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Sample records for homeless persons san

  1. Overdose Deaths Among Homeless Persons

    Science.gov (United States)

    ... Twitter Overdose Deaths Among Homeless Persons January 2013 Homelessness is a persistent problem—nearly 690,000 people ... will ultimately help address the tragic problem of homelessness too, as many homeless people cite drug or ...

  2. Bartonella quintana in Homeless Persons

    Centers for Disease Control (CDC) Podcasts

    In this podcast, Dr. Marina Eremeeva discusses an article about Bartonella quintana in homeless populations in San Francisco. Bartonella quintana is a bacterium that is transmitted by human body lice. Findings by the article’s authors suggest that Bartonella quintana may be transmitted by head lice. This could mean that populations other than homeless populations, such as school children, might be at increased risk for Bartonella quintana.

  3. Bartonella quintana in Homeless Persons

    Centers for Disease Control (CDC) Podcasts

    2009-06-30

    In this podcast, Dr. Marina Eremeeva discusses an article about Bartonella quintana in homeless populations in San Francisco. Bartonella quintana is a bacterium that is transmitted by human body lice. Findings by the article’s authors suggest that Bartonella quintana may be transmitted by head lice. This could mean that populations other than homeless populations, such as school children, might be at increased risk for Bartonella quintana.  Created: 6/30/2009 by Emerging Infectious Diseases.   Date Released: 6/30/2009.

  4. Personal Hygiene Practices among Urban Homeless Persons in Boston, MA

    OpenAIRE

    Leibler, Jessica H.; Nguyen, Daniel D.; Le?n, Casey; Gaeta, Jessie M.; Perez, Debora

    2017-01-01

    Persons experiencing homelessness in the United States experience significant barriers to self-care and personal hygiene, including limited access to clean showers, laundry and hand washing facilities. While the obstacles to personal hygiene associated with homelessness may increase risk of infectious disease, hygiene-related behaviors among people experiencing homelessness has received limited attention. We conducted a cross-sectional study of individuals experiencing homelessness in Boston,...

  5. Psychiatric Disorders and Substance Use in Homeless Youth: A Preliminary Comparison of San Francisco and Chicago

    Directory of Open Access Journals (Sweden)

    Ernika G. Quimby

    2012-08-01

    Full Text Available Youth homelessness is a growing problem in the United States. The experience of homelessness appears to have numerous adverse consequences, including psychiatric and substance use disorders. This study compared the frequencies of psychiatric disorders, including substance use, between homeless youth (18–24 years-old in San Francisco (N = 31 and Chicago (N = 56. Subjects were administered the Mini International Neuropsychiatric Interview (M.I.N.I. to assess DSM-IV-TR diagnoses and substance use disorders. Eighty-seven percent of the San Francisco youth, and 81% of the Chicago youth met criteria for at least one M.I.N.I. psychiatric diagnosis. Nearly two-thirds of the youth in both samples met criteria for a mood disorder. Approximately one-third met criteria for an anxiety disorder. Thirty-two percent of the San Francisco sample and 18% of the Chicago met criteria for Antisocial Personality Disorder. Approximately 84% of the San Francisco youth and 48% of the Chicago youth met criteria for a substance-related disorder, and more substances were used by San Francisco youth. In conclusion, the high rate of psychiatric disorders in homeless youth provides clear evidence that the mental health needs of this population are significant. Implications are discussed.

  6. Personal Hygiene Practices among Urban Homeless Persons in Boston, MA.

    Science.gov (United States)

    Leibler, Jessica H; Nguyen, Daniel D; León, Casey; Gaeta, Jessie M; Perez, Debora

    2017-08-18

    Persons experiencing homelessness in the United States experience significant barriers to self-care and personal hygiene, including limited access to clean showers, laundry and hand washing facilities. While the obstacles to personal hygiene associated with homelessness may increase risk of infectious disease, hygiene-related behaviors among people experiencing homelessness has received limited attention. We conducted a cross-sectional study of individuals experiencing homelessness in Boston, MA ( n = 194) to identify hygiene-related self-care practices and risk factors for reduced hygiene in this population. Most participants (72%) reported taking a daily shower. More than 60% reported hand washing with soap five or more times each day, and use of hand sanitizer was widespread (89% reported using sanitizer in the last week). A majority (86%) used a laundromat or laundry machine to wash clothing, while 14% reported washing clothing in the sink. Heavy drinking, injection drug use, and sleeping outdoors were identified as significant risk factors for reduced hygiene practices. People experiencing homelessness who also engage in these activities may be among the most difficult to reach for intervention, yet targeted efforts may decrease illness risk associated with reduced hygiene. Housed friends and family play a critical role in assisting homeless individuals maintain hygiene by providing showers and laundry facilities.

  7. [Characteristics of Hospitalizations of Homeless Persons in Seville, Spain].

    Science.gov (United States)

    Tornero Patricio, Sebastián; Fernández Ajuria, Alberto; Charris Castro, Liliana

    2016-02-10

    The aim was to determine the characteristics of hospital admissions of homeless persons in Seville, Spain. Observational study of 103,802 hospital admissions of 71,756 patients admitted in the Hospitals "Virgen del Rocío" and "Virgen Macarena" (Seville), in 2013 and 2014. Bivariate analysis were performed using χ2 and t-Student tests and multivariate analysis using binomial logistic regression model. 0.16% (n=163) of admissions were homeless persons and 99.84% (n=103,639) were not. The mean age at admission in homeless patients was 48 years and 76.5% of them were men. Hospital deaths of homeless patients occurred being 23 years younger. 92% of hospital admissions came from emergency departments and 10.0% of their discharges were against medical advice. The average length of stay was 4.8 days longer in homeless persons and the most frequent diagnoses on admission were mental (27.0%), infectious (19.6%) and respiratory diseases (18.4%). Mental disorders were present on 83.7% of homeless patients as secondary diagnose and 77.6% referred drugs consumption. Hospital admissions characteristics of homeless persons were particularly different. Homeless patients were hospitalized and died at a younger age than non-homeless patients. The morbidity and mortality of homeless persons reflect their vulnerable health condition.

  8. Tuberculosis in homeless persons in Poland.

    Science.gov (United States)

    Korzeniewska-Koseła, Maria; Kuś, Jan; Lewandowska, Katarzyna; Siemion-Szcześniak, Izabela

    2015-01-01

    The fall in rates of tuberculosis (TB) in many countries has been accompanied by the concentration of cases in the social risk groups including homeless persons. Comparison of TB features in homeless persons and in non-homeless patients. TB cases reported to National TB Register in Poland in whom information about the social status was available (the data about the social status were collected obligatorily in the years 2004-2013 only) were analysed. The results of DSTs were obtained from laboratory records and were available for the cases reported since 2010. Treatment outcome after 12 months was analysed for the cases registered between 2004-2012. The significance (Si) of the differences in proportions was assessed with chi-square test. Phomeless persons (HP) and 72,989 other patients (OP) with TB were included. In the group of HP, there was a greater proportion of males in comparison with OP (90.5% vs. 66.3%) (Si). The mean age of HP was 49.8 years (SD±10.9); of OP-52.9 years (SD±17.5) (Si). 16.6% of HP and 10.4% of OP were previously treated for TB (Si). The previous treatment was adequate in 62.2% of HP and in 85.8% of OP (Si). Pulmonary TB was in 98.0%, extrapulmonary TB in 2.0% of HP and, respectively, in 92.5% and 7.5% of OP (Si). Pulmonary TB was confirmed by culture in 76.3% of HP and in 64.5% of OP (Si). Sputum smears were positive in 70.7% of HP and in 62.5% of OP (Si). Caseous pneumonia occurred in 2.7% of homeless subjects and in 1.1% of OP (Si); infiltrative TB in 95.5% of HP and in 97.5% of OP (Si). Resistance to isoniazid was observed in 2.9% of HP and in 3.1% of OP; to rifampicin in 0.0% of HP and in 0.2% of OP; to isoniazid and rifampicin in 0.4% of HP and in 0.8% of OP. These differences were not Si. Treatment success rate among HP was 44.1%; default rate 24.8%; 4.0% of HP died from tuberculosis; 3.2% died from other causes; 5.2% were transferred and their outcomes were unknown; 0.4% were still on treatment; 0.4% had treatment failure; in 17

  9. A review of physical and mental health in homeless persons.

    Science.gov (United States)

    Martens, W H

    2001-01-01

    To review the physical and mental status in homeless people. A MEDLINE database search covering 5 decades was supplemented by tracing back through references from existing review work. Over 200 articles were extracted, and 106 were selected for review. Homeless persons suffer frequently from physical health problems like tuberculosis, asthma, bronchitis, HIV infection, and as a consequence, they run an increased risk for premature mortality. The prevalence of mental disorders among homeless individuals varies from 80-95% in the USA, Australia, Canada, Norway, and Germany to 25-33% in Ireland and Spain. The most prominent mental disorders among the homeless, which vary from country to country, are depression, affective disorders, substance abuse, psychotic disorders, schizophrenia, and personality disorders. Homelessness is a major public health problem that should have our special interest.

  10. Perceived reasons for loss of housing and continued homelessness among homeless persons with mental illness.

    Science.gov (United States)

    Mojtabai, Ramin

    2005-02-01

    The objective of this study was to examine the reasons for the most recent loss of housing and for continued homelessness as perceived by homeless persons with mental illness. A total of 2,974 currently homeless participants in the 1996 National Survey of Homeless Assistance Providers and Clients (NSHAPC) were asked about the reasons for their most recent loss of housing and continued homelessness. The responses of participants who had mental illness, defined both broadly and narrowly, were compared with responses of those who were not mentally ill. The broad definition of mental illness was based on a set of criteria proposed by NSHAPC investigators. The narrow definition included past psychiatric hospitalization in addition to the NSHAPC criteria. A total of 1,620 participants (56 percent) met the broad definition of mental illness, and 639 (22 percent) met the narrow definition; 1,345 participants (44 percent) did not meet any of these criteria and were categorized as not having a mental illness. Few differences in reasons for the most recent loss of housing were noted between the participants with and without mental illness. Both groups attributed their continued homelessness mostly to insufficient income, unemployment, and lack of suitable housing. Homeless persons with mental illness mostly report the same reasons for loss of housing and continued homelessness as those who do not have a mental illness. This finding supports the view that structural solutions, such as wider availability of low-cost housing and income support, would reduce the risk of homelessness among persons with mental illness, as among other vulnerable social groups.

  11. Personality disorders and treatment drop out in the homeless

    Directory of Open Access Journals (Sweden)

    Salavera C

    2013-03-01

    Full Text Available Carlos Salavera,1 José M Tricás,2 Orosia Lucha21Faculty of Education, University of Zaragoza, Zaragoza, Spain; 2Physiotherapy Research Unit, University of Zaragoza, Zaragoza, SpainAbstract: The homeless drop out of treatment relatively frequently. Also, prevalence rates of personality disorders are much higher in the homeless group than in the general population. We hypothesize that when both variables coexist – homelessness and personality disorders – the possibility of treatment drop out grows. The aim of this study was to analyze the hypotheses, that is, to study how the existence of personality disorders affects the evolution of and permanence in treatment. One sample of homeless people in a therapeutic community (N = 89 was studied. The structured clinical interview for the diagnostic and statistical manual of mental disorders (DSM-IV-TR was administered and participants were asked to complete the Millon Clinical Multiaxial Inventory-II (MCMI-II. Cluster B personality disorders (antisocial, borderline, and narcissistic avoided permanence in the treatment process while cluster C disorders, as dependent, favored adhesion to the treatment and improved the prognosis. Knowledge of these personality characteristics should be used to advocate for better services to support homeless people and prevent their dropping out before completing treatment.Keywords: MCMI-II, abandonment, personality disorder, homeless

  12. Substance use among persons with homeless experience in primary care.

    Science.gov (United States)

    Stringfellow, Erin J; Kim, Theresa W; Gordon, Adam J; Pollio, David E; Grucza, Richard A; Austin, Erika L; Johnson, N Kay; Kertesz, Stefan G

    2016-01-01

    Community survey data suggest high prevalence of substance use disorders among currently homeless individuals. There are less data regarding illicit drug and alcohol use problems of homeless-experienced persons engaged in primary care. They may have less severe use and require different care responses from primary care teams. The authors surveyed currently and formerly homeless, i.e., homeless-experienced, persons engaged in primary care at five federally funded programs in the United States, administering the World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The ASSIST definitions of lower, moderate, and high risk were used to assess a spectrum of lifetime and recent substance use, from any use to likely dependence, and to identify sociodemographic and health status characteristics associated with severity of use. Almost one half of the sample (N = 601) had recently (within the past three months) used alcohol, and one third had recently used an illicit drug. The most commonly used illicit drugs in the past three months were cannabis (19%), cocaine (16%), and opioids (7.5%). Over one half (59%) of respondents had ASSIST-defined moderate- or high-risk substance use. A significant proportion (31%) of those identified as at moderate risk had no recent substance use, but did report past problematic use. Ten percent of the lower-risk group had past problematic use of alcohol. Severity of use was associated with worse health status, but not with housing status or type of homelessness experienced. Less severe (moderate-risk) use and past problematic use, potentially indicative of remitted substance use disorders, were more common than high-risk use in this primary care, homeless-experienced sample. These findings highlight the urgency of identifying effective ways to reduce risky substance use and prevent relapse in homeless-experienced persons.

  13. Foot Conditions among Homeless Persons: A Systematic Review

    Science.gov (United States)

    To, Matthew J.; Brothers, Thomas D.; Van Zoost, Colin

    2016-01-01

    Introduction Foot problems are common among homeless persons, but are often overlooked. The objectives of this systematic review are to summarize what is known about foot conditions and associated interventions among homeless persons. Methods A literature search was conducted on MEDLINE (1966–2016), EMBASE (1947–2016), and CINAHL (1982–2016) and complemented by manual searches of reference lists. Articles that described foot conditions in homeless persons or associated interventions were included. Data were independently extracted on: general study characteristics; participants; foot assessment methods; foot conditions and associated interventions; study findings; quality score assessed using the Downs and Black checklist. Results Of 333 articles screened, 17 articles met criteria and were included in the study. Prevalence of any foot problem ranged from 9% to 65% across study populations. Common foot-related concerns were corns and calluses, nail pathologies, and infections. Foot pathologies related to chronic diseases such as diabetes were identified. Compared to housed individuals across studies, homeless individuals were more likely to have foot problems including tinea pedis, foot pain, functional limitations with walking, and improperly-fitting shoes. Discussion Foot conditions were highly prevalent among homeless individuals with up to two thirds reporting a foot health concern, approximately one quarter of individuals visiting a health professional, and one fifth of individuals requiring further follow-up due to the severity of their condition. Homeless individuals often had inadequate foot hygiene practices and improperly-fitting shoes. These findings have service provision and public health implications, highlighting the need for evidence-based interventions to improve foot health in this population. An effective interventional approach could include optimization of foot hygiene and footwear, provision of comprehensive medical treatment, and

  14. Foot Conditions among Homeless Persons: A Systematic Review.

    Science.gov (United States)

    To, Matthew J; Brothers, Thomas D; Van Zoost, Colin

    2016-01-01

    Foot problems are common among homeless persons, but are often overlooked. The objectives of this systematic review are to summarize what is known about foot conditions and associated interventions among homeless persons. A literature search was conducted on MEDLINE (1966-2016), EMBASE (1947-2016), and CINAHL (1982-2016) and complemented by manual searches of reference lists. Articles that described foot conditions in homeless persons or associated interventions were included. Data were independently extracted on: general study characteristics; participants; foot assessment methods; foot conditions and associated interventions; study findings; quality score assessed using the Downs and Black checklist. Of 333 articles screened, 17 articles met criteria and were included in the study. Prevalence of any foot problem ranged from 9% to 65% across study populations. Common foot-related concerns were corns and calluses, nail pathologies, and infections. Foot pathologies related to chronic diseases such as diabetes were identified. Compared to housed individuals across studies, homeless individuals were more likely to have foot problems including tinea pedis, foot pain, functional limitations with walking, and improperly-fitting shoes. Foot conditions were highly prevalent among homeless individuals with up to two thirds reporting a foot health concern, approximately one quarter of individuals visiting a health professional, and one fifth of individuals requiring further follow-up due to the severity of their condition. Homeless individuals often had inadequate foot hygiene practices and improperly-fitting shoes. These findings have service provision and public health implications, highlighting the need for evidence-based interventions to improve foot health in this population. An effective interventional approach could include optimization of foot hygiene and footwear, provision of comprehensive medical treatment, and addressing social factors that lead to increased risk

  15. The emergence of user organisation of homeless persons in Denmark

    DEFF Research Database (Denmark)

    Anker, Jørgen

    persons emerges in these years. The second part of the paper provides a more detailed description of the organisation, its aims, strategies and organisational structure. Some of the dilemmas and difficulties of the user organisation are finally mentioned at the end of the paper.......This paper provides an overview of the history of the user organisation of homeless persons in Denmark. The first part of the paper seeks to identify some of the processes and actors who facilitated the formation of the organisation, and it seeks to discuss why a user organisation of homeless...

  16. Chronic Pain Among Homeless Persons with Mental Illness.

    Science.gov (United States)

    Vogel, Marc; Frank, Anastasia; Choi, Fiona; Strehlau, Verena; Nikoo, Nooshin; Nikoo, Mohammadali; Hwang, Stephen W; Somers, Julian; Krausz, Michael R; Schütz, Christian G

    2017-12-01

    Chronic pain is an important public health issue. However, characteristics and needs of marginalized populations have received limited attention. Studies on prevalence and correlates of chronic pain among homeless persons are lacking. We assessed chronic pain among homeless persons with mental illness in the At Home/Chez Soi study. Cross-sectional data from a randomized controlled trial on homelessness and mental health. Data collected between 2009 and 2013 in three Canadian cities. One thousand two hundred eighty-seven homeless persons with mental illness. Data on chronic pain and utilization of prescribed and nonprescribed interventions was assessed using a chronic pain screening instrument. Mental illness was diagnosed with the Mini-International Neuropsychiatric Interview. Forty-three percent reported moderate to severe chronic pain, interfering with general daily activities (80%), sleep (78%), and social interactions (61%). Multivariate analysis indicated that increasing age and diagnoses of major depressive disorder, mood disorder with psychotic features, panic disorder, and post-traumatic stress disorder (PTSD) were independent predictors of chronic pain. Chronic pain was further associated with increased suicidality. Among participants reporting chronic pain, 64% had sought medical treatment and 56% treated pain with prescribed drugs, while 38% used illicit drugs for pain relief. Chronic pain is very common among homeless persons with mental illness and affects activities of daily living. Clinicians treating this population should be aware of the common connections between chronic pain, depression, panic disorder, PTSD, and substance use. While the data indicate the contribution of chronic pain to complex treatment needs, they also indicate a clear treatment gap. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  17. Six-year mortality in a street-recruited cohort of homeless youth in San Francisco, California.

    Science.gov (United States)

    Auerswald, Colette L; Lin, Jessica S; Parriott, Andrea

    2016-01-01

    Objectives. The mortality rate of a street-recruited homeless youth cohort in the United States has not yet been reported. We examined the six-year mortality rate for a cohort of street youth recruited from San Francisco street venues in 2004. Methods. Using data collected from a longitudinal, venue-based sample of street youth 15-24 years of age, we calculated age, race, and gender-adjusted mortality rates. Results. Of a sample of 218 participants, 11 died from enrollment in 2004 to December 31, 2010. The majority of deaths were due to suicide and/or substance abuse. The death rate was 9.6 deaths per hundred thousand person-years. The age, race and gender-adjusted standardized mortality ratio was 10.6 (95% CI [5.3-18.9]). Gender specific SMRs were 16.1 (95% CI [3.3-47.1]) for females and 9.4 (95% CI [4.0-18.4]) for males. Conclusions. Street-recruited homeless youth in San Francisco experience a mortality rate in excess of ten times that of the state's general youth population. Services and programs, particularly housing, mental health and substance abuse interventions, are urgently needed to prevent premature mortality in this vulnerable population.

  18. Six-year mortality in a street-recruited cohort of homeless youth in San Francisco, California

    Directory of Open Access Journals (Sweden)

    Colette L. Auerswald

    2016-04-01

    Full Text Available Objectives. The mortality rate of a street-recruited homeless youth cohort in the United States has not yet been reported. We examined the six-year mortality rate for a cohort of street youth recruited from San Francisco street venues in 2004. Methods. Using data collected from a longitudinal, venue-based sample of street youth 15–24 years of age, we calculated age, race, and gender-adjusted mortality rates. Results. Of a sample of 218 participants, 11 died from enrollment in 2004 to December 31, 2010. The majority of deaths were due to suicide and/or substance abuse. The death rate was 9.6 deaths per hundred thousand person-years. The age, race and gender-adjusted standardized mortality ratio was 10.6 (95% CI [5.3–18.9]. Gender specific SMRs were 16.1 (95% CI [3.3–47.1] for females and 9.4 (95% CI [4.0–18.4] for males. Conclusions. Street-recruited homeless youth in San Francisco experience a mortality rate in excess of ten times that of the state’s general youth population. Services and programs, particularly housing, mental health and substance abuse interventions, are urgently needed to prevent premature mortality in this vulnerable population.

  19. Medicolegal death of homeless persons in Tokyo Metropolis over 12 years (1999-2010).

    Science.gov (United States)

    Suzuki, Hideto; Hikiji, Wakako; Tanifuji, Takanobu; Abe, Nobuyuki; Fukunaga, Tatsushige

    2013-05-01

    Recently, the number of homeless persons in Japan has steadily decreased. However, it is not certain whether unexpected death of the homeless have actually decreased in proportion to decrease in total number of cases. The documentation of medicolegal deaths among homeless persons handled in the Tokyo Medical Examiner's Office during 1999-2010 were reviewed, and we compared the number and manner/cause of death between cases occurring before 2004 and those occurring after 2004. In addition, we compared manner/cause of death between homeless and non-homeless persons. The number of medicolegal deaths of homeless persons remained almost the same during the study period in spite of a marked decrease in the total number of homeless persons after 2004. Age distribution shifted to older after 2004, and a higher proportion of the deceased had longer postmortem periods after 2004. Comparison between the manners/causes of death of the cases occurring before 2004 and those occurring after 2004 showed little difference. Disease constituted about 70% of all cases, and causes of death from disease were more various than those of non-homeless persons. Certain specific patterns included a higher proportion of death from circulatory disease in elderly homeless persons and a higher proportion of death from alcohol-related digestive disease and tuberculosis among younger homeless persons. Regarding accidental death, hypothermia was a leading cause of death irrespective of age group. Aging and isolation among homeless persons might contribute to an unchanged number of medicolegal death of them. In addition to measures to address frequent causes of death in each age group, better intervention for isolated homeless persons might be a key factor to prevent unexpected deaths of homeless persons in the future. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  20. Modeling the mental health effects of victimization among homeless persons

    Science.gov (United States)

    Perron, Brian Edward; Alexander-Eitzman, Ben; Gillespie, David F.; Pollio, David

    2014-01-01

    Homeless persons are victims of violent and non-violent crime at higher rates than housed populations. While studies have suggested that victimization can induce or exacerbate mental health problems, there is very little known about factors that may buffer the effects of victimization. This cross-sectional study examined the influence of victimization on depressive symptoms in over 9600 homeless and mentally ill adults participating in the Access to Community Care and Effective Services and Supports study (ACCESS) conducted in multiple cities across the USA relationships between victimization, depressive symptoms, and perceived safety were tested within a structural equation modeling framework using data collected at the baseline interview. The overall model exhibited a good fit with the data. Non-physical victimization was associated with higher levels of depressive symptoms, and physical victimization was associated with lower levels of perceived safety. As hypothesized, perceived safety was a significant partial mediator of depressive symptoms. These results underscore the complexity of the relationships between victimization and depression in homeless adults and the importance of addressing different types of victimization in homeless and mentally ill adults. PMID:18703266

  1. Modeling the mental health effects of victimization among homeless persons.

    Science.gov (United States)

    Perron, Brian Edward; Alexander-Eitzman, Ben; Gillespie, David F; Pollio, David

    2008-11-01

    Homeless persons are victims of violent and non-violent crime at higher rates than housed populations. While studies have suggested that victimization can induce or exacerbate mental health problems, there is very little known about factors that may buffer the effects of victimization. This cross-sectional study examined the influence of victimization on depressive symptoms in over 9600 homeless and mentally ill adults participating in the Access to Community Care and Effective Services and Supports study (ACCESS) conducted in multiple cities across the USA relationships between victimization, depressive symptoms, and perceived safety were tested within a structural equation modeling framework using data collected at the baseline interview. The overall model exhibited a good fit with the data. Non-physical victimization was associated with higher levels of depressive symptoms, and physical victimization was associated with lower levels of perceived safety. As hypothesized, perceived safety was a significant partial mediator of depressive symptoms. These results underscore the complexity of the relationships between victimization and depression in homeless adults and the importance of addressing different types of victimization in homeless and mentally ill adults.

  2. Caring for homeless persons with serious mental illness in general hospitals.

    Science.gov (United States)

    Bauer, Leah K; Baggett, Travis P; Stern, Theodore A; O'Connell, Jim J; Shtasel, Derri

    2013-01-01

    The care of homeless persons with serious mental illness remains a common and challenging problem in general hospital settings. This article aims to review data on homelessness and its psychiatric comorbidities, and to expand the skills of providers who encounter homeless individuals in general hospital settings. Literature review reveals patient, provider, and systems factors that contribute to suboptimal health outcomes in homeless individuals. Diagnostic rigor, integrated medical and psychiatric care, trauma-informed interventions, special considerations in capacity evaluations, and health care reform initiatives can improve the treatment of homeless persons with serious mental illness. Copyright © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  3. Stressors, resources, and distress among homeless persons: a longitudinal analysis.

    Science.gov (United States)

    Wong, Y L; Piliavin, I

    2001-04-01

    Relations among stressors, resources, and psychological distress were examined using two waves of data obtained from a probability sample of homeless persons (N = 430) residing in a large, demographically diverse county in North California. The focus of research was to examine whether and how social resources and housing resources directly affect distress and mediate the impact of stress factors on depressive symptoms. Path analysis results revealed that levels of psychological distress were responsive to change in objective housing circumstances, with the attainment of domicile status being associated with fewer distress symptoms. Our findings, however, indicated only modest effects of social resources on psychological distress through direct effects and mediating effects of life stressors on distress. Overall, the study suggests that the relationships among stressors, resources, and distress for homeless persons may be understood within the same analytical framework for the general population.

  4. Effectiveness of Case Management for Homeless Persons: A Systematic Review

    Science.gov (United States)

    de Vet, Renée; van Luijtelaar, Maurice J. A.; Brilleslijper-Kater, Sonja N.; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D.

    2013-01-01

    We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness. PMID:23947309

  5. Barriers to care and service needs among chronically homeless persons in a housing first program.

    Science.gov (United States)

    Parker, R David; Albrecht, Helmut A

    2012-01-01

    In 2010, more than 600,000 people in the United States experienced homelessness. Efficient and cost-effective housing methods that reduce homelessness need to be implemented. Housing Ready programs are the standard method that often has set requirements including earned income and sobriety, among others. These programs enable a subset of the homeless to become housed. However, chronically homeless persons, who use the most resources, are often not successful at enrollment or maintaining enrollment. Housing First (H1) is a method focusing on chronically homeless persons. Housing First places a client in housing and provides services after stabilization. This article assessed differences between chronically homeless persons in a H1 program and chronically homeless persons who are not in H1. A case-control study imbedded within a homeless service program collected sociodemographic and service variables, including access and barriers to care. Although the sample was 100% native English speaking, 22% of homeless persons reported that their providers do not speak their same language. All (100%) of participants had a disabling condition under HUD guidelines, but only 17.78% of homeless controls reported having a disabling condition. There were no differences on housing status based on income, gender, race, or age. The lack of differences between these groups indicates that a H1 program can be a clear derivation from the more common Housing Ready programs that have specific requirements for participation. Provider communication may negatively impact an individual's ability to transition from homelessness. Furthermore, chronically homeless persons not in intensive case management are less likely to understand the eligibility requirements for housing and, therefore, self-disqualify because of this lack of knowledge. Intentional communication and education for chronically homeless persons are 2 examples where case managers could improve the ability of the chronically homeless

  6. A Welfare Reform--Homelessness--Foster Care Connection? The Story of "Lag Families" and "Limbo Children" in San Diego.

    Science.gov (United States)

    Institute for Children and Poverty, New York, NY.

    An analysis of data from a survey of more than 100 parents residing in emergency shelter in San Diego, California, reveals a portrait of poverty that is prevalent among women and children in the United States today. Homeless families in San Diego, as in the rest of the country, are most often headed by women in their early thirties whose prospects…

  7. Active tuberculosis among homeless persons, Toronto, Ontario, Canada, 1998-2007.

    Science.gov (United States)

    Khan, Kamran; Rea, Elizabeth; McDermaid, Cameron; Stuart, Rebecca; Chambers, Catharine; Wang, Jun; Chan, Angie; Gardam, Michael; Jamieson, Frances; Yang, Jae; Hwang, Stephen W

    2011-03-01

    While tuberculosis (TB) in Canadian cities is increasingly affecting foreign-born persons, homeless persons remain at high risk. To assess trends in TB, we studied all homeless persons in Toronto who had a diagnosis of active TB during 1998-2007. We compared Canada-born and foreign-born homeless persons and assessed changes over time. We identified 91 homeless persons with active TB; they typically had highly contagious, advanced disease, and 19% died within 12 months of diagnosis. The proportion of homeless persons who were foreign-born increased from 24% in 1998-2002 to 39% in 2003-2007. Among foreign-born homeless persons with TB, 56% of infections were caused by strains not known to circulate among homeless persons in Toronto. Only 2% of infections were resistant to first-line TB medications. The rise in foreign-born homeless persons with TB strains likely acquired overseas suggests that the risk for drug-resistant strains entering the homeless shelter system may be escalating.

  8. Exploring opportunities for healthy aging among older persons with a history of homelessness in Toronto, Canada.

    Science.gov (United States)

    Waldbrook, Natalie

    2015-03-01

    Within the areas of literature on both population aging and health and homelessness, little attention has been given to the opportunities and barriers to healthy aging among older persons with a history of homelessness. Set in the context of inner-city Toronto, Canada, this article reports on the findings from qualitative interviews with 29 formerly homeless older persons. The findings illustrate participants' experiences of positive health change since moving into a stable housing environment and the aspects of housing they perceive to have improved their health and wellbeing. The qualitative findings also draw attention to the ongoing barriers to healthy aging that can be experienced among older persons with a history of homelessness. Overall, this study draws on the lived experiences of formerly homeless older persons to offer a better understanding of the long-term effects of homelessness on health, wellbeing, and aging. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Engaging homeless persons in end of life preparations.

    Science.gov (United States)

    Song, John; Wall, Melanie M; Ratner, Edward R; Bartels, Dianne M; Ulvestad, Nancy; Gelberg, Lillian

    2008-12-01

    There are no prospective studies that have investigated the effects of an intervention to improve end of life (EOL) care in an underserved population. To determine whether homeless persons will complete an advance directive (AD). Randomized trial comparing two modes of providing an opportunity for homeless persons to complete an AD. Half of the subjects were randomized to a self-guided group (SG) who were given an AD and written instructions; the other half were given the same material but, in addition, were offered the opportunity to receive guidance to complete the AD (CG). Fifty-nine homeless persons recruited from a drop-in center. Rate of AD completion and baseline and 3-month follow-up EOL-related knowledge, attitudes, and behaviors. The overall AD completion rate was 44%, with a statistically significant higher completion rate of 59% in the CG group compared to 30% in the self-guided only group. Frequency of worry about death decreased among those who filled out an AD from 50% to 12.5%, and also among those who did not (25% to 12.5%) (p < .05). Among those who filled out an AD, there were increases in plans to write down EOL wishes (56% to 100%; p < .05) and plans to talk about these wishes with someone (63% to 94%; p < .05). This study demonstrates that people living in dire economic and social situations will complete an AD when offered the opportunity. While offering guidance resulted in higher rates of completion; even a simple self-guided AD process can achieve completion of ADs in this population.

  10. Bartonella quintana and Typhus Group Rickettsiae Exposure among Homeless Persons, Bogotá, Colombia.

    Science.gov (United States)

    Faccini-Martínez, Álvaro A; Márquez, Andrea C; Bravo-Estupiñan, Diana M; Calixto, Omar-Javier; López-Castillo, Christian A; Botero-García, Carlos A; Hidalgo, Marylin; Cuervo, Claudia

    2017-11-01

    In 2015, we investigated Bartonella quintana and typhus group rickettsiae in body lice from homeless persons in Bogotá, Colombia. We found B. quintana-infected body lice and seroprevalence of this microorganism in 19% of homeless persons and typhus group rickettsiae in 56%. Public health professionals should start preemptive measures and active vector control.

  11. Psychiatry and Emergency Medicine: Medical Student and Physician Attitudes toward Homeless Persons

    Science.gov (United States)

    Morrison, Ann; Roman, Brenda; Borges, Nicole

    2012-01-01

    Objective: The purpose of the study was to explore changes in medical students' attitudes toward homeless persons during the Psychiatry and Emergency Medicine clerkships. Simultaneously, this study explored attitudes toward homeless persons held by Psychiatry and Emergency Medicine residents and faculty in an attempt to uncover the "hidden…

  12. Barriers to Homeless Persons Acquiring Health Insurance Through the Affordable Care Act.

    Science.gov (United States)

    Fryling, Lauren R; Mazanec, Peter; Rodriguez, Robert M

    2015-11-01

    Medicaid expansion under the Affordable Care Act (ACA) is intended to provide a framework for increasing health care access for vulnerable populations, including the 1.2 million who experience homelessness each year in the United States. We sought to characterize homeless persons' knowledge of the ACA, identify barriers to their ACA enrollment, and determine access to various forms of communication that could be used to facilitate enrollment. At an urban county Level I trauma center, we interviewed all noncritically ill adults who presented to the emergency department (ED) during daytime hours and were able to provide consent. We assessed access to communication, awareness of the ACA, insurance status, and barriers preventing subjects from enrolling in health insurance and compared homeless persons' responses with concomitantly enrolled housed individuals. Of the 650 enrolled subjects, 134 (20.2%) were homeless. Homeless subjects were more likely to have never heard of the ACA (26% vs. 10%). "Not being aware if they qualify for Medicaid" was the most common (70%) and most significant (30%) barrier to enrollment reported by uninsured homeless persons. Of homeless subjects who were unsure if they qualified for Medicaid, 91% reported an income homeless subjects reported access. Homeless persons report having less knowledge of the ACA than their housed counterparts, poor understanding of ACA qualification criteria, and limited access to phone and internet. ED-based outreach and education regarding ACA eligibility may increase their enrollment. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Clinical and cognitive correlates of unsheltered status in homeless persons with psychotic disorders.

    Science.gov (United States)

    Llerena, Katiah; Gabrielian, Sonya; Green, Michael F

    2018-02-24

    Homeless persons with psychosis are particularly susceptible to unsheltered homelessness, which includes living on the streets, in cars, and other places not meant for human habitation. Homeless persons with psychosis have distinct barriers to accessing care and comprise a high-need and hard-to-serve homeless subpopulation. Therefore, this study sought to understand unsheltered homelessness in persons with psychosis and its relationship to cognitive impairment, clinical symptoms, and community functioning, examined both categorically and dimensionally. This study included 76 homeless participants with a history of a psychotic diagnosis who were enrolled in a supported housing program but had not yet received housing. This study used two different housing stability thresholds (literally homeless at any point vs. literally homeless >20% of days) for comparing homeless Veterans with psychosis living in sheltered versus unsheltered situations on cognition, clinical symptoms, and community integration. Dimensional analyses also examined the relationship between percentage of days spent in unsheltered locations and cognition, clinical symptoms, and community integration. Sheltered and unsheltered Veterans with psychosis did not differ on clinical symptoms or community integration, but there was an inconsistent group difference on cognition depending on the threshold used for determining housing stability. In the unsheltered group, cognitive deficits in overall cognition, visual learning, and social cognition were related to more days spent in unsheltered locations. Rehabilitation efforts targeting specific cognitive deficits may be useful to facilitate greater access to care and successful interventions in this population. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Perceptions of quality of life and disability in homeless persons with schizophrenia and persons with schizophrenia living in non-institutional housing

    NARCIS (Netherlands)

    van der Plas, A. G. M.; Hoek, H. W.; van Hoeken, D.; Valencia, E.; van Hemert, A. M.

    Background: Homelessness is common in persons with schizophrenia. It is unclear how housing conditions and homelessness affect their quality of life and their disability. Aims: To explore the self-perceived quality of life and disability of homeless persons with schizophrenia and of those of persons

  15. Perceptions of quality of life and disability in homeless persons with schizophrenia and persons with schizophrenia living in non-institutional housing

    NARCIS (Netherlands)

    van der Plas, A.G.M.; Hoek, H.W.; van Hoeken, D.; Valencia, E.; van Hemert, A.M.

    2012-01-01

    Background: Homelessness is common in persons with schizophrenia. It is unclear how housing conditions and homelessness affect their quality of life and their disability. Aims: To explore the self-perceived quality of life and disability of homeless persons with schizophrenia and of those of persons

  16. [EFFECT OF EDUCATIONAL LEAFLETS ON KNOWLEDGE AND ATTITUDE TO TUBERCULOSIS AMONG HOMELESS PERSONS IN TOKYO, JAPAN].

    Science.gov (United States)

    Kawatsu, Lisa; Uchimura, Kazuhiro; Watabe, Hiroyuki; Kaguraoka, Sumi; Kubota, Yuka; Sakakibara, Marie; Ishikawa, Nobukatsu

    2015-08-01

    Delay in seeking care is one of the critical issues in tuberculosis (TB) control among homeless persons in Japan. Yet knowledge of and attitude towards TB among homeless persons have remained unclear and limited efforts have been made to disseminate information related to TB among homeless persons. To evaluate the effect of TB leaflets, produced and distributed to homeless persons by a group of ex-homeless TB patients, and to understand what homeless persons know about TB. Self-administered questionnaire was conducted among homeless persons before and after distribution of the TB leaflets. Changes in the responses to each question were also subjected to principal component analysis to group questions into types according to response patterns and identify constructs of TB-related knowledge. Results of 88 participants were analyzed. TB knowledge score related to risks and symptoms significantly improved after the intervention (from 54.3% to 70.6%, p < 0.05), while knowledge on treatment cost did not. Two components were identified, namely, the "improvement in TB impression" and "improvement in TB knowledge". TB leaflets were effective in improving certain aspects of TB knowledge. However, its effect on knowledge regarding treatment cost, which may be crucial in improving delay, was limited and thus the messages need to be revised.

  17. Australian homeless persons' experiences of social connectedness, isolation and loneliness.

    Science.gov (United States)

    Bower, Marlee; Conroy, Elizabeth; Perz, Janette

    2018-03-01

    Both loneliness and a lack of social integration are associated with serious physical and psychological health issues. One population highly susceptible to social isolation and loneliness are individuals who are homeless, who also experience high rates of mental disorder and relationship breakdown. Despite this, little research has explored how social networks, isolation and loneliness are experienced for those with a history of homelessness. In-depth, semi-structured interviews were used to get a nuanced understanding of how social networks and isolation are experienced and understood by individuals experiencing homelessness. Sixteen participants who were either homeless (n = 11) or previously homeless (n = 5) in Sydney, Australia, completed one-off interviews that were audio-recorded and transcribed. Data were analysed using thematic analysis. Participants constructed their social networks as being both constrained and enabled by marginalisation. They experienced rejection from the non-homeless: the loss of critical network members, including rejection from family and a lack of companionship, and low quality and precarious relationships within the homeless community. These accounts were best conceptualised through loneliness theory. Participant's accounts signal that the homeless will likely continue feeling isolated if mainstream attitudes towards homelessness remain stigmatising and discriminatory. © 2017 John Wiley & Sons Ltd.

  18. Differences in risk behaviors, care utilization, and comorbidities in homeless persons based on HIV status.

    Science.gov (United States)

    Parker, R David; Dykema, Shana

    2014-01-01

    This cross-sectional pilot project measured differences by HIV status in chronic health conditions, primary care and emergency department use, and high-risk behaviors of homeless persons through self-report. Using selective random sampling, 244 individuals were recruited from a homeless shelter. The reported HIV prevalence was 6.56% (n = 16), with the odds of HIV higher in persons reporting crack cocaine use. HIV-infected persons were more likely to report a source of regular medical care and less likely to use the emergency department than uninfected persons. Validation of findings through exploration of HIV and health care access in homeless persons is needed to confirm that HIV-infected homeless persons are more likely to have primary care. Distinctions between primary care and specialty HIV care also need to be explored in this context. If findings are consistent, providers who care for the homeless could learn more effective ways to engage homeless patients. Copyright © 2014 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  19. Post-Hospital Medical Respite Care and Hospital Readmission of Homeless Persons

    Science.gov (United States)

    Kertesz, Stefan G.; Posner, Michael A.; O’Connell, James J.; Swain, Stacy; Mullins, Ashley N.; Michael, Shwartz; Ash, Arlene S.

    2009-01-01

    Medical respite programs offer medical, nursing, and other care as well as accommodation for homeless persons discharged from acute hospital stays. They represent a community-based adaptation of urban health systems to the specific needs of homeless persons. This paper examines whether post-hospital discharge to a homeless medical respite program was associated with a reduced chance of 90-day readmission compared to other disposition options. Adjusting for imbalances in patient characteristics using propensity scores, Respite patients were the only group that was significantly less likely to be readmitted within 90 days compared to those released to Own Care. Respite programs merit attention as a potentially efficacious service for homeless persons leaving the hospital. PMID:19363773

  20. Personality and criminal outcomes of homeless youth in a Nigerian ...

    African Journals Online (AJOL)

    Objective: The unprecedented incidence of armed robberies and the involvement of young people in these crimes necessitated — as part of a comprehensive study on homelessness and criminal behaviour in Nigeria — an assessmet and comparison of homeless youths incarcerated in prisons with a control group of ...

