{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T14:51:11Z","timestamp":1781794271199,"version":"3.54.5"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T00:00:00Z","timestamp":1775865600000},"content-version":"vor","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA043484"],"award-info":[{"award-number":["R01DA043484"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Urban Health"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>For people who inject drugs (PWID), housing instability due to decreasing housing affordability and other factors (e.g., loss of housing due to severed relational ties, evictions due to drug use) results in added pressure on an already vulnerable population. Findings on the relationship between housing instability and overdose risk among PWID have been equivocal, in part due to inconsistent and conceptually incomplete operationalizations of housing instability. We propose a holistic, multi-indicator measure of housing instability and examine its association with drug overdose to improve understanding of its relationship to overdose. The baseline data from a network-based, longitudinal study of young PWID and their networks living in metropolitan Chicago, Illinois was analyzed to examine the relationship between a housing instability index score\u2014consisting of five dichotomous variables assessing housing instability\u2014and lifetime overdose count using negative binomial regression. We found a significant positive association between the housing instability score and lifetime overdose count after adjusting for 9 variables. Our results support the practical utility of a multi-indicator measure of housing instability in predicting overdose and highlight the importance of taking a holistic approach to addressing housing instability when designing interventions.<\/jats:p>","DOI":"10.1007\/s11524-026-01066-2","type":"journal-article","created":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T18:27:19Z","timestamp":1775932039000},"page":"293-303","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Novel Index Measure of Housing-Related Risk as a Predictor of Overdose Among Young People Who Inject Drugs and Injection Networks"],"prefix":"10.1007","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0847-3243","authenticated-orcid":false,"given":"Kathleen","family":"Kristensen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie D.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlie","family":"Kaplan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliet","family":"Pineros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunhye","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maggie","family":"Kaufmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Ellen","family":"Mackesy-Amiti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basmattee","family":"Boodram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,11]]},"reference":[{"key":"1066_CR1","unstructured":"Spencer MR, Garnett MF, Mini\u00f1o AM. Drug Overdose Deaths in the United States, 2002\u20132022 [Internet]. Hyattsville, MD: National Center for Health Statistics: National Center for Health Statistics; 2024. Report No.: 491. Available from: https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db491.htm. Accessed 5 Apr 2024."},{"key":"1066_CR2","unstructured":"de Sousa T, Andrichik A, Prestera E, Rush K, Tano C, Wheeler M. The 2023 Annual Homelessness Assessment Report (AHAR) to Congress. The U.S. Department of Housing and Urban Development; 2023 Dec. Available from: https:\/\/www.huduser.gov\/portal\/sites\/default\/files\/pdf\/2023-AHAR-Part-1.pdf. Accessed 11 May 2024."