were that the mother who had just delivered had to be an adult or permission of the hospital staff to interview minors, speak reasonably well in English or Spanish, the father was alive and the parents wanted to raise the child on their own. Of the 4898 mothers interviewed primarily (at the time of delivery, in the period between mid-1998 to late 2000), most of them (89%) and 86% were interviewed after a one year gap and then again after a two-year gap respectively (Curtis et al., 2014). The fathers were also interviewed similarly.

Lehmann et al., (2001) focused on homeless women in Sacramento, CA in 1996 followed by a survey conducted in the Lehigh Valley (Allentown -- Bethlehem -- Easton) of Pennsylvania in 1997. The survey and interview questions were identical in both cases with the exception of addition of domestic violence query in the second series. The survey approached the adults who had been homeless for less than 2 months. Housed controls were those who were first timers since they turned adult. These were compared with those who were incidental homeless. The interviewee belonged to shelter homes, free meals centers, day care services, social service centers and protection from domestic violence shelters. All (100%) women availing such services were approached. 90% allowed to the screening test. The screening was done based...

Those fitting the criterion were then asked if they would want to be interviewed and 85% agreed. The interview was carried out by a trained assistant spread over 45 minutes (Lehmann et al., 2001).
Metraux et al. (2013), referred to the LC database that contains details about the 494, 147 armed forces' ex-servicemen who had a retired between July 1, 2005, and September 30, 2006. The base of this analytical data are the 100 files obtained from the VA and DoD. Database. The researchers also accessed the Social Security Administration death files from the U.S. Department of Veterans Affairs Office of the Inspector General, 2012. The data thus acquired was used to interview 310, 685 ex, army personnel. The age group was 17 to 64 years. None of the veterans had history of homelessness prior to leaving the services. They had approached the VA or DoD only after leaving the forces. The database was analyzed by deploying SAS version 9.3. (Metraux et al., 2013)

Parhar & Wormith (2013) sought to interview 100 federal offenders who would be released in a six-month period decided by the authors. However, the outcome was far from encouraging to be included as a study. The authors chose the area of Saskatchewan. Only 41 acceded to the request for an interview, out which there were five females. The respondents were evasive of their community backgrounds, no longer in contact, or back to imprisonment. As a result, only 11 could eventually be considered for interview of any significance. The data was too small for quantitative significance. The inmates were chosen from the federal correctional facilities in Saskatchewan. The interview duration was 30 minutes (Parhar & Wormith, 2013)

Thomson et al. (2013) targeted adults in household shelters and group quarters. The survey response rate was 81%. The analysis of the weighted data against the population census data of 2000 was taken for the representation value. In the field-analysis method interviews were conducted by supervisory control through trained personnel (Grant et al., 2004). The wave 1 interviews comprised of 43, 093 respondents and wave2 34, 653 from those interviewed in wave 1. In the wave2, the response rate was 86.7% as the remaining respondents could not be located or refused to accede to the request of re-interview. The wave2 design was in accordance with the NESARC directives and the sample was weighed against the civilian population of America to project the sample representation. The study was carried out on those who had never been homeless (Thomson et al., 2013).

In the first case, (Caton et al.) the shelter access facilities- gateway to state and municipal shelter providing services were accessed for homeless persons between the age of 18 and 65 years. They were revisited in intervals of six months for recurrence estimation. Curtis and colleagues sought out the data for fragile families from the hospitals where the mothers had just delivered their babies and were homeless or risked being homeless. They were revisited after a year of baseline interview and then after two more years to measure recurrence episodes. Lehmann also conducted a survey for homeless on lines similar to those of Caton but aimed only at women. Though Metraux also targeted the age group of 17 to 64, his focus was on ex-servicemen. Most of those were then found to have been deployed in the Gulf war. Parhar & Wormith sought to measure the homelessness episode and recurrence in those who had been incarcerated. This study did not prove of much value, as the inmates were prone to disappearing, avoiding interviews or reincarcerated. Thomson and colleagues sought to find as many homeless as possible like Caton or Lehmann, but interviewed many more persons as they wanted to find the estimated population representative of the total civilian population, that is now being estimated at 1% homeless across the country.

Findings

Out of the 13% mothers who experienced depression, those who feared becoming homeless (6%) and those who feared the "risk" of homelessness (14%), did eventually become so against those who did not experience postpartum depression (2% and 9%, respectively). Mental depression was seen to correspond with prior history of mental instability (22% and 10%( those without history)). Both father and mother had mental illnesses or taken drugs during pregnancy (Curtis et al., 2014).

The older people (>44 years, with f