  1. An inexpensive, interdisciplinary, methodology to conduct an impact study of homeless persons on hospital based services.

    Science.gov (United States)

    Parker, R David; Regier, Michael; Brown, Zachary; Davis, Stephen

    2015-02-01

    Homelessness is a primary concern for community health. Scientific literature on homelessness is wide ranging and diverse. One opportunity to add to existing literature is the development and testing of affordable, easily implemented methods for measuring the impact of homeless on the healthcare system. Such methodological approaches rely on the strengths in a multidisciplinary approach, including providers, both healthcare and homeless services and applied clinical researchers. This paper is a proof of concept for a methodology which is easily adaptable nationwide, given the mandated implementation of homeless management information systems in the United States and other countries; medical billing systems by hospitals; and research methods of researchers. Adaptation is independent of geographic region, budget restraints, specific agency skill sets, and many other factors that impact the application of a consistent methodological science based approach to assess and address homelessness. We conducted a secondary data analysis merging data from homeless utilization and hospital case based data. These data detailed care utilization among homeless persons in a small, Appalachian city in the United States. In our sample of 269 persons who received at least one hospital based service and one homeless service between July 1, 2012 and June 30, 2013, the total billed costs were $5,979,463 with 10 people costing more than one-third ($1,957,469) of the total. Those persons were primarily men, living in an emergency shelter, with pre-existing disabling conditions. We theorize that targeted services, including Housing First, would be an effective intervention. This is proposed in a future study.

  2. [Mental health of homeless persons. Critical review of the Anglo-Saxon literature].

    Science.gov (United States)

    Ducq, H; Guesdon, I; Roelandt, J L

    1997-01-01

    Because the visibility of homeless persons congregating in urban areas has increased since the 1980's, the relationship between homelessness and mental illness has caused more and more concern. A multitude of epidemiological surveys have been organized in Great Britain, Australia, Canada, and mainly in United States, and have attempted to evaluate scientifically the psychiatric morbidity of this population. This literature review reveals disparity of epidemiological methods in assessing the type and extent of mental illness among homeless adults. The lack of consensual definition of homelessness, the choice of different settings in which the research is organized (street, health centres, shelters), and the use of diverse instruments of psychiatric evaluation (diagnosis by clinician, by scale or by structured diagnostic interview) lead to a great disparity of the results. Thus, 1/3 of the homeless adults had prior history of psychiatric hospitalisation. Rates of psychosis range to 70% and it is estimated that 4% to 74% of the homeless persons suffer from affective disorders. Substance abuse disorder remains a problem for a significant number of these individuals, with a high frequency of dual diagnosis. Such divergent data highlight the anglo-saxon debate between those who accuse desinstitutionnalisation as a reason of homelessness, and those who blame the socioeconomic background.

  3. Empirical evidence for synchrony in the evolution of TB cases and HIV+ contacts among the San Francisco homeless.

    Directory of Open Access Journals (Sweden)

    Mojdeh Mohtashemi

    Full Text Available The re-emergence of tuberculosis (TB in the mid-1980s in many parts of the world, including the United States, is often attributed to the emergence and rapid spread of human immunodeficiency virus (HIV and acquired immunodeficiency syndrome (AIDS. Although it is well established that TB transmission is particularly amplified in populations with high HIV prevalence, the epidemiology of interaction between TB and HIV is not well understood. This is partly due to the scarcity of HIV-related data, a consequence of the voluntary nature of HIV status reporting and testing, and partly due to current practices of screening high risk populations through separate surveillance programs for HIV and TB. The San Francisco Department of Public Health, TB Control Program, has been conducting active surveillance among the San Francisco high-risk populations since the early 1990s. We present extensive TB surveillance data on HIV and TB infection among the San Francisco homeless to investigate the association between the TB cases and their HIV+ contacts. We applied wavelet coherence and phase analyses to the TB surveillance data from January 1993 through December 2005, to establish and quantify statistical association and synchrony in the highly non-stationary and ostensibly non-periodic waves of TB cases and their HIV+ contacts in San Francisco. When stratified by homelessness, we found that the evolution of TB cases and their HIV+ contacts is highly coherent over time and locked in phase at a specific periodic scale among the San Francisco homeless, but no significant association was observed for the non-homeless. This study confirms the hypothesis that the dynamics of HIV and TB are significantly intertwined and that HIV is likely a key factor in the sustenance of TB transmission among the San Francisco homeless. The findings of this study underscore the importance of contact tracing in detection of HIV+ individuals that may otherwise remain undetected, and

  4. Learning to account for the social determinants of health affecting homeless persons.

    Science.gov (United States)

    McNeil, Ryan; Guirguis-Younger, Manal; Dilley, Laura B; Turnbull, Jeffrey; Hwang, Stephen W

    2013-05-01

    Intersecting social determinants of health constrain access to care and treatment adherence among homeless populations. Because clinicians seldom receive training in the social determinants of health, they may be unprepared to account for or address these factors when developing treatment strategies for homeless individuals. This study explored: (i) clinicians' preparedness to provide care responsive to the social determinants of health in homeless populations, and (ii) the steps taken by clinicians to overcome shortcomings in their clinical training in regard to the social determinants of health. Qualitative interviews were conducted with doctors (n = 6) and nurses (n = 18) in six Canadian cities. Participants had at least 2 years of experience in providing care to homeless populations. Interview transcripts were analysed using methods of constant comparison. Participants highlighted how, when first providing care to this population, they were unprepared to account for or address social determinants shaping the health of homeless persons. However, participants recognised the necessity of addressing these factors to situate care within the social and structural contexts of homelessness. Participants' accounts illustrated that experiential learning was critical to increasing capacity to provide care responsive to the social determinants of health. Experiential learning was a continuous process that involved: (i) engaging with homeless persons in multiple settings and contexts to inform treatment strategies; (ii) evaluating the efficacy of treatment strategies through continued observation and critical reflection, and (iii) adjusting clinical practice to reflect observations and new knowledge. This study underscores the need for greater emphasis on the social determinants of health in medical education in the context of homelessness. These insights may help to inform the development and design of service-learning initiatives that integrate understandings of the

  5. L’alimentation des sans-abri / Diet of the Homeless

    Directory of Open Access Journals (Sweden)

    Carole Amistani

    2008-10-01

    Full Text Available L’alimentation des sans-logis est analysable, à partir du terrain, selon deux versants, parfois utilisés conjointement, qui sont celui de leur autonomie et/ou celui de leur dépendance envers le don alimentaire. Dans ce dernier cas, les contenus comme les formes témoignent trop souvent d’une impossibilité d’assurer l’équilibre nutritionnel de ces mangeurs et le respect des multiples aspects socialisants compris dans l’acte alimentaire. Le choix d’un traitement social dans l’ « urgence » et par l’humanitaire, tout en maintenant de manière chronique cette population à la rue, montre ainsi ses limites et les palliatifs tragiques qu’il implique tant dans l’alimentation que dans le reste des solutions qu’il propose depuis plus de vingt ans.The diet of the homeless can be looked at from two joint perspectives, both based on fieldwork : their autonomy and their dependency on food donations. In the latter case, the contents as well as the form of the donation all too often point at the impossibility of ensuring a nutritionally balanced donation and respecting the multiple social conventions linked to the act of eating. In resorting to such ‘emergency’ humanitarian relief, we maintain the chronicity of homelessness while also revealing the limits of such relief and the tragic palliatives implied, both in terms of diet and other solutions suggested over the past fifteen years.

  6. [Socio-demographics characteristics and health conditions of older homeless persons of Lima, Peru].

    Science.gov (United States)

    Moquillaza-Risco, Marlene; León, Elsa; Dongo, Mario; Munayco, César V

    2015-10-01

    Determine the socio-demographics characteristics and health conditions of older homeless persons at the time of enrollment into the National Program "Vida Digna" and the probability of functional dependency by age, and stratified by gender and cognitive impairment. MATERIALS ANDE METHODS: We performed a cross sectional study, reviewing all registration forms of the program in order to identify socio-demographic variables and health conditions of older homeless persons at the time of enrollment in the program. We did a descriptive analysis of the socio-demographic variables and we also determined the frequency of health conditions. Furthermore, we determined the probability of functional dependency by age, and stratified by gender and cognitive impairment through a logistic regression model. The older homeless persons at the time of enrollment in the program were mostly single men, with a primary education or no education. The study subjects had a high frequency of chronic and mental diseases. 50% of them had certain level of functional impairment and roughly 70% had a certain level of cognitive impairment. The probability of functional dependency increased by age, and it was higher in women than in men. This probability increased according to the level of cognitive impairment. This study shows that older homeless persons are a vulnerable population not only because they live outdoors but also because they a have also for the high prevalence of chronic and mental diseases. These diseases prevent the homeless persons from living by themselves special care to overcome their situations.

  7. Assessment of health status and quality of life of homeless persons in Belgrade, Serbia.

    Science.gov (United States)

    Sarajlija, Marija; Jugović, Aleksandar; Zivaljević, Dragan; Merdović, Boro; Sarajlija, Adrijan

    2014-02-01

    Homelessness is a problem with social, medical, economic, political and other implications. Despite a large number of studies, reports about health-related quality of life (HRQoL) of homeless persons remain sparse. There is a summary of consistent evidence that homeless people have higher prevalence of chronic disease (mental and somatic) than general population. The aim of this study was to assess HRQoL and depression in homeless persons in Belgrade, to describe their sociodemographic factors and health status (the presence of chronic mental and somatic diseases and addiction disorders) and analyse impact of sociodemographic factors and health status to HRQoL and depression of homeless persons. The study was conducted in the Shelter for Adult and Elderly Persons in Belgrade, from January 1 to January 31, 2012. A set of questionnaires used in survey included Serbian translation of SF-36 questionnaire, Serbian translation of Beck Depression Inventory-II (BDI-II) and sociodemographic questionnaire. Statistical analysis was performed by descriptive and analytic methods. Our study sample consisted of 104 adult participants. The majority of them were male (74%) and the mean age in the sample was 48.2 +/- 13.0 years. We have found that 35.6% participants had lifetime diagnosis of psychiatric disorder, most frequently depression (lifetime prevalence of 15.4% in the study group). The history of suicide attempts was registered in 28 (26.9%) participants. Lifetime illicit drugs use was reported by 12.5%, daily smoking by 82.7% and daily alcohol consumption by 8.7% of the participants. Most common somatic chronic diseases were cardiovascular while chronic lung diseases were the second most frequent. Single chronic disaese was present in 33 (31.7%) of the participants and comorbidity of 2 chronic diseases was present in 20 of them. A statistically significant difference between participants HRQoL SF-36 domain scores and norms of general population was found only for role

  8. [Impact of personality disorders in a sample of 212 homeless drug users].

    Science.gov (United States)

    Combaluzier, S; Gouvernet, B; Bernoussi, A

    2009-10-01

    The impact of the mental disorders (axis I and II, according to DSM IV) on psychosocial problems (axis IV) is now a well-known fact, notably when substance abuse disorders are encountered on axis I. This leads to the conclusion that personality disorders increase the risk of substance abuse, that substance abuse increases the risk of homelessness, that dual diagnosis has a high impact on homelessness and underlines interactions between personality disorders (PD), drug abuse (DA) and homelessness. The aim of this paper is also to study these interactions. We will process the classical epidemiological measures, which have already produced interesting findings on other substance-linked disorders. We will study the multiplicative interaction (I(AB)) and the etiological fraction (EFi) linked to interaction, which evaluate the effects of two factors on another. According to the authors, the I(AB) determines whether the co-occurrence of two risk factors in a group induces more cases than each factor acting together; also if the I(AB) is greater than 1 it is possible to estimate the EFi, that proportionally measures the number of cases of the third factor that can be attributed to the co-occurrence. We will also study the interactions of homelessness and PD on DA, of the PD and DA on homelessness, and of this association DA and homelessness on PD. The data we will use in the paper deal with the prevalence of PD in general, drug users (n=226), homeless (n=999) and homeless drug abusers (n=212). The two last data are extracted from the same population and have been collected through clinical interviews, and the diagnosis follows the DSM criteria. They are comparable to Kokkevi et al.'s sample regarding the drug (heroin), the mean age (28 years for Kokkevi et al., 27 years in our sample), and the geographic origin of the populations (Mediterranean basin). The repartition of PD differs significantly (0.001) in the homeless population and the homeless drug abusers (chi(2

  9. Enhanced Methodologies to Enumerate Persons Experiencing Homelessness in a Large Urban Area.

    Science.gov (United States)

    Troisi, Catherine L; D'Andrea, Ritalinda; Grier, Gary; Williams, Stephen

    2015-10-01

    Homelessness is a public health problem, and persons experiencing homelessness are a vulnerable population. Estimates of the number of persons experiencing homelessness inform funding allocations and services planning and directly determine the ability of a community to intervene effectively in homelessness. The point-in-time (PIT) count presents a logistical problem in large urban areas, particularly those covering a vast geographical area. Working together, academia, local government, and community organizations improved the methodology for the count. Specific enhancements include use of incident command system (ICS), increased number of staging areas/teams, specialized outreach and Special Weapons and Tactics teams, and day-after surveying to collect demographic information. This collaboration and enhanced methodology resulted in a more accurate estimate of the number of persons experiencing homelessness and allowed comparison of findings for 4 years. While initial results showed an increase due to improved counting, the number of persons experiencing homelessness counted for the subsequent years showed significant decrease during the same time period as a "housing first" campaign was implemented. The collaboration also built capacity in each sector: The health department used ICS as a training opportunity; the academics enhanced their community health efforts; the service sector was taught and implemented more rigorous quantitative methods; and the community was exposed to public health as a pragmatic and effective discipline. Improvements made to increase the reliability of the PIT count can be adapted for use in other jurisdictions, leading to improved counts and better evaluation of progress in ending homelessness. © The Author(s) 2015.

  10. Psychiatry and emergency medicine: medical student and physician attitudes toward homeless persons.

    Science.gov (United States)

    Morrison, Ann; Roman, Brenda; Borges, Nicole

    2012-05-01

    The purpose of the study was to explore changes in medical students' attitudes toward homeless persons during the Psychiatry and Emergency Medicine clerkships. Simultaneously, this study explored attitudes toward homeless persons held by Psychiatry and Emergency Medicine residents and faculty in an attempt to uncover the "hidden curriculum" in medical education, in which values are communicated from teacher to student outside of the formal instruction. A group of 79 students on Psychiatry and 66 on Emergency Medicine clerkships were surveyed at the beginning and end of their rotation regarding their attitudes toward homeless persons by use of the Health Professionals' Attitudes Toward the Homeless Inventory (HPATHI). The HPATHI was also administered to 31 Psychiatry residents and faculty and 41 Emergency Medicine residents and faculty one time during the course of this study. For Psychiatry clerks, t-tests showed significant differences pre- and post-clerkship experiences on 2 of the 23 items on the HPATHI. No statistically significant differences were noted for the Emergency Medicine students. An analysis of variance revealed statistically significant differences on 7 out of the 23 survey questions for residents and faculty in Psychiatry, as compared with those in Emergency Medicine. Results suggest that medical students showed small differences in their attitudes toward homeless people following clerkships in Psychiatry but not in Emergency Medicine. Regarding resident and faculty results, significant differences between specialties were noted, with Psychiatry residents and faculty exhibiting more favorable attitudes toward homeless persons than residents and faculty in Emergency Medicine. Given that medical student competencies should be addressing the broader social issues of homelessness, medical schools need to first understand the attitudes of medical students to such issues, and then develop curricula to overcome inaccurate or stigmatizing beliefs.

  11. The moral courage of nursing students who complete advance directives with homeless persons.

    Science.gov (United States)

    Nash, Woods; Mixer, Sandra J; McArthur, Polly M; Mendola, Annette

    2016-11-01

    Homeless persons in the United States have disproportionately high rates of illness, injury, and mortality and tend to believe that the quality of their end-of-life care will be poor. No studies were found as to whether nurses or nursing students require moral courage to help homeless persons or members of any other demographic complete advance directives. We hypothesized that baccalaureate nursing students require moral courage to help homeless persons complete advance directives. Moral courage was defined as a trait of a person or an action that overcomes fears or other challenges to achieve something of great moral worth. The hypothesis was investigated through a qualitative descriptive study. Aside from the pre-selection of a single variable to study (i.e. moral courage), our investigation was a naturalistic inquiry with narrative hues insofar as it attended to specific words and phrases in the data that were associated with that variable. A total of 15 baccalaureate nursing students at a public university in the United States responded to questionnaires that sought to elicit fears and other challenges that they both expected to experience and actually experienced while helping homeless persons complete advance directives at a local, non-profit service agency. The study was approved by the Internal Review Board of the authors' university, and each participant signed an informed consent form, which stated that the study involved no reasonably foreseeable risks and that participation was voluntary. Before meeting with homeless persons, participants reported that they expected to experience two fears and a challenge: fear of behaving in ways that a homeless person would deem inappropriate, fear of discussing a homeless person's dying and death, and the challenge of adequately conveying the advance directive's meaning and accurately recording a homeless person's end-of-life wishes. In contrast, after their meetings with homeless persons, relatively few participants

  12. [Street doctors warn of epidemic of uninsured homeless persons in the Netherlands].

    Science.gov (United States)

    Slockers, Marcel T; van Laere, Igor R A L; Smit, Ronald B J

    2015-01-01

    Over the past few years, the Netherlands Street Doctors Group, a national network of doctors and nurses providing outreach primary care to homeless people in the Netherlands, has observed a growing number of homeless patients who do not have health insurance resulting in their access to healthcare services and medication being limited. In this article we raise the alarm about the epidemic of uninsured Dutch homeless. We explain and comment on the reasons why people are no longer insured and elaborate on the regulations and obligations related to homelessness and the characteristics of consumers and providers of social and medical services. We describe how difficult it is for homeless people to become re-insured as in order to follow a complex set of requirements commitment and patience are necessary. For most homeless patients, the re-insurance process requires the personal guidance and support of a motivated case manager. Consequently, we suggest that policy makers and service providers should have a better understanding of factors contributing to being uninsured and more compassion for those who are.

  13. Socio-demographics characteristics and health conditions of older homeless persons of Lima, Peru

    OpenAIRE

    Moquillaza-Risco, Marlene; Programa Nacional Vida Digna (PNVD), Ministerio de la Mujer y Poblaciones Vulnerables. Lima, Perú.; León, Elsa; Programa Nacional Vida Digna (PNVD), Ministerio de la Mujer y Poblaciones Vulnerables. Lima, Perú.; Dongo, Mario; Programa Nacional Vida Digna (PNVD), Ministerio de la Mujer y Poblaciones Vulnerables. Lima, Perú.; Munayco, César V.; Programa Nacional Vida Digna (PNVD), Ministerio de la Mujer y Poblaciones Vulnerables. Lima, Perú.

    2015-01-01

    Objectives. Determine the socio-demographics characteristics and health conditions of older homeless persons at the time of enrollment into the National Program “Vida Digna” and the probability of functional dependency by age, and stratified by gender and cognitive impairment. Materials ande methods. We performed a cross sectional study, reviewing all registration forms of the program in order to identify socio-demographic variables and health conditions of older homeless persons at the time ...

  14. Personality assessment of homeless adults as a tool for service planning.

    Science.gov (United States)

    Tolomiczenko, G S; Sota, T; Goering, P N

    2000-01-01

    The psychiatric status of homeless adults has been described primarily in terms of Axis I disorders. By adding a subset of the Personality Assessment Inventory, this study tests the feasibility and usefulness of a brief, self-administered questionnaire to obtain scores on several dimensions of personality. Cluster analysis sorted 112 tested subjects into four groups characterized by distinct profiles. Two of these were characterized by extreme scores on pathological dimensions of personality (borderline features, antisocial traits, and aggressivity) and differed primarily on the dimension of suicidality. The third reflected moderate levels of personality dysfunction and the fourth did not deviate from adult nonclinical norms. The validity of the clusters was supported by demographic, background, and diagnostic subgroup differences. Brief personality assessment can be a cost-effective approach to matching services with clinical needs of homeless adults by attending to interpersonal dimensions that will likely affect service provision.

  15. Response to culturally competent drug treatment among homeless persons with different living arrangements.

    Science.gov (United States)

    Guerrero, Erick G; Song, Ahyoung; Henwood, Benjamin; Kong, Yinfei; Kim, Tina

    2018-02-01

    This study investigated the association between program cultural competence and homeless individuals' drug use after treatment in Los Angeles County, California. Los Angeles County has the largest and most diverse population of homeless individuals in the nation. We randomly selected for analysis 52 drug-treatment programs and 2158 participants who identified as homeless in the Los Angeles County Participant Reporting System in 2011. We included their living arrangements (indoors and stable, indoors and unstable, and outdoors) and individual and program characteristics (particularly whether their programs used six culturally competent practices) in multilevel regression analyses. The outcome was days of primary drug use at discharge.Results showed that higher levels of staff personal involvement in minority communities (IRR=0.437; 95% CI=0.222, 0.861) and outreach to minority communities (IRR = 0.406; 95% CI=0.213, 0.771) were associated with fewer days of drug use at discharge. Homeless individuals living outdoors used their primary drug more often than any other group. Yet, compared to individuals with other living arrangements, when outdoor homeless individuals were treated by programs with the highest community resources and linkages (IRR=0.364; 95% CI=0.157, 0.844), they reported the fewest days of drug use. We discuss implications for program evaluation and community engagement policies and practices. Copyright © 2017. Published by Elsevier Ltd.

  16. Injury-related visits and comorbid conditions among homeless persons presenting to emergency departments.

    Science.gov (United States)

    Hammig, Bart; Jozkowski, Kristen; Jones, Ches

    2014-04-01

    The authors examined the clinical characteristics of homeless patients presenting to emergency departments (EDs) in the United States, with a focus on unintentional and intentional injury events and related comorbid conditions. The study included a nationally representative sample of patients presenting to EDs with data obtained from the 2007 through 2010 National Hospital Ambulatory Medical Care Survey (NHAMCS). Descriptive and analytical epidemiologic analyses were employed to examine injuries among homeless patients. Homeless persons made 603,000 visits annually to EDs, 55% of which were for injuries, with the majority related to unintentional (52%) and self-inflicted (23%) injuries. Multivariate logistic regression analyses revealed that homeless patients had a higher odds of presenting with injuries related to unintentional (odds ratio [OR]=1.4. 95% confidence interval [CI]=1.1 to 1.9), self-inflicted (OR=6.0, 95% CI=3.7 to 9.5), and assault (OR=3.0, 95% CI=1.5 to 5.9) injuries. A better understanding of the injuries affecting homeless populations may provide medical and public health professionals insight into more effective ways to intervene and limit further morbidity and mortality related to specific injury outcomes. © 2014 by the Society for Academic Emergency Medicine.

  17. Evidence that head and body lice on homeless persons have the same genotype.

    Directory of Open Access Journals (Sweden)

    Aurélie Veracx

    Full Text Available Human head lice and body lice are morphologically and biologically similar but have distinct ecologies. They were shown to have almost the same basic genetic content (one gene is absent in head lice, but differentially express certain genes, presumably responsible for the vector competence. They are now believed to be ecotypes of the same species (Pediculus humanus and based on mitochondrial studies, body lice have been included with head lice in one of three clades of human head lice (Clade A. Here, we tested whether head and body lice collected from the same host belong to the same population by examining highly polymorphic intergenic spacers. This study was performed on lice collected from five homeless persons living in the same shelter in which Clade A lice are prevalent. Lice were individually genotyped at four spacer loci. The genetic identity and diversity of lice from head and body populations were compared for each homeless person. Population genetic structure was tested between lice from the two body regions and between the lice from different host individuals.We found two pairs of head and body lice on the same homeless person with identical multi locus genotypes. No difference in genetic diversity was found between head and body louse populations and no evidence of significant structure between the louse populations was found, even after controlling for a possible effect of the host individual. More surprisingly, no structure was obvious between lice of different homeless persons.We believe that the head and body lice collected from our five subjects belong to the same population and are shared between people living in the same shelter. These findings confirm that head and body lice are two ecotypes of the same species and show the importance of implementing measures to prevent lice transmission between homeless people in shelters.

  18. Perceptions of quality of life and disability in homeless persons with schizophrenia and persons with schizophrenia living in non-institutional housing.

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    van der Plas, A G M; Hoek, H W; van Hoeken, D; Valencia, E; van Hemert, A M

    2012-11-01

    Homelessness is common in persons with schizophrenia. It is unclear how housing conditions and homelessness affect their quality of life and their disability. To explore the self-perceived quality of life and disability of homeless persons with schizophrenia and of those of persons with schizophrenia living in non-institutional housing. Seventy-six not-homeless and 50 homeless persons with schizophrenia were assessed using the World Health Organization's Quality of Life - short version (WHOQOL-Bref) and Disability Assessment Schedule (WHODAS-II). Univariate comparisons of the two groups were made for sociodemographic variables, clinical characteristics, perceived quality of life and disability. A regression model was used to adjust for potential confounding factors between quality of life, disability and housing. After controlling for age, gender, marital status and age of first hospital admission, homeless persons had more positive scores for the quality of life domain 'health', for the disability domain 'getting along with people' and for the total disability score than persons in non-institutional housing. Contrary to our expectations, the persons in non-institutional housing reported a lower quality of life and more disability than the homeless people. Future research should clarify whether non-institutional housing in and of itself can improve the well-being of people with schizophrenia.

  19. Assessment of health status and quality of life of homeless persons in Belgrade, Serbia

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    Sarajlija Marija

    2014-01-01

    Full Text Available Background/Aim. Homelessness is a problem with social, medical, economic, political and other implications. Despite a large number of studies, reports about health-related quality of life (HRQoL of homeless persons remain sparse. There is a summary of consistent evidence that homeless people have higher prevalence of chronic disease (mental and somatic than general population. The aim of this study was to assess HRQoL and depression in homeless persons in Belgrade, to describe their sociodemographic factors and health status (the presence of chronic mental and somatic diseases and addiction disorders and analyse impact of sociodemographic factors and health status to HRQoL and depression of homeless persons. Methods. The study was conducted in the Shelter for Adult and Elderly Persons in Belgrade, from January 1 to January 31, 2012. A set of questionnaires used in survey included Serbian translation of SF-36 questionnaire, Serbian translation of Beck Depression Inventory-II (BDI-II and sociodemographic questionnaire. Statistical analysis was performed by descriptive and analytic methods. Results. Our study sample consisted of 104 adult participants. The majority of them were male (74% and the mean age in the sample was 48.2 ± 13.0 years. We have found that 35.6% participants had lifetime diagnosis of psychiatric disorder, most frequently depression (lifetime prevalence of 15.4% in the study group. The history of suicide attempts was registered in 28 (26.9% participants. Lifetime illicit drugs use was reported by 12.5%, daily smoking by 82.7% and daily alcohol consumption by 8.7% of the participants. Most common somatic chronic diseases were cardiovascular while chronic lung diseases were the second most frequent. Single chronic disease was present in 33 (31.7% of the participants and comorbidity of 2 chronic diseases was present in 20 of them. A statistically significant difference between participants` HRQoL SF-36 domain scores and norms of

  20. Housing first for homeless persons with active addiction: are we overreaching?

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    Kertesz, Stefan G; Crouch, Kimberly; Milby, Jesse B; Cusimano, Robert E; Schumacher, Joseph E

    2009-06-01

    More than 350 communities in the United States have committed to ending chronic homelessness. One nationally prominent approach, Housing First, offers early access to permanent housing without requiring completion of treatment or, for clients with addiction, proof of sobriety. This article reviews studies of Housing First and more traditional rehabilitative (e.g., "linear") recovery interventions, focusing on the outcomes obtained by both approaches for homeless individuals with addictive disorders. According to reviews of comparative trials and case series reports, Housing First reports document excellent housing retention, despite the limited amount of data pertaining to homeless clients with active and severe addiction. Several linear programs cite reductions in addiction severity but have shortcomings in long-term housing success and retention. This article suggests that the current research data are not sufficient to identify an optimal housing and rehabilitation approach for an important homeless subgroup. The research regarding Housing First and linear approaches can be strengthened in several ways, and policymakers should be cautious about generalizing the results of available Housing First studies to persons with active addiction when they enter housing programs.

  1. Environmental, parental, and personal influences on food choice, access, and overweight status among homeless children.

    Science.gov (United States)

    Richards, Rickelle; Smith, Chery

    2007-10-01

    In-depth interviews were conducted with homeless children (n=56, aged 6-13 years) in an urban center in Minnesota, USA, to determine factors influencing food choice, food access, and weight status, with interview questions developed using the Social Cognitive Theory. Interview transcripts were coded and then evaluated both collectively and by weight status ( or = 85th percentile=overweight). Forty-five percent of children were overweight. Environmental, parental, and personal factors emerged as common themes influencing food access and choice. Despite children's personal food preferences, homelessness and the shelter environment created restrictive conditions that influenced food choice and access. Shelter rules, lack of adequate storage and cooking facilities, and limited food stores near the shelter, impacted the type and quality of food choices, ultimately affecting hunger, weight status, and perceived health.

  2. Health-related quality of life (EQ-5D) among homeless persons compared to a general population sample in Stockholm County, 2006.

    Science.gov (United States)

    Sun, Sun; Irestig, Robert; Burström, Bo; Beijer, Ulla; Burström, Kristina

    2012-03-01

    To describe and compare health-related quality of life (HRQoL) among homeless persons with a general population sample in Stockholm County, 2006, and to analyse the importance of certain social determinants of health among the homeless. Face-to-face interviews with 155 homeless persons and a postal survey to a general population sample, mainly based on the same questionnaire, including questions on social determinants of health and HRQoL measured with the EQ-5D. Chronic illness was three times more common among the homeless. HRQoL was worse among homeless persons than in the general population sample: the homeless reported more problems, especially more severe problems, in all the EQ-5D dimensions and had considerably lower EQ-5D(index) and EQ(VAS) score than the general population. Most problems were reported in the dimension anxiety/depression. Among the homeless, longer duration and more severe degree of homelessness lowered HRQoL, but few determinants were statistically significantly related to HRQoL. Having mental disease significantly lowered HRQoL. This study was an attempt to include hard-to-reach groups in an assessment of population health. Homeless persons had considerably worse HRQoL than the general population and reported most problems in the dimension anxiety/depression. Some diseases may contribute to causing homelessness; others may be seen as consequences. Homeless persons are a vulnerable group in society. Further interview studies are needed based on larger sample of homeless persons to explore health determinants such as sex, age, socioeconomic factors, duration and degree of homelessness, and health-related behaviours among the homeless persons.

  3. What differentiates homeless persons who died by suicide from other suicides in Australia? A comparative analysis using a unique mortality register.

    Science.gov (United States)

    Arnautovska, U; Sveticic, J; De Leo, D

    2014-04-01

    To study the incidence of suicide by homeless persons over a 20-year period, and identify demographic and clinical characteristics that distinguish these cases from those in non-homeless persons. A comparative analysis of homeless and non-homeless persons who died by suicide between 1990 and 2009 in Queensland, Australia. Ninety-two persons (82 males and 10 females) were identified from the Queensland Suicide Register as being homeless at the time of death. Suicide rates were calculated for the second decade only due to the lack of population numbers of homeless persons in the first decade. Homeless persons had almost twice higher suicide rate than non-homeless counterparts. They were more often male, of young age, single/never married, non-Indigenous, unemployed, had at least one physical illness or other stressful life event prior to death, had drug and alcohol abuse problems, and also were more likely to have evidence for an untreated mental illness. Regression analysis showed that being unemployed, having a history of legal problems and not being diagnosed with mental illness were strongly associated with suicide among homeless persons. This study is the first in Australia, and the second study internationally, to examine the characteristics of homeless people who died by suicide. Although based on a relatively small sample, the present work nonetheless carries practical implications for the development of targeted suicide prevention strategies in this peculiar population of individuals.

  4. Chronically homeless persons' participation in an advance directive intervention: A cohort study.

    Science.gov (United States)

    Leung, Alexander K; Nayyar, Dhruv; Sachdeva, Manisha; Song, John; Hwang, Stephen W

    2015-09-01

    Chronically homeless individuals have high rates of hospitalization and death, and they may benefit from the completion of advance directives. To determine the rate of advance directive completion using a counselor-guided intervention, identify characteristics associated with advance directive completion, and describe end-of-life care preferences in a group of chronically homeless individuals. Participants completed a survey and were offered an opportunity to complete an advance directive with a trained counselor. A total of 205 residents of a shelter in Canada for homeless men (89.1% of those approached) participated from April to June 2013. Duration of homelessness was ⩾12 months in 72.8% of participants, and 103 participants (50.2%) chose to complete an advance directive. Socio-demographic characteristics, health status, and health care use were not associated with completion of an advance directive. Participants were more likely to complete an advance directive if they reported thinking about death on a daily basis, believed that thinking about their friends and family was important, or reported knowing their wishes for end-of-life care but not having told anyone about these wishes. Among individuals who completed an advance directive, 61.2% named a substitute decision maker, and 94.1% expressed a preference to receive cardiopulmonary resuscitation in the event of a cardiorespiratory arrest if there was a chance of returning to their current state of health. A counselor-guided intervention can achieve a high rate of advance directive completion among chronically homeless persons. Most participants expressed a preference to receive cardiopulmonary resuscitation in the event of a cardiorespiratory arrest. © The Author(s) 2015.

  5. Early detection of tuberculosis outbreaks among the San Francisco homeless: trade-offs between spatial resolution and temporal scale.

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    Brandon W Higgs

    Full Text Available BACKGROUND: San Francisco has the highest rate of tuberculosis (TB in the U.S. with recurrent outbreaks among the homeless and marginally housed. It has been shown for syndromic data that when exact geographic coordinates of individual patients are used as the spatial base for outbreak detection, higher detection rates and accuracy are achieved compared to when data are aggregated into administrative regions such as zip codes and census tracts. We examine the effect of varying the spatial resolution in the TB data within the San Francisco homeless population on detection sensitivity, timeliness, and the amount of historical data needed to achieve better performance measures. METHODS AND FINDINGS: We apply a variation of space-time permutation scan statistic to the TB data in which a patient's location is either represented by its exact coordinates or by the centroid of its census tract. We show that the detection sensitivity and timeliness of the method generally improve when exact locations are used to identify real TB outbreaks. When outbreaks are simulated, while the detection timeliness is consistently improved when exact coordinates are used, the detection sensitivity varies depending on the size of the spatial scanning window and the number of tracts in which cases are simulated. Finally, we show that when exact locations are used, smaller amount of historical data is required for training the model. CONCLUSION: Systematic characterization of the spatio-temporal distribution of TB cases can widely benefit real time surveillance and guide public health investigations of TB outbreaks as to what level of spatial resolution results in improved detection sensitivity and timeliness. Trading higher spatial resolution for better performance is ultimately a tradeoff between maintaining patient confidentiality and improving public health when sharing data. Understanding such tradeoffs is critical to managing the complex interplay between public

  6. Association of housing first implementation and key outcomes among homeless persons with problematic substance use.

    Science.gov (United States)

    Davidson, Clare; Neighbors, Charles; Hall, Gerod; Hogue, Aaron; Cho, Richard; Kutner, Bryan; Morgenstern, Jon

    2014-11-01

    Housing First is a supportive housing model for persons with histories of chronic homelessness that emphasizes client-centered services, provides immediate housing, and does not require treatment for mental illness or substance abuse as a condition of participation. Previous studies of Housing First have found reduced governmental costs and improved personal well-being among participants. However, variations in real-world program implementation require better understanding of the relationship between implementation and outcomes. This study investigated the effects of Housing First implementation on housing and substance use outcomes. Study participants were 358 individuals with histories of chronic homelessness and problematic substance use. Clients were housed in nine scatter-site Housing First programs in New York City. Program fidelity was judged across a set of core Housing First components. Client interviews at baseline and 12 months were used to assess substance use. Clients in programs with greater fidelity to consumer participation components of Housing First were more likely to be retained in housing and were less likely to report using stimulants or opiates at follow-up. Consistently implemented Housing First principles related to consumer participation were associated with superior housing and substance use outcomes among chronically homeless individuals with a history of substance use problems. The study findings suggest that program implementation is central to understanding the potential of Housing First to help clients achieve positive housing and substance use outcomes.

  7. Tuberculosis screening among homeless persons with AIDS living in single-room-occupancy hotels.

    Science.gov (United States)

    Layton, M C; Cantwell, M F; Dorsinville, G J; Valway, S E; Onorato, I M; Frieden, T R

    1995-11-01

    Congregate facilities for homeless persons with the acquired immunodeficiency syndrome (AIDS) are often endemic for tuberculosis. We evaluated tuberculosis screening methods at single-room-occupancy hotels housing persons with AIDS. Residents were screened by cross matching the New York City Tuberculosis Registry, interviewing for tuberculosis history, skin testing, and chest radiography. Cases were classified as either previously or newly diagnosed. Among the 106 participants, 16 (15%) previously diagnosed tuberculosis cases were identified. Participants' tuberculosis histories were identified by the questionnaire (100%) or by registry match (69%). Eight participants (50%) were noncompliant with therapy. These findings prompted the establishment of a directly observed therapy program on site.

  8. Heavy precipitation as a risk factor for shigellosis among homeless persons during an outbreak - Oregon, 2015-2016.

    Science.gov (United States)

    Hines, Jonas Z; Jagger, Meredith A; Jeanne, Thomas L; West, Nicole; Winquist, Andrea; Robinson, Byron F; Leman, Richard F; Hedberg, Katrina

    2018-03-01

    Shigella species are the third most common cause of bacterial gastroenteritis in the United States. During a Shigella sonnei outbreak in Oregon from July 2015 through June 2016, Shigella cases spread among homeless persons with onset of the wettest rainy season on record. We conducted time series analyses using Poisson regression to determine if a temporal association between precipitation and shigellosis incidence existed. Models were stratified by housing status. Among 105 infections identified, 45 (43%) occurred in homeless persons. With increasing precipitation, cases increased among homeless persons (relative risk [RR] = 1.36 per inch of precipitation during the exposure period; 95% confidence interval [CI] = 1.17-1.59), but not among housed persons (RR = 1.04; 95% CI 0.86-1.25). Heavy precipitation likely contributed to shigellosis transmission among homeless persons during this outbreak. When heavy precipitation is forecast, organizations working with homeless persons could consider taking proactive measures to mitigate spread of enteric infections. Published by Elsevier Ltd.

  9. The access of the homeless persons with tuberculosis to the health care: an integrative review

    Directory of Open Access Journals (Sweden)

    Annelissa Andrade Virgínio de Oliveira

    2017-04-01

    Full Text Available Introduction: The Tuberculosis (TB keeps being a big public health problem in the world, having the poverty, the bad life condition, the bad income distribution, the social iniquity and the disability on the health system as a substrate to its maintenance. Objective: To identify the scientific knowledge produced under the access to the health service of the homeless person sick by TB. Method: Integrative literature review conducted from April to June, 2016, having as inclusion criteria: publications written in Portuguese, English or Spanish, published from 1990 to 2015, indexed on the data basis: LILACS, SciELO, MEDLINE and Web of Science and portals Virtual Health Library (VHL and MEDLINE/PubMed, that had the text completely available online. As searching strategy was used the Boolean operator AND, with the descriptors: Tuberculosis, health services accessibility; homeless persons. To obtain the information that answered the research guideline question was elaborated a form that contemplated the following items: identification, theme, descriptors or key-words, abstract, introduction, method, results, discussion, conclusions and references. The search resulted in 51 articles that, observed with the inclusion and exclusion criteria, resulted in 10 complete articles. The data analyzes was made in qualitative terms, summarized in three categories: I Specific characteristics of the homeless people access to the health services to tuberculosis diagnostic and treatment; II Access difficulty to the health care: factors related to homeless people and factors related to health services; III Strategies to overcome the access difficulties of the homeless person (HLP  to the health care. Results: pointed that the homeless people have a higher risk to get sick by TB, presenting TB incidence rate 10 to 20 times higher than the general population. Many obstacles that limited those people access to the health services were identified. Many times they presented

  10. Effect of permethrin-impregnated underwear on body lice in sheltered homeless persons: a randomized controlled trial.

    Science.gov (United States)

    Benkouiten, Samir; Drali, Rezak; Badiaga, Sékéné; Veracx, Aurélie; Giorgi, Roch; Raoult, Didier; Brouqui, Philippe

    2014-03-01

    The control of body lice in homeless persons remains a challenge. To determine whether the use of long-lasting insecticide-treated underwear provides effective long-term protection against body lice in homeless persons. A randomized, double-blind, placebo-controlled trial was conducted in February and December 2011 in 2 homeless shelters (Madrague Ville and Forbin) in Marseille, France. Of the 125 homeless persons screened for eligibility, 73 body lice-infested homeless persons, 18 years or older, were enrolled. Body lice-infested homeless persons were randomly assigned to receive 0.4% permethrin-impregnated underwear or an identical-appearing placebo for 45 days, in a 1:1 ratio, with a permuted block size of 10. Visits were scheduled at days 14 and 45. Data regarding the presence or absence of live body lice were collected. The primary and secondary end points were the proportions of homeless persons free of body lice on days 14 and 45, respectively. Mutations associated with permethrin resistance in the body lice were also identified. Significantly more homeless persons receiving permethrin-impregnated underwear than homeless persons receiving the placebo were free of body lice on day 14 in the intent-to-treat population (28% vs 9%; P = .04), with a between-group difference of 18.4 percentage points (95% CI, 1.4-35.4), and in the per-protocol population (34% vs 11%; P = .03), with a between-group difference of 23.7 percentage points (95% CI, 3.6-43.7). This difference was not sustained on day 45. At baseline, the prevalence of the permethrin-resistant haplotype was 51% in the permethrin group and 44% in the placebo group. On day 45, the permethrin-resistant haplotype was significantly more frequent in the permethrin group than in the placebo group (73% vs 45%, P < .001). Permethrin-impregnated underwear is more efficient than placebo at eliminating body louse infestations by day 14; however, this difference was not sustained on day 45. The use of permethrin

  11. San Diego Met High School: Personalization as a Foundation

    Science.gov (United States)

    Principal Leadership, 2010

    2010-01-01

    The mission of San Diego Met High School is to prepare students for college and the workforce through active learning, academic rigor, and community involvement in a small school setting. Because personalization is a key component of the school culture, advisories of 20-25 students work with the same teachers for all four years. Advisers, parents,…

  12. The Architecture of Recovery: Two Kinds of Housing Assistance for Chronic Homeless Persons with Substance Use Disorders.

