Objectives: This study examines rates of lifetime adult homelessness among foreign-born adults in the United States and how they differ from native-born adults. Study design: Cross-sectional data from a nationally representative US sample were analyzed. Methods: A sample of 29,896 native-born (weighted 84.1%) and 6404 foreign-born (weighted 16.0%) US adults participating in the National Epidemiologic Survey on Alcohol and Related Conditions-III were compared on rates of homelessness, controlling for sociodemographic characteristics, mental and substance-use disorders, health insurance, and use of welfare. Results: There was no significant difference in rates of lifetime adult homelessness between foreign-born adults and native-born adults (1.0% vs 1.7%). Foreign-born participants were less likely to have various mental and substance-use disorders, less likely to receive welfare, and less likely to have any lifetime incarceration. The number of years foreign-born adults lived in the United States was significantly associated with risk for homelessness. Conclusions: These findings suggest the ‘healthy immigrant effect’ applies to the mental health and social functioning of US immigrants but may not necessarily apply to homelessness. Long-standing immigration procedures requiring mental health and psychosocial evaluations may contribute to selection effects. © 2018

immigrants Homelessness Mental illness welfare incarceration

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