Problem gambling and homelessness: Results from an epidemiologic study

Background: Both homelessness and problem gambling are serious public health concerns. Like problem gamblers, homeless individuals suffer more health, mental health, and substance abuse problems than those without such problems. Many problem gamblers experience adverse consequences severe enough to precipitate loss of their jobs, families, and, ultimately, housing. Despite the apparent relationship between problem gambling and homelessness, few studies have evaluated associations between problem gambling and homelessness, particularly among African-Americans.

Objectives: The NIDA-funded SUNCODA (Service Use, Needs, Costs, and Outcomes of Drug Abuse in Homeless Populations) study collected data relevant to substance abuse, mental health, and demographic characteristics of homeless problem gamblers.

Method: The Diagnostic Interview Schedule, Composite International Diagnostic Interview Substance Abuse Module, and South Oaks Gambling Screen (SOGS) were administered to an epidemiologic sample of 275 predominately African-American homeless individuals. Based on responses to the SOGS, respondents were divided into three groups: lifetime non-gamblers (n=60), recreational gamblers (n=152), and problem gamblers (n=63).

Results: Nearly one-fourth (23%) of these homeless individuals were classified as problem gamblers. Problem gamblers were more likely to be male, homeless because of health problems, and report frequent charges of public intoxication. They also had the highest rates of lifetime substance abuse, antisocial personality disorder, schizophrenia, bipolar disorder, and any psychiatric disorder.

Conclusions: Problem gambling in this homeless sample was nearly 4 times as prevalent as in the general population. Accordingly, health services for the homeless, particularly African-Americans, should include assessment of problem gambling. Implications for design and implementation of these services will be discussed.