    Science.gov (United States)

    Wittman, Friedner D; Polcin, Douglas L; Sheridan, Dave

    2017-01-01

    Roughly half a million persons in the United States are homeless on any given night and over a third of those individuals have significant alcohol/other drug (AOD) problems. Many are chronically homeless and in need of assistance for a variety of problems. However, the literature on housing services for this population has paid limited attention to comparative analyses contrasting different approaches. We examined the literature on housing models for homeless persons with AOD problems and critically analyzed how service settings and operations aligned with service goals. We found two predominant housing models that reflect different service goals: Sober Living Houses (SLHs) and Housing First (HF). SLHs are communally based living arrangements that draw on the principles of Alcoholics Anonymous. They emphasize a living environment that promotes abstinence and peer support for recovery. HF is based on the premise that many homeless persons with substance abuse problems will reject abstinence as a goal. Therefore, the HF focus is providing subsidized or free housing and optional professional services for substance abuse, psychiatric disorders and other problems. If homeless service providers are to develop comprehensive systems for homeless persons with AOD problems, they need to consider important contrasts in housing models, including definitions of "recovery," roles of peer support, facility management, roles for professional service, and the architectural designs that support the mission of each type of housing. This paper is the first to consider distinct consumer choices within homeless service systems and provide recommendations to improve each based upon an integrated analysis that considers how architecture and operations align with service goals.

  13. Tuberculosis among drug users and homeless persons: impact of voluntary X-ray investigation on active case finding.

    Science.gov (United States)

    Goetsch, U; Bellinger, O K; Buettel, K-L; Gottschalk, R

    2012-08-01

    Illicit drug use and homelessness are major contributors to the incidence of tuberculosis (TB) among inhabitants of major cities. The primary objective of this study was to establish a sustainable low-threshold chest X-ray screening programme for pulmonary TB among illicit drug users and homeless persons and to integrate this into the existing public health programme for active case finding. A secondary objective was to estimate the coverage of the programme, assess other risk factors and determine TB rates and treatment outcome in these two groups. Illicit drug users and homeless persons were asked to voluntarily participate in an X-ray screening programme. The coverage of the intervention, total number and characteristics of cases and the follow-up of treatment were assessed. A total of 4,529 chest radiographs were made from 3,477 persons, of whom 66% were homeless and 34% were illicit drug users, between May 2002 and April 2007. Coverage for screening once every 2 years ranged between 18 and 26%. Thirty-nine TB cases (14 drug users, 25 homeless persons) were identified, representing 8.7% of the total case load of 448 notified cases of pulmonary TB in Frankfurt during this period. Among the drug users, human immunodeficiency virus coinfection (10/14) seemed to play a key role in the development of TB. The case-finding rate of 861/100,000 radiographs (1,122/100,000 persons) is as high as that in routine contact investigations (1,078/100,000). Among all individuals with TB, 76% completed treatment. A novel targeted TB screening approach with voluntary radiographic examination of illicit drug users and homeless persons can be integrated into the existing public TB prevention programme and provides a high case-finding rate.

  14. Diabetes in homeless persons: barriers and enablers to health as perceived by patients, medical, and social service providers.

    Science.gov (United States)

    Elder, Nancy C; Tubb, Matthew R

    2014-01-01

    The ways homelessness and diabetes affect each other is not well known. The authors sought to understand barriers and enablers to health for homeless people with diabetes as perceived by homeless persons and providers. The authors performed semistructured interviews with a sample of participants (seven homeless persons, six social service providers, and five medical providers) in an urban Midwest community. Data analysis was performed with the qualitative editing method. Participants described external factors (chaotic lifestyle, diet/food availability, access to care, and medications) and internal factors (competing demands, substance abuse, stress) that directly affect health. Social service providers were seen as peripheral to diabetes care, although all saw their primary functions as valuable. These factors and relationships are appropriately modeled in a complex adaptive chronic care model, where the framework is bottom up and stresses adaptability, self-organization, and empowerment. Adapting the care of homeless persons with diabetes to include involvement of patients and medical and social service providers must be emergent and responsive to changing needs.

  15. Adverse events and treatment completion for latent tuberculosis in jail inmates and homeless persons.

    Science.gov (United States)

    Lobato, Mark N; Reves, Randall R; Jasmer, Robert M; Grabau, John C; Bock, Naomi N; Shang, Nong

    2005-04-01

    Recently, a short-course treatment using 60 daily doses of rifampin and pyrazinamide was recommended for latent tuberculosis (TB) infection (LTBI). To determine the acceptability, tolerability, and completion of treatment. Observational cohort study. Five county jails and TB outreach clinics for homeless populations in three cities. Study staff enrolled 1,211 patients (844 inmates and 367 homeless persons). Sites used 60 daily doses of rifampin and pyrazinamide, an approved treatment regimen for LTBI. Types and frequency of drug-related adverse events and outcomes of treatment. Prior to treatment, 25 of 1,178 patients (2.1%) had a serum aminotransferase measurement at least 2.5 times the upper limit of normal. Patients who reported excess alcohol use in the past 12 months were more likely than other patients to have an elevated pretreatment serum aminotransferase level (odds ratio, 2.1; 95% confidence interval, 1.1 to 6.1; p = 0.03). Treatment was stopped in 66 of 162 patients (13.4%) who had a drug-related adverse event. Among 715 patients who had serum aminotransferase measured during treatment, 43 patients (6.0%) had an elevation > 5 times the upper limits of normal, including one patient who died of liver failure attributed to treatment. In multivariate analyses, increasing age, an abnormal baseline aspartate aminotransferase level, and unemployment within the past 24 months were independent risk factors for hepatotoxicity. Completion rates were similar in jail inmates (47.5%) and homeless persons (43.6%). This study detected the first treatment-associated fatality with the rifampin and pyrazinamide regimen, prompting surveillance that detected unacceptable levels of hepatotoxicity and retraction of recommendations for its routine use. Completion rates for LTBI treatment using a short-course regimen exceeds historical rates using isoniazid. Efforts to identify an effective short-course treatment for LTBI should be given a high priority.

  16. The Impact of Criminal Justice Involvement and Housing Outcomes Among Homeless Persons with Co-occurring Disorders.

    Science.gov (United States)

    Mitchell, Jessica N; Clark, Colleen; Guenther, Christina C

    2017-11-01

    The relationship between criminal justice involvement and housing among homeless persons with co-occurring disorders was examined. Program participants assisted in moving to stable housing were interviewed at baseline, six months, and discharge. Those who remained homeless at follow-up and discharge had significantly more time in jail in the past month than those who were housed. However, criminal justice involvement was not significantly related to housing status at the six month follow-up or discharge. Findings suggest that housing people with complex behavioral health issues reduces the likelihood of further criminal justice involvement.

  17. Impact of housing on the survival of persons with AIDS.

    Science.gov (United States)

    Schwarcz, Sandra K; Hsu, Ling C; Vittinghoff, Eric; Vu, Annie; Bamberger, Joshua D; Katz, Mitchell H

    2009-07-07

    Homeless persons with HIV/AIDS have greater morbidity and mortality, more hospitalizations, less use of antiretroviral therapy, and worse medication adherence than HIV-infected persons who are stably housed. We examined the effect of homelessness on the mortality of persons with AIDS and measured the effect of supportive housing on AIDS survival. The San Francisco AIDS registry was used to identify homeless and housed persons who were diagnosed with AIDS between 1996 and 2006. The registry was computer-matched with a housing database of homeless persons who received housing after their AIDS diagnosis. The Kaplan-Meier product limit method was used to compare survival between persons who were homeless at AIDS diagnosis and those who were housed. Proportional hazards models were used to estimate the independent effects of homelessness and supportive housing on survival after AIDS diagnosis. Of the 6,558 AIDS cases, 9.8% were homeless at diagnosis. Sixty-seven percent of the persons who were homeless survived five years compared with 81% of those who were housed (p Homelessness increased the risk of death (adjusted relative hazard [RH] 1.20; 95% confidence limits [CL] 1.03, 1.41). Homeless persons with AIDS who obtained supportive housing had a lower risk of death than those who did not (adjusted RH 0.20; 95% CL 0.05, 0.81). Supportive housing ameliorates the negative effect of homelessness on survival with AIDS.

  18. L’alimentation des sans-abri / Diet of the Homeless

    OpenAIRE

    Carole Amistani; Daniel Terrolle

    2008-01-01

    L’alimentation des sans-logis est analysable, à partir du terrain, selon deux versants, parfois utilisés conjointement, qui sont celui de leur autonomie et/ou celui de leur dépendance envers le don alimentaire. Dans ce dernier cas, les contenus comme les formes témoignent trop souvent d’une impossibilité d’assurer l’équilibre nutritionnel de ces mangeurs et le respect des multiples aspects socialisants compris dans l’acte alimentaire. Le choix d’un traitement social dans l’ « urgence » et par...

  19. Intellectual disability and homelessness.

    Science.gov (United States)

    Mercier, C; Picard, S

    2011-04-01

    The association between poverty and intellectual disability (ID) has been well documented. However, little is known about persons with ID who face circumstances of extreme poverty, such as homelessness. This paper describes the situation of persons with ID who were or are homeless in Montreal and are currently receiving services from a team dedicated to homeless persons. (1) To describe the characteristics, history and current situation of these persons; and (2) to report within-group differences as a function of gender and current residential status. The data were collected from files using an anonymous chart summary. Descriptive statistics on the whole sample (n = 68) and inferential statistics on cross-tabulations by gender and residential status were performed. Persons with ID exhibited several related problems. Some of these persons, primarily women, experienced relatively short periods of homelessness and their situations stabilised once they were identified and followed up. Other persons with ID experienced chronic homelessness that appeared to parallel the number and severity of their other problems. When compared with a previous epidemiological study of the homeless in Montreal, the population of homeless persons with ID differed from the overall homeless population in a number of respects. The results suggest prevention and intervention targets. The need for epidemiological research appears particularly clear in light of the fact that below-average intellectual functioning has been identified as a risk factor for homelessness and a predisposing factor for vulnerability among street people. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.

  20. Effects of sustained abstinence among treated substance-abusing homeless persons on housing and employment.

    Science.gov (United States)

    Milby, Jesse B; Schumacher, Joseph E; Wallace, Dennis; Vuchinich, Rudy; Mennemeyer, Stephen T; Kertesz, Stefan G

    2010-05-01

    We examined whether cocaine-dependent homeless persons had stable housing and were employed 6, 12, and 18 months after they entered a randomized controlled trial comparing 2 treatments. One group (n = 103) received abstinence-contingent housing, vocational training, and work; another group (n = 103) received the same intervention plus cognitive behavioral day treatment. We examined baseline and early treatment variables for association with long-term housing and employment. Although the enhanced-treatment group achieved better abstinence rates, the groups did not differ in long-term housing and employment stability. However, consecutive weeks of abstinence during treatment (and to a lesser extent, older age and male gender) predicted long-term housing and employment stability after adjustment for baseline differences in employment, housing, and treatment. Our data showed a relationship of abstinence with housing stability. Contrasting these results with the increasingly popular Housing First interventions reveals important gaps in our knowledge to be addressed in future research.

  1. Co-occurring substance abuse and mental health problems among homeless persons: Suggestions for research and practice

    Science.gov (United States)

    Polcin, Douglas L.

    2016-01-01

    Abstract Communities throughout the U.S. are struggling to find solutions for serious and persistent homelessness. Alcohol and drug problems can be causes and consequences of homelessness, as well as co-occurring problems that complicate efforts to succeed in finding stable housing. Two prominent service models exist, one known as “Housing First” takes a harm reduction approach and the other known as the “linear” model typically supports a goal of abstinence from alcohol and drugs. Despite their popularity, the research supporting these models suffers from methodological problems and inconsistent findings. One purpose of this paper is to describe systematic reviews of the homelessness services literature, which illustrate weaknesses in research designs and inconsistent conclusions about the effectiveness of current models. Problems among some of the seminal studies on homelessness include poorly defined inclusion and exclusion criteria, inadequate measures of alcohol and drug use, unspecified or poorly implemented comparison conditions, and lack of procedures documenting adherence to service models. Several recent papers have suggested broader based approaches for homeless services that integrate alternatives and respond better to consumer needs. Practical considerations for implementing a broader system of services are described and peer-managed recovery homes are presented as examples of services that address some of the gaps in current approaches. Three issues are identified that need more attention from researchers: (1) improving upon the methodological limitations in current studies, (2) assessing the impact of broader based, integrated services on outcome, and (3) assessing approaches to the service needs of homeless persons involved in the criminal justice system. PMID:27092027

  2. Mental Disorder Among Homeless Persons in the United States: An Overview of Recent Empirical Literature.

    Science.gov (United States)

    Robertson, Marjorie J.

    1986-01-01

    Reviews literature on the homeless reporting higher rates of psychiatric disorder, psychological distress, and previous psychiatric hospitalization compared to the general population. However, understandardized methodology and lack of consistent findings across studies prohibit reliable prevalence estimates of mental disorder among the homeless.…

  3. Change in neurocognition by housing type and substance abuse among formerly homeless seriously mentally ill persons.

    Science.gov (United States)

    Caplan, Brina; Schutt, Russell K; Turner, Winston M; Goldfinger, Stephen M; Seidman, Larry J

    2006-03-01

    To test the effect of living in group housing rather than independent apartments on executive functioning, verbal memory and sustained attention among formerly homeless persons with serious mental illness and to determine whether substance abuse modifies this effect. In metropolitan Boston, 112 persons in Department of Mental Health shelters were randomly assigned to group homes ("Evolving Consumer Households", with project facilitator, group meetings, resident decision-making) or independent apartments. All were case managed. A neuropsychological test battery was administered at baseline, at 18 months (Time 2), with an 81% follow-up rate, and at 48 months (Time 3), with a 59% follow-up rate. Hierarchical Linear Modeling was applied to executive functioning--assessed with the Wisconsin Card Sorting Test (Perseverations)-Logical Memory story recall, and an auditory Continuous Performance Test (CPT) for sustained attention. Subject characteristics were controlled. When moved to group homes, subjects without a lifetime substance abuse history improved on Perseverations, while those who moved to independent apartments deteriorated on Perseverations. Across the two housing conditions, subjects showed no change in Perseverations, but improved on Logical Memory story recall and the CPT. Type of housing placement can influence cognitive functioning; notably, socially isolating housing is associated with weakened executive functioning. Substance abuse significantly diminishes environmental effects. These are important factors to consider in housing placement and subsequent treatment.

  4. Tuberculosis infection among homeless persons and caregivers in a high-tuberculosis-prevalence area in Japan: a cross-sectional study.

    Science.gov (United States)

    Tabuchi, Takahiro; Takatorige, Toshio; Hirayama, Yukio; Nakata, Nobuaki; Harihara, Shigeyoshi; Shimouchi, Akira; Fujita, Koshiro; Yoshida, Hiroko; Tamura, Yoshitaka; Nagai, Takayuki; Matsumoto, Tomoshige; Takashima, Tetsuya; Iso, Hiroyasu

    2011-01-21

    Tuberculosis (TB) is a major public health problem. The Airin district of Osaka City has a large population of homeless persons and caregivers and is estimated to be the largest TB-endemic area in the intermediate-prevalence country, Japan. However, there have been few studies of homeless persons and caregivers. The objective of this study is to detect active TB and to assess the prevalence and risk factors for latent TB infection among homeless persons and caregivers. We conducted a cross-sectional study for screening TB infection (active and latent TB infections) using questionnaire, chest X-ray (CXR), newly available assay for latent TB infection (QuantiFERON-TB Gold In-Tube; QFT) and clinical evaluation by physicians at the Osaka Socio-Medical Center Hospital between July 2007 and March 2008. Homeless persons and caregivers, aged 30-74 years old, who had not received CXR examination within one year, were recruited. As for risk factors of latent TB infection, the odds ratios (OR) and 95% confidence intervals (95% CI) for QFT-positivity were calculated using logistic regression model. Complete responses were available from 436 individuals (263 homeless persons and 173 caregivers). Four active TB cases (1.5%) among homeless persons were found, while there were no cases among caregivers. Out of these four, three had positive QFT results. One hundred and thirty-three (50.6%) homeless persons and 42 (24.3%) caregivers had positive QFT results. In multivariate analysis, QFT-positivity was independently associated with a long time spent in the Airin district: ≥10 years versus homeless (OR = 2.53; 95% CI, 1.39-4.61) and for caregivers (OR = 2.32; 95% CI, 1.05-5.13), and the past exposure to TB patients for caregivers (OR = 3.21; 95% CI, 1.30-7.91) but not for homeless persons (OR = 1.51; 95% CI, 0.71-3.21). Although no active TB was found for caregivers, one-quarter of them had latent TB infection. In addition to homeless persons, caregivers need examinations for

  5. South Dakota's 1996 Homeless Report. Homeless, Not Hopeless.

    Science.gov (United States)

    South Dakota State Dept. of Education and Cultural Affairs, Pierre.

    To study the number and status of homeless people in South Dakota, a questionnaire was mailed to approximately 701 persons who were likely to have knowledge of homeless people. Responses were received from 349 people. Estimated numbers of homeless people include those who live with others because they lack adequate resources to maintain a fixed,…

  6. Associations of Housing First Configuration and Crime and Social Connectedness Among Persons With Chronic Homelessness Histories.

    Science.gov (United States)

    Whittaker, Elizabeth; Flatau, Paul Robert; Swift, Wendy; Dobbins, Timothy A; Burns, Lucinda

    2016-10-01

    This study compared changes in criminal justice contact, quality of life, and social connectedness over a 12-month follow-up period between participants in two Housing First configurations (scattered site [SS] and congregate site [CS]). A longitudinal, quantitative design was utilized for this ecological study. Changes in individual outcomes over time were compared for SS and CS participants who completed both baseline and 12-month follow-up surveys (N=63). The number of contacts with various types of criminal justice system channels differed significantly between SS and CS participants, decreasing significantly among SS participants and increasing significantly among CS participants. The two groups did not differ on quality-of-life outcomes or social-connectedness measures, with the exception of case management engagement, whereby a greater proportion of SS participants disengaged from this service over time compared with CS participants. At follow-up, significant within-group changes over time emerged, with increased boredom reported among SS participants, whereas CS participants reported improvements in social relationships, with fewer reporting losing their temper. The findings supported the notion that the Housing First approach has the potential to significantly improve the lives of persons who have experienced chronic homelessness, a traditionally marginalized and vulnerable group. Over time, this may result in a reduction in the use of acute services, thereby reducing societal costs. The challenge remains to identify the suitability of particular configurations of housing and support and how service delivery can optimize individual outcomes so positive outcomes are maintained in the longer term.

  7. Living conditions, ability to seek medical treatment, and awareness of health conditions and healthcare options among homeless persons in Tokyo, Japan.

    Science.gov (United States)

    Ohtsu, Tadahiro; Toda, Ryouhei; Shiraishi, Tomonobu; Toyoda, Hirokuni; Toyozawa, Hideyasu; Kamioka, Yasuaki; Ochiai, Hirotaka; Shimada, Naoki; Shirasawa, Takako; Hoshino, Hiromi; Kokaze, Akatsuki

    2011-12-01

    Empirical data indicative of the health conditions and medical needs of homeless persons are scarce in Japan. In this study, with the aim of contributing to the formulation of future healthcare strategies for the homeless, we conducted a self-administered questionnaire survey and interviews at a park in Shinjuku Ward, Tokyo, to clarify the living conditions of homeless persons and their health conditions and awareness about the availability of medical treatment. Responses from 55 homeless men were recorded (response rate: 36.7%). With the exception of one person, none of them possessed a health insurance certificate. Half of the respondents reported having a current income source, although their modal monthly income was 30,000 yen($1 was approximately 90 yen). The number of individuals who responded "yes" to the questions regarding "Consulting a doctor on the basis of someone's recommendation" and "Being aware of the location of the nearest hospital or clinic" was significantly higher among those who had someone to consult when they were ill than among those who did not (the odds ratios [95% confidence intervals] were 15.00 [3.05-93.57] and 11.45 [1.42-510.68], respectively). This showed that whether or not a homeless person had a person to consult might influence his healthcare-seeking behavior. When queried about the entity they consulted (multiple responses acceptable), respondents mentioned "life support organizations" (61.1%) and "public offices" (33.3%). Overall, 94.5% of the respondents were aware of swine flu (novel influenza A (H1N1)). Their main sources of information were newspapers and magazines. On the basis of these findings, with regard to the aim of formulating healthcare strategies for homeless persons, while life support organizations and public offices play significant roles as conduits to medical institutions, print media should be considered useful for communicating messages to homeless persons.

  8. 24 CFR 91.205 - Housing and homeless needs assessment.

    Science.gov (United States)

    2010-04-01

    ...) Homeless needs. The plan must provide a concise summary of the nature and extent of homelessness (including rural homelessness and chronically homeless persons), addressing separately the need for facilities and...) who are currently housed but threatened with homelessness. The plan also must contain a brief...

  9. Impact of housing on the survival of persons with AIDS

    Directory of Open Access Journals (Sweden)

    Vittinghoff Eric

    2009-07-01

    Full Text Available Abstract Background Homeless persons with HIV/AIDS have greater morbidity and mortality, more hospitalizations, less use of antiretroviral therapy, and worse medication adherence than HIV-infected persons who are stably housed. We examined the effect of homelessness on the mortality of persons with AIDS and measured the effect of supportive housing on AIDS survival. Methods The San Francisco AIDS registry was used to identify homeless and housed persons who were diagnosed with AIDS between 1996 and 2006. The registry was computer-matched with a housing database of homeless persons who received housing after their AIDS diagnosis. The Kaplan-Meier product limit method was used to compare survival between persons who were homeless at AIDS diagnosis and those who were housed. Proportional hazards models were used to estimate the independent effects of homelessness and supportive housing on survival after AIDS diagnosis. Results Of the 6,558 AIDS cases, 9.8% were homeless at diagnosis. Sixty-seven percent of the persons who were homeless survived five years compared with 81% of those who were housed (p Conclusion Supportive housing ameliorates the negative effect of homelessness on survival with AIDS.

  10. The role of neurocognition and social context in predicting community functioning among formerly homeless seriously mentally ill persons.

    Science.gov (United States)

    Schutt, Russell K; Seidman, Larry J; Caplan, Brina; Martsinkiv, Anna; Goldfinger, Stephen M

    2007-11-01

    To test the influence of neurocognitive functioning on community functioning among formerly homeless persons with serious mental illness and to determine whether that influence varies with social context, independent of individual characteristics. In metropolitan Boston, 112 persons in Department of Mental Health shelters were administered a neuropsychological test battery and other measures and then randomly assigned to empowerment-oriented group homes or independent apartments, as part of a longitudinal study of the effects of housing on multiple outcomes. Subjects' case managers completed Rosen's 5-dimensional Life Skills Inventory at 3, 6, 12, and 18 months and subjects reported on their social contacts at baseline, 6, 12, and 18 months. Subject characteristics are controlled in the analysis. Three dimensions of neurocognitive functioning--executive function, verbal declarative memory, and vigilance--each predicted community functioning. Better executive function predicted improved self-care and less turbulent behavior among persons living alone, better memory predicted more positive social contacts for those living in a group home, and higher levels of vigilance predicted improved communication in both housing types. Neurocognition predicts community functioning among homeless persons with severe mental illness, but in a way that varies with the social context in which community functioning occurs.

  11. Perceptions, Attitudes, and Experience Regarding mHealth Among Homeless Persons in New York City Shelters.

    Science.gov (United States)

    Asgary, Ramin; Sckell, Blanca; Alcabes, Analena; Naderi, Ramesh; Adongo, Philip; Ogedegbe, Gbenga

    2015-01-01

    Mobile health may be an effective means of providing access and education to the millions of homeless Americans. We conducted semi-structured interviews with 50 homeless people from different shelters in New York City to evaluate their perceptions, attitudes, and experiences regarding mobile health. Participants' average age was 51.66 (SD = 11.34) years; duration of homelessness was 2.0 (SD = 3.10) years. The majority had a mobile phone with the ability to receive and send text messages. Most participants attempted to maintain the same phone number over time. The homeless were welcoming and supportive of text messaging regarding health care issues, including appointment reminders, health education, or management of diseases considering their barriers and mobility, and believed it would help them access necessary health care. Overwhelmingly they preferred text reminders that were short, positively framed, and directive in nature compared to lengthy or motivational texts. The majority believed that free cell phone plans would improve their engagement with, help them navigate, and ultimately improve their access to care. These positive attitudes and experience could be effectively used to improve health care for the homeless. Policies to improve access to mobile health and adapted text messaging strategies regarding the health care needs of this mobile population should be considered.

  12. Substance abuse treatment and psychiatric comorbidity: do benefits spill over? analysis of data from a prospective trial among cocaine-dependent homeless persons

    Directory of Open Access Journals (Sweden)

    Kertesz Stefan G

    2006-09-01

    Full Text Available Abstract Background Comorbid psychiatric illness can undermine outcomes among homeless persons undergoing addiction treatment, and psychiatric specialty care is not always readily available. The prognosis for nonsubstance abuse psychiatric diagnoses among homeless persons receiving behaviorally-based addiction treatment, however, is little studied. Results Data from an addiction treatment trial for 95 cocaine-dependent homeless persons (1996–1998 were used to profile psychiatric diagnoses at baseline and 6 months, including mood-related disorders (e.g. depression and anxiety-related disorders (e.g. post-traumatic stress disorder. Treatment interventions, including systematic reinforcement for goal attainment, were behavioral in orientation. There was a 32% reduction in the prevalence of comorbid non-addiction psychiatric disorder from baseline to 6 months, with similar reductions in the prevalence of mood (-32% and anxiety-related disorders (-20% (p = 0.12. Conclusion Among cocaine-dependent homeless persons with psychiatric comorbidity undergoing behavioral addiction treatment, a reduction in comorbid psychiatric disorder prevalence was observed over 6 months. Not all participants improved, suggesting that even evidence-based addiction treatment will prove insufficient for a meaningful proportion of the dually diagnosed homeless population.

  13. Personal goals and factors related to QoL in Dutch homeless people: what is the role of goal-related self-efficacy?

    Science.gov (United States)

    van der Laan, Jorien; Boersma, Sandra N; van Straaten, Barbara; Rodenburg, Gerda; van de Mheen, Dike; Wolf, Judith R L M

    2017-05-01

    Very little is known about the personal goals of homeless people and how these relate to their quality of life (QoL). By using survey data on 407 homeless adults upon entry to the social relief system in 2011, we examined the personal goals of homeless adults and the association between their perceived goal-related self-efficacy and their QoL. A hierarchical regression analysis was used to analyse the association between QoL and goal-related self-efficacy, relative to factors contributing to QoL, such as demographic characteristics, socioeconomic resources, health and service use. Results indicate that the majority of homeless adults had at least one personal goal for the coming 6 months and that most goals concerned housing and daily life (94.3%) and finances (83.6%). The QoL of homeless adults appeared to be lower in comparison with general population samples. General goal-related self-efficacy was positively related to QoL (β = 0.09, P = 0.042), independent of socioeconomic resources (i.e. income and housing), health and service use. The strongest predictors of QoL were psychological distress (β = -0.45, P people as the starting point of integrated service programmes and to promote their goal-related self-efficacy by strength-based interventions. © 2017 John Wiley & Sons Ltd.

  14. Differential experiences of discrimination among ethnoracially diverse persons experiencing mental illness and homelessness.

    Science.gov (United States)

    Zerger, Suzanne; Bacon, Sarah; Corneau, Simon; Skosireva, Anna; McKenzie, Kwame; Gapka, Susan; O'Campo, Patricia; Sarang, Aseefa; Stergiopoulos, Vicky

    2014-12-14

    This mixed methods study explored the characteristics of and experiences with perceived discrimination in an ethnically diverse urban sample of adults experiencing homelessness and mental illness. Data were collected in Toronto, Ontario, as part of a 4-year national randomized field trial of the Housing First treatment model. Rates of perceived discrimination were captured from survey questions regarding perceived discrimination among 231 ethnoracially diverse participants with moderate mental health needs. The qualitative component included thirty six in-depth interviews which explored how individuals who bear these multiple identities of oppression navigate stigma and discrimination, and what affects their capacity to do so. Quantitative analysis revealed very high rates of perceived discrimination related to: homelessness/poverty (61.5%), race/ethnicity/skin colour (50.6%) and mental illness/substance use (43.7%). Immigrants and those who had been homeless three or more years reported higher perceived discrimination on all three domains. Analysis of qualitative interviews revealed three common themes related to navigating these experiences of discrimination among participants: 1) social distancing; 2) old and new labels/identities; and, 3) 'homeland' cultures. These study findings underscore poverty and homelessness as major sources of perceived discrimination, and expose underlying complexities in the navigation of multiple identities in responding to stigma and discrimination. Current Controlled Trials ISRCTN42520374 . Registered 18 August 2009.

  15. Reaching out to Ray: delivering palliative care services to a homeless person in Melbourne, Australia.

    Science.gov (United States)

    MacWilliams, Judy; Bramwell, Michael; Brown, Sally; O'Connor, Margaret

    2014-02-01

    Most terminally ill people express a preference for dying at home. Within established models of palliative care, achieving death at home is a particular challenge for homeless people. This paper describes a quality-improvement project undertaken by a community-based palliative care service in Melbourne, Australia, to understand homeless people's palliative care needs and the challenges that workers face. Six semi-structured interviews with workers in hospital and community-based settings were undertaken and a case study documented. The results were used to initiate discussion about how policy and protocols for the community-based palliative care service might serve this population more effectively. The findings confirmed that homeless people have complex psychosocial and medical needs. They may be periodically uncontactable or living in unsafe settings, experience isolation from social support networks, and have issues of compliance with treatment protocols exacerbated by mental health problems and/or substance abuse. Service providers had particular challenges in meeting the palliative care needs of homeless people. A flexible, compassionate, and coordinated response is required, and more work is needed to explore how the needs of this particular group can be met.

  16. Vaccination against hepatitis A and B in persons subject to homelessness in inner Sydney: vaccine acceptance, completion rates and immunogenicity.

    Science.gov (United States)

    Poulos, Roslyn G; Ferson, Mark J; Orr, Karen J; McCarthy, Michele A; Botham, Susan J; Stern, Jerome M; Lucey, Adrienne

    2010-04-01

    To determine acceptance, completion rates and immunogenicity of the standard vaccination schedule for hepatitis A (HAV) and B (HBV) in persons subject to homelessness. A convenience sample of clients (n=201) attending a medical clinic for homeless and disadvantaged persons in Sydney was enrolled. Serological screening for HAV and HBV was undertaken. An appropriate vaccination program was instituted. Post-vaccination serology determined serological response. Although many clients had serological evidence of past infection, at least 138 (69%) clients had the potential to benefit from vaccination. For hepatitis A and B vaccinations, completion rates were 73% (73 of 100 clients) and 75% (69 of 92 clients), respectively; after vaccination, protective antibody was found in 98.2% (56 of 57) and 72% (36 of 50) of clients, respectively. A successful vaccination program can be mounted with a vulnerable population. We consider a clinic with a well-established history of acceptance and utilisation by the target group; a low staff turnover and regular clientele; inclusion of vaccination as part of routine client care; and counselling (part of pre- and post-serological testing) essential components in achieving good vaccination completion rates. © 2010 The Authors. Journal Compilation © 2010 Public Health Association of Australia.

  17. Designing a smoking cessation intervention for the unique needs of homeless persons: a community-based randomized clinical trial.

    Science.gov (United States)

    Goldade, Kate; Whembolua, Guy-Lucien; Thomas, Janet; Eischen, Sara; Guo, Hongfei; Connett, John; Des Jarlais, Don; Resnicow, Ken; Gelberg, Lillian; Owen, Greg; Grant, Jon; Ahluwalia, Jasjit S; Okuyemi, Kolawole S

    2011-12-01

    Although smoking prevalence remains strikingly high in homeless populations (~70% and three times the US national average), smoking cessation studies usually exclude homeless persons. Novel evidence-based interventions are needed for this high-risk subpopulation of smokers. To describe the aims and design of a first-ever smoking cessation clinical trial in the homeless population. The study was a two-group randomized community-based trial that enrolled participants (n = 430) residing across eight homeless shelters and transitional housing units in Minnesota. The study objective was to test the efficacy of motivational interviewing (MI) for enhancing adherence to nicotine replacement therapy (NRT; nicotine patch) and smoking cessation outcomes. Participants were randomized to one of the two groups: active (8 weeks of NRT + 6 sessions of MI) or control (NRT + standard care). Participants attended six in-person assessment sessions and eight retention visits at a location of their choice over 6 months. Nicotine patch in 2-week doses was administered at four visits over the first 8 weeks of the 26-week trial. The primary outcome was cotinine-verified 7-day point-prevalence abstinence at 6 months. Secondary outcomes included adherence to nicotine patch assessed through direct observation and patch counts. Other outcomes included the mediating and/or moderating effects of comorbid psychiatric and substance abuse disorders. Lessons learned from the community-based cessation randomized trial for improving recruitment and retention in a mobile and vulnerable population included: (1) the importance of engaging the perspectives of shelter leadership by forming and convening a Community Advisory Board; (2) locating the study at the shelters for more visibility and easier access for participants; (3) minimizing exclusion criteria to allow enrollment of participants with stable psychiatric comorbid conditions; (4) delaying the baseline visit from the eligibility visit by a week

  18. Relevance of a subjective quality of life questionnaire for long-term homeless persons with schizophrenia.

    Science.gov (United States)

    Girard, V; Tinland, A; Bonin, J P; Olive, F; Poule, J; Lancon, C; Apostolidis, T; Rowe, M; Greacen, T; Simeoni, M C

    2017-02-17

    Increasing numbers of programs are addressing the specific needs of homeless people with schizophrenia in terms of access to housing, healthcare, basic human rights and other domains. Although quality of life scales are being used to evaluate such programs, few instruments have been validated for people with schizophrenia and none for people with schizophrenia who experience major social problems such as homelessness. The aim of the present study was to validate the French version of the S-QoL a self-administered, subjective quality of life questionnaire specific to schizophrenia for people with schizophrenia who are homeless. In a two-step process, the S-QoL was first administered to two independent convenience samples of long-term homeless people with schizophrenia in Marseille, France. The objective of the first step was to analyse the psychometric properties of the S-QoL. The objective of the second step was to examine, through qualitative interviews with members of the population in question, the relevance and acceptability of the principle quality of life indicators used in the S-QoL instrument. Although the psychometric characteristics of the S-QoL were found to be globally satisfactory, from the point of view of the people being interviewed, acceptability was poor. Respondents frequently interrupted participation complaining that questionnaire items did not take into account the specific context of life on the streets. Less intrusive questions, more readily understandable vocabulary and greater relevance to subjects' living conditions are needed to improve the S-QoL questionnaire for this population. A modular questionnaire with context specific sections or specific quality of life instruments for socially excluded populations may well be the way forward.

  19. Effect of an End-of-Life Planning Intervention on the completion of advance directives in homeless persons: a randomized trial.

    Science.gov (United States)

    Song, John; Ratner, Edward R; Wall, Melanie M; Bartels, Dianne M; Ulvestad, Nancy; Petroskas, Dawn; West, Melissa; Weber-Main, Anne Marie; Grengs, Leah; Gelberg, Lillian

    2010-07-20

    Few interventions have focused on improving end-of-life care for underserved populations, such as homeless persons. To determine whether homeless persons will complete a counseling session on advance care planning and fill out a legal advance directive designed to assess care preferences and preserve the dignity of marginalized persons. Prospective, single-blind, randomized trial comparing self-guided completion of an advance directive with professionally assisted advance care planning. (ClinicalTrials.gov registration number: NCT00546884) 8 sites serving homeless persons in Minneapolis, Minnesota. 262 homeless persons recruited between November 2007 and August 2008. Minimal, self-guided intervention consisting of advance directive forms and written educational information versus a one-on-one advance planning intervention consisting of counseling and completing an advance directive with a social worker. Rate of advance directive completion, assessed by inspection of completed documents. The overall completion rate for advance directives was 26.7% (95% CI, 21.5% to 32.5%), with a higher rate in the counselor-guided group (37.9%) than in the self-guided group (12.8%) (CI of adjusted difference, 15.3 to 34.3 percentage points). This difference persisted across all sites and most subgroups. The advance directive's 4 clinical scenarios found a preference for surrogate decision making in 29% to 34% of written responses. Sampling was limited to a more stable subset of the homeless population in Minneapolis and may have been subject to selection bias. Modest compensation to complete the preintervention survey could have influenced participants to complete advance directives. Both a simple and complex intervention successfully engaged a diverse sample of homeless persons in advance care planning. One-on-one assistance significantly increased the completion rate. Homeless persons can respond to an intervention to plan for end-of-life care and can express specific preferences

  20. Concurrent Disorders and Health Care Utilization Among Homeless and Vulnerably Housed Persons in Canada.

    Science.gov (United States)

    Zhang, Linda; Norena, Monica; Gadermann, Anne; Hubley, Anita; Russell, Lara; Aubry, Tim; To, Matthew J; Farrell, Susan; Hwang, Stephen; Palepu, Anita

    2018-03-01

    Individuals who are homeless or vulnerably housed have a higher prevalence of concurrent disorders, defined as having a mental health diagnosis and problematic substance use, compared to the general housed population. The study objective was to investigate the effect of having concurrent disorders on health care utilization among homeless or vulnerably housed individuals, using longitudinal data from the Health and Housing in Transition Study. In 2009, 1190 homeless or vulnerably housed adults were recruited in Ottawa, Toronto, and Vancouver, Canada. Participants completed baseline interviews and four annual follow-up interviews, providing data on sociodemographics, housing history, mental health diagnoses, problematic drug use with the Drug Abuse Screening Test (DAST-10), problematic alcohol use with the Alcohol Use Disorders Identification Test (AUDIT), chronic health conditions, and utilization of the following health care services: emergency department (ED), hospitalization, and primary care. Concurrent disorders were defined as the participant having ever received a mental health diagnosis at baseline and having problematic substance use (i.e., DAST-10 ≥ 6 and/or AUDIT ≥ 20) at any time during the study period. Three generalized mixed effects logistic regression models were used to examine the independent association of having concurrent disorders and reporting ED use, hospitalization, or primary care visits in the past 12 months. Among our sample of adults who were homeless or vulnerably housed, 22.6% (n = 261) reported having concurrent disorders at baseline. Individuals with concurrent disorders had significantly higher odds of ED use (adjusted odds ratio [AOR] = 1.71; 95% confidence interval [CI], 1.4-2.11), hospitalization (AOR = 1.45; 95% CI, 1.16-1.81), and primary care visits (AOR = 1.34; 95% CI, 1.05-1.71) in the past 12 months over the four-year follow-up period, after adjusting for potential confounders. Concurrent disorders were associated with

  1. A marginal structural model to estimate the causal effect of antidepressant medication treatment on viral suppression among homeless and marginally housed persons with HIV.

    Science.gov (United States)

    Tsai, Alexander C; Weiser, Sheri D; Petersen, Maya L; Ragland, Kathleen; Kushel, Margot B; Bangsberg, David R

    2010-12-01

    Depression strongly predicts nonadherence to human immunodeficiency virus (HIV) antiretroviral therapy, and adherence is essential to maintaining viral suppression. This suggests that pharmacologic treatment of depression may improve virologic outcomes. However, previous longitudinal observational analyses have inadequately adjusted for time-varying confounding by depression severity, which could yield biased estimates of treatment effect. Application of marginal structural modeling to longitudinal observation data can, under certain assumptions, approximate the findings of a randomized controlled trial. To determine whether antidepressant medication treatment increases the probability of HIV viral suppression. Community-based prospective cohort study with assessments conducted every 3 months. Community-based research field site in San Francisco, California. One hundred fifty-eight homeless and marginally housed persons with HIV who met baseline immunologic (CD4+ T-lymphocyte count, 13) inclusion criteria, observed from April 2002 through August 2007. Probability of achieving viral suppression to less than 50 copies/mL. Secondary outcomes of interest were probability of being on an antiretroviral therapy regimen, 7-day self-reported percentage adherence to antiretroviral therapy, and probability of reporting complete (100%) adherence. Marginal structural models estimated a 2.03 greater odds of achieving viral suppression (95% confidence interval [CI], 1.15-3.58; P = .02) resulting from antidepressant medication treatment. In addition, antidepressant medication use increased the probability of antiretroviral uptake (weighted odds ratio, 3.87; 95% CI, 1.98-7.58; P effect is likely attributable to improved adherence to a continuum of HIV care, including increased uptake and adherence to antiretroviral therapy.

  2. Development and Implementation of an Academic-Community Partnership to Enhance Care among Homeless Persons

    Directory of Open Access Journals (Sweden)

    Sharon B.S. Gatewood, Pharm.D.