},{"key":"1066_CR3","doi-asserted-by":"crossref","unstructured":"Brady BR, Taj EA, Cameron E, Yoder AM, De La Rosa JS. A diagram of the social-ecological conditions of opioid misuse and overdose. Int J Environ Res Public Health. 2023;20(20):6950.","DOI":"10.3390\/ijerph20206950"},{"key":"1066_CR4","doi-asserted-by":"crossref","unstructured":"Des Jarlais DC, Braine N, Friedmann P. Unstable housing as a factor for increased injection risk behavior at US syringe exchange programs. AIDS Behav. 2007;11(6 Suppl):78\u201384.","DOI":"10.1007\/s10461-007-9227-6"},{"key":"1066_CR5","doi-asserted-by":"crossref","unstructured":"Topp L, Iversen J, Baldry E, Maher L. Housing instability among people who inject drugs: results from the Australian needle and syringe program survey. J Urban Health. 2013;90(4):699\u2013716.","DOI":"10.1007\/s11524-012-9730-6"},{"key":"1066_CR6","doi-asserted-by":"crossref","unstructured":"Williams LD, Lee E, Latkin C, Mackesy-Amiti ME, Kaufmann M, Copulsky E, et al. Economic challenges and behavioral and mental health risks for overdose during the COVID-19 pandemic among people who inject drugs. Int J Environ Res Public Health. 2022;19(9):5351.","DOI":"10.3390\/ijerph19095351"},{"key":"1066_CR7","doi-asserted-by":"crossref","unstructured":"Feldmeyer B, Cullen FT, Sun D, Kulig TC, Chouhy C, Zidar M. The community determinants of death: comparing the macro-level predictors of overdose, homicide, and suicide deaths, 2000 to 2015. Socius Sociol Res Dyn World. 2022;8:237802312211003.","DOI":"10.1177\/23780231221100392"},{"key":"1066_CR8","doi-asserted-by":"crossref","unstructured":"Chiang JC, Bluthenthal RN, Wenger LD, Auerswald CL, Henwood BF, Kral AH. Health risk associated with residential relocation among people who inject drugs in Los Angeles and San Francisco, CA: a cross sectional study. BMC Public Health. 2022;22(1):823\u2013823.","DOI":"10.1186\/s12889-022-13227-4"},{"key":"1066_CR9","doi-asserted-by":"crossref","unstructured":"Bretteville-Jensen AL, Lillehagen M, Gjersing L, Andreas JB. Illicit use of opioid substitution drugs: prevalence, user characteristics, and the association with non-fatal overdoses. Drug Alcohol Depend. 2014;147:89\u201396.","DOI":"10.1016\/j.drugalcdep.2014.12.002"},{"key":"1066_CR10","doi-asserted-by":"crossref","unstructured":"Calvo M, MacFarlane J, Zaccaro H, Curtis M, Cab\u00e1n M, Favaro J, et al. Young people who use drugs engaged in harm reduction programs in New York City: overdose and other risks. Drug Alcohol Depend. 2017;178:106\u201314.","DOI":"10.1016\/j.drugalcdep.2017.04.032"},{"key":"1066_CR11","doi-asserted-by":"crossref","unstructured":"Doran KM, Rahai N, McCormack RP, Milian J, Shelley D, Rotrosen J, et al. Substance use and homelessness among emergency department patients. Drug Alcohol Depend. 2018;188:328\u201333.","DOI":"10.1016\/j.drugalcdep.2018.04.021"},{"key":"1066_CR12","doi-asserted-by":"crossref","unstructured":"Yamamoto A, Needleman J, Gelberg L, Kominski G, Shoptaw S, Tsugawa Y. Association between homelessness and opioid overdose and opioid-related hospital admissions\/emergency department visits. Soc Sci Med. 2019;242:112585\u2013112585.","DOI":"10.1016\/j.socscimed.2019.112585"},{"key":"1066_CR13","doi-asserted-by":"crossref","unstructured":"DeBeck K, Small W, Wood E, Li K, Montaner J, Kerr T. Public injecting among a cohort of injecting drug users in Vancouver, Canada. J Epidemiol Community Health. 2009;63(1):81\u20136.","DOI":"10.1136\/jech.2007.069013"},{"key":"1066_CR14","doi-asserted-by":"crossref","unstructured":"Dickson-Gomez J, McAuliffe T, Quinn K. The effects of housing status, stability and the social contexts of housing on drug and sexual risk behaviors. AIDS Behav. 