Ethnic disparities in health and health-related behaviors among homeless women

Limited research has focused on ethnic differences in homeless women's health. Using a probability sample of homeless women in Los Angeles, we employ the Behavioral Model for Vulnerable Populations to examine the predisposing, enabling, and need factors associated with health and health-related behaviors in this population. A community-based probability sample of 974 homeless women in 66 shelters and meal programs underwent a one hour structured face-to-face interview. Numerous ethnic differences in the correlates of health and health-behavior exist among homeless women. White women are especially vulnerable to poor health, reporting more gynecological symptoms, limitations on physical functioning, history of drug and alcohol abuse, and history of psychiatric hospitalization. White women's experience of homelessness is also more severe compared to African Americans and Hispanics; White women had been homeless longer on average and reported more exits from homelessness. No significant ethnic differences exist in key sociodemographic factors including income, health insurance coverage, work status, or receipt of food stamps. The experience of homelessness differs by ethnicity, as do the correlates of health and health-related behaviors. White women in this population experience poorer health than African American and Hispanic women on a number of measures. These ethnic differences must be considered when using the Behavioral Model for Vulnerable Populations to examine health outcomes. While most homeless women have health disparities, our findings that white homeless women had the greatest disparity on many measures suggest that this subgroup also needs to be targeted by program planners and policy makers to improve their health.