    2011-01-01

    Full Text Available An academic-community partnership between a Health Care for the Homeless (HCH clinic and a school of pharmacy was created in 2005 to provide medication education and identify medication related problems. The urban community based HCH clinic in the Richmond, VA area provides primary health care to the homeless, uninsured and underinsured. The center also offers eye care, dental care, mental health and psychiatric care, substance abuse services, case management, laundry and shower facilities, and mail services at no charge to those in need. Pharmacist services are provided in the mental health and medical clinics. A satisfaction survey showed that the providers and staff (n = 13 in the clinic were very satisfied with the integration of pharmacist services. The quality and safety of medication use has improved as a result of the academic-community collaborative. Education and research initiatives have also resulted from the collaborative. This manuscript describes the implementation, outcomes and benefits of the partnership for both the HCH clinic and the school of pharmacy.An academic-community partnership between a Health Care for the Homeless (HCH clinic and a school of pharmacy was created in 2005 to provide medication education and identify medication related problems. The urban community based HCH clinic in the Richmond, VA area provides primary health care to the homeless, uninsured and underinsured. The center also offers eye care, dental care, mental health and psychiatric care, substance abuse services, case management, laundry and shower facilities, and mail services at no charge to those in need. Pharmacist services are provided in the mental health and medical clinics. A satisfaction survey showed that the providers and staff (n = 13 in the clinic were very satisfied with the integration of pharmacist services. The quality and safety of medication use has improved as a result of the academic-community collaborative. Education and

  3. Risk behavior and access to HIV/AIDS prevention services in a community sample of homeless persons entering permanent supportive housing.

    Science.gov (United States)

    Wenzel, Suzanne L; Rhoades, Harmony; Harris, Taylor; Winetrobe, Hailey; Rice, Eric; Henwood, Ben

    2017-05-01

    Homeless persons suffer disproportionately high rates of HIV infection, and moving into permanent supportive housing (PSH) can provide a stable base from which to access needed prevention services. However, little is known about HIV risk or prevention behavior during this critical time of transition. The current study investigated STI and HIV risk and prevention behavior and recent use of prevention and treatment services (i.e., education, testing, medication) among homeless persons preparing to move into PSH. Data come from interviews with 421 homeless adults before they moved into PSH. Thirty-seven percent of the respondents were sexually active; of those, 75.7% reported unprotected sex. Nearly two-thirds (64%) reported past year HIV testing and 40% reported testing for another STI. Fewer than one-third (31%) of respondents reported receiving posttest counseling at their last HIV test. HIV seropositivity was self-reported by 10%. Among those persons who were HIV-positive, 57.1% reported less than 100% antiretroviral (ARV) adherence. Among HIV-negative respondents, less than 1% had been prescribed preexposure prophylaxis (PrEP). Less than half (46.4%) of the sample reported any HIV prevention education in the past year. This population of homeless adults about to move into PSH report high rates of HIV risk behavior, but low rates of HIV prevention education and very little PrEP utilization. Further, low rates of ARV adherence among HIV-positive respondents indicate significant risk for HIV transmission and acquisition. Entering PSH is a period of transition for homeless persons when integrated care is critically important to ensure positive health outcomes, but these data suggest that PrEP and other HIV prevention services are poorly accessed among this population. As such, multipronged services that integrate PrEP and other HIV prevention services are needed to prevent transmission and acquisition of HIV in this high-risk, vulnerable population and ensure the

  4. The Disadvantage of Homelessness in Children's Schooling.

    Science.gov (United States)

    Shaver, Debra M.; Dornbusch, Sanford M.

    This paper presents findings of a study that investigated the extent to which homeless children in the United States receive the "free and appropriate education" to which they are entitled. Data were collected through several surveys conducted in two San Francisco Bay Area counties: (1) surveys of parents in homeless shelters with 313…

  5. Development and Implementation of an Academic-Community Partnership to Enhance Care among Homeless Persons

    Directory of Open Access Journals (Sweden)

    Sharon B.S. Gatewood

    2011-01-01

    Full Text Available An academic-community partnership between a Health Care for the Homeless (HCH clinic and a school of pharmacy was created in 2005 to provide medication education and identify medication related problems. The urban community based HCH clinic in the Richmond, VA area provides primary health care to the homeless, uninsured and underinsured. The center also offers eye care, dental care, mental health and psychiatric care, substance abuse services, case management, laundry and shower facilities, and mail services at no charge to those in need. Pharmacist services are provided in the mental health and medical clinics. A satisfaction survey showed that the providers and staff (n = 13 in the clinic were very satisfied with the integration of pharmacist services. The quality and safety of medication use has improved as a result of the academic-community collaborative. Education and research initiatives have also resulted from the collaborative. This manuscript describes the implementation, outcomes and benefits of the partnership for both the HCH clinic and the school of pharmacy. Type: Clinical Experience

  6. Patient predictors and utilization of health services within a medical home for homeless persons.

    Science.gov (United States)

    Jones, Audrey L; Thomas, Roxanne; Hedayati, Daniel O; Saba, Shaddy K; Conley, James; Gordon, Adam J

    2018-02-07

    The Veterans Health Administration (VHA) established a patient-centered medical home model of care for veterans experiencing homelessness called a Homeless Patient Aligned Care Team (HPACT) to improve engagement with primary care and reduce utilization of hospital-based services. To evaluate the impact of the HPACT model, this study compares the number and type of health care visits in the 12 months before and after enrollment in HPACT at one VHA facility, and explores patient characteristics associated with increases and decreases in visits. Chart reviews of VHA medical records were conducted for all patients enrolled in an HPACT in Pittsburgh, Pennsylvania, between May 2012 and December 2013 (N = 179). Multivariable mixed-effect logistic regressions estimated differences in having any visit in the 0-6 months and 7-12 months before and after HPACT enrollment, and multinomial logistic regressions predicted increases or decreases versus no change in number of visits over 12 months. Compared with 0-6 months prior to HPACT, patients were more likely to visit primary care in the 0-6 months (adjusted odds ratio [aOR] = 4.91, 95% confidence interval [CI] = 2.94-8.20) and 7-12 months (aOR = 2.30, 95% CI = 1.42-3.72) following HPACT. Patients were less likely to visit the emergency department (ED) or to be hospitalized in the 0-6 months (aOR = 0.57, 95% CI = 0.34-0.94; and aOR = 0.55, 95% CI = 0.25-0.76) and 7-12 months (aOR = 0.43, 95% CI = 0.33-0.91; and aOR = 0.45, 95% CI = 0.26-0.80) following HPACT. Patients were less likely to visit mental health (aOR = 0.35, 95% CI = 0.20-0.60) and addiction specialists (aOR = 0.39, 95% CI = 0.18-0.84) in the 7-12 months following HPACT. Overall, 59% of patients had increases in primary care visits following HPACT. Female patients and those with self-housing were less likely to have increases versus no change in primary care visits (adjusted relative risk ratio [aRRR] = 0.15, 95% CI = 0.03-0.74; and aRRR = 0.35, 95% CI = 0

  7. Factors Affecting Sexual History Taking in a Health Center Serving Homeless Persons.

    Science.gov (United States)

    Sowicz, Timothy Joseph; Bradway, Christine K

    2018-03-01

    Low rates of documentation of sexual histories have been reported and research on sexual history taking (SHT) has focused on the content of, barriers to collecting, and interventions to improve documentation of sexual histories. Absent from this literature is an understanding of the contextual factors affecting SHT. To address this gap, a focused ethnography of one health center was conducted. Data were collected through observations of health care encounters and interviews with health care providers (HCPs). No SHT was observed and this was likely influenced by patients' characteristics, communication between patients and HCPs, the prioritization of patients' basic needs, and time constraints imposed upon encounters. Given that the health center studied serves patients experiencing homelessness, behavioral health concerns, and opioid use disorder, findings illuminate areas for future inquiry into a patient population affected by social as well as physiologic determinants of health and potentially at high risk for adverse sexual health outcomes.

  8. The effects of HIV stigma on health, disclosure of HIV status, and risk behavior of homeless and unstably housed persons living with HIV.

    Science.gov (United States)

    Wolitski, Richard J; Pals, Sherri L; Kidder, Daniel P; Courtenay-Quirk, Cari; Holtgrave, David R

    2009-12-01

    HIV-related stigma negatively affects the lives of persons living with HIV/AIDS (PLWHA). Homeless/unstably housed PLWHA experience myriad challenges and may be particularly vulnerable to the effects of HIV-related stigma. Homeless/unstably housed PLWHA from 3 U.S. cities (N = 637) completed computer-assisted interviews that measured demographics, self-assessed physical and mental health, medical utilization, adherence, HIV disclosure, and risk behaviors. Internal and perceived external HIV stigma were assessed and combined for a total stigma score. Higher levels of stigma were experienced by women, homeless participants, those with a high school education or less, and those more recently diagnosed with HIV. Stigma was strongly associated with poorer self-assessed physical and mental health, and perceived external stigma was associated with recent non-adherence to HIV treatment. Perceived external stigma was associated with decreased HIV disclosure to social network members, and internal stigma was associated with drug use and non-disclosure to sex partners. Interventions are needed to reduce HIV-related stigma and its effects on the health of homeless/unstably housed PLWHA.

  9. 流浪精神病人共病人格障碍调查%Personality Disorder of Homelessness Psychiatric Disorder

    Institute of Scientific and Technical Information of China (English)

    蔡燕玉; 钟远惠; 付美华; 张玉珊

    2016-01-01

    Objective:To survey on the comorbidity of personality disorder(PD)with psychiatric disorder on home‐lessness .Methods:A total of 864 patients with homelessness psychiatric disorder were consecutively examined in the Third People's Hospital of Meizhou City and Mental hospital of Guangzhou Civil Administration .All subjects inclu‐ding troublemaking group(n=380)and non-troublemaking group(n=484)were investigated with self -made ques‐tionnaire ,SCID- Ⅱ .Results:The comorbidity rate of personality disorder with homelessness psychiatric disorder was 69 3.% .Compared with the non -troublemaking group ,the troublemaking group had significant difference in the avoidant(χ2 =154 7. ,P<0 0.1) ,depressive(χ2 =28 5.9 ,P<0 0.1) ,passive-aggressive(χ2 =65 4.0 ,P<0 0.1) ,obsess‐ive-compulsive(χ2 =75 3.1 ,P<0 .01) ,paranoid(χ2 =79 .24 ,P<0 0.1) ,schizoid(χ2 =8 .43 ,P<0 0.1) ,schizotypal (χ2 =11 1.1 ,P<0 0.1) ,borderline(χ2 =27 9.7 ,P<0 0.1) ,antisocial personality disorder(χ2 =16 9.9 ,P<0 0.5) .There were significant differences in the avoidant(χ2 =30 8.5 ,P<0 0.1) ,dependent personality disorder(χ2 =9 .279 ,P<0 0.1)in the schizophrenia and non -schizophrenia group .Conclusion:The personality disorder rate of homelessness psychiatric disorder is very high ,and we should consider the influence of personality disorder in the treatment of homeless psychiatric disorder .%目的:探讨流浪精神病人人格障碍的共病情况。方法:将来自梅州市第三人民医院和广州市民政局精神病院流浪精神病人864例连续入组,分为肇事肇祸组( n=380例)和非肇事肇祸组( n=484例),采用自制调查表、人格障碍访谈问卷第2版(SCID-II)对其进行横断面评估。结果:流浪精神病人精神疾病与人格障碍共病率为693.%,在回避型(χ2=1547.,P<00.1)、强迫型(χ2=753.1,P<00.1)、被动攻击型(χ2=654.0,P<00.1)、抑郁型(χ2=285.9

  10. Residential Stability Reduces Unmet Health Care Needs and Emergency Department Utilization among a Cohort of Homeless and Vulnerably Housed Persons in Canada.

    Science.gov (United States)

    Jaworsky, Denise; Gadermann, Anne; Duhoux, Arnaud; Naismith, Trudy E; Norena, Monica; To, Matthew J; Hwang, Stephen W; Palepu, Anita

    2016-08-01

    This study examined the association of housing status over time with unmet physical health care needs and emergency department utilization among homeless and vulnerably housed persons in Canada. Homeless and vulnerably housed individuals completed interviewer-administered surveys on housing, unmet physical health care needs, health care utilization, sociodemographic characteristics, substance use, and health conditions at baseline and annually for 4 years. Generalized logistic mixed effects regression models examined the association of residential stability with unmet physical health care needs and emergency department utilization, adjusting for potential confounders. Participants were from Vancouver (n = 387), Toronto (n = 390), and Ottawa (n = 396). Residential stability was associated with lower odds of having unmet physical health needs (adjusted odds ratio (AOR), 0.82; 95 % confidence interval (CI), 0.67, 0.98) and emergency department utilization (AOR, 0.74; 95 % CI, 0.62, 0.88) over the 4-year follow-up period, after adjusting for potential confounders. Residential stability is associated with fewer unmet physical health care needs and lower emergency department utilization among homeless and vulnerably housed individuals. These findings highlight the need to address access to stable housing as a significant determinant of health disparities.

  11. The Hotel Study—Clinical and Health Service Effectiveness in a Cohort of Homeless or Marginally Housed Persons

    Science.gov (United States)

    Cervantes-Larios, Alejandro; Jones, Andrea A.; Vila-Rodriguez, Fidel; Montaner, Julio S.; Tran, Howard; Nham, Jimmy; Panenka, William J.; Lang, Donna J.; Thornton, Allen E.; Vertinsky, Talia; Barr, Alasdair M.; Procyshyn, Ric M.; Smith, Geoffrey N.; Buchanan, Tari; Krajden, Mel; Krausz, Michael; MacEwan, G. William; Gicas, Kristina M.; Leonova, Olga; Langheimer, Verena; Rauscher, Alexander; Schultz, Krista

    2017-01-01

    Objective: The Hotel Study was initiated in Vancouver’s Downtown East Side (DTES) neighborhood to investigate multimorbidity in homeless or marginally housed people. We evaluated the clinical effectiveness of existing, illness-specific treatment strategies and assessed the effectiveness of health care delivery for multimorbid illnesses. Method: For context, we mapped the housing locations of patients presenting for 552,062 visits to the catchment hospital emergency department (2005-2013). Aggregate data on 22,519 apprehensions of mentally ill people were provided by the Vancouver Police Department (2009-2015). The primary strategy was a longitudinal cohort study of 375 people living in the DTES (2008-2015). We analysed mortality and evaluated the clinical and health service delivery effectiveness for infection with human immunodeficiency virus or hepatitis C virus, opioid dependence, and psychosis. Results: Mapping confirmed the association between poverty and greater number of emergency visits related to substance use and mental illness. The annual change in police apprehensions did not differ between the DTES and other policing districts. During 1581 person-years of cohort observation, the standardized mortality ratio was 8.43 (95% confidence interval, 6.19 to 11.50). Physician visits were common (84.3% of participants over 6 months). Clinical treatment effectiveness was highest for HIV/AIDS, intermediate for opioid dependence, and lowest for psychosis. Health service delivery mechanisms provided examples of poor access, poor treatment adherence, and little effect on multimorbid illnesses. Conclusions: Clinical effectiveness was variable, and illness-specific service delivery appeared to have little effect on multimorbidity. New models of care may need to be implemented. PMID:28199798

  12. The Hotel Study-Clinical and Health Service Effectiveness in a Cohort of Homeless or Marginally Housed Persons.

    Science.gov (United States)

    Honer, William G; Cervantes-Larios, Alejandro; Jones, Andrea A; Vila-Rodriguez, Fidel; Montaner, Julio S; Tran, Howard; Nham, Jimmy; Panenka, William J; Lang, Donna J; Thornton, Allen E; Vertinsky, Talia; Barr, Alasdair M; Procyshyn, Ric M; Smith, Geoffrey N; Buchanan, Tari; Krajden, Mel; Krausz, Michael; MacEwan, G William; Gicas, Kristina M; Leonova, Olga; Langheimer, Verena; Rauscher, Alexander; Schultz, Krista

    2017-07-01

    The Hotel Study was initiated in Vancouver's Downtown East Side (DTES) neighborhood to investigate multimorbidity in homeless or marginally housed people. We evaluated the clinical effectiveness of existing, illness-specific treatment strategies and assessed the effectiveness of health care delivery for multimorbid illnesses. For context, we mapped the housing locations of patients presenting for 552,062 visits to the catchment hospital emergency department (2005-2013). Aggregate data on 22,519 apprehensions of mentally ill people were provided by the Vancouver Police Department (2009-2015). The primary strategy was a longitudinal cohort study of 375 people living in the DTES (2008-2015). We analysed mortality and evaluated the clinical and health service delivery effectiveness for infection with human immunodeficiency virus or hepatitis C virus, opioid dependence, and psychosis. Mapping confirmed the association between poverty and greater number of emergency visits related to substance use and mental illness. The annual change in police apprehensions did not differ between the DTES and other policing districts. During 1581 person-years of cohort observation, the standardized mortality ratio was 8.43 (95% confidence interval, 6.19 to 11.50). Physician visits were common (84.3% of participants over 6 months). Clinical treatment effectiveness was highest for HIV/AIDS, intermediate for opioid dependence, and lowest for psychosis. Health service delivery mechanisms provided examples of poor access, poor treatment adherence, and little effect on multimorbid illnesses. Clinical effectiveness was variable, and illness-specific service delivery appeared to have little effect on multimorbidity. New models of care may need to be implemented.

  13. The Convergent and Concurrent Validity of Trait-Based Prototype Assessment of Personality Disorder Categories in Homeless Persons

    Science.gov (United States)

    Samuel, Douglas B.; Connolly, Adrian J.; Ball, Samuel A.

    2012-01-01

    The "DSM-5" proposal indicates that personality disorders (PDs) be defined as collections of maladaptive traits but does not provide a specific diagnostic method. However, researchers have previously suggested that PD constructs can be assessed by comparing individuals' trait profiles with those prototypic of PDs and evidence from the…

  14. Indigenous homelessness

    DEFF Research Database (Denmark)

    Being homeless in one’s homeland is a colonial legacy for many Indigenous people in settler societies. The construction of Commonwealth nation-states from colonial settler societies depended on the dispossession of Indigenous peoples from their lands. The legacy of that dispossession and related...... attempts at assimilation that disrupted Indigenous practices, languages, and cultures—including patterns of housing and land use—can be seen today in the disproportionate number of Indigenous people affected by homelessness in both rural and urban settings. Essays in this collection explore the meaning...... and scope of Indigenous homelessness in the Canada, Australia, and New Zealand. They argue that effective policy and support programs aimed at relieving Indigenous homelessness must be rooted in Indigenous conceptions of home, land, and kinship, and cannot ignore the context of systemic inequality...

  15. Homelessness Felt

    OpenAIRE

    Robinson, Catherine

    2011-01-01

    The felt—as both methodology and experiential terrain—remains under-explored and under-theorised in research on homelessness.  This experimental piece traces the multi-sensory engagement of ethnographic and biographic fieldwork undertaken for separate projects with homeless people in two capital cities on Australia’s east coast.  The epistemological contributions and emotional dimensions of seeing, tasting, touching, smelling and listening are explored.  Throu...

  16. Tuberculosis and Homelessness in the United States, 1994–2003

    Science.gov (United States)

    Haddad, Maryam B.; Wilson, Todd W.; Ijaz, Kashef; Marks, Suzanne M.; Moore, Marisa

    2017-01-01

    Context Tuberculosis (TB) rates among US homeless persons cannot be calculated because they are not included in the US Census. However, homelessness is often associated with TB. Objectives To describe homeless persons with TB and to compare risk factors and disease characteristics between homeless and nonhomeless persons with TB. Design and Setting Cross-sectional analysis of all verified TB cases reported into the National TB Surveillance System from the 50 states and the District of Columbia from 1994 through 2003. Main Outcome Measures Number and proportion of TB cases associated with homelessness, demographic characteristics, risk factors, disease characteristics, treatment, and outcomes. Results Of 185 870 cases of TB disease reported between 1994 and 2003, 11 369 were among persons classified as homeless during the 12 months before diagnosis. The annual proportion of cases associated with homelessness was stable (6.1%–6.7%). Regional differences occurred with a higher proportion of TB cases associated with homelessness in western and some southern states. Most homeless persons with TB were male (87%) and aged 30 to 59 years. Black individuals represented the highest proportion of TB cases among the homeless and nonhomeless. The proportion of homeless persons with TB who were born outside the United States (18%) was lower than that for non-homeless persons with TB (44%). At the time of TB diagnosis, 9% of homeless persons were incarcerated, usually in a local jail; 3% of nonhomeless persons with TB were incarcerated. Compared with nonhomeless persons, homeless persons with TB had a higher prevalence of substance use (54% alcohol abuse, 29.5% noninjected drug use, and 14% injected drug use), and 34% of those tested had coinfection with human immunodeficiency virus. Compared with nonhomeless persons, TB disease in homeless persons was more likely to be infectious but not more likely to be drug resistant. Health departments managed 81% of TB cases in homeless

  17. The Changing Character of Homelessness in the United States.

    Science.gov (United States)

    Axelson, Leland J.; Dail, Paula W.

    1988-01-01

    Describes new form of homeless persons, a growing population of homeless individuals and families who are not mentally ill, not wanderers, and may be employed. Examines changing character of homelessness and makes recommendations for a public policy response to the problem. (Author/NB)

  18. Homeless Children in America: Challenges for the 1990s.

    Science.gov (United States)

    Rafferty, Yvonne

    The 1980s brought an unprecedented rise in the number of homeless families with children. That there may be as many as three million homeless persons in the United States, with families representing one-third of this population, indicates that homelessness is a social problem of catastrophic proportions. This paper finds that while Federal…

  19. Health status and utilisation of the healthcare system by homeless and non-homeless people in Vienna.

    Science.gov (United States)

    Wagner, Julia; Diehl, Katharina; Mutsch, Livia; Löffler, Walter; Burkert, Nathalie; Freidl, Wolfgang

    2014-05-01

    This case-control study describes the health situation, internal and external resources, and utilisation of healthcare facilities by a marginalised population consisting of homeless people in Vienna, Austria, compared with a non-homeless control population. Among the homeless group, participants lived in halfway houses (70%) or permanent housing (30%) in Vienna. Personal interviews were conducted in July 2010 with 66 homeless individuals, and their data were compared with data from non-homeless subjects from the Austrian Health Interview Survey using conditional logistic regression. Compared with the control group, homeless persons suffered more often from chronic diseases (P resources of homeless people, even though homeless people seek medical care at a higher rate than controls. Continuing health promotion projects for this high-risk group and the strengthening of social resources are recommended. © 2013 John Wiley & Sons Ltd.

  20. Tuberculosis and homelessness in the United States, 1994-2003.

    Science.gov (United States)

    Haddad, Maryam B; Wilson, Todd W; Ijaz, Kashef; Marks, Suzanne M; Moore, Marisa

    2005-06-08

    Tuberculosis (TB) rates among US homeless persons cannot be calculated because they are not included in the US Census. However, homelessness is often associated with TB. To describe homeless persons with TB and to compare risk factors and disease characteristics between homeless and nonhomeless persons with TB. Cross-sectional analysis of all verified TB cases reported into the National TB Surveillance System from the 50 states and the District of Columbia from 1994 through 2003. Number and proportion of TB cases associated with homelessness, demographic characteristics, risk factors, disease characteristics, treatment, and outcomes. Of 185,870 cases of TB disease reported between 1994 and 2003, 11,369 were among persons classified as homeless during the 12 months before diagnosis. The annual proportion of cases associated with homelessness was stable (6.1%-6.7%). Regional differences occurred with a higher proportion of TB cases associated with homelessness in western and some southern states. Most homeless persons with TB were male (87%) and aged 30 to 59 years. Black individuals represented the highest proportion of TB cases among the homeless and nonhomeless. The proportion of homeless persons with TB who were born outside the United States (18%) was lower than that for nonhomeless persons with TB (44%). At the time of TB diagnosis, 9% of homeless persons were incarcerated, usually in a local jail; 3% of nonhomeless persons with TB were incarcerated. Compared with nonhomeless persons, homeless persons with TB had a higher prevalence of substance use (54% alcohol abuse, 29.5% noninjected drug use, and 14% injected drug use), and 34% of those tested had coinfection with human immunodeficiency virus. Compared with nonhomeless persons, TB disease in homeless persons was more likely to be infectious but not more likely to be drug resistant. Health departments managed 81% of TB cases in homeless persons. Directly observed therapy, used for 86% of homeless patients

  1. Case Study Methodology and Homelessness Research

    Directory of Open Access Journals (Sweden)

    Jill Pable

    2013-10-01

    Full Text Available This paper describes the potential suitability of case study methodology for inquiry with the homeless population. It references a research study that uses case study research method to build theory. This study's topic is the lived experience of destitute individuals who reside in homeless shelters, and explores the homeless shelter built environment's potential influence on resident satisfaction and recovery. Case study methodology may be appropriate because it explores real-life contextual issues that characterize homelessness and can also accommodate the wide range of homeless person demographics that make this group difficult to study in a generalized fashion. Further, case study method accommodates the need within research in this area to understand individualized treatments as a potential solution for homelessness.

  2. Homelessness and Housing Insecurity Among Former Prisoners

    Directory of Open Access Journals (Sweden)

    Claire W. Herbert

    2015-11-01

    Full Text Available The United States has experienced dramatic increases in both incarceration rates and the population of insecurely housed or homeless persons since the 1980s. These marginalized populations have strong overlaps, with many people being poor, minority, and from an urban area. That a relationship between homelessness, housing insecurity, and incarceration exists is clear, but the extent and nature of this relationship is not yet adequately understood. We use longitudinal, administrative data on Michigan parolees released in 2003 to examine returning prisoners’ experiences with housing insecurity and homelessness. Our analysis finds relatively low rates of outright homelessness among former prisoners, but very high rates of housing insecurity, much of which is linked to features of community supervision, such as intermediate sanctions, returns to prison, and absconding. We identify risk factors for housing insecurity, including mental illness, substance use, prior incarceration, and homelessness, as well as protective “buffers” against insecurity and homelessness, including earnings and social supports.

  3. Military sexual trauma among homeless veterans.

    Science.gov (United States)

    Pavao, Joanne; Turchik, Jessica A; Hyun, Jenny K; Karpenko, Julie; Saweikis, Meghan; McCutcheon, Susan; Kane, Vincent; Kimerling, Rachel

    2013-07-01

    Military sexual trauma (MST) is the Veteran Health Administration's (VHA) term for sexual assault and/or sexual harassment that occurs during military service. The experience of MST is associated with a variety of mental health conditions. Preliminary research suggests that MST may be associated with homelessness among female Veterans, although to date MST has not been examined in a national study of both female and male homeless Veterans. To estimate the prevalence of MST, examine the association between MST and mental health conditions, and describe mental health utilization among homeless women and men. National, cross-sectional study of 126,598 homeless Veterans who used VHA outpatient care in fiscal year 2010. All variables were obtained from VHA administrative databases, including MST screening status, ICD-9-CM codes to determine mental health diagnoses, and VHA utilization. Of homeless Veterans in VHA, 39.7 % of females and 3.3 % of males experienced MST. Homeless Veterans who experienced MST demonstrated a significantly higher likelihood of almost all mental health conditions examined as compared to other homeless women and men, including depression, posttraumatic stress disorder, other anxiety disorders, substance use disorders, bipolar disorders, personality disorders, suicide, and, among men only, schizophrenia and psychotic disorders. Nearly all homeless Veterans had at least one mental health visit and Veterans who experienced MST utilized significantly more mental health visits compared to Veterans who did not experience MST. A substantial proportion of homeless Veterans using VHA services have experienced MST, and those who experienced MST had increased odds of mental health diagnoses. Homeless Veterans who had experienced MST had higher intensity of mental health care utilization and high rates of MST-related mental health care. This study highlights the importance of trauma-informed care among homeless Veterans and the success of VHA homeless

  4. Perceptions about Homeless Elders and Community Responsibility

    Science.gov (United States)

    Kane, Michael N.; Green, Diane; Jacobs, Robin

    2013-01-01

    Human service students were surveyed ("N" = 207) to determine their perceptions about homeless elders and communal responsibility for their well-being. Using a backward regression analysis, a final model ("F" = 15.617, "df" = 7, "p" < 0.001) for Perceptions about Homeless Persons and Community…

  5. Homelessness Felt

    Directory of Open Access Journals (Sweden)

    Catherine Robinson

    2011-04-01

    Full Text Available The felt—as both methodology and experiential terrain—remains under-explored and under-theorised in research on homelessness.  This experimental piece traces the multi-sensory engagement of ethnographic and biographic fieldwork undertaken for separate projects with homeless people in two capital cities on Australia’s east coast.  The epistemological contributions and emotional dimensions of seeing, tasting, touching, smelling and listening are explored.  Through a series of short ‘felt’ reflections, consideration of the critical role of corporeality in coming to know and inscribe the experiences of others is prompted.  The feeling, researching body is posited as central to new, productive and holistic intertwinings with felt-experience and the mixed trajectories of grief, humour, violence and trauma that often characterise persistent homelessness are made vivid. 

  6. Homelessness Felt

    Directory of Open Access Journals (Sweden)

    Catherine Robinson

    2011-04-01

    Full Text Available The felt—as both methodology and experiential terrain—remains under-explored and under-theorised in research on homelessness.  This experimental piece traces the multi-sensory engagement of ethnographic and biographic fieldwork undertaken for separate projects with homeless people in two capital cities on Australia’s east coast.  The epistemological contributions and emotional dimensions of seeing, tasting, touching, smelling and listening are explored.  Through a series of short ‘felt’ reflections, consideration of the critical role of corporeality in coming to know and inscribe the experiences of others is prompted.  The feeling, researching body is posited as central to new, productive and holistic intertwinings with felt-experience and the mixed trajectories of grief, humour, violence and trauma that often characterise persistent homelessness are made vivid.

  7. Harm reduction services as a point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs: a qualitative analysis.

    Science.gov (United States)

    McNeil, Ryan; Guirguis-Younger, Manal; Dilley, Laura B; Aubry, Tim D; Turnbull, Jeffrey; Hwang, Stephen W

    2012-05-17

    Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers that they face to accessing end-of-life care services. Many homeless and marginally housed persons who use these substances must therefore rely upon alternate sources of end-of-life care and support. This article explores the role of harm reduction services in end-of-life care services delivery to homeless and marginally housed persons who use alcohol and/or illicit drugs. A qualitative case study design was used to explore end-of-life care services delivery to homeless and marginally housed persons in six Canadian cities. A key objective was to explore the role of harm reduction services. 54 health and social services professionals participated in semi-structured qualitative interviews. All participants reported that they provided care and support to this population at end-of-life. Harm reduction services (e.g., syringe exchange programs, managed alcohol programs, etc.) were identified as a critical point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs. Where possible, harm reduction services facilitated referrals to end-of-life care services for this population. Harm reduction services also provided end-of-life care and support when members of this population were unable or unwilling to access end-of-life care services, thereby improving quality-of-life and increasing self-determination regarding place-of-death. While partnerships between harm reduction programs and end-of-life care services are identified as one way to improve access, it is noted that more comprehensive harm reduction services might be needed in end-of-life care settings if they are to engage this underserved population.

  8. From substance use to homelessness or vice versa?

    Science.gov (United States)

    McVicar, Duncan; Moschion, Julie; van Ours, Jan C

    2015-07-01

    Homelessness is associated with substance use, but whether substance use precedes or follows homelessness is unclear. We investigate the nature of the relationship between homelessness and substance use using data from the unique Australian panel dataset Journeys Home collected in 4 surveys over the period from October 2011 to May 2013. Our data refer to 1325 individuals who were homeless or at risk of becoming homeless. We investigate dynamics in homelessness and substance use over the survey period. We find that the two are closely related: homeless individuals are more likely to be substance users and substance users are more likely to be homeless. These relationships, however, are predominantly driven by observed and unobserved individual characteristics which cause individuals to be both more likely to be homeless and to be substance users. Once we take these personal characteristics into account it seems that homelessness does not affect substance use, although we cannot rule out that alcohol use increases the probability that an individual becomes homeless. These overall relationships also hide some interesting heterogeneity by 'type' of homelessness. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Tuberculosis among the homeless, United States, 1994–2010

    Science.gov (United States)

    Bamrah, S.; Yelk Woodruff, R. S.; Powell, K.; Ghosh, S.; Kammerer, J. S.; Haddad, M. B.

    2016-01-01

    SUMMARY OBJECTIVES 1) To describe homeless persons diagnosed with tuberculosis (TB) during the period 1994–2010, and 2) to estimate a TB incidence rate among homeless persons in the United States. METHODS TB cases reported to the National Tuberculosis Surveillance System were analyzed by origin of birth. Incidence rates were calculated using the US Department of Housing and Urban Development homeless population estimates. Analysis of genotyping results identified clustering as a marker for transmission among homeless TB patients. RESULTS Of 270 948 reported TB cases, 16 527 (6%) were homeless. The TB incidence rate among homeless persons ranged from 36 to 47 cases per 100 000 population in 2006–2010. Homeless TB patients had over twice the odds of not completing treatment and of belonging to a genotype cluster. US- and foreign-born homeless TB patients had respectively 8 and 12 times the odds of substance abuse. CONCLUSIONS Compared to the general population, homeless persons had an approximately 10-fold increase in TB incidence, were less likely to complete treatment and more likely to abuse substances. Public health outreach should target homeless populations to reduce the excess burden of TB in this population. PMID:24125444

  10. Tuberculosis among the homeless, United States, 1994-2010.

    Science.gov (United States)

    Bamrah, S; Yelk Woodruff, R S; Powell, K; Ghosh, S; Kammerer, J S; Haddad, M B

    2013-11-01

    1) To describe homeless persons diagnosed with tuberculosis (TB) during the period 1994-2010, and 2) to estimate a TB incidence rate among homeless persons in the United States. TB cases reported to the National Tuberculosis Surveillance System were analyzed by origin of birth. Incidence rates were calculated using the US Department of Housing and Urban Development homeless population estimates. Analysis of genotyping results identified clustering as a marker for transmission among homeless TB patients. Of 270,948 reported TB cases, 16,527 (6%) were homeless. The TB incidence rate among homeless persons ranged from 36 to 47 cases per 100,000 population in 2006-2010. Homeless TB patients had over twice the odds of not completing treatment and of belonging to a genotype cluster. US- and foreign-born homeless TB patients had respectively 8 and 12 times the odds of substance abuse. Compared to the general population, homeless persons had an approximately 10-fold increase in TB incidence, were less likely to complete treatment and more likely to abuse substances. Public health outreach should target homeless populations to reduce the excess burden of TB in this population.

  11. Changes in causes of death among persons with AIDS: San Francisco, California, 1996-2011.

    Science.gov (United States)

    Schwarcz, Sandra K; Vu, Annie; Hsu, Ling Chin; Hessol, Nancy A

    2014-10-01

    The increased life expectancy among HIV-infected persons treated with combination antiretroviral therapy (ART), risk behaviors, and co-morbidities associated with ART place HIV-infected persons at risk for non-HIV-related causes of death. We used the San Francisco HIV/AIDS registry to identify deaths that occurred from January 1996 through December 2011. Temporal trends in AIDS- and non-AIDS-related mortality rates, the proportion of underlying and contributory causes of death, and the ratio of observed deaths in the study population to expected number of deaths among California men aged 20-79 (standardized mortality ratio [SMR]) of underlying causes of death were examined. A total of 5338 deaths were identified. The annual AIDS-related death rate (per 100 deaths) declined from 10.8 in 1996 to 0.9 in 2011 (pdeath rate from non-AIDS-related causes declined from 2.1 in 1996 to 0.9 in 2011 (pdeaths due to all types of heart disease combined, all non-AIDS cancers combined, mental disorders resulting from substance abuse, drug overdose, suicide and chronic obstructive pulmonary disease increased significantly over time. The SMRs for liver diseased decreased significantly over time but remained elevated. Our data highlight the importance of age-related causes of death as well as deaths from causes that are, at least in part, preventable.

  12. Youth Homelessness 2006

    Science.gov (United States)

    MacKenzie, David; Chamberlain, Chris

    2008-01-01

    The third national census of homeless school students, conducted in 2006, found that the number of homeless students had decreased since 2001. There were 9,389 homeless students in 2006 compared with 12,227 in 2001. Three groups were over-represented in the homeless population: Indigenous students, young people from single parent and blended…

  13. The reality of homeless mobility and implications for improving care.

    Science.gov (United States)

    Parker, R David; Dykema, Shana

    2013-08-01

    Homeless persons are perceived as a highly mobile population, and have high rates of co-morbid conditions, including mental health and substance use issues. This study sought to determine the characteristics of the mobility and reported health conditions of homeless persons. The sample for this cross sectional study (n = 674) accounted for 88 % of the homeless population in a medium sized southern city in the United States. Participants were recruited from a homeless shelter operating during the winter season. Homeless persons were less mobile than the general state population (46.11 % were born in-state vs. 40.7 % of the general population) and less transient than the general state population (78 % reported an in-state zip code for the last permanent residence). 31.9 % reported a disabling condition of a serious and long term nature. These findings challenge the concept that homeless persons are primarily a mobile population. Furthermore, homeless persons in this sample were more likely to remain in the state where they lived after becoming homeless. Thus, provider perceptions that homeless persons would not benefit from referral to a regular source of outpatient care may be misinformed. As homeless persons often seek care in emergency departments for conditions that could be addressed through outpatient care, if a medical care system implemented standard practices specifically for homeless patients, this could decrease recidivism. Such interventions represent significant opportunities to reduce costs, conserve resources, and improve care through policy modification that ensures a focus on a successful, active linkage to outpatient care and programs specific to the homeless population.

  14. Life changes among homeless persons with mental illness: a longitudinal study of housing first and usual treatment.

    Science.gov (United States)

    Nelson, Geoffrey; Patterson, Michelle; Kirst, Maritt; Macnaughton, Eric; Isaak, Corinne A; Nolin, Danielle; McAll, Christopher; Stergiopoulos, Vicky; Townley, Greg; MacLeod, Timothy; Piat, Myra; Goering, Paula N

    2015-06-01

    This study compared the life changes of homeless people with mental illness participating in Housing First or treatment as usual and examined factors related to various changes. Semistructured narrative interviews were conducted with 219 participants in five Canadian cities at baseline; 197 were interviewed again at 18 months after random assignment to Housing First (N=119) or treatment as usual (N=78). Interviews were coded across 13 life domains, and each participant was categorized as reporting positive, mixed-neutral, or negative changes. Housing First and treatment as usual participants were compared with respect to change patterns. Thematic analysis was used to examine factors related to various changes. The percentage of participants in Housing First reporting positive changes was more than double that for participants in treatment as usual, and treatment as usual participants were four times more likely than Housing First participants to report negative changes. Factors related to positive changes included having stable good-quality housing, increased control over substance use, positive relationships and social support, and valued social roles. Factors related to negative changes included precarious housing, negative social contacts, isolation, heavy substance use, and hopelessness. Factors related to mixed-neutral changes were similar to those for participants reporting negative changes but were less intense. Housing First with intensive support was related to more positive changes among homeless adults with mental illness across five Canadian cities. Those with poor housing or support, more common in treatment as usual, continued to struggle. These findings are relevant for services and social change to benefit this population.

  15. Risk factors associated with recurrent homelessness after a first homeless episode.

    Science.gov (United States)

    McQuistion, Hunter L; Gorroochurn, Prakash; Hsu, Eustace; Caton, Carol L M

    2014-07-01

    Alcohol and drug use are commonly associated with the experience of homelessness. In order to better understand this, we explored the prevalence of drug and alcohol use as it related to successful re-housing within a sample of first-time single homeless adults at municipal shelters. From within this sample, we compared the features of recurrent homelessness with those of chronic homelessness and of being stably housed. We interviewed 344 subjects upon shelter entry and followed each one every six months for 18 months using standardized social and mental health measures. We analyzed baseline assessments relative to housing experiences during follow-up using Chi square and multinomial logistic regression. Eighty-one percent (N = 278) obtained housing over 18 months, of which 23.7 % (N = 66) experienced homelessness again. Recurrent homelessness was more common among those with a high school education and if initially re-housed with family. Bivariate analysis resulted in the observation of the highest rate of alcohol and other drug use among this recurrent group and multinomial logistic regression supported this only with the coupling of arrest history and diagnosed antisocial personality disorder. With relatively high rates of recurrent homelessness, there were differences between subjects who experienced recurrent homelessness compared to those who were stably housed and with chronic homelessness. That alcohol and other substance use disorders were associated with recurrent homelessness only if they were linked to other risk factors highlights the complexity of causes for homelessness and a resultant need to organize them into constellations of causal risk factors. Consistent with this, there should be initiatives that span bureaucratic boundaries so as to flexibly meet multiple complex service needs, thus improving outcomes concerning episodes of recurrent homelessness.

  16. Pathways to youth homelessness.

    Science.gov (United States)

    Martijn, Claudine; Sharpe, Louise

    2006-01-01

    Research documents high levels of psychopathology among homeless youth. Most research, however, has not distinguished between disorders that are present prior to homelessness and those that develop following homelessness. Hence whether psychological disorders are the cause or consequence of homelessness has not been established. The aim of this study is to investigate causal pathways to homelessness amongst currently homeless youth in Australia. The study uses a quasi-qualitative methodology to generate hypotheses for larger-scale research. High rates of psychological disorders were confirmed in the sample 35 homeless youth aged 14-25. The rates of psychological disorders at the point of homelessness were greater than in normative samples, but the rates of clinical disorder increased further once homeless. Further in-depth analyses were conducted to identify the temporal sequence for each individual with a view to establishing a set of causal pathways to homelessness and trajectories following homelessness that characterised the people in the sample. Five pathways to homelessness and five trajectories following homelessness were identified that accounted for the entire sample. Each pathway constituted a series of interactions between different factors similar to that described by Craig and Hodson (1998. Psychological Medicine, 28, 1379-1388) as "complex subsidiary pathways". The major findings were that (1) trauma is a common experience amongst homeless youth prior to homelessness and figured in the causal pathways to homelessness for over half of the sample; (2) once homeless, for the majority of youth there is an increase in the number of psychological diagnoses including drug and alcohol diagnoses; and (3) crime did not precede homelessness for all but one youth; however, following homelessness, involvement in criminal activity was common and became a distinguishing factor amongst youth. The implications of these findings for future research and service

  17. Homelessness as a predictor of mortality

    DEFF Research Database (Denmark)

    Feodor Nilsson, Sandra; Laursen, Thomas Munk; Hjorthøj, Carsten

    2018-01-01

    Purpose: The purpose of this study was to examine the association between homelessness and psychiatric disorders, including substance use disorders, on one hand, and cause-specific and all-cause mortality on the other in a high-income country. Methods: A historical nationwide register-based cohort...... study of the Danish population from 15 years of age between 2000 and 2011 was conducted. The association between homelessness, psychiatric disorders, and mortality was analysed by Poisson Regression adjusting for important confounders. Standardised mortality ratios (SMRs) were calculated for people...... with a history of homelessness compared with the general population using direct age-standardisation. Results: During 51,892,324 person-years of observation, 656,448 died. People with at least one homeless shelter contact accounted for 173,592 person-years with 4345 deaths. The excess mortality in the population...