2017;21(7):2079\u201392.","DOI":"10.1007\/s10461-017-1738-1"},{"key":"1066_CR15","doi-asserted-by":"crossref","unstructured":"Kelly L, Hindmarch GM, Watkins KE, McCullough CM, Griffin BA, Meredith LS, et al. Association between housing status and mental health and substance use severity among individuals with opioid use disorder and co-occurring depression and\/or PTSD. BMC Prim Care. 2025;26(1):250.","DOI":"10.1186\/s12875-025-02947-2"},{"key":"1066_CR16","doi-asserted-by":"crossref","unstructured":"Milaney K, Passi J, Zaretsky L, Liu T, O\u2019Gorman CM, Hill L, et al. Drug use, homelessness and health: responding to the opioid overdose crisis with housing and harm reduction services. Harm Reduct J. 2021;18(1):1\u201392.","DOI":"10.1186\/s12954-021-00539-8"},{"key":"1066_CR17","doi-asserted-by":"crossref","unstructured":"Fortier E, Sylvestre MP, Artenie AA, Minoyan N, Jutras-Aswad D, Roy \u00c9, et al. Associations between housing stability and injecting frequency fluctuations: findings from a cohort of people who inject drugs in Montr\u00e9al, Canada. Drug Alcohol Depend. 2020;206:107744\u2013107744.","DOI":"10.1016\/j.drugalcdep.2019.107744"},{"key":"1066_CR18","doi-asserted-by":"crossref","unstructured":"Headley Konkel R, Hoffman CY. Immediate and neighborhood contextual effects on intentional, accidental, and fatal drug overdoses in a non-urban jurisdiction. Deviant Behav. 2021;42(11):1494\u2013511.","DOI":"10.1080\/01639625.2020.1756457"},{"key":"1066_CR19","doi-asserted-by":"crossref","unstructured":"Whittaker E, Swift W, Roxburgh A, Dietze P, Cogger S, Bruno R, et al. Multiply disadvantaged: health and service utilisation factors faced by homeless injecting drug consumers in Australia. Drug Alcohol Rev. 2015;34(4):379\u201387.","DOI":"10.1111\/dar.12257"},{"key":"1066_CR20","doi-asserted-by":"crossref","unstructured":"Frederick TJ, Chwalek M, Hughes J, Karabanow J, Kidd S. How stable is stable? Defining and measuring housing stability. J Community Psychol. 2014;42(8):964\u201379.","DOI":"10.1002\/jcop.21665"},{"key":"1066_CR21","doi-asserted-by":"crossref","unstructured":"Cotton BP, Schwartz-Barcott D. Residential instability among low-income families: a concept analysis. Arch Psychiatr Nurs. 2016;30(2):257\u201361.","DOI":"10.1016\/j.apnu.2015.11.006"},{"key":"1066_CR22","doi-asserted-by":"crossref","unstructured":"Clapham D. Pathways approaches to homelessness research. J Community Appl Soc Psychol. 2003;13(2):119\u201327.","DOI":"10.1002\/casp.717"},{"key":"1066_CR23","unstructured":"Murdoch J, Brahmachari M, Okyere D, 2M Research, Moumen F, Streiff S, et al. Measuring housing insecurity: index development using american housing survey data | HUD USER. Department of Housing and Urban Development; 2023. Available from: https:\/\/www.huduser.gov\/portal\/publications\/Measuring-Housing-Insecurity-Index-Development-Using-AHS-Data.html. Accessed 14 Jan 2026."},{"key":"1066_CR24","unstructured":"Argonne National Laboratory. Housing Stability Index. Available from: https:\/\/www.anl.gov\/dis\/housing-stability-index. Accessed 14 Jan 2026."},{"key":"1066_CR25","doi-asserted-by":"crossref","unstructured":"Farero A, Sullivan CM, L\u00f3pez-Zer\u00f3n G, Bowles RP, Sprecher M, Chiaramonte D, Engleton J. Development and validation of the housing instability scale. J Soc Distress Homeless. 2024;33(1):142\u201351.","DOI":"10.1080\/10530789.2022.2127852"},{"key":"1066_CR26","doi-asserted-by":"crossref","unstructured":"P\u00e9rez-Figueroa RE, Obonyo DJ, Santoscoy S, Surratt HL, Lekas HM, Lewis CF, et al. Housing instability, structural vulnerability, and non-fatal opioid overdoses among people who use heroin in Washington Heights New York City. Behav Med. 2022;48(4):320\u201330.","DOI":"10.1080\/08964289.2021.1922347"},{"key":"1066_CR27","doi-asserted-by":"crossref","unstructured":"Mackesy-Amiti ME, Falk J, Latkin C, Kaufmann M, Williams L, Boodram