Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #105241

David E. Pollio, PhD, George Warren Brown School of Social Work, Washington University, One Brookings Dr., Box 1196, St. Louis, MO 63130-4899, (314) 935-7516, depollio@gwbmail.wustl.edu, Carol S. North, MD, MPE, School of Medicine, Washington University, Department of Psychiatry, 660 S Euclid, CB 8134, Renard Building, Room 2210, St. Louis, MO 63110, Karin M. Eyrich, PhD, School of Social Administration, Temple University, 1301 Cecil B. Moore Ave, Ritter Annex, Philadelphia, PA 19122, and Brian McKean, Washington University, George Warren Brown School of Social Work, Box 1196, St. Louis, MO 63130-4899.

Introduction: Locating services in neighborhoods often meets resistance, making the argument that “undesirables” will follow services to their new locations. This phenomenon, labeled NIMBY (“Not In My Back Yard”) and often associated with addiction, mental health, and homelessness services, remains untested. The purpose of this study is to test a “NIMBY hypothesis”—that clients move closer to their services—in a homeless drug abusing population.

Methods: A homeless sample (N=400) was randomly recruited. Individuals provided addresses of their current sleeping locations at baseline, and again at 12-month follow-up. Structured diagnostic interviews were conducted for lifetime substance abuse/dependence and other mental illness. Service use data were collected directly from all homeless, addiction, and mental health services within the urban area. Using ArcView software, street-route distance was calculated from sleeping location to each service agency used during the interim (n=7,700). Regression analyses using Taylor Service Linearization Method (SAS' Proc Surveyreg) were used to compare: (1) change in distance traveled at baseline versus follow-up and (2) among psychiatric diagnoses.

Results: Change in distance did not decrease significantly baseline to follow-up, in the full sample or in any diagnostic subgroup.

Discussion: Results failed to support the NIMBY hypothesis. For homelessness, it appears that sleeping location did not increasingly cluster geographically with services over time. One possible explanation is that sleeping location is dictated more by availability than convenience among homeless. The findings appear to support a counter-argument that, in terms of sleeping location, NIMBY with homeless is driven more by stigma than by reality.

Learning Objectives: At the conclusion of the session users will be able to

• Assess the validity of the NIMBY argument for neighborhoods resisting development of new services.
• Articulate the use of spatial technology in understanding the impact of distance traveled by homeless to services.
• Identify the role that addiction and mental illness play in the association between distance and service use.

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation