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The current study focuses on three dimensions of treatment neighborhood environments that may influence treatment retention: neighborhood disadvantage, stability, and concentrated immigration. We examined treatment outcomes for a total of 9,319 individuals who were admitted for initial treatment in 56 outpatient clinics in Cook County, Illinois. Census-tract-level data were used to measure facility neighborhood environment. We found that neighborhood disadvantage was unrelated to individual treatment completion. Immigrant concentration was found to increase the likelihood of substance abuse treatment completion, although it was attenuated after controlling for patient problem severity and referral sources. Neighborhood stability was found to be positively related to treatment completion. These results suggest that knowledge of neighborhood context should be an important consideration when making placement decisions of new treatment facilities. Knowledge of neighborhood impact on treatment attrition should also be considered essential information to be used for client placement, treatment program design, and discharge protocols. [ABSTRACT FROM AUTHOR]

Incarcerated women are among the most vulnerable and perhaps the least studied populations in the US. Significant proportions of female inmates are substance users, and many living in unstable housing conditions or being homeless. Female inmates are often at high risk of engaging in sex exchange for drugs or housing needs. While a disproportionate number of incarcerated women have experienced childhood household adversities and maltreatments, the effects of these childhood experiences on psychosocial and behavioral outcomes of this population in later life. We apply a life course perspective to examine these pathways in a sample of incarcerated women in Cook County, Illinois. Findings demonstrated lasting, but differential, effects of household adversities and childhood abuse on subsequent life risks and opportunities among these women. [ABSTRACT FROM AUTHOR]

PURPOSE: To investigate whether substance abuse is a direct factor in the explanation of homelessness or one that operates indirectly through disaffiliation and human capital processes to place individuals at greater risk of the condition.METHODS: Analyses were conducted using data on substance abuse and homeless experiences from a random probability sample of 481 homeless persons and those at risk of homelessness in Cook County, Illinois. Covariance structure models were used to assess substance abuse, human capital, and disaffiliation as potential precursors of homelessness, with particular attention paid to the direct and indirect role of substance abuse in the loss of domicile.RESULTS: Analysis of several nested models of homelessness links substance abuse only indirectly to loss of domicile, primarily through its impact on social and institutional affiliations. Contrary to expectations, substance abuse did not impact homelessness indirectly by diminishing the accumulation of human capital.CONCLUSIONS: The role of disaffiliation as a proximate cause of homelessness was confirmed. This locates the phenomenon within the context of society itself, as a direct result of a breakdown in the social bonds necessary for human community. Substance abuse plays a critical role in this breakdown, negatively influencing social as well as institutional relationships. [Copyright &y& Elsevier]