B. Egocentric network characteristics of people who inject drugs in the Chicago metro area and associations with hepatitis C virus and injection risk behavior. Harm Reduct J. 2022;19(1):58.","DOI":"10.1186\/s12954-022-00642-4"},{"key":"1066_CR28","doi-asserted-by":"crossref","unstructured":"Boodram B, Mackesy-Amiti ME, Khanna A, Brickman B, Dahari H, Ozik J. People who inject drugs in metropolitan Chicago: a meta-analysis of data from 1997-2017 to inform interventions and computational modeling toward hepatitis C microelimination. PLoS One. 2022;17(1):e0248850\u2013e0248850.","DOI":"10.1371\/journal.pone.0248850"},{"key":"1066_CR29","doi-asserted-by":"crossref","unstructured":"Boodram B, Hotton AL, Shekhtman L, Gutfraind A, Dahari H. High-risk geographic mobility patterns among young urban and suburban persons who inject drugs and their injection network members. J Urban Health. 2018;95(1):71\u201382.","DOI":"10.1007\/s11524-017-0185-7"},{"key":"1066_CR30","unstructured":"ASPE. Poverty guidelines. Available from: https:\/\/aspe.hhs.gov\/topics\/poverty-economic-mobility\/poverty-guidelines. Accessed 9 Aug 2022."},{"key":"1066_CR31","doi-asserted-by":"crossref","unstructured":"DeBeck K, Cheng T, Montaner JS, Beyrer C, Elliott R, Sherman S, et al. HIV and the criminalization of drug use among people who inject drugs: a systematic review. Lancet HIV. 2017;4(8):e357\u201374.","DOI":"10.1016\/S2352-3018(17)30073-5"},{"key":"1066_CR32","doi-asserted-by":"crossref","unstructured":"Kirwan A, Curtis M, Dietze P, Aitken C, Woods E, Walker S, et al. The prison and transition health (PATH) cohort study: study protocol and baseline characteristics of a cohort of men with a history of injecting drug use leaving prison in Australia. J Urban Health. 2019;96(3):400\u201310.","DOI":"10.1007\/s11524-019-00353-5"},{"key":"1066_CR33","doi-asserted-by":"crossref","unstructured":"Gousia K, Baranowska-Rataj A, Middleton T, Nizalova O. The impact of unemployment and non-standard forms of employment on the housing autonomy of young adults. Work Employ Soc. 2021;35(1):157\u201377.","DOI":"10.1177\/0950017020936875"},{"key":"1066_CR34","doi-asserted-by":"crossref","unstructured":"Martins SS, Sampson L, Cerd\u00e1 M, Galea S. Worldwide prevalence and trends in unintentional drug overdose: a systematic review of the literature. Am J Public Health. 2015;105(11):e29\u201349.","DOI":"10.2105\/AJPH.2015.302843"},{"key":"1066_CR35","doi-asserted-by":"crossref","unstructured":"Linton SL, Celentano DD, Kirk GD, Mehta SH. The longitudinal association between homelessness, injection drug use, and injection-related risk behavior among persons with a history of injection drug use in Baltimore, MD. Drug Alcohol Depend. 2013;132(3):457\u201365.","DOI":"10.1016\/j.drugalcdep.2013.03.009"},{"key":"1066_CR36","doi-asserted-by":"crossref","unstructured":"Davidson PJ, McLean RL, Kral AH, Gleghorn AA, Edlin BR, Moss AR. Fatal heroin-related overdose in San Francisco, 1997\u20132000: a case for targeted intervention. J Urban Health. 2003;80(2):261\u201373.","DOI":"10.1093\/jurban\/jtg029"},{"key":"1066_CR37","doi-asserted-by":"crossref","unstructured":"Latkin CA, Hua W, Tobin K. Social network correlates of self-reported non-fatal overdose. Drug Alcohol Depend. 2004;73(1):61\u20137.","DOI":"10.1016\/j.drugalcdep.2003.09.005"},{"key":"1066_CR38","doi-asserted-by":"crossref","unstructured":"Latkin CA, Gicquelais RE, Clyde C, Dayton L, Davey-Rothwell M, German D, et al. Stigma and drug use settings as correlates of self-reported, non-fatal overdose among people who use drugs in Baltimore, Maryland. Int J Drug Policy. 