  18. Social network characteristics and HIV vulnerability among transgender persons in San Salvador: identifying opportunities for HIV prevention strategies.

    Science.gov (United States)

    Barrington, Clare; Wejnert, Cyprian; Guardado, Maria Elena; Nieto, Ana Isabel; Bailey, Gabriela Paz

    2012-01-01

    The purpose of this study is to improve understanding of HIV vulnerability and opportunities for HIV prevention within the social networks of male-to-female transgender persons in San Salvador, El Salvador. We compare HIV prevalence and behavioral data from a sample of gay-identified men who have sex with men (MSM) (n = 279), heterosexual or bisexual identified MSM (n = 229) and transgender persons (n = 67) recruited using Respondent Driven Sampling. Transgender persons consistently reported higher rates of HIV risk behavior than the rest of the study population and were significantly more likely to be involved in sex work. While transgender persons reported the highest rates of exposure to HIV educational activities they had the lowest levels of HIV-related knowledge. Transgender respondents' social networks were homophilous and efficient at recruiting other transgender persons. Findings suggest that transgender social networks could provide an effective and culturally relevant opportunity for HIV prevention efforts in this vulnerable population.

  19. Antisocial personality disorder predicts methamphetamine treatment outcomes in homeless, substance-dependent men who have sex with men.

    Science.gov (United States)

    Fletcher, Jesse B; Reback, Cathy J

    2013-09-01

    One-hundred-thirty-one homeless, substance-dependent MSM were enrolled in a randomized controlled trial to assess the efficacy of a contingency management (CM) intervention for reducing substance use and increasing healthy behavior. Participants were randomized into conditions that either provided additional rewards for substance abstinence and/or health-promoting/prosocial behaviors ("CM-full"; n=64) or for study compliance and attendance only ("CM-lite"; n=67). The purpose of this secondary analysis was to determine the affect of ASPD status on two primary study outcomes: methamphetamine abstinence, and engagement in prosocial/health-promoting behavior. Analyses revealed that individuals with ASPD provided more methamphetamine-negative urine samples (37.5%) than participants without ASPD (30.6%). When controlling for participant sociodemographics and condition assignment, the magnitude of this predicted difference increases to 10% and reached statistical significance (p<.05). On average, participants with ASPD earned fewer vouchers for health-promoting/prosocial behaviors than participants without ASPD ($10.21 [SD=$7.02] versus $18.38 [SD=$13.60]; p<.01). Participants with ASPD displayed superior methamphetamine abstinence outcomes regardless of CM schedule; even with potentially unlimited positive reinforcement, individuals with ASPD displayed suboptimal outcomes in achieving health-promoting/prosocial behaviors. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Tuberculosis and homelessness in Montreal: a retrospective cohort study

    Science.gov (United States)

    2011-01-01

    Background Montreal is Canada's second-largest city, where mean annual tuberculosis (TB) incidence from 1996 to 2007 was 8.9/100,000. The objectives of this study were to describe the epidemiology of TB among homeless persons in Montreal and assess patterns of transmission and sharing of key locations. Methods We reviewed demographic, clinical, and microbiologic data for all active TB cases reported in Montreal from 1996 to 2007 and identified persons who were homeless in the year prior to TB diagnosis. We genotyped all available Mycobacterium tuberculosis isolates by IS6110 restriction fragment length polymorphism (IS6110-RFLP) and spoligotyping, and used a geographic information system to identify potential locations for transmission between persons with matching isolates. Results There were 20 cases of TB in homeless persons, out of 1823 total reported from 1996-2007. 17/20 were Canadian-born, including 5 Aboriginals. Homeless persons were more likely than non-homeless persons to have pulmonary TB (20/20), smear-positive disease (17/20, odds ratio (OR) = 5.7, 95% confidence interval (CI): 1.7-20), HIV co-infection (12/20, OR = 14, 95%CI: 4.8-40), and a history of substance use. The median duration from symptom onset to diagnosis was 61 days for homeless persons vs. 28 days for non-homeless persons (P = 0.022). Eleven homeless persons with TB belonged to genotype-defined clusters (OR = 5.4, 95%CI: 2.2-13), and ten potential locations for transmission were identified, including health care facilities, homeless shelters/drop-in centres, and an Aboriginal community centre. Conclusions TB cases among homeless persons in Montreal raise concerns about delayed diagnosis and ongoing local transmission. PMID:22034944

  1. Homelessness and Housing Insecurity Among Former Prisoners.

    OpenAIRE

    Herbert, CW; Morenoff, JD; Harding, DJ

    2015-01-01

    The United States has experienced dramatic increases in both incarceration rates and the population of insecurely housed or homeless persons since the 1980s. These marginalized populations have strong overlaps, with many people being poor, minority, and from an urban area. That a relationship between homelessness, housing insecurity, and incarceration exists is clear, but the extent and nature of this relationship is not yet adequately understood. We use longitudinal, administrative data on M...

  2. Life Shocks and Homelessness

    Science.gov (United States)

    Corman, Hope; Noonan, Kelly; Reichman, Nancy E.

    2014-01-01

    We exploited an exogenous health shock—namely, the birth of a child with a severe health condition—to investigate the effect of a life shock on homelessness in large cities in the United States as well as the interactive effects of the shock with housing market characteristics. We considered a traditional measure of homelessness, two measures of housing instability thought to be precursors to homelessness, and a combined measure that approximates the broadened conceptualization of homelessness under the 2009 Homeless Emergency Assistance and Rapid Transition to Housing Act (2010). We found that the shock substantially increases the likelihood of family homelessness, particularly in cities with high housing costs. The findings are consistent with the economic theory of homelessness, which posits that homelessness results from a conjunction of adverse circumstances in which housing markets and individual characteristics collide. PMID:23868747

  3. Veterans and Homelessness

    National Research Council Canada - National Science Library

    Perl, Libby

    2007-01-01

    .... The Department of Veterans Affairs (VA) estimates that it has served approximately 300 returning veterans in its homeless programs and has identified over 1,000 more as being at risk of homelessness...

  4. People Experiencing Chronic Homelessness

    Science.gov (United States)

    ... People with Disabilities Share Ending Chronic Homelessness Among People with Disabilities Last updated on May 31, 2018 We can end homelessness for people with disabilities in our communities who experience recurring ...

  5. Life shocks and homelessness.

    Science.gov (United States)

    Curtis, Marah A; Corman, Hope; Noonan, Kelly; Reichman, Nancy E

    2013-12-01

    We exploited an exogenous health shock-namely, the birth of a child with a severe health condition-to investigate the effect of a life shock on homelessness in large cities in the United States as well as the interactive effects of the shock with housing market characteristics. We considered a traditional measure of homelessness, two measures of housing instability thought to be precursors to homelessness, and a combined measure that approximates the broadened conceptualization of homelessness under the 2009 Homeless Emergency Assistance and Rapid Transition to Housing Act (2010). We found that the shock substantially increases the likelihood of family homelessness, particularly in cities with high housing costs. The findings are consistent with the economic theory of homelessness, which posits that homelessness results from a conjunction of adverse circumstances in which housing markets and individual characteristics collide.

  6. Parenting while Being Homeless

    Science.gov (United States)

    Swick, Kevin J.; Williams, Reginald; Fields, Evelyn

    2014-01-01

    This article explores the dynamics of parenting while being in a homeless context. The mosaic of stressors involved in this homeless parenting process are explicated and discussed. In addition, resources and strategies that may support parenting are presented and discussed.

  7. [Homeless on the streets of Copenhagen].

    Science.gov (United States)

    Nordentoft, M

    1994-05-16

    A group of homeless people living in the streets is described with the purpose of gaining the knowledge necessary to prevent development of homelessness and establishing programmes for the homeless. Out-reach work in the streets and cooperation with private and religious organisations was conducted during a two-year period and 59 homeless persons were interviewed. Fifteen were women and 44 were men. Upbringing, social conditions, daily living, physical and mental health and contact with health services, social security and private organisations were highlighted in a structured and semistructured interview. Compared with the background population the homeless had much more frequently childhood experience of parents' divorce or death of one of the parents. The women were significantly older than the men and the majority of the women were suffering from schizophrenia and had very little contact with network and public services. The majority of the men were abusing alcohol or drugs, many had had a troublesome childhood with stays in institutions. Many had had many contacts with different social institutions and a criminal record. Among the homeless in the streets of Copenhagen, the prevalence of mental illness, especially schizophrenia, is high. It is recommended that homelessness among the mentally ill is prevented by a special effort directed towards the patient group at risk of becoming homeless and through establishing different housing facilities with varying degrees of professional support. Out-reach work towards the homeless mentally ill should be carried out with the purpose of establishing contact with psychiatric services and securing the possibility of compulsory admission.

  8. Homelessness in America.

    Science.gov (United States)

    Baumohl, Jim, Ed.

    This book about homelessness in the United States offers 16 chapters in three parts. Part 1, "History Definitions, and Causes," includes: (1) "Redefining the Cursed Word: A Historical Interpretation of American Homelessness" (Kim Hopper and Jim Baumohl); (2) "Homelessness: Definitions and Counts" (Martha R. Burt); (3)…

  9. Psychopathology in Young People Experiencing Homelessness: A Systematic Review

    Science.gov (United States)

    Shelton, Katherine H.; van den Bree, Marianne B. M.; Los, Férenc J.

    2013-01-01

    Understanding mental health issues faced by young homeless persons is instrumental to the development of successful targeted interventions. No systematic review of recent published literature on psychopathology in this group has been completed. We conducted a systematic review of published research examining the prevalence of psychiatric problems among young homeless people. We examined the temporal relationship between homelessness and psychopathology. We collated 46 articles according to the PRISMA Statement. All studies that used a full psychiatric assessment consistently reported a prevalence of any psychiatric disorder from 48% to 98%. Although there was a lack of longitudinal studies of the temporal relationship between psychiatric disorders and homelessness, findings suggested a reciprocal link. Supporting young people at risk for homelessness could reduce homelessness incidence and improve mental health. PMID:23597340

  10. Children Who Are Homeless: Implications for Educational Diagnosticians.

    Science.gov (United States)

    Yamaguchi, Barbara J.; Strawser, Sherri; Higgins, Kyle

    1998-01-01

    Families with children are the fastest growing group of persons who are homeless. To address their needs for education, this article discusses legal mandates, barriers to education presented by school requirements, effects of homelessness on children and youth, and the role of the educational diagnostician in providing services. Offers 14…

  11. In from the Cold: Art Therapy with Homeless Men.

    Science.gov (United States)

    Braun, Lisa Nelson

    1997-01-01

    Describes experiences in using art with the homeless in an open studio approach. Discusses how offering open studio time with a range of materials showed that the homeless, each with a unique style and personal interests, were eager to create art objects and present them to the public. (RJM)

  12. Enumerating the Hidden Homeless: Strategies to Estimate the Homeless Gone Missing From a Point-in-Time Count

    Directory of Open Access Journals (Sweden)

    Agans Robert P.

    2014-06-01

    Full Text Available To receive federal homeless funds, communities are required to produce statistically reliable, unduplicated counts or estimates of homeless persons in sheltered and unsheltered locations during a one-night period (within the last ten days of January called a point-in-time (PIT count. In Los Angeles, a general population telephone survey was implemented to estimate the number of unsheltered homeless adults who are hidden from view during the PIT count. Two estimation approaches were investigated: i the number of homeless persons identified as living on private property, which employed a conventional household weight for the estimated total (Horvitz-Thompson approach; and ii the number of homeless persons identified as living on a neighbor’s property, which employed an additional adjustment derived from the size of the neighborhood network to estimate the total (multiplicity-based approach. This article compares the results of these two methods and discusses the implications therein.

  13. Art messaging to engage homeless young adults.

    Science.gov (United States)

    Nyamathi, Adeline; Slagle, Alexandra; Thomas, Alexandra; Hudson, Angela; Kahilifard, Farinaz; Avila, Glenna; Orser, Julie; Cuchilla, Manuel

    2011-01-01

    Art has been shown to be an empowering and engaging entity with numerous benefits to vulnerable populations, including the homeless persons and young adults. However, little is known how homeless young adults perceive the use of art as messages that can communicate the danger of initiating or continuing drug and alcohol use. The purpose of this study was to solicit perspectives of homeless, drug-using young adults as to how art can be used to design messages for their peers about the danger of initiating or continuing drug and alcohol use. Qualitative methodology via focus group discussions was utilized to engage 24 homeless young adults enrolled from a drop-in site in Santa Monica, California. The findings revealed support for a myriad of delivery styles, including in-person communication, flyers, music, documentary film, and creative writing. The young adults also provided insight into the importance of the thematic framework of messages. Such themes ranged from empowering and hopeful messages to those designed to scare young homeless adults into not experimenting with drugs. The findings indicate that in addition to messages communicating the need to prevent or reduce drug and alcohol use, homeless young adults respond to messages that remind them of goals and dreams they once had for their future, and to content that is personal, real, and truthful. Our research indicates that messages that reinforce protective factors such as hope for the future and self-esteem may be as important to homeless young adults as information about the risks and consequences of drug use.

  14. National Center on Family Homelessness

    Science.gov (United States)

    ... raise awareness of the current state of child homelessness in the United States, documents the number of homeless children in every state, their well-being, their risk for child homelessness, and state level planning and policy efforts. Child ...

  15. Occupation-based practices and homelessness: A scoping review.

    Science.gov (United States)

    Roy, Laurence; Vallée, Catherine; Kirsh, Bonnie H; Marshall, Carrie Anne; Marval, Rebecca; Low, Alissa

    2017-04-01

    Persons experiencing or at risk of homelessness have occupational needs that are seldom addressed in the Canadian system of care. The lack of documented evidence on occupational therapy practices in this field hinders the development of the profession. This article identifies current and potential practices that aim to enable or support the occupations of persons experiencing or at risk of homelessness. A scoping review was conducted, including evidence from both occupational therapy and non-occupational therapy sources. One hundred and seventy-eight papers were selected in the areas of occupational performance skills training, enrichment of occupational repertoire, employment/education, physical rehabilitation services, child/family services, community building, occupational transition from homeless to housed, literacy, and disaster relief. Occupational therapists can build environments and create opportunities that facilitate occupational engagement of individuals experiencing homelessness. Gaps in knowledge include the evaluation of occupational therapy practices, the Canadian context of family homelessness, and the cultural safety of occupational therapy interventions.

  16. Suicide and unintentional injury mortality among homeless people

    DEFF Research Database (Denmark)

    Feodor Nilsson, Sandra; Hjorthøj, Carsten Rygaard; Erlangsen, Annette

    2014-01-01

    BACKGROUND: Homeless people have elevated mortality, especially due to external causes. We aimed to examine suicide and unintentional injury mortality levels and identify predictors in the homeless population. METHODS: A nationwide, register-based cohort study of homeless people aged 16 years...... and older was carried out using the Danish Homeless Register, 1999-2008. RESULTS: In all, 32 010 homeless people (70.5% men) were observed. For men, the mortality rate was 174.4 [95% confidence interval (CI) = 150.6-198.1] per 100 000 person-years for suicide and 463.3 (95% CI = 424.......6-502.0) for unintentional injury. For women, the corresponding rates were 111.4 (95% CI = 81.7-141.1) for suicide and 241.4 (95% CI = 197.6-285.1) for unintentional injury. Schizophrenia spectrum, affective, personality and substance use disorders were strongly associated with increased risk of suicide; the highest risk...

  17. The nature and prevalence of chronic pain in homeless persons: an observational study [v1; ref status: indexed, http://f1000r.es/o6

    Directory of Open Access Journals (Sweden)

    Rebecca Fisher

    2013-07-01

    Full Text Available Background: Homeless people are known to suffer disproportionately with health problems that reduce physical functioning and quality of life, and shorten life expectancy. They suffer from a wide range of diseases that are known to be painful, but little information is available about the nature and prevalence of chronic pain in this vulnerable group. This study aimed to estimate the prevalence of chronic pain among homeless people, and to examine its location, effect on activities of daily living, and relationship with alcohol and drugs. Methods: We conducted face-to-face interviews with users of homeless shelters in four major cities in the United Kingdom, in the winters of 2009-11. Participants completed the Brief Pain Inventory, Short Form McGill Pain questionnaire, Leeds Assessment of Neuropathic Symptoms and Signs, and detailed their intake of prescribed and unprescribed medications and alcohol. We also recorded each participant’s reasons for homelessness, and whether they slept rough or in shelters. Findings: Of 168 shelter users approached, 150 (89.3% participated: 93 participants (63% reported experiencing pain lasting longer than three months; the mean duration of pain experienced was 82.2 months. The lower limbs were most frequently affected. Opioids appeared to afford a degree of analgesia for some, but whilst many reported symptoms suggestive of neuropathic pain, very few were taking anti-neuropathic drugs. Interpretation: The prevalence of chronic pain in the homeless appears to be substantially higher than the general population, is poorly controlled, and adversely affects general activity, walking and sleeping. It is hard to discern whether chronic pain is a cause or effect of homelessness, or both. Pain is a symptom, but in this challenging group it might not always be possible to treat the underlying cause. Exploring the diagnosis and treatment of neuropathic pain may offer a means of improving the quality of these vulnerable

  18. Trichomonas vaginalis infection among homeless and unstably housed adult women living in a resource-rich urban environment.

    Science.gov (United States)

    Riley, Elise D; Cohen, Jennifer; Dilworth, Samantha E; Grimes, Barbara; Marquez, Carina; Chin-Hong, Peter; Philip, Susan S

    2016-06-01

    The social context of poverty is consistently linked to Trichomonas vaginalis infection, yet few studies regarding T. vaginalis have been conducted exclusively among low-income individuals. We identified social determinants of health associated with prevalent T. vaginalis infection among homeless and unstably housed adult women. Between April and October of 2010, we conducted cross-sectional T. vaginalis screening and behavioural interviews in an existing cohort of San Francisco homeless and unstably housed women. Data were analysed using multivariable logistical regression. Among 245 study participants, the median age was 47 years and 72% were of non-Caucasian race/ethnicity. T. vaginalis prevalence was 12%, compared to 3% in the general population, and 33% of infected individuals reported no gynaecological symptoms. In adjusted analysis, the odds of T. vaginalis infection were lower among persons older than 47 years, the population median (OR=0.14, 95% CI 0.04 to 0.38), and higher among those reporting recent short-term homeless shelter stays (OR=5.36, 95% CI 1.57 to 18.26). Race and income did not reach levels of significance. Sensitivity analyses indicated that testing all women who report recent unprotected sex would identify more infections than testing those who report gynaecological symptoms (20/30 vs 10/30; p=0.01). The prevalence of T. vaginalis is high among homeless and unstably housed adult women, over one-third of infected individuals have no gynaecological symptoms, and correlates of infection differ from those reported in the general population. Targeted screening and treatment among impoverished women reporting recent unprotected sex, particularly young impoverished women and all women experiencing short-term homelessness, may reduce complications related to this treatable infection. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. Homeless In America, Homeless In California

    OpenAIRE

    John M. Quigley; Steven Raphael; Eugene Smolensky

    2001-01-01

    It is generally believed that the increased incidence of homelessness in the United States has arisen from broad societal factors, such as changes in the institutionalization of the mentally ill, increases in drug addiction and alcohol usage, and so forth. This paper presents a comprehensive test of the alternate hypothesis that variations in homelessness arise from changed circumstances in the housing market and in the income distribution. We assemble essentially all the systematic informati...

  20. Women and Homelessness

    DEFF Research Database (Denmark)

    Koch-Nielsen, Inger; Munk, Anders; Raun, Mette

    This report has been produced for the Observatory on Homelessness, managed by FEANTSA: European Federation of National Organizations Working with the Homeless. The Observatory is supported financially by the Commission of the European Union. The paper is based on the guidelines set up by the Obse......This report has been produced for the Observatory on Homelessness, managed by FEANTSA: European Federation of National Organizations Working with the Homeless. The Observatory is supported financially by the Commission of the European Union. The paper is based on the guidelines set up...

  1. Homelessness in schizophrenia.

    Science.gov (United States)

    Foster, Adriana; Gable, James; Buckley, John

    2012-09-01

    The impact of mental illness, comorbid substance abuse, and medication nonadherence, coupled with disjointed psychiatric and social services, conspires to a disproportionately high rate of psychiatric disorders among people who are homeless in the United States. This article reviews the prevalence of homeless among the mentally ill as well as the prevalence of mental illness among the homeless and details barriers in access to care and the solutions that have been attempted. The need and solutions to introduce a new generation of physicians and allied health care workers to the unique health care needs of the homeless population are highlighted. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. The homeless pregnant woman.

    Science.gov (United States)

    Esen, Umo I

    2017-09-01

    Women who are pregnant and homeless constitute a unique group at significant risk of adverse foetal and maternal outcomes. Despite this heightened risk profile, social housing support to this group of women is less than satisfactory. Concerted effort and more collaborative working is needed by all who provide social, and healthcare services to homeless pregnant women, to improve the lot of these women. Clear definitions and legislative provisions in respect of the homeless will go a long way in reducing ambiguity and close loopholes which currently act to deny the homeless pregnant woman social housing support at a time when it is most needed.

  3. CoC Homeless Populations and Subpopulations Reports

    Data.gov (United States)

    Department of Housing and Urban Development — This report displays the data communities reported to HUD about the nature of and amount of persons who are homeless as part of HUD's Point-in-Time (PIT) Count. This...

  4. Perceived racial, sexual identity, and homeless status-related discrimination among Black adolescents and young adults experiencing homelessness: Relations with depressive symptoms and suicidality.

    Science.gov (United States)

    Gattis, Maurice N; Larson, Andrea

    2016-01-01

    There is a dearth of empirical evidence that addresses how racial minority, sexual minority, and homeless statuses, with their accompanying experiences of stigma and discrimination, are related to mental health in adolescent and young adult populations. The current study addresses this gap by examining the associations between multiple forms of discrimination, depressive symptoms, and suicidality in a sample of 89 Black adolescents and young adults (52% female; 47% nonheterosexual, ages 16-24) experiencing homelessness. Results from a series of ordinary least squares and logistic regressions suggested that perceived homelessness stigma and racial discrimination were associated with higher levels of depressive symptoms, controlling for gender, age, and other types of discrimination, while perceived sexual identity discrimination showed no association. Having ever spent a homeless night on the street, an indicator of homelessness severity, accounted for a substantial amount of the association between homelessness stigma and depressive symptoms. In contrast, suicidality was not significantly associated with any measure of discrimination, homelessness severity, or personal characteristics. We also found no indication that the associations between perceived discrimination targeted at racial and homelessness statuses and mental health differed by sexual minority status. Our results suggest that depressive symptoms and suicidality are prevalent among Black homeless youth, and that depressive symptoms are particularly associated with racial discrimination and indicators of homelessness. The roles of discrimination and a lack of safe housing may be taken into account when designing programs and policies that address the mental health of Black adolescents and young adults experiencing homelessness. (c) 2016 APA, all rights reserved).

  5. Self-perceived strengths among people who are homeless

    OpenAIRE

    Tweed, Roger G.; Biswas-Diener, Robert; Lehman, Darrin R.

    2012-01-01

    This study examined self-perceived strengths among 116 people who were homeless. Those who had experienced a longer period of current homelessness tended to report fewer personal strengths (r = −0.23). Nonetheless, in spite of their marginalized position in society, the vast majority of participants (114 out of 116) perceived personal strengths. A prior diagnosis with mental illness was not associated with the number of strengths reported, but self-perception of strengths was associated with ...

  6. The Rights of Homeless Students.

    Science.gov (United States)

    Strong, Penny

    This booklet presents information concerning homelessness and the education of homeless children nationwide and in Illinois. Estimates of the number of homeless children vary widely. Reasons for homeless children's failure to attend school include school residency requirements, delays in transfer of documents, and lack of transportation. The…

  7. Memory impairment among people who are homeless: a systematic review.

    Science.gov (United States)

    Ennis, Naomi; Roy, Sylvain; Topolovec-Vranic, Jane

    2015-01-01

    Cognitive impairment may interfere with an individual's ability to function independently in the community and may increase the risk of becoming and remaining homeless. The purpose of this study was to systematically review the literature on memory deficits among people who are homeless in order to gain a better understanding of its nature, causes and prevalence. Studies that measured memory functioning as an outcome among a sample of homeless persons were included. Data on sampling, outcome measures, facet of memory explored and prevalence of memory impairment were extracted from all selected research studies. Included studies were evaluated using a critical appraisal process targetted for reviewing prevalence studies. Eleven studies were included in the review. Verbal memory was the most commonly studied facet of memory. Potential contributing factors to memory deficits among persons who are homeless were explored in seven studies. Memory deficits were common among the samples of homeless persons studied. However, there was a great deal of variation in the methodology and quality of the included studies. Conceptualisations of "homelessness" also differed across studies. There is a need for more controlled research using validated neuropsychological tools to evaluate memory impairment among people who are homeless.

  8. Homeless Health Concerns

    Science.gov (United States)

    ... make it worse. That's why the health of homeless people in the United States is worse than that of the general population. Common health problems include Mental health problems Substance abuse ... and skin infections Many homeless women are victims of domestic or sexual abuse. ...

  9. 'Growing Old' in Shelters and 'On the Street': Experiences of Older Homeless People.

    Science.gov (United States)

    Grenier, Amanda; Sussman, Tamara; Barken, Rachel; Bourgeois-Guérin, Valerie; Rothwell, David

    2016-01-01

    Homelessness among older people in Canada is both a growing concern, and an emerging field of study. This article reports thematic results of qualitative interviews with 40 people aged 46 to 75, carried out as part of a mixed-methods study of older people who are homeless in Montreal, Quebec, Canada. Our participants included people with histories of homelessness (n = 14) and persons new to homelessness in later life (n = 26). Interviews focused on experiences at the intersections of aging and homelessness including social relationships, the challenges of living on the streets and in shelters in later life, and the future. This article outlines the 5 main themes that capture the experience of homelessness for our participants: age exacerbates worries; exclusion and isolation; managing significant challenges; shifting needs and realities; and resilience, strength, and hope. Together, these findings underscore the need for specific programs geared to the unique needs of older people who are homeless.

  10. United States Air Force Personalized Medicine and Advanced Diagnostics Program Panel: Representative Research at the San Antonio Military Medical Center

    Science.gov (United States)

    2016-05-20

    health system. dedicated to excellence in global care PROCESSING OF PROFESSIONAL MEDICAL RESEARCH PUBLICATIONS/PRESENTATIONS INSTRUCTIONS 1. The...present this research at the University of Texas at San Antonio/SAMHS & Universities Research Forum, SURF 2016 in San Antonio, TX, on 20 May 2016. The...at San Antonio/SAMHS & Universities Research Forum, SURF 2016 in San Antonio, TX, on 20 May 2016. 3. LAWS AND REGULATIONS: DoD 5500.07-R, Joint

  11. HIV Risk Behavior and Access to Services: What Predicts HIV Testing among Heterosexually Active Homeless Men?

    Science.gov (United States)

    Wenzel, Suzanne L.; Rhoades, Harmony; Tucker, Joan S.; Golinelli, Daniela; Kennedy, David P.; Zhou, Annie; Ewing, Brett

    2012-01-01

    HIV is a serious epidemic among homeless persons, where rates of infection are estimated to be three times higher than in the general population. HIV testing is an effective tool for reducing HIV transmission and for combating poor HIV/AIDS health outcomes that disproportionately affect homeless persons, however, little is known about the HIV…

  12. Recognizing the Needs of the Homeless.

    Science.gov (United States)

    France, Joseph B.

    This paper summarizes reports and research on the homeless in the United States, presents findings of a survey of Red Cross chapters on services to the homeless, and describes programs for the homeless of selected Red Cross chapters. Section 1 discusses definitions of homelessness and methodologies used to count homeless people. The homeless are…

  13. Healthcare Needs of Homeless Youth in the United States

    OpenAIRE

    TERRY, Marisa J; BEDI, Gurpreet; PATEL, Neil

    2010-01-01

    Approximately 1.6 - 2.8 million youth at any given time in the United States are considered homeless and at high risk for poor social and health outcomes. It is estimated that in the United States homelessness overall is expected to rise 10 -20 percent in the next year. While governmental and private programs exist to address the tribulations faced by homeless persons, youth continue to be underserved. The 2009, $787 billion economic stimulus package includes $1.5 billion to address issues...

  14. Coping and resilience among ethnoracial individuals experiencing homelessness and mental illness.

    Science.gov (United States)

    Paul, Sayani; Corneau, Simon; Boozary, Tanya; Stergiopoulos, Vicky

    2018-03-01

    The multiple challenges that ethnoracial homeless individuals experiencing mental illness face are well documented. However, little is known about how this homeless subpopulation copes with the compounding stressors of racial discrimination, homelessness and mental illness. This study is an in-depth investigation of the personal perceived strengths, attitudes and coping behaviors of homeless adults of diverse ethnoracial backgrounds experiencing homelessness and mental illness in Toronto, Canada. Using qualitative methods, 36 in-depth semi-structured interviews were conducted to capture the perspectives of ethnoracial homeless participants with mental illness on coping and resilience. Transcripts were analyzed using thematic analysis. Similar to prior findings in the general homeless population, study participants recognized personal strengths and attitudes as great sources of coping and resilience, describing hope and optimism, self-esteem and confidence, insight into their challenges and spirituality as instrumental to overcoming current challenges. In addition, participants described several coping strategies, including seeking support from family, friends and professionals; socializing with peers; engaging in meaningful activities; distancing from overwhelming challenges; and finding an anchor. Findings suggest that homeless adults with mental illness from ethnoracial groups use similar coping strategies and sources of resilience with the general homeless population and highlight the need for existing services to foster hope, recognize and support individual coping strategies and sources of resilience of homeless individuals experiencing complex challenges.

  15. Stand up for epilepsy San Diego photo-shoot: a personal odyssey.

    Science.gov (United States)

    Kaufman, Kenneth R; Kaufman, Nathaniel D

    2013-06-01

    Stigma towards epilepsy results in barriers to social integration, education, employment, and marriage, with increased divorce rates. There is a societal need to realise that many persons with epilepsy (PWE) lead normal lives and can be highly educated with effective employment. Integration of PWE into sports is therapeutic both for PWE (decreased seizure frequency, decreased comorbid conditions, and increased psychosocial skills) and society. Stand Up For Epilepsy (SUFE), overseen by the ILAE Task Force on Sports and Epilepsy, is an international project in which action photographs with PWE were taken as a means to destigmatise epilepsy. This autobiographical narrative describes how SUFE initiated effective athlete-PWE interactions with positive PWE, athlete, and parent responses. Expansion of SUFE is recommended to further destigmatise epilepsy. Participation in SUFE can serve as a personal odyssey for PWE.

  16. Organizing homeless people

    DEFF Research Database (Denmark)

    Anker, Jørgen

    2008-01-01

    People who are homeless belong to some of the most vulnerable, dispersed and disorganized groups in welfare societies. Yet in 2001, a national interest organization of homeless people was formed for the first time in Denmark. This article identifies the processes that facilitated the formation...... of the organization. It focuses on the importance of ideological and institutional conditions and changes, and it stresses the importance of alliances between progressive actors in the field and in the political-administrative system, in addition to the presence of dedicated activists among people who are or have...... been homeless. The analysis may thus serve as a case of inspiration for activists and professionals who want to improve homeless people's opportunities for participation in other national settings....

  17. Homelessness Assistance and Resources

    Science.gov (United States)

    ... Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma ... needs of homeless and vulnerable populations through disaster planning, response, and ... Development Subscribe to Email Updates Contact Us Connect ...

  18. Trauma and post-traumatic stress disorder among homeless adults in Sydney.

    Science.gov (United States)

    Taylor, Kathryn M; Sharpe, Louise

    2008-03-01

    International studies indicate high prevalence rates of post-traumatic stress disorder within homeless populations. In Australia, studies indicate high rates of trauma among homeless adults, yet post-traumatic stress disorder has not been investigated in homeless Australian adults. The primary aim of this project was to determine the prevalence of post-traumatic stress disorder among homeless adults in Sydney. Further, another aim of the study was to determine whether the onset of post-traumatic stress disorder preceded the first episode of homelessness or was a consequence of homelessness. The sample consisted of 70 homeless men and women aged 18-73 years, who were randomly sampled through eight homeless services. A computer-assisted face-to-face structured clinical interview was conducted with each participant. Lifetime prevalence of post-traumatic stress disorder was determined via the Composite International Diagnostic Interview. The majority of the sample had experienced at least one traumatic event in their lifetime (98%). Indeed, the mean number of traumas per person was six. The 12 month prevalence of post-traumatic stress disorder was higher among homeless adults in Sydney in comparison to the Australian general population (41% vs 1.5%). But 79% of the sample had a lifetime prevalence of post-traumatic stress. In 59% of cases, the onset of post-traumatic stress disorder preceded the age of the first reported homeless episode. Homeless adults in Sydney frequently experience trauma and post-traumatic stress disorder. The study found that trauma and post-traumatic stress disorder more often precede homelessness, but re-victimization is common. These findings highlight the high mental health needs among homeless people and have implications for services for homeless people.

  19. Youth Homelessness in Denmark?

    DEFF Research Database (Denmark)

    Børner Stax, Tobias

    Based on a literature study this chapter reflects upon the existence of youth homelessness in Denmark. The chapter contains reflections upon the juridical measures directed towards youngsters living on the margin of the Danish society and presents two concrete project directed towards young people...... living rough. The chapter is taken form an anthology discussion youth homelessness in the different member states of the European Union....

  20. Representaciones sociales sobre las personas sin hogar: una herencia aún no superada (Social representations on homeless persons: an inheritance still not overcome

    Directory of Open Access Journals (Sweden)

    María José Rubio-Martín

    2017-06-01

    Full Text Available El objetivo de este artículo es conocer las representaciones sociales sobre las PSH a principios del siglo XX. Partiendo de una metodología cualitativa, se hizo una recopilación y análisis de prensa. Basando esta estrategia en la incidencia que los medios de comunicación tienen en las representaciones sociales. El marco teórico partió de las teorías sobre las nuevas estrategias de criminalización del sinhogarismo. En los resultados se resalta cómo siguen vivas viejas representaciones estigmatizadoras y excluyentes. Lo que debe ser considerado en las políticas públicas en un contexto de profunda crisis y vulnerabilidad socioeconómica. | The objective of this article is to know the social representations about the Homeless People in the early twentieth century. Starting from a qualitative methodology, a compilation and analysis of the press was made. Basing this strategy on the impact that the media have on social representations. The theoretical framework started from theories about the new strategies of criminalization of homelessness. The results highlight how old and stigmatizing and excluding representations are still alive. What should be considered in public policies in a context of deep crisis and socio-economic vulnerability.

  1. National Coalition for Homeless Veterans

    Science.gov (United States)

    ... Continues Support of National Campaign to End Veteran Homelessness Nov. 14, 2017 This Veterans Day, Harbor Freight ... support of the national campaign to end veteran homelessness through generous contributions to the National Coalition for ...

  2. October 1986 San Salvador, El Salvador Images

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — At least 1,000 people killed, 10,000 injured, 200,000 homeless and severe damage in the San Salvador area. About 50 fatalities were the result of landslides in the...

  3. Prevalence and Correlates of Heroin–Methamphetamine Co-Injection Among Persons Who Inject Drugs in San Diego, California, and Tijuana, Baja California, Mexico

    Science.gov (United States)

    Meacham, Meredith C.; Strathdee, Steffanie A.; Rangel, Gudelia; Armenta, Richard F.; Gaines, Tommi L.; Garfein, Richard S.

    2016-01-01

    Objective: Although persons who inject drugs (PWID) in the western United States–Mexico border region are known to inject both heroin and methamphetamine, little is known about the prevalence and risks associated with co-injection of this depressant–stimulant combination (also known as “goofball” and “Mexican speedball”). Method: Baseline data from parallel cohort studies of PWID conducted concurrently in San Diego, CA, and Tijuana, Mexico, were used to estimate the prevalence and identify correlates of heroin–methamphetamine co-injection. PWID older than 18 years of age who reported injecting illicit drugs in the past month (N = 1,311; 32.7% female) were recruited in San Diego (n = 576) and Tijuana (n = 735) and completed interviewer-administered questionnaires. Bivariate and multivariable logistic regression analyses were used to identify correlates of heroin–methamphetamine co-injection. Results: The prevalence of co-injection in the past 6 months was 39.9% overall and was higher in Tijuana (55.8%) than in San Diego (19.8%). In multivariable analyses adjusting for study cohort, distributive syringe sharing, purchasing syringes prefilled with drugs, finding it hard to get new syringes, reporting great or urgent need for treatment, and younger age were independently associated with co-injection. Past-6-month overdose was significantly associated with higher odds of co-injection in San Diego than in Tijuana. Conclusions: These findings indicate that heroin–methamphetamine co-injection is more common in Tijuana than in San Diego, yet this practice was only associated with overdose in San Diego. Heroin–methamphetamine co-injection was also independently associated with HIV-associated injection risk behaviors. Overdose-prevention interventions should address co-injection of depressants and stimulants. PMID:27588536

  4. Prevalence and Correlates of Heroin-Methamphetamine Co-Injection Among Persons Who Inject Drugs in San Diego, California, and Tijuana, Baja California, Mexico.

    Science.gov (United States)

    Meacham, Meredith C; Strathdee, Steffanie A; Rangel, Gudelia; Armenta, Richard F; Gaines, Tommi L; Garfein, Richard S

    2016-09-01

    Although persons who inject drugs (PWID) in the western United States-Mexico border region are known to inject both heroin and methamphetamine, little is known about the prevalence and risks associated with co-injection of this depressant-stimulant combination (also known as "goofball" and "Mexican speedball"). Baseline data from parallel cohort studies of PWID conducted concurrently in San Diego, CA, and Tijuana, Mexico, were used to estimate the prevalence and identify correlates of heroin-methamphetamine co-injection. PWID older than 18 years of age who reported injecting illicit drugs in the past month (N = 1,311; 32.7% female) were recruited in San Diego (n = 576) and Tijuana (n = 735) and completed interviewer-administered questionnaires. Bivariate and multivariable logistic regression analyses were used to identify correlates of heroin-meth-amphetamine co-injection. The prevalence of co-injection in the past 6 months was 39.9% overall and was higher in Tijuana (55.8%) than in San Diego (19.8%). In multivariable analyses adjusting for study cohort, distributive syringe sharing, purchasing syringes prefilled with drugs, finding it hard to get new syringes, reporting great or urgent need for treatment, and younger age were independently associated with co-injection. Past-6-month overdose was significantly associated with higher odds of co-injection in San Diego than in Tijuana. These findings indicate that heroin-methamphetamine co-injection is more common in Tijuana than in San Diego, yet this practice was only associated with overdose in San Diego. Heroin-methamphetamine coinjection was also independently associated with HIV-associated injection risk behaviors. Overdose-prevention interventions should address co-injection of depressants and stimulants.

  5. Societal Constraints, Systemic Disadvantages and Homelessness: An Individual Case Study

    Directory of Open Access Journals (Sweden)

    Carol Kauppi

    2013-10-01

    Full Text Available Research utilizing the individual case study method examined the complex issues related to pathways into and out of home-lessness for an Aboriginal man from a First Nation community on the western James Bay in Canada. This instrumental case study focused on an individual's story, rather than on a site or a group of individuals, an incident or a series of incidents, or a program [6] [15]. First, as a research tool, it provides insight into the issue of homelessness and some of its causes from the perspective of an Aboriginal person. Second, the in-depth data gathered allowed us to understand some of the factors that work and those that do not work in facilitating transitions out of homelessness. Third, as an educational tool, it allows people from the outside to have a better understanding of how systemic disadvantages contribute to individuals falling into homelessness.

  6. Does Race Matter in Addressing Homelessness? A Review of the Literature

    Science.gov (United States)

    Jones, Marian Moser

    2017-01-01

    Since the 1980s, black persons have been overrepresented in the United States homeless population. Given that morbidity and mortality is elevated among both the black population and the homeless population in comparison to the general U.S. population, this overrepresentation has important implications for health policy. However, the racial demographics of homelessness have received little attention from policymakers. This article reviews published social and behavioral science literature that addresses the relationship between race and contemporary homelessness in the United States. This literature points to substantial differences between racial subgroups of the U.S. homeless population in vulnerabilities, health risks, behaviors, and service outcomes. Such observed differences suggest that policies and programs to prevent and end homelessness must explicitly consider race as a factor in order to be of maximum effectiveness. The limited scope of these findings also suggests that more research is needed to better understand these differences and their implications. PMID:29576910

  7. The causes of homelessness in later life: findings from a 3-nation study.

    Science.gov (United States)

    Crane, Maureen; Byrne, Kathleen; Fu, Ruby; Lipmann, Bryan; Mirabelli, Frances; Rota-Bartelink, Alice; Ryan, Maureen; Shea, Robert; Watt, Hope; Warnes, Anthony M

    2005-05-01

    This article presents findings from a study of the causes of homelessness among newly homeless older people in selected urban areas of the United States, England, and Australia. Interviews were conducted in each country with > or =122 older people who had become homeless during the last 2 years. Information was also collected from the subjects' key workers about the circumstances and problems that contributed to homelessness. Two-thirds of the subjects had never been homeless before. Antecedent causes were the accommodation was sold or needed repair, rent arrears, death of a close relative, relationship breakdown, and disputes with other tenants and neighbors. Contributory factors were physical and mental health problems, alcohol abuse, and gambling problems. Most subjects became homeless through a combination of personal problems and incapacities, welfare policy gaps, and service delivery deficiencies. Whereas there are nation-specific variations, across the three countries, the principal causes and their interactions are similar.

  8. Programmatic Impact of 5 Years of Mortality Surveillance of New York City Homeless Populations

    Science.gov (United States)

    Marder, Dova; Begier, Elizabeth; Gutkovich, Alexander; Mos, Robert; Griffin, Angela; Zimmerman, Regina; Madsen, Ann

    2013-01-01

    A homeless mortality surveillance system identifies emerging trends in the health of the homeless population and provides this information to key stakeholders in a timely and ongoing manner to effect evidence-based, programmatic change. We describe the first 5 years of the New York City homeless mortality surveillance system and, for the first time in peer-reviewed literature, illustrate the impact of key elements of sustained surveillance (i.e., timely dissemination of aggregate mortality data and real-time sharing of information on individual homeless decedents) on the programs of New York City’s Department of Homeless Services. These key elements had a positive impact on the department’s programs that target sleep-related infant deaths and hypothermia, drug overdose, and alcohol-related deaths among homeless persons. PMID:24148068

  9. Pathways into homelessness: recently homeless adults - problems and service use before and after becoming homeless in Amsterdam

    NARCIS (Netherlands)

    van Laere, Igor R.; de Wit, Matty A. S.; Klazinga, Niek S.

    2009-01-01

    ABSTRACT: OBJECTIVE: To improve homelessness prevention practice, we met with recently homeless adults, to explore their pathways into homelessness, problems and service use, before and after becoming homeless. METHODS: Recently homeless adults (last housing lost up to two years ago and legally

  10. Feasibility and Acceptability of a Colocated Homeless-Tailored Primary Care Clinic and Emergency Department.

    Science.gov (United States)

    Gabrielian, Sonya; Chen, Jennifer C; Minhaj, Beena P; Manchanda, Rishi; Altman, Lisa; Koosis, Ella; Gelberg, Lillian

    2017-10-01

    Homeless adults have low primary care engagement and high emergency department (ED) utilization. Homeless-tailored, patient-centered medical homes (PCMH) decrease this population's acute care use. We studied the feasibility (focused on patient recruitment) and acceptability (conceptualized as clinicians' attitudes/beliefs) of a pilot initiative to colocate a homeless-tailored PCMH with an ED. After ED triage, low-acuity patients appropriate for outpatient care were screened for homelessness; homeless patients chose between a colocated PCMH or ED visit. To study feasibility, we captured (from May to September 2012) the number of patients screened for homelessness, positive screens, unique patients seen, and primary care visits. We focused on acceptability to ED clinicians (physicians, nurses, social workers); we sent a 32-item survey to ED clinicians (n = 57) who worked during clinic hours. Questions derived from an instrument measuring clinician attitudes toward homeless persons; acceptability of homelessness screening and the clinic itself were also explored. Over the 5 months of interest, 281 patients were screened; 172 (61.2%) screened positive for homelessness; 112 (65.1%) of these positive screens were seen over 215 visits. Acceptability data were obtained from 56% (n = 32) of surveyed clinicians. Attitudes toward homeless patients were similar to prior studies of primary care physicians. Most (54.6%) clinicians agreed with the homelessness screening procedures. Nearly all (90.3%) clinicians supported expansion of the homeless-tailored clinic; a minority (42.0%) agreed that ED colocation worked well. Our data suggest the feasibility of recruiting patients to a homeless-tailored primary care clinic colocated with the ED; however, the clinic's acceptability was mixed. Future quality improvement work should focus on tailoring the clinic to increase its acceptability among ED clinicians, while assessing its impact on health, housing, and costs.

  11. A Social Capital Approach to Identifying Correlates of Perceived Social Support among Homeless Youth

    Science.gov (United States)

    Barman-Adhikari, Anamika; Bowen, Elizabeth; Bender, Kimberly; Brown, Samantha; Rice, Eric

    2016-01-01

    Background: The ability of homeless youth to accumulate resources through their personal relationships with others (i.e. social capital) is often associated with improved outcomes across multiple domains. Despite growing evidence documenting the heterogeneity of homeless youths' relationships, many youth still experience adversities or lack access…

  12. Viral hepatitis in a homeless shelter in Hawai'i.

    Science.gov (United States)

    Boyce, Daniel E C; Tice, Alan D; Ona, Fernando V; Akinaka, Kenneth T; Lusk, Heather

    2009-06-01

    It is estimated that as many as 21,000 people in the state of Hawai'i may be infected with HCV Most of those infected with viral hepatitis are unaware they are infected. Complications from viral hepatitis include liver cirrhosis and hepatocellular carcinoma. Hawai'i has the highest incidence of hepatocellular carcinoma in the United States. In 2003 there were over 6000 homeless and over 155,000 people at-risk of becoming homeless living in the state of Hawai'i. Risk factors for hepatitis, such as drug use, tattoos, sexual contact, and sharing of personal hygiene equipment are more prevalent in the homeless population. To determine the incidence of hepatitis B and C among a population of homeless individuals, a health fair was held at a Honolulu area homeless shelter with approximately 200 residents. The incidence of hepatitis B and C was determined by anti-HCV and HBsAg blood tests. A survey was also conducted regarding risk factors and basic demographics. Fifty-nine homeless adults volunteered for testing and took the survey. Thirty-one (52%) volunteers were born in Micronesia, twenty-four (41%) were born in the United States, two (3%) were born in Samoa, one (2%) was born in the Philippines, and one (2%) was born in the Marshall Islands. Forty adults were tested for Hepatitis C antibody, three of which tested positive. The primary risk factor among this group was jail time (100%), followed by illegal drug injection (67%), tattoos (67%), ear/body piercing (67%), snorting drugs (33%), blood transfusions (33%), and a sex partner with hepatitis (33%). Forty adults were also tested for HBsAg, One of which tested positive. This was a recent immigrant from Micronesia. Homeless people in Hawai'i are more likely to have hepatitis B or C because risk factors are common among this population. Additionally a large proportion of Hawai'i's homeless people come from the Pacific Islands, where the prevalence of hepatitis B is one of the highest in the world. In addition there

  13. Self-perceived strengths among people who are homeless.

    Science.gov (United States)

    Tweed, Roger G; Biswas-Diener, Robert; Lehman, Darrin R

    2012-11-01

    This study examined self-perceived strengths among 116 people who were homeless. Those who had experienced a longer period of current homelessness tended to report fewer personal strengths (r = -0.23). Nonetheless, in spite of their marginalized position in society, the vast majority of participants (114 out of 116) perceived personal strengths. A prior diagnosis with mental illness was not associated with the number of strengths reported, but self-perception of strengths was associated with altruistic orientation. The Values in Action (VIA) taxonomy of character strengths captured many of the responses generated by this population. The most frequently mentioned character categories included social intelligence, kindness, persistence, authenticity and humour. The most frequently mentioned other strengths included personal skills (e.g. music, sports), job skills, intelligence and education. The results have relevance for efforts to build self-perceptions that facilitate escape from homelessness.

  14. Tuberculosis infection and homelessness in Melbourne, Australia, 1995-1996.

    Science.gov (United States)

    Kermode, M; Crofts, N; Speed, B; Miller, P; Streeton, J

    1999-10-01

    To describe tuberculosis infection among persons experiencing homelessness in inner Melbourne, Australia. Homeless people were surveyed during late 1995 and early 1996. In stage one of the study 284 homeless people from crisis and long-term accommodation sites were recruited by means of stratified, systematic, random sampling. In stage two a convenience sample of 100 homeless people from squats and the streets were recruited. Participants completed a questionnaire and Mantoux testing was performed. A past history of tuberculosis was reported by 3%. Thirty-seven per cent had a Mantoux > or =10 mm; 21% > or =15 mm; and 11% > or =20 mm. A Mantoux > or =15 mm was independently associated with being aged > or =40 years, coming from the accommodated sample, overseas birth, and a past history of tuberculosis. Using logistic regression modelling, a Mantoux > or =15 mm was predicted by being aged > or =40 years, overseas birth, and past history of tuberculosis. Mantoux test results suggest that this group of homeless people had a high prevalence of infection with the tubercle bacillus. Many aspects of the physical and social circumstances of homeless people predispose to reactivation and have the potential to enhance rapid spread should latent infection become active disease.

  15. Homeless Blogs as Travelogues. Travel as a Struggle for Recognition and Emplacement

    Directory of Open Access Journals (Sweden)

    Halina Gąsiorowska

    2017-07-01

    Full Text Available Applying Clifford’s broad concept of travel, I discuss American homeless blogs as autobiographical travel writing serving the struggle for recognition of the street people. The analysed travelogues are hitchhiker Ruth Rader’s Ruthie in the Sky blog and self-made woman Brianna Karp’s Girl’s Guide to Homelessness – a memoir published on the basis of the blog bearing the same title. In the travelogues I analyse the characteristic features of a personal travel writing: travel of the self, advice for future travelers, geographic information and portrayal of society in which the travel is undertaken. I claim that homeless bloggers recounting their stories of otherness and displacement in the US contribute to (reconstructing American cultural identity their personal Self, just like many other American travelers before. Additionally, homeless blogging about homelessness is shown as the process of emplacement (Casey – the bloggers’ attempt of making themselves at home in the world.

  16. Strengths perspective among the homeless adolescents: A systematic review

    Directory of Open Access Journals (Sweden)

    Janmejaya Samal

    2017-01-01

    Full Text Available Background: Earlier, the scholars of family studies have primarily focused on the problems and weaknesses of the families. However, during these days, there is a shift from problems to strength-based perspective. Methodology: Search of literature was carried out through internet-based Google Scholar search engine. Of the 112 titles obtained 21 titles fit the criteria of the study objectives, of which 9 full-text articles were finally selected for the purpose of this review. Results: In this review, nine full-text articles were reviewed. Nine of these researches investigated different facets of strengths perspective among the homeless adolescents. Chronologically, nine of these reviewed studies delineated the following thematic facets of strengths perspective among the homeless adolescents. These include personal strength and informal resources, personal strength in high-risk environment, strengths perspective during the transition of adolescence to adulthood, personal and social strengths that refrained the homeless adolescents form intravenous drug use, resilience and self-esteem, religion as an important strength, “hope” as a way of living among the homeless adolescents, coping strategies of street-involved youth, and usage of internet and social media as an important strength among homeless adolescents. Conclusion: Strengths perspective helps the youth to become a master of their own lives and helps to deal with all the adversities in life.

  17. Peer substance use and homelessness predicting substance abuse from adolescence through early adulthood.

    Science.gov (United States)

    Tompsett, Carolyn J; Domoff, Sarah E; Toro, Paul A

    2013-06-01

    Adolescents who experience homelessness are at higher risk for abusing substances, and for being exposed to substance-using peers. The current study used a longitudinal design to track substance abuse, affiliation with substance-using peers, and episodes of homelessness among a sample of 223 adolescents who were housed at the baseline data collection and 148 adolescents who were housed at baseline. Participants were interviewed at six waves over 6.5 years, covering an age range from 13 to 25. Many participants experienced a recurrence of homelessness during follow-up, with 64.6 % of the baseline homeless group and 22.6 % of the baseline housed group reporting an additional episode of homelessness. Both alcohol abuse and other drug abuse symptoms showed an increase in adolescence followed by slowing in early adulthood. Recent homelessness and friend alcohol use predicted alcohol abuse symptoms, and the strength of the influence of friend use decreased over time. Recent homelessness and friend drug use predicted other drug abuse symptoms. Duration of the initial episode of adolescent homelessness showed no influence on substance abuse over time, or the effects of other predictors, highlighting the importance of conceptualizing the experience of homelessness as a recent stressor rather than an enduring personal characteristic.

  18. An Observational Study of Suicide Death in Homeless and Precariously Housed People in Toronto.

    Science.gov (United States)

    Sinyor, Mark; Kozloff, Nicole; Reis, Catherine; Schaffer, Ayal

    2017-07-01

    Homelessness has been identified as an important risk factor for suicide death, but there is limited research characterising homeless people who die by suicide. The goal of this study is to identify personal, clinical, and suicide method-related factors that distinguish homeless and precariously housed people who die from suicide from those who are not homeless at the time of suicide. Coroner records were reviewed for all suicide deaths in Toronto from 1998 to 2012. Data abstracted included housing status as well as other demographics, clinical variables such as the presence of mental illness, and suicide method. Of 3319 suicide deaths, 60 (1.8%) were homeless and 230 (6.9%) were precariously housed. Homeless and precariously housed people were each younger than nonhomeless people ( P suicide note. Homeless people and precariously housed were more likely to have died by fall/jump than nonhomeless people (62%, 57%, and 29%, respectively). Homeless and precariously housed people are overrepresented among suicide deaths in a large urban center and differ demographically, clinically, and in their suicide method from nonhomeless people who die by suicide. Targeted suicide prevention strategies should aim to address factors specific to homeless people.

  19. Causes of homelessness prevalence: Relationship between homelessness and disability.

    Science.gov (United States)

    Nishio, Akihiro; Horita, Ryo; Sado, Tadahiro; Mizutani, Seiko; Watanabe, Takahiro; Uehara, Ryosuke; Yamamoto, Mayumi

    2017-03-01

    Many studies have reported that the prevalence of mental illness and cognitive disability is higher among homeless individuals compared to the general population, and the rates of mental illness among the homeless population have recently increased. This study: (i) compares causes of homelessness or barriers to escaping homelessness for people with/without mental illness/cognitive disability; (ii) reveals problems with the Japanese homeless policy; and (iii) proposes an effective and necessary support system. The participants were 114 homeless individuals. A psychiatric diagnostic interview and the Wechsler Adult Intelligence Scale, version III were used to measure participants' mental health and cognitive abilities. A questionnaire was administered comprising 17 items related to the causes of their homelessness and barriers to escaping from it. Participants were divided into four groups - with/without mental illness or cognitive disability - and Fisher's exact test was used to compare the questionnaire results. Individuals with cognitive disabilities considered bad relationships with their family members to be the cause of their homelessness. Conversely, normal individuals considered their homelessness to be the result of debt more so than did individuals with mental problems. Individuals with mental illness had more difficulties escaping homelessness than did either normal individuals or individuals with cognitive disability. This tendency was observed most strongly among individuals with both mental illness and cognitive disability. Most homeless individuals considered economic problems to be the cause of their homelessness; however, difficulties with human relationships were also important factors and were more difficult for participants to acknowledge. Furthermore, these difficulties were exacerbated among those individuals with mental problems. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

  20. Experience of primary care among homeless individuals with mental health conditions.

    Directory of Open Access Journals (Sweden)

    Joya G Chrystal

    Full Text Available The delivery of primary care to homeless individuals with mental health conditions presents unique challenges. To inform healthcare improvement, we studied predictors of favorable primary care experience among homeless persons with mental health conditions treated at sites that varied in degree of homeless-specific service tailoring. This was a multi-site, survey-based comparison of primary care experiences at three mainstream primary care clinics of the Veterans Administration (VA, one homeless-tailored VA clinic, and one tailored non-VA healthcare program. Persons who accessed primary care service two or more times from July 2008 through June 2010 (N = 366 were randomly sampled. Predictor variables included patient and organization characteristics suggested by the patient perception model developed by Sofaer and Firminger (2005, with an emphasis on mental health. The primary care experience was assessed with the Primary Care Quality-Homeless (PCQ-H questionnaire, a validated survey instrument. Multiple regression identified predictors of positive experiences (i.e. higher PCQ-H total score. Significant predictors of a positive experience included a site offering tailored service design, perceived choice among providers, and currently domiciled status. There was an interaction effect between site and severe psychiatric symptoms. For persons with severe psychiatric symptoms, a homeless-tailored service design was significantly associated with a more favorable primary care experience. For persons without severe psychiatric symptoms, this difference was not significant. This study supports the importance of tailored healthcare delivery designed for homeless persons' needs, with such services potentially holding special relevance for persons with mental health conditions. To improve patient experience among the homeless, organizations may want to deliver services that are tailored to homelessness and offer a choice of providers.

  1. Relación entre marketing interno y compromiso organizacional en el personal de salud del Hospital de San Juan de Lurigancho

    OpenAIRE

    Zegarra Del Rosario, Francisco Eduardo

    2014-01-01

    La presente investigación tiene como propósito efectuar una descripción del marketing interno y como ésta se relaciona con el compromiso organizacional en el personal de salud, (médicos y enfermeras), del Hospital de San Juan de Lurigancho. Se utilizó un diseño descriptivo correlacional, con una muestra de 155 profesionales, médicos y enfermeras, a quienes se les aplicó dos instrumentos de evaluación: el Cuestionario de Marketing Interno de María Bohnenberger y el Inventario de Compromiso Org...

  2. Experience of Primary Care among Homeless Individuals with Mental Health Conditions

    Science.gov (United States)

    Chrystal, Joya G.; Glover, Dawn L.; Young, Alexander S.; Whelan, Fiona; Austin, Erika L.; Johnson, Nancy K.; Pollio, David E.; Holt, Cheryl L.; Stringfellow, Erin; Gordon, Adam J.; Kim, Theresa A.; Daigle, Shanette G.; Steward, Jocelyn L.; Kertesz, Stefan G

    2015-01-01

    The delivery of primary care to homeless individuals with mental health conditions presents unique challenges. To inform healthcare improvement, we studied predictors of favorable primary care experience among homeless persons with mental health conditions treated at sites that varied in degree of homeless-specific service tailoring. This was a multi-site, survey-based comparison of primary care experiences at three mainstream primary care clinics of the Veterans Administration (VA), one homeless-tailored VA clinic, and one tailored non-VA healthcare program. Persons who accessed primary care service two or more times from July 2008 through June 2010 (N = 366) were randomly sampled. Predictor variables included patient and organization characteristics suggested by the patient perception model developed by Sofaer and Firminger (2005), with an emphasis on mental health. The primary care experience was assessed with the Primary Care Quality-Homeless (PCQ-H) questionnaire, a validated survey instrument. Multiple regression identified predictors of positive experiences (i.e. higher PCQ-H total score). Significant predictors of a positive experience included a site offering tailored service design, perceived choice among providers, and currently domiciled status. There was an interaction effect between site and severe psychiatric symptoms. For persons with severe psychiatric symptoms, a homeless-tailored service design was significantly associated with a more favorable primary care experience. For persons without severe psychiatric symptoms, this difference was not significant. This study supports the importance of tailored healthcare delivery designed for homeless persons’ needs, with such services potentially holding special relevance for persons with mental health conditions. To improve patient experience among the homeless, organizations may want to deliver services that are tailored to homelessness and offer a choice of providers. PMID:25659142

  3. Cocreating with the homeless?

    DEFF Research Database (Denmark)

    Hansen, Brian Benjamin; Gemal, Carsten Høy

    2014-01-01

    The article is based on the case of a group of homeless people who in the fall of 2013 occupied a central site in the Danish town of Aarhus. The authors argue that this specific case is an ideal object of investigation for casting light on a new situation in the field of public administration....... Public administration has recently moved from the paradigm of New Public Management to a new and still undetermined paradigm, which focuses on activating and engaging citizens, treating them as equal partners in the process of co-creating welfare services and the community itself as a brand. Using...... the case of the homeless, the authors argue that participatory citizenship should not only be viewed as “added value” to the field of public administration, but rather as emerging within a dynamic and conflict-ridden field between citizens and administration where new types of value are potentially created...

  4. Homeless in Galilee

    Directory of Open Access Journals (Sweden)

    Robert L. Brawley

    2011-04-01

    Full Text Available This article has located Jesus’ saying about homelessness in the context of the Roman Empire as it was experienced in Galilee. Homelessness is part of a broader picture that translates into loss of access to the resources of the land. The thesis is that in light of a theology of land resulting from the development of Abrahamic covenant traditions and the prophetic hope expressed especially in Isaiah, Ezekiel and Psalm 37, Jesus proclaimed God’s kingdom as God’s rule over heaven and earth, which implicates restoration of equitable access to the resources of the earth. The Lord’s Prayer, presumptions about the water of Jacob’s well in John 4 and the parable of the unjust steward in Luke 16 are used to demonstrate understandings of violations of equitable access according to Abrahamic covenant traditions and the hope for the restoration thereof.

  5. Advance care planning with individuals experiencing homelessness: Literature review and recommendations for public health practice.

    Science.gov (United States)

    Hubbell, Sarah A

    2017-09-01

    Vulnerable populations in the United States experience disparities in access to advance care planning and may have significant unmet health care needs at the end of life, including unrelieved suffering. People who are homeless have increased morbidity and mortality risks, yet lack opportunities to communicate end-of-life preferences. This paper includes a narrative literature review of advance care planning interventions and qualitative investigations into end-of-life concerns among people experiencing homelessness. Trials of clinician-guided interventions with homeless individuals demonstrated effectiveness in achieving advance directive completion and surrogate decision-maker designation. End-of-life concerns among homeless persons included fears of dying alone, dying unnoticed, or remaining unidentified after death. Research participants also reported concerns regarding burial and notification of family members. Public health practitioners should facilitate advance care planning for people who are homeless by providing opportunities for education and discussion on care options and advance directives. © 2017 Wiley Periodicals, Inc.

  6. Can Better National Policy End Family Homelessness?

    Science.gov (United States)

    Roman, Nan

    2010-01-01

    An understanding of the close link between federal policy and family homelessness is critical for ensuring that one day no child in the United States is homeless. This article discusses the nature of family homelessness, the national policy framework that exists to help vulnerable families, the homeless assistance system that federal policy has…

  7. Children Who Are Homeless: Implications for Educators.

    Science.gov (United States)

    Yamaguchi, Barbara J.; Strawser, Sherri; Higgins, Kyle

    1997-01-01

    Reviews the definition and demographics of homeless students; the effects of homelessness on developmental, psychological, behavioral, and academic growth; the legal mandates regarding homeless students; and barriers to education. Recommendations for fostering success for homeless students are offered. (Author/DB)

  8. Homeless Students: A Search for Understanding.

    Science.gov (United States)

    Robertson, Donna Friedman

    1998-01-01

    Describes a qualitative research project examining homelessness's effects on children's schooling, highlighting a South Carolina intervention program's success. Research disclosed an informal homelessness "caste system," the political unpopularity of providing homeless services, homeless kids' high rates of academic failure and problem…

  9. Prognosis for Homeless Children and Adolescents.

    Science.gov (United States)

    Reganick, Karol A.

    1997-01-01

    Notes that children and adolescents appear to suffer the most detrimental effects of homelessness. Discusses the problems faced by homeless youth and the educational systems that must respond to them, including causes and demographics of homelessness, detrimental effects of shelters, the victimization of homeless adolescents, and educational and…

  10. Building Strategies To Meet the Developmental Needs of Homeless Children.

    Science.gov (United States)

    D'Andrea, Michael; And Others

    While most people would readily agree that all family members and especially children are likely to experience adverse effects to their personal development as a result of being homeless, it is both surprising and distressing to note how little attention this topic has received in the professional literature to date. Counselors are well-advised to…

  11. Youth Homelessness and Individualised Subjectivity

    Science.gov (United States)

    Farrugia, David

    2011-01-01

    This article aims to contribute to understandings of youth homelessness and subjectivity by analysing identity construction in terms of young people's negotiation of the structural and institutional environment of youth homelessness. I suggest that while existing literature on this topic concentrates mainly on micro-social encounters, the…

  12. The Homeless in Contemporary Society.

    Science.gov (United States)

    Bingham, Richard D.; And Others

    This book consists of 15 chapters on understanding and helping the homeless. The first seven chapters present the "new" homeless in historical context and describe this population and its situation. The remaining eight chapters discuss policy and program options of the government and other organizations in attempting to alleviate the problems of…

  13. Youth Homelessness: Early Intervention & Prevention.

    Science.gov (United States)

    Chamberlain, Chris; MacKenzie, David

    The issue of youth homelessness in Australia is examined in the context of relevant social and educational policies. The exploration is based on 8 years of research into the situation of homeless youth in Australia involving several studies, including a study of school students in 9 communities and field visits to 100 schools. In 1994, researchers…

  14. Pathways into homelessness: recently homeless adults problems and service use before and after becoming homeless in Amsterdam

    Directory of Open Access Journals (Sweden)

    de Wit Matty A

    2009-01-01

    Full Text Available Abstract Background To improve homelessness prevention practice, we met with recently homeless adults, to explore their pathways into homelessness, problems and service use, before and after becoming homeless. Methods Recently homeless adults (last housing lost up to two years ago and legally staying in the Netherlands were sampled in the streets, day centres and overnight shelters in Amsterdam. In April and May 2004, students conducted interviews and collected data on demographics, self reported pathways into homelessness, social and medical problems, and service use, before and after becoming homeless. Results among 120 recently homeless adults, (male 88%, Dutch 50%, average age 38 years, mean duration of homelessness 23 weeks, the main reported pathways into homelessness were evictions 38%, relationship problems 35%, prison 6% and other reasons 22%. Compared to the relationship group, the eviction group was slightly older (average age 39.6 versus 35.5 years; p = 0.08, belonged more often to a migrant group (p = 0.025, and reported more living single (p Conclusion the recently homeless fit the overall profile of the homeless population in Amsterdam: single (Dutch men, around 40 years, with a mix of financial debts, addiction, mental and/or physical health problems. Contacts with services were fragmented and did not prevent homelessness. For homelessness prevention, systematic and outreach social medical care before and during homelessness should be provided.

  15. Medical Care of the Homeless: An American and International Issue.

    Science.gov (United States)

    Fleisch, Sheryl B; Nash, Robertson

    2017-03-01

    Homeless persons die significantly younger than their housed counterparts. In many cases, relatively straightforward primary care issues escalate into life-threatening, expensive emergencies. Poor health outcomes driven by negative interactions between comorbid symptoms meet the definition of a health syndemic in this population. Successful primary care of patients struggling with homelessness may result in long-term lifesaving measures along with decreased expenditure to hospital systems. This primary prevention requires patience, creativity, and acknowledgment that the source of many confounders may lay outside the control of these patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Psychological distress among homeless adults.

    Science.gov (United States)

    Gelberg, L; Linn, L S

    1989-05-01

    Recent studies have reported a high prevalence of mental illness among the homeless. As part of a community-based survey of 529 homeless adults, we developed and tested a model to increase our understanding of the factors related to their psychological distress. Using a previously validated and reliable scale of perceived psychological distress, we found that homeless adults were more likely to report psychological distress than the general population (80% vs. 49%). Distress levels were not associated with most demographic or homeless characteristics or general appearance. However, distress was related to unemployment, greater cigarette and alcohol use, worse physical health, fewer social supports, and perceived barriers to obtaining needed medical care. Since mental, physical, and social health are strongly related among homeless adults, alleviating distress among them may be most effectively done by implementing a broad-based health services package coupled with employment programs provided in an accessible service delivery setting.

  17. Vision Problems in Homeless Children.

    Science.gov (United States)

    Smith, Natalie L; Smith, Thomas J; DeSantis, Diana; Suhocki, Marissa; Fenske, Danielle

    2015-08-01

    Vision problems in homeless children can decrease educational achievement and quality of life. To estimate the prevalence and specific diagnoses of vision problems in children in an urban homeless shelter. A prospective series of 107 homeless children and teenagers who underwent screening with a vision questionnaire, eye chart screening (if mature enough) and if vision problem suspected, evaluation by a pediatric ophthalmologist. Glasses and other therapeutic interventions were provided if necessary. The prevalence of vision problems in this population was 25%. Common diagnoses included astigmatism, amblyopia, anisometropia, myopia, and hyperopia. Glasses were required and provided for 24 children (22%). Vision problems in homeless children are common and frequently correctable with ophthalmic intervention. Evaluation by pediatric ophthalmologist is crucial for accurate diagnoses and treatment. Our system of screening and evaluation is feasible, efficacious, and reproducible in other homeless care situations.

  18. Psychocentrism and Homelessness: The Pathologization/Responsibilization Paradox

    Directory of Open Access Journals (Sweden)

    Erin Dej

    2016-08-01

    Full Text Available Psychocentrism is a governing neoliberal rationality that pathologizes human problems and frames individuals as responsible for socially structured inequalities. The homeless community provides an important case study to examine the ways psychocentrism manifests among an excluded population. This paper explores the paradox whereby homeless individuals are simultaneously pathologized and responsibilized through psychocentric discourses in which their status as economically poor becomes individualized as a symptom of mental illness and/or addiction. Although medicalized understandings of mental and emotional distress pervade the homeless industry, the obligations of freedom in the neoliberal era mean that individuals alone are held responsible for their failures. The paper examines the ways individuals experiencing homelessness are compelled to embark on an entrepreneurial project of the self that requires them to accept blame for their social precariousness. Further, it deconstructs the narratives that regard social explanations as an excuse and a failure of individual accountability. I argue that the “shamed poor” adopt empowerment discourses touted by the homeless industry, which paradoxically encourage individuals to find strength in their personal failures and to work toward self-governance, devoid of historical, social, and cultural context.

  19. Factors associated with receipt of pension and compensation benefits for homeless veterans in the VBA/VHA Homeless Outreach Initiative.

    Science.gov (United States)

    Chen, Joyce H; Rosenheck, Robert A; Greenberg, Greg A; Seibyl, Catherine

    2007-03-01

    Public support payments may facilitate exit from homelessness for persons with mental illness. We examined data from 10,641 homeless veterans contacted from October 1, 1995 to September 30, 2002 in a collaborative outreach program designed to facilitate access to Department of Veterans Affairs (VA) disability benefits. Those who were awarded benefits (22% of contacted veterans) were more likely to report disability, poor to fair self-rated health, and were more likely to have used VA services in the past. Thus, this program achieved only modest success and was most successful with veterans who were already receiving VA services and who might have received benefits even without the outreach effort.

  20. 76 FR 45693 - Safety Zone; San Diego POPS Fireworks, San Diego, CA

    Science.gov (United States)

    2011-08-01

    ...-AA00 Safety Zone; San Diego POPS Fireworks, San Diego, CA AGENCY: Coast Guard, DHS. ACTION: Temporary... San Diego Bay in support of the San Diego POPS Fireworks. This safety zone is necessary to provide for... of the waterway during scheduled fireworks events. Persons and vessels will be prohibited from...

  1. Título do sítio electrónico: Fédération Européenne des Associations Nacionales Travaillant avec les Sans-Abri e European Observatory on Homelessness

    Directory of Open Access Journals (Sweden)

    João Aldeia

    2012-10-01

    Full Text Available Optou-se por apresentar conjuntamente as duas páginas pela sua estreita articulação temática e institucional. Criada em 1989, a FEANTSA – Fédération Européenne des Associations Nacionales Travaillant avec les Sans-Abri – é uma organização não-governamental (ONG dedicada a eliminar a pobreza e exclusão social de indivíduos sem-abrigo ou em risco de conhecer esta situação, que congrega mais de 100 ONGs locais e nacionais de vários Estados-membros da União Europeia, sendo financiada pela Comiss...

  2. Screening for tuberculosis in an urban shelter for homeless in Switzerland: a prospective study.

    Science.gov (United States)

    Janssens, Jean-Paul; Wuillemin, Timothee; Adler, Dan; Jackson, Yves

    2017-05-16

    Whereas high risk groups such as asylum seekers are systematically screened for active tuberculosis (TB) upon entry in Switzerland, this strategy does not apply to homeless persons despite a reported high risk. Geneva health and social authorities implemented an intersectoral project to screen for active TB in homeless persons. We aimed to assess acceptability of this program and prevalence of active TB in this group. This prospective study targeted all homeless adults registering for shelter accommodation in Geneva during winter 2015. Applicants were proposed a questionnaire-based screening ( www.tb-screen.ch ) exploring epidemiological and clinical risk factors for active TB. Participants with a positive score underwent diagnostic procedures at Geneva University Hospital. Enhanced TB surveillance targeting homeless persons in the community was continued 3 months after the study termination. Overall, 726/832 (87.3%) homeless persons accepted the screening procedure. Most were young male migrants without access to care in Switzerland. Male gender (adjusted OR: 2.14; 95% confidence interval: 1.27-3.62), age below 25 years (aOR: 4.16; 95% CI: 1.27-13.64) and short duration of homelessness (aOR: 1.75; 95% CI: 1.06-2.87) were predictors of acceptance. Thirty (4.1%) had positive screening scores but none of the 24 who underwent further testing had active TB. Post-study surveillance did not identify any incident case in Geneva. Active TB screening targeting highly mobile homeless persons in shelters was well accepted and feasible. The participants' sociodemographic profile highlighted the heterogeneity of homeless groups in Europe and the null TB prevalence the variability of their active TB risks. These findings underline the feasibility of health programs targeting this hard to reach group and the need for close monitoring of this social group considering the rapid changes in international mobility patterns to tailor preventive and screening strategies to the local

  3. San Personal Ornaments from the Later Stone Age at Blombos Cave and Blomboschfontein, southern Cape, South Africa

    OpenAIRE

    Vibe, Ingrid M Østby

    2007-01-01

    A critical factor that distinguishes modern humans, Homo sapiens, from animals is the ability to communicate using symbols. One example is the use of personal ornaments. People in all cultures use personal ornaments to express something about themselves, and a wide range of functions and meanings can be applied to different ornamentation. The personal ornaments from three Later Stone Age sites in the Blomboschfontein Region, southern Cape, South Africa were analysed in order to determine vari...

  4. Adults Experiencing Homelessness in the US–Mexico Border Region: A Photovoice Project

    Science.gov (United States)

    Moya, Eva Margarita; Chavez-Baray, Silvia M.; Loweree, Jacqueline; Mattera, Brian; Martinez, Nahomi

    2017-01-01

    Homelessness is a social, economic, and political crisis in the United States. In particular, the US–Mexico Border region has seen a surge of homelessness, specifically among veterans, women victims of intimate partner violence, and immigrants. In 2014, 12 persons in El Paso, TX, with experience of being homeless used the photovoice methodology to participate in a project titled, “The Voices and Images of the Residents of the Opportunity Center for the Homeless: A Visual Project on the Identity and Challenges Homeless Adults Face on the Border Region.” The project was led by faculty from the Department of Social Work and facilitated by graduate students from the Departments of Social Work, Sociology, and Anthropology at the University of Texas at El Paso. In partnership with the Opportunity Center for the Homeless, a community-based organization, a gallery of photographs with respective narratives was produced along with a video documentary. The participants identified four themes: broken systems, invisibility, opportunities and what works, and growth and determination. These themes represent participants’ life experiences with homelessness and their aspirations. In addition to the photo gallery, participants supported the development of a Call to Action asking the community, policy, and decision makers to commit to changing the current social, economic, and political conditions affecting individuals experiencing homelessness. The gallery, Call to Action, and overall participant experiences with photovoice were shared during local, regional, and national conferences and events, including three State of the Homeless Conferences led by the Opportunity Center for the Homeless in partnership with the university. PMID:28580355

  5. Adults Experiencing Homelessness in the US–Mexico Border Region: A Photovoice Project

    Directory of Open Access Journals (Sweden)

    Eva Margarita Moya

    2017-05-01

    Full Text Available Homelessness is a social, economic, and political crisis in the United States. In particular, the US–Mexico Border region has seen a surge of homelessness, specifically among veterans, women victims of intimate partner violence, and immigrants. In 2014, 12 persons in El Paso, TX, with experience of being homeless used the photovoice methodology to participate in a project titled, “The Voices and Images of the Residents of the Opportunity Center for the Homeless: A Visual Project on the Identity and Challenges Homeless Adults Face on the Border Region.” The project was led by faculty from the Department of Social Work and facilitated by graduate students from the Departments of Social Work, Sociology, and Anthropology at the University of Texas at El Paso. In partnership with the Opportunity Center for the Homeless, a community-based organization, a gallery of photographs with respective narratives was produced along with a video documentary. The participants identified four themes: broken systems, invisibility, opportunities and what works, and growth and determination. These themes represent participants’ life experiences with homelessness and their aspirations. In addition to the photo gallery, participants supported the development of a Call to Action asking the community, policy, and decision makers to commit to changing the current social, economic, and political conditions affecting individuals experiencing homelessness. The gallery, Call to Action, and overall participant experiences with photovoice were shared during local, regional, and national conferences and events, including three State of the Homeless Conferences led by the Opportunity Center for the Homeless in partnership with the university.

  6. Infectious Diseases in the Homeless

    Centers for Disease Control (CDC) Podcasts

    In this podcast, Ted Pestorius speaks with Dr. Marian McDonald, Associate Director for Minority and Women’s Health at CDC about an article in September 2008 issue of Emerging Infectious Diseases on infectious diseases in the homeless. There are an estimated 100 million homeless people worldwide today, and this number is likely to grow. The homeless population is vulnerable to many diseases, including HIV, hepatitis, and tuberculosis. Dr. McDonald discusses why this population is so vulnerable.

  7. Infectious Diseases in the Homeless

    Centers for Disease Control (CDC) Podcasts

    2008-08-26

    In this podcast, Ted Pestorius speaks with Dr. Marian McDonald, Associate Director for Minority and Women’s Health at CDC about an article in September 2008 issue of Emerging Infectious Diseases on infectious diseases in the homeless. There are an estimated 100 million homeless people worldwide today, and this number is likely to grow. The homeless population is vulnerable to many diseases, including HIV, hepatitis, and tuberculosis. Dr. McDonald discusses why this population is so vulnerable.  Created: 8/26/2008 by Emerging Infectious Diseases.   Date Released: 8/27/2008.

  8. Mortality among the homeless: Causes and meteorological relationships.

    Directory of Open Access Journals (Sweden)

    Jerzy Romaszko

    Full Text Available The homeless constitute a subpopulation particularly exposed to atmospheric conditions, which, in the temperate climate zone, can result in both cold and heat stress leading to the increased mortality hazard. Environmental conditions have become a significant independent risk factor for mortality from specific causes, including circulatory or respiratory diseases. It is known that this group is particularly prone to some addictions, has a shorter life span, its members often die of different causes than those of the general population and may be especially vulnerable to the influence of weather conditions.The retrospective analysis is based on data concerning 615 homeless people, out of which 176 died in the analyzed period (2010-2016. Data for the study was collected in the city of Olsztyn, located in north-east Poland, temperate climatic zone of transitional type. To characterize weather conditions, meteorological data including daily minimum and maximum temperatures and the Universal Thermal Climate Index (UTCI were used.The average life span of a homeless person was shorter by about 17.5 years than that recorded for the general population. The average age at death of a homeless male was 56.27 years old (SD 10.38, and 52.00 years old (SD 9.85 of a homeless female. The most frequent causes of death were circulatory system diseases (33.80%. A large number of deaths were attributable to smoking (47.18%, whereas a small number was caused by infectious diseases, while a relatively large proportion of deaths were due to tuberculosis (2.15%. Most deaths occurred in the conditions of cold stress (of different intensity. Deaths caused by hypothermia were thirteen-fold more frequently recorded among the homeless than for the general population. A relative risk of death for a homeless person even in moderate cold stress conditions is higher (RR = 1.84 than in thermoneutral conditions.Our results indicate excessive mortality among the homeless as well as

  9. Pathways into homelessness: recently homeless adults problems and service use before and after becoming homeless in Amsterdam.

    Science.gov (United States)

    van Laere, Igor R; de Wit, Matty A; Klazinga, Niek S

    2009-01-07

    To improve homelessness prevention practice, we met with recently homeless adults, to explore their pathways into homelessness, problems and service use, before and after becoming homeless. Recently homeless adults (last housing lost up to two years ago and legally staying in the Netherlands) were sampled in the streets, day centres and overnight shelters in Amsterdam. In April and May 2004, students conducted interviews and collected data on demographics, self reported pathways into homelessness, social and medical problems, and service use, before and after becoming homeless. among 120 recently homeless adults, (male 88%, Dutch 50%, average age 38 years, mean duration of homelessness 23 weeks), the main reported pathways into homelessness were evictions 38%, relationship problems 35%, prison 6% and other reasons 22%. Compared to the relationship group, the eviction group was slightly older (average age 39.6 versus 35.5 years; p = 0.08), belonged more often to a migrant group (p = 0.025), and reported more living single (p homelessness, in the total group, contacts with any social service were 38% and with any medical service 27%. Despite these contacts they did not keep their house. During homelessness only contacts with social work and benefit agencies increased, contacts with medical services remained low. the recently homeless fit the overall profile of the homeless population in Amsterdam: single (Dutch) men, around 40 years, with a mix of financial debts, addiction, mental and/or physical health problems. Contacts with services were fragmented and did not prevent homelessness. For homelessness prevention, systematic and outreach social medical care before and during homelessness should be provided.

  10. Engaging the Homeless Paranoid Patient

    Science.gov (United States)

    Patel, Gayatri

    2007-01-01

    For people who are disenfranchised from society for other reasons, especially homelessness, a paranoid delusional system can create an additional obstacle in the therapeutic engagement and treatment of such individuals. In this article, we describe a composite case of a homeless woman with paranoid schizophrenia. Through this case example, we will explore various obstacles to treatment and discuss strategies to overcome these hurdles to treatment, initiate a therapeutic alliance, and further facilitate and maintain therapy. PMID:20526407

  11. Are childhood abuse and neglect related to age of first homelessness episode among currently homeless adults?

    Science.gov (United States)

    Mar, Marissa Y; Linden, Isabelle A; Torchalla, Iris; Li, Kathy; Krausz, Michael

    2014-01-01

    This study investigates 500 homeless adults and the associations between childhood maltreatment types and the age of first reported homelessness episode. Those first experiencing homelessness in youth (age 24 years or younger; 46%) were compared with those first experiencing homelessness at a later age (older than age 24 years). In individual models, physical abuse, emotional abuse, and emotional neglect were associated with first experiencing homelessness during youth (p homeless during youth (p homeless earlier in life and support the need for early interventions with at-risk families.