2019;68:86\u201392.","DOI":"10.1016\/j.drugpo.2019.03.012"},{"key":"1066_CR39","doi-asserted-by":"crossref","unstructured":"van Draanen J, Tsang C, Mitra S, Phuong V, Murakami A, Karamouzian M, et al. Mental disorder and opioid overdose: a systematic review. Soc Psychiatry Psychiatr Epidemiol. 2021;57(4):647\u201371.","DOI":"10.1007\/s00127-021-02199-2"},{"key":"1066_CR40","doi-asserted-by":"crossref","unstructured":"Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385\u2013401.","DOI":"10.1177\/014662167700100306"},{"key":"1066_CR41","doi-asserted-by":"crossref","unstructured":"Smith LR, Earnshaw VA, Copenhaver MM, Cunningham CO. Substance use stigma: reliability and validity of a theory-based scale for substance-using populations. Drug Alcohol Depend. 2016;1(162):34\u201343.","DOI":"10.1016\/j.drugalcdep.2016.02.019"},{"key":"1066_CR42","doi-asserted-by":"crossref","unstructured":"Vallance K, Pauly B, Wallace B, Chow C, Perkin K, Martin G, et al. Factors associated with public injection and nonfatal overdose among people who inject drugs in street-based settings. Drugs\u202f: Educ Prevent Polic. 2018;25(1):38\u201346.","DOI":"10.1080\/09687637.2017.1351524"},{"key":"1066_CR43","doi-asserted-by":"crossref","unstructured":"Dunn KE, Barrett FS, Yepez-Laubach C, Meyer AC, Hruska BJ, Petrush K, et al. Opioid overdose experience, risk behaviors, and knowledge in drug users from a rural versus an urban setting. J Subst Abuse Treat. 2016;71:1\u20137.","DOI":"10.1016\/j.jsat.2016.08.006"},{"key":"1066_CR44","doi-asserted-by":"crossref","unstructured":"Koops-Van Hoffen HE, Lenthe van FJ, Poelman MP, Droomers M, Borl\u00e9e F, Vendrig-De Punder YMR, et al. Understanding the mechanisms linking holistic housing renovations to health and well-being of adults in disadvantaged neighbourhoods: a realist review. Health Place. 2023;80:102995.","DOI":"10.1016\/j.healthplace.2023.102995"},{"key":"1066_CR45","doi-asserted-by":"crossref","unstructured":"Baxter AJ, Tweed EJ, Katikireddi SV, Thomson H. Effects of housing first approaches on health and well-being of adults who are homeless or at risk of homelessness: systematic review and meta-analysis of randomised controlled trials. J Epidemiol Community Health. 2019;73(5):379\u201387.","DOI":"10.1136\/jech-2018-210981"}],"container-title":["Journal of Urban Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11524-026-01066-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11524-026-01066-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11524-026-01066-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T13:52:19Z","timestamp":1781790739000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11524-026-01066-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":45,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["1066"],"URL":"https:\/\/doi.org\/10.1007\/s11524-026-01066-2","relation":{},"ISSN":["1099-3460","1468-2869"],"issn-type":[{"value":"1099-3460","type":"print"},{"value":"1468-2869","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"11 April 2026","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 June 2026","order":3,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Update","order":4,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A mention of Table 1 in the Primary Covariate: Housing Instability Index section has been corrected since the original publication of the article.","order":5,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The data analyzed in this manuscript are part of a study that was approved by the Institutional Review Board at the University of Illinois Chicago (Protocol #2017\u20130388). Informed consent was obtained from all study participants prior to participation, following the guidelines set out by the IRB.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval and Consent to Participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}}]}}