  12. Homeless Families since 1980: Implications for Education.

    Science.gov (United States)

    McChesney, Kay Young

    1993-01-01

    Synthesizes research findings from 10 studies on urban homeless families; and details their demographic characteristics, including the number of children, race, ethnicity, and family composition. Focus is on mothers with children and the effects of homelessness on children. (SLD)

  13. Homelessness : its definition and various problems

    OpenAIRE

    Shiga, Fumiya

    2008-01-01

    The purpose of this short paper is to review articles or data on homelessness to grasp what it is and its status quo in Australia, including various allied problems. In this short paper, the definitions of homelessness and the related notion of home are reviewed at first because it is important to find the meaning and difference for development in understanding of and gaining an insight into the homelessness. After that, the present situations or characteristics of homelessness and its proble...

  14. Financing Cocaine Use in a Homeless Population

    OpenAIRE

    North, Carol S.; Pollio, David E.

    2017-01-01

    Background: Cocaine use is highly prevalent among homeless populations, yet little is known about how it is financed. This study examined associations of income sources with cocaine use and financing of drugs in a longitudinal evaluation of a homeless sample. Methods: A homeless sample was recruited systematically in St. Louis in 1999–2001 and longitudinally assessed annually over two years using the Diagnostic Interview Schedule and the Homeless Supplement, with urine drug testing. Results: ...

  15. Challenges to discussing palliative care with people experiencing homelessness: a qualitative study

    Science.gov (United States)

    Shulman, Caroline; Low, Joseph; Hewett, Nigel; Daley, Julian; Davis, Sarah; Brophy, Nimah; Howard, Diana; Vivat, Bella; Kennedy, Peter; Stone, Patrick

    2017-01-01

    Objectives To explore the views and experiences of people who are homeless and those supporting them regarding conversations and approaches to palliative care Setting Data were collected between October 2015 and October 2016 in homeless hostels and day centres and with staff from primary and secondary healthcare providers and social care services from three London boroughs. Participants People experiencing homelessness (n=28), formerly homeless people (n=10), health and social care providers (n=48), hostel staff (n=30) and outreach staff (n=10). Methods In this qualitative descriptive study, participants were recruited to interviews and focus groups across three London boroughs. Views and experiences of end-of-life care were explored with people with personal experience of homelessness, health and social care professionals and hostel and outreach staff. Saturation was reached when no new themes emerged from discussions. Results 28 focus groups and 10 individual interviews were conducted. Participants highlighted that conversations exploring future care preferences and palliative care with people experiencing homelessness are rare. Themes identified as challenges to such conversations included attitudes to death; the recovery focused nature of services for people experiencing homelessness; uncertainty regarding prognosis and place of care; and fear of negative impact. Conclusions This research highlights the need for a different approach to supporting people who are homeless and are experiencing advanced ill health, one that incorporates uncertainty and promotes well-being, dignity and choice. We propose parallel planning and mapping as a way of working with uncertainty. We acknowledge that these approaches will not always be straightforward, nor will they be suitable for everyone, yet moving the focus of conversations about the future away from death and dying, towards the present and the future may facilitate conversations and enable the wishes of people who are

  16. Challenges to discussing palliative care with people experiencing homelessness: a qualitative study.

    Science.gov (United States)

    Hudson, Briony F; Shulman, Caroline; Low, Joseph; Hewett, Nigel; Daley, Julian; Davis, Sarah; Brophy, Nimah; Howard, Diana; Vivat, Bella; Kennedy, Peter; Stone, Patrick

    2017-11-28

    To explore the views and experiences of people who are homeless and those supporting them regarding conversations and approaches to palliative care SETTING: Data were collected between October 2015 and October 2016 in homeless hostels and day centres and with staff from primary and secondary healthcare providers and social care services from three London boroughs. People experiencing homelessness (n=28), formerly homeless people (n=10), health and social care providers (n=48), hostel staff (n=30) and outreach staff (n=10 ). METHODS: In this qualitative descriptive study, participants were recruited to interviews and focus groups across three London boroughs. Views and experiences of end-of-life care were explored with people with personal experience of homelessness, health and social care professionals and hostel and outreach staff. Saturation was reached when no new themes emerged from discussions. 28 focus groups and 10 individual interviews were conducted. Participants highlighted that conversations exploring future care preferences and palliative care with people experiencing homelessness are rare. Themes identified as challenges to such conversations included attitudes to death; the recovery focused nature of services for people experiencing homelessness; uncertainty regarding prognosis and place of care; and fear of negative impact. This research highlights the need for a different approach to supporting people who are homeless and are experiencing advanced ill health, one that incorporates uncertainty and promotes well-being, dignity and choice. We propose parallel planning and mapping as a way of working with uncertainty. We acknowledge that these approaches will not always be straightforward, nor will they be suitable for everyone, yet moving the focus of conversations about the future away from death and dying, towards the present and the future may facilitate conversations and enable the wishes of people who are homeless to be known and explored.

  17. The Invisible Homeless: A New Urban Ecology.

    Science.gov (United States)

    Ropers, Richard H.

    Contemporary homelessness is the result of increasing social and economic inequality faced by those in American society who are most vulnerable to individual, family, and economic instability. This case study of the homeless population of Los Angeles (California), based on two surveys conducted in 1984, views the homeless as a segment of the…

  18. The Second Student-Run Homeless Shelter

    Science.gov (United States)

    Seider, Scott C.

    2012-01-01

    From 1983-2011, the Harvard Square Homeless Shelter (HSHS) in Cambridge, Massachusetts, was the only student-run homeless shelter in the United States. However, college students at Villanova, Temple, Drexel, the University of Pennsylvania, and Swarthmore drew upon the HSHS model to open their own student-run homeless shelter in Philadelphia,…

  19. Newly Homeless Youth Typically Return Home

    OpenAIRE

    Milburn, Norweeta G.; Rosenthal, Doreen; Rotheram-Borus, Mary Jane; Mallett, Shelley; Batterham, Philip; Rice, Eric; Solorio, Rosa

    2007-01-01

    165 newly homeless adolescents from Melbourne, Australia and 261 from Los Angeles, United States were surveyed and followed for two years. Most newly homeless adolescents returned home (70% U.S., 47% Australia) for significant amounts of time (39% U.S., 17% Australia more than 12 months) within two years of becoming homeless.

  20. Homelessness and Its Effects on Children.

    Science.gov (United States)

    Hart-Shegos, Ellen

    Homelessness influences every facet of children's lives, inhibiting their physical, emotional, cognitive, social, and behavioral development. Homeless women face such obstacles to healthy pregnancies as chemical abuse, chronic health problems, and lack of prenatal care. Homeless infants are more likely to have low birth weights and are at greater…

  1. 34 CFR 300.19 - Homeless children.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Homeless children. 300.19 Section 300.19 Education... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.19 Homeless children. Homeless children has the...

  2. Usage of unscheduled hospital care by homeless individuals in Dublin, Ireland: a cross-sectional study.

    Science.gov (United States)

    Ní Cheallaigh, Clíona; Cullivan, Sarah; Sears, Jess; Lawlee, Ann Marie; Browne, Joe; Kieran, Jennifer; Segurado, Ricardo; O'Carroll, Austin; O'Reilly, Fiona; Creagh, Donnacha; Bergin, Colm; Kenny, Rose Anne; Byrne, Declan

    2017-12-01

    Homeless people lack a secure, stable place to live and experience higher rates of serious illness than the housed population. Studies, mainly from the USA, have reported increased use of unscheduled healthcare by homeless individuals.We sought to compare the use of unscheduled emergency department (ED) and inpatient care between housed and homeless hospital patients in a high-income European setting in Dublin, Ireland. A large university teaching hospital serving the south inner city in Dublin, Ireland. Patient data are collected on an electronic patient record within the hospital. We carried out an observational cross-sectional study using data on all ED visits (n=47 174) and all unscheduled admissions under the general medical take (n=7031) in 2015. The address field of the hospital's electronic patient record was used to identify patients living in emergency accommodation or rough sleeping (hereafter referred to as homeless). Data on demographic details, length of stay and diagnoses were extracted. In comparison with housed individuals in the hospital catchment area, homeless individuals had higher rates of ED attendance (0.16 attendances per person/annum vs 3.0 attendances per person/annum, respectively) and inpatient bed days (0.3 vs 4.4 bed days/person/annum). The rate of leaving ED before assessment was higher in homeless individuals (40% of ED attendances vs 15% of ED attendances in housed individuals). The mean age of homeless medical inpatients was 44.19 years (95% CI 42.98 to 45.40), whereas that of housed patients was 61.20 years (95% CI 60.72 to 61.68). Homeless patients were more likely to terminate an inpatient admission against medical advice (15% of admissions vs 2% of admissions in homeless individuals). Homeless patients represent a significant proportion of ED attendees and medical inpatients. In contrast to housed patients, the bulk of usage of unscheduled care by homeless people occurs in individuals aged 25-65 years. © Article author

  3. Protective factors associated with fewer multiple problem behaviors among homeless/runaway youth.

    Science.gov (United States)

    Lightfoot, Marguerita; Stein, Judith A; Tevendale, Heather; Preston, Kathleen

    2011-01-01

    Although homeless youth exhibit numerous problem behaviors, protective factors that can be targeted and modified by prevention programs to decrease the likelihood of involvement in risky behaviors are less apparent. The current study tested a model of protective factors for multiple problem behavior in a sample of 474 homeless youth (42% girls; 83% minority) ages 12 to 24 years. Higher levels of problem solving and planning skills were strongly related to lower levels of multiple problem behaviors in homeless youth, suggesting both the positive impact of preexisting personal assets of these youth and important programmatic targets for further building their resilience and decreasing problem behaviors. Indirect relationships between the background factors of self-esteem and social support and multiple problem behaviors were significantly mediated through protective skills. The model suggests that helping youth enhance their skills in goal setting, decision making, and self-reliant coping could lessen a variety of problem behaviors commonly found among homeless youth.

  4. Mental health services for homeless: patient profile and factors associated with suicide and homicide.

    LENUS (Irish Health Repository)

    Dunne, E

    2012-03-01

    This study aimed to establish a profile of users of the mental health service for homeless in Cork, comparing this group with those attending a General Adult Service. The homeless group were significantly more likely to be male (89% v. 46%o), unemployed (96% v. 68%), unmarried (98% v. 75%) and under 65 (94% v. 83%). Diagnostically, there was a significantly higher prevalence of schizophrenia (50% v. 34%); personality disorder (37% v. 11%) and substance dependence (74% v. 19%) in the homeless service users. They were more likely to have a history of deliberate self harm (54% v. 21%) and violence (48% v. 10%). Severe mental illness has a high prevalence in the homeless population, with particularly high levels of factors associated with suicide and homicide. Poor compliance and complexity of illness lead to a requirement for significant input from multidisciplinary mental health teams members.

  5. Homelessness among older african-american women: interpreting a serious social issue through the arts in community-based participatory action research.

    Science.gov (United States)

    Feen-Calligan, Holly; Washington, Olivia G M; Moxley, David P

    2009-01-01

    This article describes the incorporation of the arts into a community-based participatory action research (CBPAR) project formulated to develop and test practices for helping homeless older African-American women. Studying how older African-American women become homeless has evolved into developing and testing promising interventions by the Leaving Homelessness Intervention Research Project (LHIRP). The women's participation in creative group activities helped them to communicate their experience with homelessness, express their concerns, develop personal strengths, and obtained mutual understanding. The use of multiple art forms has revealed a number of creative strengths among the participants, which have in turn inspired innovative artistic strategies and methodologies as part of the multiple methods that LHIRP incorporates. These interventions have been useful in helping participants resolve their homelessness. The role and benefit of the arts in CBPAR is described to show how creative activities help researchers and the public to better understand the complexities of homelessness.

  6. Health Status and Health Care Experiences among Homeless Patients in Federally Supported Health Centers: Findings from the 2009 Patient Survey

    Science.gov (United States)

    Lebrun-Harris, Lydie A; Baggett, Travis P; Jenkins, Darlene M; Sripipatana, Alek; Sharma, Ravi; Hayashi, A Seiji; Daly, Charles A; Ngo-Metzger, Quyen

    2013-01-01

    Objective To examine health status and health care experiences of homeless patients in health centers and to compare them with their nonhomeless counterparts. Data Sources/Study Setting Nationally representative data from the 2009 Health Center Patient Survey. Study Design Cross-sectional analyses were limited to adults (n = 2,683). We compared sociodemographic characteristics, health conditions, access to health care, and utilization of services among homeless and nonhomeless patients. We also examined the independent effect of homelessness on health care access and utilization, as well as factors that influenced homeless patients' health care experiences. Data Collection Computer-assisted personal interviews were conducted with health center patients. Principal Findings Homeless patients had worse health status—lifetime burden of chronic conditions, mental health problems, and substance use problems—compared with housed respondents. In adjusted analyses, homeless patients had twice the odds as housed patients of having unmet medical care needs in the past year (OR = 1.98, 95 percent CI: 1.24–3.16) and twice the odds of having an ED visit in the past year (OR = 2.00, 95 percent CI: 1.37–2.92). Conclusions There is an ongoing need to focus on the health issues that disproportionately affect homeless populations. Among health center patients, homelessness is an independent risk factor for unmet medical needs and ED use. PMID:23134588

  7. The Educational Rights of Children and Youth Experiencing Homelessness: What Service Providers Need to Know. McKinney-Vento Law into Practice Brief Series

    Science.gov (United States)

    National Center for Homeless Education at SERVE, 2016

    2016-01-01

    Children and youth who experience homelessness face many barriers to education, yet school can be a source of stability, affirmation, and hope during a time of chaos and trauma when a young person loses his or her housing. Community service providers play a key role in linking homeless children and youth to schools and providing wraparound…

  8. Profiles and Trends in Danish Homelessness

    DEFF Research Database (Denmark)

    Christensen, Ivan; Koch-Nielsen, Inger

    Due to an increased visibility in homelessness from the late 80s and onwards many political initiatives have been taken to reduce homelessness and to improve the situation for the homeless. The aim of this article is to try to describe the development in homelessness in Denmark since the late 80s...... in homelessness. The composition of the group has changed, as the proportion of young and elderly seems to have decreased and the proportion of the middle-aged to have increased. There is probably an increase in the proportion of ethnic minorities, whereas a change in the gender composition is difficult to verify...

  9. Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study.

    Directory of Open Access Journals (Sweden)

    Rebecca T Brown

    Full Text Available Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (<18 years, young adulthood (ages 18-25, and middle adulthood (ages 26-49. We used a structured modeling approach to identify experiences associated with first adult homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment and lower attainment of adult milestones (i.e., marriage, full-time employment compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs.

  10. Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study

    Science.gov (United States)

    Brown, Rebecca T.; Goodman, Leah; Guzman, David; Tieu, Lina; Ponath, Claudia; Kushel, Margot B.

    2016-01-01

    Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment) and lower attainment of adult milestones (i.e., marriage, full-time employment) compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs. PMID:27163478

  11. Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study.

    Science.gov (United States)

    Brown, Rebecca T; Goodman, Leah; Guzman, David; Tieu, Lina; Ponath, Claudia; Kushel, Margot B

    2016-01-01

    Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment) and lower attainment of adult milestones (i.e., marriage, full-time employment) compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs.

  12. Blossoming Behind Bars: Relationships Between Eco-Education, Ethics and Personal Empowerment in Gardening and Mindfulness Programming Within San Quentin Prison

    Science.gov (United States)

    Benham, L.; O'Malley, R.; Todd, A. M.; Fassett, D.; Waitkus, B.

    2014-12-01

    Parallels exist between American environmental practice and those of our criminal justice system. Common among these are "throw-away" approaches, often yielding more complex problems then those attempted to solve. Personal change can be expressed via deepening sense of context and purpose, extending beyond concerns for self. Incarceration often exacerbates a thirst for new meaning-making, highly relevant to both criminal and ecological rehabilitation. Primary field data was gathered from incarcerated men, with a focus on the Insight Garden Program in San Quentin State Prison. A mixed method was used, with open-ended qualitative interviews and three established multiple-choice survey instruments: an environmental literacy quiz; a Locus of Control test (a psychological survey measuring one's sense of self-agency); and the "Six Americas" survey instrument, which stratifies responses of climate change opinion. Two control groups in the same unit were included in the study: inmates taking other programs but not gardening, and inmates in no programming at all. This research explores patterns in the ways people come to terms with personal moral obligation, as well as how restorative ecological engagement may be transformational for humans in personal crisis. Participants described prison programming in general as contributing profoundly to personal transformation. Beyond that, programming with a strong ecological focus offered vocational, intellectual, emotional and even spiritual change, which in turn has been shown to aid in reducing recidivism rates. Given a sample size of 58 participants total, the 174 surveys conducted were not primarily intended to achieve statistical significances but augment the overall perspective, for individuals, or for groups. Some correlations of significance were observed, however, between control groups, survey data, and with general US population data. Most intriguing, analysis of the qualitative interview data yielded patterns of

  13. Rethinking the Effects of Homelessness on Children: Resiliency and Competency.

    Science.gov (United States)

    Douglass, Anne

    1996-01-01

    Reviews discrepancies in the research on the learning and development of homeless children. Describes a child care program at a homeless shelter that enrolls both homeless and nonhomeless children; and presents case studies of two successfully adjusted homeless children. Discusses homeless children's resiliency and the need to assess their…

  14. Predictors of Retention in a Homeless Veteran Intervention Program

    Science.gov (United States)

    2012-12-01

    Transitional Housing for homeless persons; 2. Hospital (Psychological or Physical condition)/Substance abuse treatment facility or detox center; 3. Jail...condition)/Substance abuse treatment facility or detox center; 91 Jail, prison, or juvenile detention facility; 115 Place not meant for human... detox center 6 = Hospital (non-psychiatric) 7 = Jail, prison or juvenile detention facility 12 = Staying or living in a family member’s room

  15. Gender, coping strategies, homelessness stressors, and income generation among homeless young adults in three cities.

    Science.gov (United States)

    Ferguson, Kristin M; Bender, Kimberly; Thompson, Sanna J

    2015-06-01

    This study examined gender differences among homeless young adults' coping strategies and homelessness stressors as they relate to legal (e.g., full-time employment, selling personal possessions, selling blood/plasma) and illegal economic activity (e.g., selling drugs, theft, prostitution). A sample of 601 homeless young adults was recruited from 3 cities (Los Angeles, CA [n = 200], Austin, TX [n = 200], and Denver, CO [n = 201]) to participate in semi-structured interviews from March 2010 to July 2011. Risk and resilience correlates of legal and illegal economic activity were analyzed using six Ordinary Least Squares regression models with the full sample and with the female and male sub-samples. In the full sample, three variables (i.e., avoidant coping, problem-focused coping, and mania) were associated with legal income generation whereas eight variables (i.e., social coping, age, arrest history, transience, peer substance use, antisocial personality disorder [ASPD], substance use disorder [SUD], and major depressive episode [MDE]) were associated with illegal economic activity. In the female sub-sample, three variables (i.e., problem-focused coping, race/ethnicity, and transience) were correlated with legal income generation whereas six variables (i.e., problem-focused coping, social coping, age, arrest history, peer substance use, and ASPD) were correlated with illegal economic activity. Among males, the model depicting legal income generation was not significant yet seven variables (i.e., social coping, age, transience, peer substance use, ASPD, SUD, and MDE) were associated with illegal economic activity. Understanding gender differences in coping strategies and economic activity might help customize interventions aimed at safe and legal income generation for this population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Desired Destinations of Homeless Women: Realizing Aspirations Within the Context of Homelessness.

    Science.gov (United States)

    Biederman, Donna J; Forlan, Nicole

    2016-08-01

    Despite recent decreases, homelessness remains a substantial problem in the United States. Homelessness is associated with poor health, and homeless women experience earlier mortality than their housed counterparts. Understanding the aspirations of homeless women may offer service providers avenues for intervention to increase well-being among this vulnerable population. This study, a secondary analysis of transcribed interviews (n = 20), provides insight into the aspirations of homeless women. Opportunities for service providers to intervene on these aspirations within the context of homelessness are offered.

  17. Homelessness as culture: How transcultural nursing theory can assist caring for the homeless.

    Science.gov (United States)

    Law, Kate; John, William

    2012-11-01

    The concepts of culture and homelessness are both complex and contested. This paper examines homelessness through the lens of transcultural nursing theory, increasing understanding of both homelessness and transcultural theory. We argue that homelessness can be usefully conceptualised as a culture and that the application of transcultural theory to caring for homeless people will add further to the utility of these theories. The application of transcultural theory can add to the repertoire of skills the nurse needs to care for not only homeless clients, but, for a diverse range of client groups. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Elderly homeless veterans in Los Angeles: chronicity and precipitants of homelessness.

    Science.gov (United States)

    van den Berk-Clark, Carissa; McGuire, James

    2013-12-01

    We compared the characteristics of chronically homeless and acutely homeless elderly veterans to better understand precipitants of homelessness. We conducted interviews with 33 chronically and 26 acutely homeless veterans aged 65 years and older receiving transitional housing services in Los Angeles, California, between 2003 and 2005. We asked questions regarding their sociodemographic characteristics and other social status measures. Other precipitants of homelessness were acquired via observation and open-ended and structured questions. Both veterans groups were more similar than different, with substantial levels of physical, psychiatric, and social impairment. They differed significantly in homelessness history, with chronically homeless veterans having more homelessness episodes and more total time homeless. They were also less educated and had smaller social networks. In response to open-ended questioning, elderly homeless veterans revealed how health and substance use issues interacted with loss of social support and eviction to exacerbate homelessness. Assessment of a range of factors is needed to address risk factors and events leading to homelessness. Further research with larger samples is needed to confirm the characteristics and needs of the elderly homeless veteran population.

  19. 76 FR 76917 - Homeless Management Information Systems Requirements

    Science.gov (United States)

    2011-12-09

    ...-P-01] Homeless Management Information Systems Requirements AGENCY: Office of the Assistant Secretary... for the establishment of regulations for Homeless Management Information Systems (HMIS), which are the... community development, Homeless, Information technology system, Management system, Nonprofit organizations...

  20. Factors associated with violent victimisation among homeless adults in Sydney, Australia.

    Science.gov (United States)

    Larney, Sarah; Conroy, Elizabeth; Mills, Katherine L; Burns, Lucy; Teesson, Maree

    2009-08-01

    To determine the prevalence and correlates of violent victimisation among homeless people in inner-Sydney. Cross-sectional design. Clients of a shelter for homeless, substance-using adults were interviewed about their drug use, mental health and violent victimisation in the previous 12 months. Logistic regression was used to identify factors associated with victimisation. Participants reported complex drug use histories and high levels of depression, post-traumatic stress disorder (PTSD) and schizophrenia or other psychotic disorders. Forty-eight per cent of participants reported past year victimisation. In univariate analyses, being female, schizophrenia/psychotic disorder, PTSD, depression and regular use of psychostimulants were associated with increased risk of victimisation. In multivariate analyses, regular use of psychostimulants (odds ratio [95% CI] 5.07 [1.53-16.84]), schizophrenia or other psychotic disorder (3.13 [1.24-7.9], and depression (2.65 [1.07-6.59]) were associated with increased risk of victimisation. This sample of homeless, substance-using adults experienced high levels of violence. People with poor mental health and regular psychostimulant users were at greater risk of victimisation. A longitudinal study to determine whether victimisation prolongs homelessness is warranted. Clinical staff working with homeless populations need to be aware of the likelihood of past and future victimisation and its effects on mental health. Homeless persons may benefit from learning to identify risk situations for victimisation and how to de-escalate potentially violent situations.

  1. Barriers and bridges to care: voices of homeless female adolescent youth in Seattle, Washington, USA.

    Science.gov (United States)

    Ensign, Josephine; Panke, Aileen

    2002-01-01

    The purpose of this study was to conduct an assessment of reproductive health-seeking behaviours, sources of advice, and access to care issues among a sample of clinic-based homeless adolescent women. Adolescent women are among the most vulnerable and medically underserved subgroups within the homeless population in the United States. Homeless youth are rarely invited to participate in research aimed at improving their access to appropriate health care. Also, the culture in which they live and the personal experience of being homeless are often not addressed. The research was descriptive, using focus groups and individual interviews with a purposeful sample of 20 female youth, aged 14-23 years. The women said that they seek health advice from other women, including their mothers even while they are homeless. They reported first trying self-care interventions, and going to clinics when self-care actions no longer worked. They stated that the main barriers to health care were lack of insurance, confusion over consent, transportation problems, lack of respect (from providers) for their own self-knowledge, and judgementalism from providers. Using the concept of cultural competency, the results provide insights into how to improve communication and health care services for these women. Health care providers need to recognize and appreciate the lifestyle, beliefs, and adaptive attitudes of homeless youth, rather than labelling them as 'deviant'. All personnel who interact with and on behalf of homeless youth must be adequately trained in general knowledge regarding the health of homeless youth as well as in an understanding of the role that culture plays in their health-seeking behaviours.

  2. "Homeless Networks: Testing Peer and Homed Networks Against Location Choice"

    OpenAIRE

    Shinichiro Iwata; Koji Karato

    2007-01-01

    This paper examines the location choices of homeless people in Osaka City, and finds them concentrated because of homeless networks. The paper also shows that different types of homeless networks operate in two different homeless groups: (1) peer networks that provide a social tie inside homeless communities are observed in groups that had not had work experience in the day labor market; (2) homed networks that provide a social tie outside homeless communities affect location choice in the ex...

  3. End-of-life care for homeless people: A qualitative analysis exploring the challenges to access and provision of palliative care.

    Science.gov (United States)

    Shulman, Caroline; Hudson, Briony F; Low, Joseph; Hewett, Nigel; Daley, Julian; Kennedy, Peter; Davis, Sarah; Brophy, Niamh; Howard, Diana; Vivat, Bella; Stone, Patrick

    2018-01-01

    Being homeless or vulnerably housed is associated with death at a young age, frequently related to medical problems complicated by drug or alcohol dependence. Homeless people experience high symptom burden at the end of life, yet palliative care service use is limited. To explore the views and experiences of current and formerly homeless people, frontline homelessness staff (from hostels, day centres and outreach teams) and health- and social-care providers, regarding challenges to supporting homeless people with advanced ill health, and to make suggestions for improving care. Thematic analysis of data collected using focus groups and interviews. Single homeless people ( n = 28), formerly homeless people ( n = 10), health- and social-care providers ( n = 48), hostel staff ( n = 30) and outreach staff ( n = 10). This research documents growing concern that many homeless people are dying in unsupported, unacceptable situations. It highlights the complexities of identifying who is palliative and lack of appropriate places of care for people who are homeless with high support needs, particularly in combination with substance misuse issues. Due to the lack of alternatives, homeless people with advanced ill health often remain in hostels. Conflict between the recovery-focused nature of many services and the realities of health and illness for often young homeless people result in a lack of person-centred care. Greater multidisciplinary working, extended in-reach into hostels from health and social services and training for all professional groups along with more access to appropriate supported accommodation are required to improve care for homeless people with advanced ill health.

  4. Youth Homelessness and Social Stigma

    Science.gov (United States)

    Kidd, Sean A.

    2007-01-01

    Building upon previous exploratory qualitative research (Kidd S.A. (2003) "Child Adol. Social Work J." 20(4):235-261), this paper examines the mental health implications of social stigma as it is experienced by homeless youth. Surveys conducted with 208 youths on the streets and in agencies in New York City and Toronto revealed…

  5. Homeless--And Doubled Up

    Science.gov (United States)

    Dill, Vicky

    2015-01-01

    The bank foreclosed on your home because your parents divorced and don't have enough money to pay the mortgage. You're locked out of your house. Where will the family sleep? Most families turn to friends and relatives at times like these. That's why about 75 percent of the 1,258,182 homeless students in the United States live…

  6. Homelessness: The Foster Care Connection.

    Science.gov (United States)

    Institute for Children and Poverty, New York, NY.

    Roughly 600,000 families are homeless today in America, while over 2.7 million children are in foster care or out-of-home placements. Few policymakers have examined these issues together, or understood that they are interrelated and must be addressed jointly to break the cycle of family disintegration, violence, and poverty. A recent survey by the…

  7. To Be Young and Homeless.

    Science.gov (United States)

    Egan, Jennifer

    2002-01-01

    Describes the experiences of several families who are homeless in New York City, looking at what it is like for the children in these families, how the parents cope with trying to find work and a place to live, and how these families are treated by the system as they wait for various kinds of assistance. (SM)

  8. Self-transcendence and well-being in homeless adults.

    Science.gov (United States)

    Runquist, Jennifer J; Reed, Pamela G

    2007-03-01

    This study examines the relationships of spiritually and physically related variables to well-being among homeless adults. A convenience sample of 61 sheltered homeless persons completed the Spiritual Perspective Scale, the Self-Transcendence Scale, the Index of Well-Being, and items measuring fatigue and health status. The data were subjected to correlational and multiple regression analysis. Positive, significant correlations were found among spiritual perspective, self-transcendence, health status, and well-being. Fatigue was inversely correlated with health status and well-being. Self-transcendence and health status together explained 59% of the variance in well-being. The findings support Reed's theory of self-transcendence, in which there is the basic assumption that human beings have the potential to integrate difficult life situations. This study contributes to the growing body of evidence that conceptualizes homeless persons as having spiritual, emotional, and physical capacities that can be used by health care professionals to promote well-being in this vulnerable population.

  9. Calidad de Vida Profesional y Síndrome de Burnout del personal de salud del Servicio de Cuidado Crítico Neonatal del Hospital “San Bartolomé”, Lima – 2014

    OpenAIRE

    Rojas Salinas, Jakelina Marly; Pintado Dávila, Janet

    2015-01-01

    Conocer la calidad de vida profesional y el Síndrome de Burnout del personal de salud es muy importante porque ambos pueden determinar el rendimiento laboral, la obtención de mejores resultados y una elevada productividad. Objetivo: Describir las características de la Calidad de Vida Profesional y el Síndrome de Burnout del personal de salud del Servicio de Cuidado Crítico Neonatal del Hospital “San Bartolomé”, Lima -2014. Material y Método: Se ha realizado un estudio de enf...

  10. Homelessness Outcome Reporting Normative Framework: Systems-Level Evaluation of Progress in Ending Homelessness

    Science.gov (United States)

    Austen, Tyrone; Pauly, Bernie

    2012-01-01

    Homelessness is a serious and growing issue. Evaluations of systemic-level changes are needed to determine progress in reducing or ending homelessness. The report card methodology is one means of systems-level assessment. Rather than solely establishing an enumeration, homelessness report cards can capture pertinent information about structural…

  11. Urban characteristics and homelessness in Bucharest

    Directory of Open Access Journals (Sweden)

    Mirela Paraschiv

    2013-06-01

    Full Text Available Urban poverty continues to prove itself a concern in cities’ territorial planning as it disrupts the quality of life and the development process in some cities. Homelessness emerges sometimes as extreme urban poverty even in developed European Union countries. The study assesses Bucharest urban space to differentiate characteristics that influence the homeless to locate in certain places. The analysis included a three-level urban space categorization. Functional types of space were correlated to homelessness presence according to three space characteristics: property type, physical structure and state of use. The main findings argue that homeless people localization in Bucharest depends on urban space capacity to meet homelessness housing and living needs. Analysis’ conclusions evidence homeless location patterns to urban planners and authorities that may use the information to improve policies and actions to alleviate extreme poverty in Bucharest.

  12. San Francisco District Laboratory (SAN)

    Data.gov (United States)

    Federal Laboratory Consortium — Program CapabilitiesFood Analysis SAN-DO Laboratory has an expert in elemental analysis who frequently performs field inspections of materials. A recently acquired...

  13. Housing First or no housing? Housing and homelessness at the end of alcohol and drug treatment.

    Science.gov (United States)

    Dyb, Evelyn

    2016-10-01

    The rate of alcohol and drug dependency is high among homeless persons in Norway as well as in other Western societies. National homeless surveys also show a certain correlation between discharge from institutions and homelessness. However, the rate of homelessness versus the rate with fixed abode at the end of specialised alcohol and drug treatment has not been examined using quantitative methods. A cross-sectional survey was conducted in alcohol and drug treatment units in the national health services and private clinics. The survey investigates the housing outcome at the end of treatment compared to the situation at the start of treatment using an individual questionnaire for patients ending treatment in a specific time window. Housing outcome is measured by the odds ratio of having a fixed abode at the end of treatment in relation to main intoxicating substance, type of treatment (in- and outpatient), completing versus cutting short the treatment, housing situation at the start of treatment, socioeconomic capital, mental health problems, individual plan, medical assisted treatment, and a set of background variables. The housing versus homeless situation hardly changes during the treatment period. In both a bivariate analysis and a simple multivariate model, principal intoxicating substance is the strongest predictor of having a fixed abode both before and after treatment. However, a more sophisticated analysis indicates that socioeconomic resources and social capital play along with the preferred intoxicating substance as predictors of having permanent housing. After more than a decade of a housing-led national homeless policy, and wide embracement of Housing First approaches in the European Union, homeless persons entering specialised alcohol and drug treatment are likely to return to the streets and hostels at the end of treatment. Access to housing after treatment is very limited for those lacking resources to solve their housing problem without assistance

  14. Nurse-led primary health care for homeless men: a multimethods descriptive study.

    Science.gov (United States)

    Roche, M A; Duffield, C; Smith, J; Kelly, D; Cook, R; Bichel-Findlay, J; Saunders, C; Carter, D J

    2017-12-21

    To explore the primary healthcare needs and health service use of homeless men in inner Sydney. People experiencing homelessness have greater health needs than the general population and place high demands on tertiary care, which is expensive and may not be the optimum service for their needs. Accessible, approachable and affordable primary healthcare services could improve the health of homeless persons and potentially decrease costs to the healthcare system. A multimethod design using a cross-sectional survey (n = 40) and administrative data (n = 2 707 daily summaries) collected from a nurse-led primary healthcare clinic for homeless men in Sydney. Survey respondents were aged 27-76 years. Health problems reflected multimorbidity, with mental health issues present in almost all respondents. The majority had attended the clinic more than 20 times in the past year and said the services, treatments and referrals helped them avoid the emergency department. Administrative data indicated that medication administration was the most frequent service provided. Referrals to other health services doubled over the 7-year period. Multiple morbidities, particularly mental health issues, are associated with homelessness. A proactive approach by nurses including preventative services appeared to overcome barriers to health service use. This nurse-led primary healthcare clinic highlights the importance of providing services to homeless men with multiple comorbidities. Respect and trust in addition to easy access to health services appear to be important facilitators of health service use. A greater number of primary health services that collaborate with specialist services, including nurse-led clinics, may facilitate health care for persons who are homeless, reducing the burden on acute services. © 2017 International Council of Nurses.

  15. Homelessness in a Scandinavian welfare state

    DEFF Research Database (Denmark)

    Benjaminsen, Lars

    2016-01-01

    This article analyses the risk of homelessness in the Danish adult population. The study is based on individual, administrative micro-data for about 4.15 million Danes who were 18 years or older on 1 January 2002. Homelessness is measured by shelter use from 2002 to 2011. Data also cover civil st...... that homelessness in Denmark is widely concentrated amongst individuals with complex support needs, rather than associated with wider poverty problems....

  16. Addressing the Needs of Homeless Students.

    Science.gov (United States)

    Holloway, John H.

    2003-01-01

    Reviews studies on the plight and needs of homeless students. Includes reports on family mobility and school attendance, dysfunctional families, and school intervention strategies. (Contains 11 references.) (PKP)

  17. Risk Factors for Homelessness Among US Veterans

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A.

    2015-01-01

    Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. PMID:25595171

  18. Mortality Among Homeless Adults in Boston: Shifts in Causes of Death Over a 15-year Period

    Science.gov (United States)

    Baggett, Travis P.; Hwang, Stephen W.; O'Connell, James J.; Porneala, Bianca C.; Stringfellow, Erin J.; Orav, E. John; Singer, Daniel E.; Rigotti, Nancy A.

    2013-01-01

    Background Homeless persons experience excess mortality, but U.S.-based studies on this topic are outdated or lack information about causes of death. No studies have examined shifts in causes of death for this population over time. Methods We assessed all-cause and cause-specific mortality rates in a cohort of 28,033 adults aged 18 years or older who were seen at Boston Health Care for the Homeless Program between January 1, 2003, and December 31, 2008. Deaths were identified through probabilistic linkage to the Massachusetts death occurrence files. We compared mortality rates in this cohort to rates in the 2003–08 Massachusetts population and a 1988–93 cohort of homeless adults in Boston using standardized rate ratios with 95% confidence intervals. Results 1,302 deaths occurred during 90,450 person-years of observation. Drug overdose (n=219), cancer (n=206), and heart disease (n=203) were the major causes of death. Drug overdose accounted for one-third of deaths among adults homeless adults in Boston remains high and unchanged since 1988–93 despite a major interim expansion in clinical services. Drug overdose has replaced HIV as the emerging epidemic. Interventions to reduce mortality in this population should include behavioral health integration into primary medical care, public health initiatives to prevent and reverse drug overdose, and social policy measures to end homelessness. PMID:23318302

  19. Mental health disorders among homeless, substance-dependent men who have sex with men.

    Science.gov (United States)

    Fletcher, Jesse B; Reback, Cathy J

    2017-07-01

    Homelessness is associated with increased prevalence of mental health disorders, substance use disorders and mental health/substance use disorder comorbidity in the United States of America. Gay, bisexual and other men who have sex with men (MSM) living in the United States are at increased risk for homelessness, and have also evidenced elevated mental health and substance use disorder prevalence relative to their non-MSM male counterparts. Secondary analysis of data from a randomised controlled trial estimating the diagnostic prevalence of substance use/mental health disorder comorbidity among a sample of homeless, substance-dependent MSM (DSM-IV verified; n = 131). The most prevalent substance use/mental health disorder comorbidities were stimulant dependence comorbid with at least one depressive disorder (28%), alcohol dependence comorbid with at least one depressive disorder (26%) and stimulant dependence comorbid with antisocial personality disorder (25%). Diagnostic depression and antisocial personality disorder both demonstrated high rates of prevalence among homeless, substance-dependent (particularly stimulant and alcohol dependent) MSM. [Fletcher JB, Reback CJ. Mental health disorders among homeless, substance-dependent men who have sex with men. Drug Alcohol Rev 2016;36:555-559]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

  20. Opportunities for Engaging Low-Income, Vulnerable Populations in Health Care: A Systematic Review of Homeless Persons’ Access to and Use of Information Technologies

    Science.gov (United States)

    Li, Alice E.; Hogan, Timothy P.

    2013-01-01

    We systematically reviewed the health and social science literature on access to and use of information technologies by homeless persons by searching 5 bibliographic databases. Articles were included if they were in English, represented original research, appeared in peer-reviewed publications, and addressed our research questions. Sixteen articles met our inclusion criteria. We found that mobile phone ownership ranged from 44% to 62%; computer ownership, from 24% to 40%; computer access and use, from 47% to 55%; and Internet use, from 19% to 84%. Homeless persons used technologies for a range of purposes, some of which were health related. Many homeless persons had access to information technologies, suggesting possible health benefits to developing programs that link homeless persons to health care through mobile phones and the Internet. PMID:24148036

  1. Association of childhood abuse with homeless women's social networks.

    Science.gov (United States)

    Green, Harold D; Tucker, Joan S; Wenzel, Suzanne L; Golinelli, Daniela; Kennedy, David P; Ryan, Gery W; Zhou, Annie J

    2012-01-01

    Childhood abuse has been linked to negative sequelae for women later in life including drug and alcohol use and violence as victim or perpetrator and may also affect the development of women's social networks. Childhood abuse is prevalent among at-risk populations of women (such as the homeless) and thus may have a stronger impact on their social networks. We conducted a study to: (a) develop a typology of sheltered homeless women's social networks; (b) determine whether childhood abuse was associated with the social networks of sheltered homeless women; and (c) determine whether those associations remained after accounting for past-year substance abuse and recent intimate partner abuse. A probability sample of 428 homeless women from temporary shelter settings in Los Angeles County completed a personal network survey that provided respondent information as well as information about their network members' demographics and level of interaction with each other. Cluster analyses identified groups of women who shared specific social network characteristics. Multinomial logistic regressions revealed variables associated with group membership. We identified three groups of women with differing social network characteristics: low-risk networks, densely connected risky networks (dense, risky), and sparsely connected risky networks (sparse, risky). Multinomial logistic regressions indicated that membership in the sparse, risky network group, when compared to the low-risk group, was associated with history of childhood physical abuse (but not sexual or emotional abuse). Recent drug abuse was associated with membership in both risky network groups; however, the association of childhood physical abuse with sparse, risky network group membership remained. Although these findings support theories proposing that the experience of childhood abuse can shape women's social networks, they suggest that it may be childhood physical abuse that has the most impact among homeless women

  2. Comparison of insight and clinical variables in homeless and non-homeless psychiatric inpatients in China.

    Science.gov (United States)

    Fu, Yan-Nan; Cao, Xiao-Lan; Hou, Cai-Lan; Ng, Chee H; Ungvari, Gabor S; Chiu, Helen F K; Lin, Yong-Qiang; Wang, Lihui; Zheng, Xiaocong; Jia, Fu-Jun; Xiang, Yu-Tao

    2017-09-01

    There are no published data on insight in homeless patients with psychiatric disorders in China. This study examined insight in homeless and non-homeless Chinese psychiatric inpatients in relation to demographic and clinical variables. A total of 278 homeless and 222 non-homeless inpatients matched in age and gender were included in the study. Demographic and clinical characteristics were collected based on a review of medical charts and a clinical interview with standardized instruments. Insight was evaluated with the Insight and Treatment Attitudes Questionnaire. Altogether 20.5% of homeless inpatients and 43.7% of the non-homeless controls had good insight. Compared with homeless inpatients with impaired insight, homeless inpatients with good insight had higher physical quality of life, longer duration of illness and less severe positive and negative symptoms. Impaired insight appeared more common in homeless psychiatric inpatients in China. Further studies should address the need for effective therapeutic interventions that promote homeless patients' insight. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  3. A Qualitative Examination of Smoke-Free Policies and Electronic Cigarettes Among Sheltered Homeless Adults.

    Science.gov (United States)

    Vijayaraghavan, Maya; Hurst, Samantha; Pierce, John P

    2017-05-01

    To examine attitudes toward smoke-free policies and perceptions of e-cigarette use among homeless adults. A cross-sectional qualitative study was conducted. Study setting comprised seven transitional homeless shelters with indoor smoke-free policies in San Diego County; facilities differed in outdoor restrictions on smoking. Sixty-six current or former smokers were the study participants. Participants completed a questionnaire on smoking behaviors, perceived antitobacco norms, and attitudes toward smoke-free policies, and attended a focus group interview that explored these topics. We used a directed content analysis approach to analyze the focus group transcripts. Clients in facilities with outdoor restrictions on smoking had stronger perceived antitobacco norms than those in facilities without such restrictions. We identified the following major themes: attitudes toward smoke-free policies, the use of e-cigarettes, the addictive potential of cigarettes, vulnerability to tobacco industry marketing, and interest in smoking cessation. The consensus was that smoke-free policies were important because they limited secondhand smoke exposure to nonsmokers and children. All were curious about e-cigarettes, particularly if they could be smoked in areas where smoking was prohibited and/or used as a cessation aid. In this study of homeless adults, there was strong support for indoor and outdoor smoke-free policies. However, misperceptions that e-cigarettes could be used indoors could threaten antitobacco norms, highlighting opportunities to educate about the potential risks of e-cigarette use among homeless individuals.

  4. Homelessness in the U.S.: A Historical Analysis

    Science.gov (United States)

    Murphy, Joseph; Tobin, Kerri

    2014-01-01

    In this article, the authors examine homelessness across time and examine, in an introductory way, homelessness today. The authors start by examining important themes that ribbon homelessness in America over the last 300 years. Next, they provide a period analysis of homelessness from the birth of the country through the late 1970s. In the last…

  5. Homeless Children: Addressing the Challenge in Rural Schools. ERIC Digest.

    Science.gov (United States)

    Vissing, Yvonne M.

    Despite stereotypes to the contrary, homelessness is as prevalent in rural as urban areas. This digest examines the implications of homelessness for rural children and youth and discusses possible actions by rural educators. An estimated half of the rural homeless are families with children. Compared to urban counterparts, rural homeless families…

  6. An Examination of Criminal Behavior among the Homeless.

    Science.gov (United States)

    Solarz, Andrea

    Homelessness is a significant social problem in the United States, with an estimated 2.5 million homeless people in this country today. While criminal activity may become a means for the homeless to obtain resources needed for basic survival, little is known about the level of criminal activity among the homeless or about the types of crimnal…

  7. Who Is Doing Well? A Typology of Newly Homeless Adolescents

    Science.gov (United States)

    Milburn, Norweeta; Liang, Li-Jung; Lee, Sung-Jae; Rotheram-Borus, Mary Jane; Rosenthal, Doreen; Mallett, Shelley; Lightfoot, Marguerita; Lester, Patricia

    2009-01-01

    There is growing evidence to support developing new typologies for homeless adolescents. Current typologies focus on the risks associated with being homeless, with less consideration of the positive attributes of homeless adolescents. The authors examined both risk and protective factors in a sample of newly homeless adolescents. Using cluster…

  8. Comparisons of substance abuse, high-risk sexual behavior and depressive symptoms among homeless youth with and without a history of foster care placement.

    Science.gov (United States)

    Hudson, Angela L; Nandy, Karabi

    2012-10-01

    The purpose of this study was to compare prevalence of substance use, high-risk sexual behaviors, and depression symptoms between homeless youth with and without a history of foster care placement. Approximately 26,000 young persons exit foster care annually in the United States. Once they 'age out' of foster care, however, many young persons do not have access to comprehensive health care. They also are at risk for substance abuse, homelessness, or mental illness. Because persons with a history of foster care are at risk for negative psycho-social outcomes, it is unclear if these young people might be different than homeless youth without this history. The design is descriptive and cross-sectional. A total of 156 homeless young persons, of whom 44 had a history of foster care placement, were recruited from a drop-in center that caters to homeless youth and young adults. The sample was majority male and white; ages were 16-25. Significantly higher proportion of homeless former foster youth used methamphetamine within the last six months compared to non-fostered homeless youth p = 0.03). Homeless former foster youth were significantly older (p = 0.02) and less educated (p = 0.02) than their homeless counterparts without a history of foster care placement. Prevalence of using tobacco, marijuana, alcohol, crack cocaine, and powder cocaine were similar for both groups. Although not significant, a higher proportion of homeless former foster youth reported trading sex for money or drugs compared to non-fostered, homeless youth (19% versus 12% [trading sex for money], and 26% versus 14% [trading sex for drugs], respectively. Findings from this study show that, in general, homelessness is a negative outcome, irrespective of having a foster care history. However, those with that history need continued support when transitioning to independent living, such as access to health care, and encouragement to further their education. It is important that nurses, who serve homeless

  9. Can You Trust Self-Report Data Provided by Homeless Mentally Ill Individuals?

    Science.gov (United States)

    Calsyn, Robert J.; And Others

    1993-01-01

    Reliability and validity of self-report data provided by 178 mentally ill homeless persons were generally favorable. Self-reports of service use also generally agreed with treatment staff estimates, providing further validity evidence. Researchers and administrators can be relatively confident in using such data. (SLD)

  10. Predictors of Transience among Homeless Emerging Adults

    Science.gov (United States)

    Ferguson, Kristin M.; Bender, Kimberly; Thompson, Sanna J.

    2014-01-01

    This study identified predictors of transience among homeless emerging adults in three cities. A total of 601 homeless emerging adults from Los Angeles, Austin, and Denver were recruited using purposive sampling. Ordinary least squares regression results revealed that significant predictors of greater transience include White ethnicity, high…

  11. Working to End Family Homelessness. Annual Report

    Science.gov (United States)

    National Center on Family Homelessness (NJ1), 2012

    2012-01-01

    The National Center on Family Homelessness is determined to end family homelessness. Sheltering families provides a temporary safe haven. Connecting families to permanent housing, essential services, and critical supports can change their lives forever. Through research the Center learns what families need to rebound from the housing, economic,…

  12. Young Children and Families Experiencing Homelessness

    Science.gov (United States)

    Wilson, Allison B.; Squires, Jane

    2014-01-01

    The increasing prevalence of homelessness among young children and families in the United States is described, as is the developmental impact on young children and cost to society. Although services are mandated for this population under the McKinney­-Vento Act, Education of Homeless Children and Youth Program, and the Individuals With…

  13. The New Poverty: Homeless Families in America.

    Science.gov (United States)

    Nunez, Ralph da Costa

    This book discusses homeless families in the United States and advocates the efforts of residential educational and employment training centers--American Family Inns--which provide comprehensive services education, job training, and parenting and life skills to address the poverty-related conditions that contribute to homelessness. Chapters of the…

  14. Preliminary Findings on Rural Homelessness in Ohio.

    Science.gov (United States)

    First, Richard J.; And Others

    This report is designed to present preliminary findings from the first comprehensive study of rural homelessness in the United States. The study was conducted during the first 6 months of 1990, and data were collected from interviews with 921 homeless adults in 21 randomly selected rural counties in Ohio. The sample counties represent 26% of the…

  15. Educating Homeless Children in the United States.

    Science.gov (United States)

    Yon, Maria

    1995-01-01

    A survey of 102 urban school districts in large cities indicates that school districts have responded to the requirements of the Stewart B. McKinney Act for the education of homeless children to varying degrees. However, 69 percent of districts described the problem of homeless students as nonexistent or small. (SLD)

  16. 77 FR 20849 - Homeless Veterans' Reintegration Program

    Science.gov (United States)

    2012-04-06

    .... Funding Opportunity Description: Section 2021 of Title 38 of the United States Code (U.S.C.) reauthorizes the Homeless Veterans Reintegration Program (HVRP) through fiscal year (FY) 2012 and indicates: ``the... DEPARTMENT OF LABOR Homeless Veterans' Reintegration Program AGENCY: Veterans' Employment and...

  17. The Impact of Homelessness on Children.

    Science.gov (United States)

    Rafferty, Yvonne; Shinn, Marybeth

    1991-01-01

    Reviews community-based research on the effects of homelessness on children. Homeless children face threats to their future well-being resulting from health problems, hunger, poor nutrition, developmental delays, anxiety, depression, behavioral problems, and educational underachievement. Contributing factors may include inadequate shelter,…

  18. Housing Subsidies and Homelessness: A Simple Idea

    Directory of Open Access Journals (Sweden)

    Brendan O’Flaherty

    2012-01-01

    Full Text Available Reducing homelessness is an indisputable social good, and housing subsidies offer one way to do so. However, subsidies come in many different varieties and are intricately bound up with economic and social policies. This paper, written by one of North America’s leading urban economists, cuts through the tangle and argues that the simplest approach is the best. The ideal way to deter people from harmful acts is to reward them for abstaining. Thus, to combat homelessness, governments should offer housing allowances to people for every night they are not homeless. This optimal homelessness-reducing home allowance (OHRHA is open to adjustment to suit individual circumstances and the effects of homelessness on different demographics. It is meant to reduce homelessness by aligning individual and societal incentives, forcing people to bear the consequences or realize the benefits that their actions impose on others. The author explores methods for financing OHRHA, examines means for tailoring it to meet the diverse needs of the homeless and discusses the policy’s effect on urban housing markets, all while comparing and contrasting the proposal to existing homelessness-reduction measures in Alberta, Canada and the US.

  19. Homeless in Galilee | Brawley | HTS Teologiese Studies ...

    African Journals Online (AJOL)

    This article has located Jesus' saying about homelessness in the context of the Roman Empire as it was experienced in Galilee. Homelessness is part of a broader picture that translates into loss of access to the resources of the land. The thesis is that in light of a theology of land resulting from the development of Abrahamic ...

  20. Spirituality and Mental Health among Homeless Mothers

    Science.gov (United States)

    Hodge, David R.; Moser, Stephanie E.; Shafer, Michael S.

    2012-01-01

    Mothers are one of the fastest growing segments of the homeless population in the United States. Although mental health problems often contribute to homelessness, little is known about the factors that affect mothers' mental health. To help identify protective factors, this longitudinal study examined the relationship between spirituality and…

  1. San Marino.

    Science.gov (United States)

    1985-02-01

    San Marino, an independent republic located in north central Italy, in 1983 had a population of 22,206 growing at an annual rate of .9%. The literacy rate is 97% and the infant mortality rate is 9.6/1000. The terrain is mountainous and the climate is moderate. According to local tradition, San Marino was founded by a Christian stonecutter in the 4th century A.D. as a refuge against religious persecution. Its recorded history began in the 9th century, and it has survived assaults on its independence by the papacy, the Malatesta lords of Rimini, Cesare Borgia, Napoleon, and Mussolini. An 1862 treaty with the newly formed Kingdom of Italy has been periodically renewed and amended. The present government is an alliance between the socialists and communists. San Marino has had its own statutes and governmental institutions since the 11th century. Legislative authority at present is vested in a 60-member unicameral parliament. Executive authority is exercised by the 11-member Congress of State, the members of which head the various administrative departments of the goverment. The posts are divided among the parties which form the coalition government. Judicial authority is partly exercised by Italian magistrates in civil and criminal cases. San Marino's policies are tied to Italy's and political organizations and labor unions active in Italy are also active in San Marino. Since World War II, there has been intense rivalry between 2 political coalitions, the Popular Alliance composed of the Christian Democratic Party and the Independent Social Democratic Party, and the Liberty Committee, coalition of the Communist Party and the Socialist Party. San Marino's gross domestic product was $137 million and its per capita income was $6290 in 1980. The principal economic activities are farming and livestock raising, along with some light manufacturing. Foreign transactions are dominated by tourism. The government derives most of its revenue from the sale of postage stamps to

  2. 75 FR 22164 - Urban Non-Urban Homeless Female Veterans and Homeless Veterans With Families' Reintegration Into...

    Science.gov (United States)

    2010-04-27

    ... Non-Urban Homeless Female Veterans and Homeless Veterans With Families' Reintegration Into Employment... addresses complex problems facing Homeless Female Veterans and/or Veterans with Families eligible to... (including job readiness, literacy training, and skills training) to expedite the reintegration of homeless...

  3. Population-based surveillance for invasive pneumococcal disease in homeless adults in Toronto.

    Directory of Open Access Journals (Sweden)

    Agron Plevneshi

    Full Text Available BACKGROUND: Identification of high-risk populations for serious infection due to S. pneumoniae will permit appropriately targeted prevention programs. METHODS: We conducted prospective, population-based surveillance for invasive pneumococcal disease and laboratory confirmed pneumococcal pneumonia in homeless adults in Toronto, a Canadian city with a total population of 2.5 M, from January 1, 2002 to December 31, 2006. RESULTS: We identified 69 cases of invasive pneumococcal disease and 27 cases of laboratory confirmed pneumococcal pneumonia in an estimated population of 5050 homeless adults. The incidence of invasive pneumococcal disease in homeless adults was 273 infections per 100,000 persons per year, compared to 9 per 100,000 persons per year in the general adult population. Homeless persons with invasive pneumococcal disease were younger than other adults (median age 46 years vs 67 years, P<.001, and more likely than other adults to be smokers (95% vs. 31%, P<.001, to abuse alcohol (62% vs 15%, P<.001, and to use intravenous drugs (42% vs 4%, P<.001. Relative to age matched controls, they were more likely to have underlying lung disease (12/69, 17% vs 17/272, 6%, P = .006, but not more likely to be HIV infected (17/69, 25% vs 58/282, 21%, P = .73. The proportion of patients with recurrent disease was five fold higher for homeless than other adults (7/58, 12% vs. 24/943, 2.5%, P<.001. In homeless adults, 28 (32% of pneumococcal isolates were of serotypes included in the 7-valent conjugate vaccine, 42 (48% of serotypes included in the 13-valent conjugate vaccine, and 72 (83% of serotypes included in the 23-valent polysaccharide vaccine. Although no outbreaks of disease were identified in shelters, there was evidence of clustering of serotypes suggestive of transmission of pathogenic strains within the homeless population. CONCLUSIONS: Homeless persons are at high risk of serious pneumococcal infection. Vaccination, physical structure changes

  4. The Hunger–Obesity Paradox: Obesity in the Homeless

    OpenAIRE

    Koh, Katherine A.; Hoy, Jessica S.; O’Connell, James J.; Montgomery, Paul

    2012-01-01

    Despite stereotypes of the homeless population as underweight, the literature lacks a rigorous analysis of weight status in homeless adults. The purpose of this study is to present the body mass index (BMI) distribution in a large adult homeless population and to compare this distribution to the non-homeless population in the United States. Demographic, BMI, and socioeconomic variables from patients seen in 2007–2008 were collected from the Boston Health Care for the Homeless Program (BHCHP)....

  5. Subjective social status predicts quit-day abstinence among homeless smokers.

    Science.gov (United States)

    Reitzel, Lorraine R; Kendzor, Darla E; Cao, Yumei; Businelle, Michael S

    2014-01-01

    Smoking prevalence is alarmingly high among the homeless. Few studies have focused on predictors of smoking abstinence in this population. Subjective social status, a person's ranking of their own social standing relative to others in the United States or in their own self-defined communities, has predicted smoking cessation among domiciled smokers in analyses adjusted for objective socioeconomic status and other demographic variables. This study examined if subjective social status predicted quit-day abstinence among homeless smokers making a quit attempt. Longitudinal study using self-reported survey data. Transitional homeless shelter in Dallas, Texas. A total of 57 homeless smokers enrolled in a cessation program. Predictors were the Subjective Social Status-U.S (SSS-U.S.) and the Subjective Social Status-Community (SSS-Community) ladders measured 1 week pre quit. Covariates were sociodemographics and tobacco dependence measured 1 week pre quit. The outcome was self-reported and biochemically verified smoking abstinence on the quit day. Analysis . Covariate-adjusted logistic regression models. Higher rankings on the SSS-U.S. ladder, but not the SSS-Community ladder, predicted abstinence on the quit day (p = .005). Lower rankings on the SSS-U.S. ladder predicted increased risk of relapse on the quit day or the inability to quit at all. The SSS-U.S. ladder might be useful in identifying homeless smokers needing additional preparation and intervention before initiating a quit attempt.

  6. Relationship between adverse childhood experiences and homelessness and the impact of axis I and II disorders.

    Science.gov (United States)

    Roos, Leslie E; Mota, Natalie; Afifi, Tracie O; Katz, Laurence Y; Distasio, Jino; Sareen, Jitender

    2013-12-01

    We investigated the links between homelessness associated with serious mental and physical healthy disparities and adverse childhood experiences (ACEs) in nationally representative data, with Axis I and II disorders as potential mediators. We examined data from the National Epidemiologic Survey of Alcohol and Related Conditions in 2001-2002 and 2004-2005, and included 34,653 participants representative of the noninstitutionalized US population who were 20 years old or older. We studied the variables related to 4 classes of Axis I disorders, all 10 Axis II personality disorders, a wide range of ACEs, and a lifetime history of homelessness. Analyses revealed high prevalences of each ACE in individuals experiencing lifetime homelessness (17%-60%). A mediation model with Axis I and II disorders determined that childhood adversities were significantly related to homelessness through direct effects (adjusted odd ratios = 2.04, 4.24) and indirect effects, indicating partial mediation. Population attributable fractions were also reported. Although Axis I and II disorders partially mediated the relationship between ACEs and homelessness, a strong direct association remained. This novel finding has implications for interventions and policy. Additional research is needed to understand relevant causal pathways.

  7. Dietary inadequacies observed in homeless men visiting an emergency night shelter in Paris.

    Science.gov (United States)

    Darmon, N; Coupel, J; Deheeger, M; Briend, A

    2001-04-01

    To assess the dietary intake and the nutritional status of homeless men. A night emergency shelter in Paris, France. Dietary survey (48-h) including alcohol intake and a questionnaire on age, duration of homelessness, smoking habits. Subjects were also weighed and measured. Ninety-seven men aged 18-72 years (mean 43.3), of whom 54% were homeless for more than 18 months, 82% were smokers and 53% were regular and/or excessive drinkers. The BMI distribution was shifted towards low values, the percentage of wasted persons being four times higher than in the reference population. The mean total energy intake was 2376 kcal and included a high and highly variable percentage of energy derived from alcohol (12.0% Among drinkers, the mean ethanol intake was 90 g and there was a significant negative correlation between ethanol and non-alcoholic energy intakes. The median intakes of potassium, calcium, zinc, vitamins B1, B2, and niacin were lower than European Population Reference Intakes but only the mean intake of vitamin B1 was significantly lower. Eighty percent of non-alcoholic energy was provided by charitable organisations. For most nutrients, the nutritional density of the shelter ration was not significantly different from the density of the foods purchased by the homeless. These data suggest that the content of some nutrients should be increased in existing food assistance programs for homeless people in France.

  8. Characteristics and Factors Associated With Pain in Older Homeless Individuals: Results From the Health Outcomes in People Experiencing Homelessness in Older Middle Age (HOPE HOME) Study.

    Science.gov (United States)

    Landefeld, John C; Miaskowski, Christine; Tieu, Lina; Ponath, Claudia; Lee, Christopher T; Guzman, David; Kushel, Margot

    2017-09-01

    Individuals experiencing homelessness in the United States are aging; little is known about chronic pain in this population. In a cross-sectional, population-based study, we interviewed 350 homeless individuals aged 50 years and older to describe pain experienced by older persons experiencing homelessness and to assess factors associated with chronic moderate to severe pain, defined as pain lasting ≥3 months, with a past week average severity score of 5 to 10 (scale 0-10). The median age of participants was 58 years. Participants were predominantly African American (79.6%) and male (77.3%). Overall, 46.8% reported chronic moderate to severe pain. Almost half of participants reported a diagnosis of arthritis (44.3%) and one-third reported symptoms consistent with post-traumatic stress disorder (PTSD; 32.8%). Three-quarters (75.3%) endorsed a personal history of abuse. In multivariate analyses, PTSD (adjusted odds ratio [AOR]: 2.2, 95% confidence interval [CI], 1.4-3.7), arthritis (AOR: 4.8, 95% CI, 3.0-7.8), and history of experiencing abuse (AOR: 2.4, 95% CI, 1.3-4.3) were associated with chronic moderate to severe pain. HIV status, diabetes, depressive symptoms, and substance use were not associated with pain. Clinicians should consider the management of associated mental health conditions and the sequelae of experiencing abuse in the treatment of chronic pain in older adults experiencing homelessness. This article describes the prevalence and factors associated with chronic pain in older homeless adults. Almost half report chronic pain, which was associated with PTSD, arthritis, and personal history of abuse. Clinicians should address chronic pain, trauma, and the associated mental health conditions in this high-risk population. Copyright © 2017 American Pain Society. Published by Elsevier Inc. All rights reserved.

  9. Suicidal behavior among homeless people in Japan.

    Science.gov (United States)

    Okamura, Tsuyoshi; Ito, Kae; Morikawa, Suimei; Awata, Shuichi

    2014-04-01

    The purpose of this study is to investigate the frequency and correlates of suicidal behavior among homeless people in Japan. A face-to-face survey was conducted in two districts of Tokyo, Japan, with 423 subjects who resided on streets and riversides and in urban parks and stations (street homeless) or who were residents of shelters, cheap hotels, or welfare homes for homeless people (sheltered homeless). When questioned about suicidal ideation in the previous 2 weeks, 51 subjects (12.2% of valid responses) had a recurring wish to die, 29 (6.9%) had frequent thoughts of suicide, and 22 (5.3%) had made suicide plans. In addition, 11 (2.9%) subjects had attempted suicide in the previous 2 weeks and 74 (17.7%) reported that they had ever attempted suicide. In univariate logistic regression analyses, street homelessness, lack of perceived emotional social support, poor subjective health perception, visual impairment, pain, insomnia, poor mental well-being, and current depression were significantly associated with recurrent thoughts of suicide in the previous 2 weeks. Among these, current depression had the greatest significance. In multivariate logistic regression analyses after controlling for depression, street homelessness and lack of perceived emotional social support were significantly associated with recurrent thoughts of suicide in the previous 2 weeks. Comprehensive interventions including housing and social support as well as mental health services might be crucial as effective strategies for suicide prevention among homeless people.

  10. Ethical issues in research with homeless youths.

    Science.gov (United States)

    Ensign, Josephine; Ammerman, Seth

    2008-05-01

    This paper is a report of a study to document researcher, healthcare provider and programme administrators' experiences with ethical issues in research with homeless youths in North America. While there are legal and ethical guidelines for research with adolescents and with vulnerable populations in general, there are no specific guidelines for the ethical conduct of research with homeless youths. Using a web-based questionnaire, healthcare and social service providers, programme administrators and researchers working with homeless young people throughout the United States of America and Canada were surveyed in 2005. The survey group consisted of 120 individuals; a total of 72 individuals completed the survey. Survey questions included experiences with using incentives in research with homeless youths, consent and experiences with ethics review boards. Numerical data were analysed using frequencies and cross-tabulations. Text data were analysed qualitatively. Researchers doing mental health and/or substance use research tended to use money as a research incentive, whereas healthcare providers and programme administrators tended to use non-monetary incentives. The majority of respondents reported using written consent for research from homeless youths, including minors. Respondents reporting difficulties with ethics review boards were mainly involved with intervention research. Consensus is needed from a variety of stakeholders, including homeless youths and service providers, on use of various types of research incentives for different types of research, as well as use of consent for homeless youths who are minors.

  11. How are homeless people treated in the healthcare system and other societal institutions? Study of their experiences and trust.

    Science.gov (United States)

    Irestig, Robert; Burström, Kristina; Wessel, Maja; Lynöe, Niels

    2010-05-01

    To elucidate the perceived treatment that the homeless have received from the healthcare and other societal organisations and to present homeless persons' trust in the healthcare system and suggestions of necessary changes for improving it. Homeless individuals in special houses and institutions in the County of Stockholm were asked to answer a short version of a public health survey, including added questions about how they experienced the healthcare providers' attitudes towards them and how much trust they had in the healthcare system. A total of 155 homeless persons (123 male and 32 female) were interviewed. Three-quarters of the participants stated that they had fairly or very high trust in healthcare services and also felt that they had been fairly or very well treated. Fewer females than males reported being treated well and they declared a lower degree of trust in the healthcare system. The homeless suggest that extra resources be set aside to organise their healthcare, including a higher level of knowledge of the medical problems prevailing in the group. Those who felt badly treated also asked for less neglect and disrespect from the healthcare staff. Even though a majority experience that they are being well treated within the healthcare system, the study also indicated disadvantages in the treatment of homeless persons in Sweden. The study also reveals an imbalance between the official ethical framework in Sweden and of the specific moral of some individual healthcare providers. One way to facilitate their entry into the healthcare system might be to create special surgeries for the homeless.

  12. Comparisons of family environment between homeless and non-homeless individuals with schizophrenia in Xiangtan, Hunan.

    Science.gov (United States)

    Chen, Jinliang; Chen, Jindong; Li, Shuchun; Liu, Jun; Ouyang, Guohua; Luo, Wenxuan; Guo, Xiaofeng; Li, Ting; Li, Kaijie; Li, Zhenkuo; Wang, Gan

    2015-06-25

    Homelessness is an increasingly important problem for individuals with serious mental illness in China. Identify the characteristics of families that are associated with homelessness among individuals with schizophrenia. Participants were 1856 homeless individuals with schizophrenia (defined as those who had no place of residence or involved caregivers for 7 consecutive days) and 1728 non-homeless individuals with schizophrenia from Xiangtan, Hunan. The self-completion Family Environment Scale-Chinese Version (FES-CV) was administered to these participants after their acute psychotic symptoms resolved. Compared to individuals in the non-homeless group, those in the homeless group were older and more likely to be non-locals (i.e., from outside of Xiangtan), be residents of rural (versus urban) communities, have temporary (versus permanent) jobs, be married, and have a low level of education. After controlling for demographic differences using multivariate logistic regression models, homelessness was independently associated higher scores in the FES-CV intellectual-cultural orientation, organization, achievement orientation, and control subscales and with lower scores in the FES-CV cohesion, moralreligious emphasis, independence, and active-recreational orientation subscales. After controlling for sociodemographic factors, certain aspects of the family environment areassociated with being homeless among patients with schizophrenia in China. Further work is needed to identify interventions that can reduce the risk of homelessness in high-risk individuals.

  13. Effectiveness of interventions to improve the health and housing status of homeless people: a rapid systematic review

    Science.gov (United States)

    2011-01-01

    provide important new evidence regarding interventions to improve health, housing status, and access to healthcare for homeless populations. The additional studies included in this current review provide further support for earlier evidence which found that coordinated treatment programs for homeless persons with concurrent mental illness and substance misuse issues usually result in better health and access to healthcare than usual care. This review also provides a synthesis of existing evidence regarding interventions that specifically support homeless populations with HIV. PMID:21831318

  14. Effectiveness of interventions to improve the health and housing status of homeless people: a rapid systematic review.

    Science.gov (United States)

    Fitzpatrick-Lewis, Donna; Ganann, Rebecca; Krishnaratne, Shari; Ciliska, Donna; Kouyoumdjian, Fiona; Hwang, Stephen W

    2011-08-10

    interventions to improve health, housing status, and access to healthcare for homeless populations. The additional studies included in this current review provide further support for earlier evidence which found that coordinated treatment programs for homeless persons with concurrent mental illness and substance misuse issues usually result in better health and access to healthcare than usual care. This review also provides a synthesis of existing evidence regarding interventions that specifically support homeless populations with HIV.

  15. Effectiveness of interventions to improve the health and housing status of homeless people: a rapid systematic review

    Directory of Open Access Journals (Sweden)

    Kouyoumdjian Fiona

    2011-08-01

    . Conclusions These studies provide important new evidence regarding interventions to improve health, housing status, and access to healthcare for homeless populations. The additional studies included in this current review provide further support for earlier evidence which found that coordinated treatment programs for homeless persons with concurrent mental illness and substance misuse issues usually result in better health and access to healthcare than usual care. This review also provides a synthesis of existing evidence regarding interventions that specifically support homeless populations with HIV.

  16. How Feasible is Multiple Time Point Web-Based Data Collection with Individuals Experiencing Street Homelessness?

    Science.gov (United States)

    Eyrich-Garg, Karin M; Moss, Shadiya L

    2017-02-01

    Three barriers investigators often encounter when conducting longitudinal work with homeless or other marginalized populations are difficulty tracking participants, high rates of no-shows for follow-up interviews, and high rates of loss to follow-up. Recent research has shown that homeless populations have substantial access to information technologies, including mobile devices and computers. These technologies have the potential both to make longitudinal data collection with homeless populations easier and to minimize some of these methodological challenges. This pilot study's purpose was to test whether individuals who were homeless and sleeping on the streets-the "street homeless"-would answer questions remotely through a web-based data collection system at regular "follow-up" intervals. We attempted to simulate longitudinal data collection in a condensed time period. Participants (N = 21) completed an in-person baseline interview. Each participant was given a remotely reloadable gift card. Subsequently, weekly for 8 weeks, participants were sent an email with a link to a SurveyMonkey questionnaire. Participants were given 48 h to complete each questionnaire. Data were collected about life on the streets, service use, community inclusion, substance use, and high-risk sexual behaviors. Ten dollars was remotely loaded onto each participant's gift card when they completed the questionnaire within the completion window. A substantial number of participants (67% of the total sample and 86% of the adjusted sample) completed at least seven out of the eight follow-up questionnaires. Most questionnaires were completed at public libraries, but several were completed at other types of locations (social service agencies, places of employment, relative/friend/acquaintance's domiciles, or via mobile phone). Although some of the questions were quite sensitive, very few participants skipped any questions. The only variables associated with questionnaire completion were

  17. Preliminary needs assessment of mobile technology use for healthcare among homeless veterans

    Directory of Open Access Journals (Sweden)

    D. Keith McInnes

    2015-07-01

    Full Text Available Background. Homeless veterans have complex healthcare needs, but experience many barriers to treatment engagement. While information technologies (IT, especially mobile phones, are used to engage patients in care, little is known about homeless veterans’ IT use. This study examines homeless veterans’ access to and use of IT, attitudes toward health-related IT use, and barriers to IT in the context of homelessness.Methods. Qualitative interviews were conducted with 30 homeless veterans in different housing programs in Boston, MA, ranging from emergency shelters to supportive transitional housing that allow stays of up to 2 years. Interviews were conducted in person, audio recorded and then transcribed. Three researchers coded transcripts. Inductive thematic analysis was used.Results. Most participants (90% had a mobile phone and were receptive to IT use for health-related communications. A common difficulty communicating with providers was the lack of a stable mailing address. Some participants were using mobile phones to stay in touch with providers. Participants felt mobile-phone calls or text messages could be used to remind patients of appointments, prescription refills, medication taking, and returning for laboratory results. Mobile phone text messaging was seen as convenient, and helped participants stay organized because necessary information was saved in text messages. Some reported concerns about the costs associated with mobile phone use (calls and texting, the potential to be annoyed by too many text messages, and not knowing how to use text messaging.Conclusion. Homeless veterans use IT and welcome its use for health-related purposes. Technology-assisted outreach among this population may lead to improved engagement in care.

  18. "Walking in a maze": community providers' difficulties coordinating health care for homeless patients.

    Science.gov (United States)

    LaCoursiere Zucchero, Terri; McDannold, Sarah; McInnes, D Keith

    2016-09-07

    While dual usage of US Department of Veterans Affairs (VA) and non-VA health services increases access to care and choice for veterans, it is also associated with a number of negative consequences including increased morbidity and mortality. Veterans with multiple health conditions, such as the homeless, may be particularly susceptible to the adverse effects of dual use. Homeless veteran dual use is an understudied yet timely topic given the Patient Protection and Affordable Care Act and Veterans Choice Act of 2014, both of which may increase non-VA care for this population. The study purpose was to evaluate homeless veteran dual use of VA and non-VA health care by describing the experiences, perspectives, and recommendations of community providers who care for the population. Three semi-structured focus group interviews were conducted with medical, dental, and behavioral health providers at a large, urban Health Care for the Homeless (HCH) program. Qualitative content analysis procedures were used. HCH providers experienced challenges coordinating care with VA medical centers for their veteran patients. Participants lacked knowledge about the VA health care system and were unable to help their patients navigate it. The HCH and VA medical centers lacked clear lines of communication. Providers could not access the VA medical records of their patients and felt this hampered the quality and efficiency of care veterans received. Substantial challenges exist in coordinating care for homeless veteran dual users. Our findings suggest recommendations related to education, communication, access to electronic medical records, and collaborative partnerships. Without dedicated effort to improve coordination, dual use is likely to exacerbate the fragmented care that is the norm for many homeless persons.

  19. Preliminary needs assessment of mobile technology use for healthcare among homeless veterans.

    Science.gov (United States)

    McInnes, D Keith; Fix, Gemmae M; Solomon, Jeffrey L; Petrakis, Beth Ann; Sawh, Leon; Smelson, David A

    2015-01-01

    Background. Homeless veterans have complex healthcare needs, but experience many barriers to treatment engagement. While information technologies (IT), especially mobile phones, are used to engage patients in care, little is known about homeless veterans' IT use. This study examines homeless veterans' access to and use of IT, attitudes toward health-related IT use, and barriers to IT in the context of homelessness. Methods. Qualitative interviews were conducted with 30 homeless veterans in different housing programs in Boston, MA, ranging from emergency shelters to supportive transitional housing that allow stays of up to 2 years. Interviews were conducted in person, audio recorded and then transcribed. Three researchers coded transcripts. Inductive thematic analysis was used. Results. Most participants (90%) had a mobile phone and were receptive to IT use for health-related communications. A common difficulty communicating with providers was the lack of a stable mailing address. Some participants were using mobile phones to stay in touch with providers. Participants felt mobile-phone calls or text messages could be used to remind patients of appointments, prescription refills, medication taking, and returning for laboratory results. Mobile phone text messaging was seen as convenient, and helped participants stay organized because necessary information was saved in text messages. Some reported concerns about the costs associated with mobile phone use (calls and texting), the potential to be annoyed by too many text messages, and not knowing how to use text messaging. Conclusion. Homeless veterans use IT and welcome its use for health-related purposes. Technology-assisted outreach among this population may lead to improved engagement in care.

  20. A history in-care predicts unique characteristics in a homeless population with mental illness.

    Science.gov (United States)

    Roos, Leslie E; Distasio, Jino; Bolton, Shay-Lee; Katz, Laurence Y; Afifi, Tracie O; Isaak, Corinne; Goering, Paula; Bruce, Lucille; Sareen, Jitender

    2014-10-01

    Multiple studies of homeless persons report an increased prevalence of a history in-care, but there is a dearth of information on associated outcomes or relevant demographic profiles. This information is critical to understanding if certain individuals are at elevated risk or might benefit from specific intervention. Here, we investigate how a history in-care relates to demographics and multiple outcome measures in a homeless population with mental illness. Using the Mini International Neuropsychiatric Interview (MINI), the Short-Form 12, and a trauma questionnaire, we investigated baseline differences in demographics and length of homelessness in the At Home/Chez Soi Trial (N=504) Winnipeg homeless population with and without a history in-care. Approximately 50% of the homeless sample reported a history in-care. This group was significantly more likely to be young, female, married or cohabitating, of Aboriginal heritage, have less education, and have longer lifetime homelessness. Individuals of Aboriginal heritage with a history in-care were significantly more likely to report a familial history of residential school. Individuals with a history in-care experienced different prevalence rates of Axis 1 mental disorders. Those with a history in-care also reported significantly more traumatic events (particularly interpersonal). A distinctive high-risk profile emerged for individuals with a history in-care. Sociocultural factors of colonization and intergenerational transmission of trauma appear to be particularly relevant in the trajectories for individuals of Aboriginal heritage. Given the high prevalence of a history in-care, interventions and policy should reflect the specific vulnerability of this population, particularly in regards to trauma-informed services. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Prevalence of nasal colonization of methicillin-resistant Staphylococcus aureus in homeless and economically disadvantaged populations in Kansas City

    Directory of Open Access Journals (Sweden)

    Megan Ottomeyer

    2016-10-01

    Full Text Available Nasal colonization of methicillin-resistant Staphylococcus aureus (MRSA plays an important role in the epidemiology and pathogenesis of disease. Situations of close-quarter contact in groups are generally regarded as a risk factor for community acquired MRSA strains due to transmission via fomites and person to person contact. With these criteria for risk, homeless individuals using shelter facilities, including showers and toilets, should be considered high risk for colonization and infection. The aim of this study was to determine the prevalence of nasal colonization of MRSA in a homeless population compared to established rates of colonization within the public and a control group of subjects from a neighboring medical school campus, and to analyze phylogenetic diversity among the MRSA strains. Nasal samples were taken from the study population of 332 adult participants, and analyzed. In addition, participants were surveyed about various lifestyle factors in order to elucidate potential patterns of behavior associated with MRSA colonization. Homeless and control groups both had higher prevalence of MRSA (9.8% and 10.6% respectively when compared to the general population reported by previous studies (1.8%. However, the control group had a similar MRSA rate compared to healthcare workers (4.6% while the homeless population had an increased prevalence. Risk factors identified in this study included male gender, age over 50 years and use of antibiotics within the past 3 months. Phylogenetic relationships between 9 of the positive samples from the homeless population were analyzed, showing 8 of the 9 samples had a high degree of relatedness between the spaA genes of the MRSA strains. This indicates that the same MRSA strain might be transmitted from person to person among homeless population. These findings increase our understanding of key differences in MRSA characteristics within homeless populations as well as risks for MRSA associated with

  2. The Occupational Wellbeing of People Experiencing Homelessness

    OpenAIRE

    Thomas, Yvonne; Gray, M.; McGinty, S.

    2017-01-01

    This paper reports findings of a study that utilised an occupational perspective to explore how wellbeing was achieved and sustained by the occupations of people experiencing homelessness in Australia. Thirty three in-depth qualitative interviews were conducted with homeless individuals in a regional city in Australia. Data from the interviews were thematically analysed to understand the relationship between wellbeing, as defined by the individual, and the occupations engaged in by people exp...

  3. Illness narratives of people who are homeless

    Directory of Open Access Journals (Sweden)

    Cecilia Håkanson

    2016-11-01

    Full Text Available Multiple illnesses are common in all homeless populations. While most previous studies have focused on experiences of mental illness, there is a scarcity of studies about experiences of bodily illness among people who are homeless. This study aimed to explore illness narratives of people who are homeless, and how homelessness as a social context shapes the experience of multiple and/or advancing somatic conditions. The design was a qualitative single-case study, using interpretive description. Data were generated through interviews, with nine participants who were homeless rough sleepers in Stockholm, Sweden, recruited while receiving care in a support home for homeless people with complex care needs. The findings revealed experiences of illness embedded in narratives about falling ill, being ill, and the future. The particularity of these illness narratives and the way that they are shaped by homelessness give rise to several observations: the necessity of a capable body for survival; chaos and profound solitude in illness and self-care management; ambiguous feelings about receiving care, transitioning from independence, and “freedom” in the streets to dependency and being institutionalized; and finally, the absence of hope and desire for recovery or a better future. The narratives are discussed from the perspective of Frank's four types of illness stories (restitution, chaos, quest, and testimony. The findings stress that to provide appropriate care and support to people who are homeless and have multiple and/or advancing somatic conditions, health care professionals need to be informed both about the individual's biography and about the circumstances under which illness and self-care takes place in the streets.

  4. Distal Stressors and Depression among Homeless Men

    OpenAIRE

    Coohey, Carol; Easton, Scott D.

    2016-01-01

    Depression is a common problem among homeless men that may interfere with functional tasks, such as securing stable housing, obtaining employment, and accessing health services. Previous research on depression among homeless men has largely focused on current psychosocial resources, substance abuse, and past victimization. Guided by Ensel and Lin’s life course stress process model, the authors examined whether distal stressors, including victimization and exposure to parent problems in childh...

  5. Urban characteristics and homelessness in Bucharest

    OpenAIRE

    Mirela Paraschiv

    2013-01-01

    Urban poverty continues to prove itself a concern in cities’ territorial planning as it disrupts the quality of life and the development process in some cities. Homelessness emerges sometimes as extreme urban poverty even in developed European Union countries. The study assesses Bucharest urban space to differentiate characteristics that influence the homeless to locate in certain places. The analysis included a three-level urban space categorization. Functional types of space were correlated...

  6. How Positive Is Their Future? Assessing the Role of Optimism and Social Support in Understanding Mental Health Symptomatology among Homeless Adults.

    Science.gov (United States)

    Fitzpatrick, Kevin M

    2017-04-01

    Optimism has been noted as a primary protective factor in understanding mental health symptomatology in clinical and non-clinical settings. Any exploration of optimism has been absent in understanding mental health outcomes among homeless people. This study, using intensive interviews with 168 homeless adults in Northwest Arkansas, examines the role that social support and optimism play in lessening the negative impact of homeless circumstances/experiences on mental health symptomatology. Using OLS, findings support a mediating/protective role that social support and optimism play in lowering the negative effects of childhood life experiences on depressive symptoms among homeless persons. Despite the overwhelming conditions of homelessness, persons with higher levels of optimism and social support report lower depression and anxiety symptoms. The findings are discussed paying particular attention to the importance of developing and maintaining the perception of support and resiliency in preserving a positive outlook for the future among homeless persons facing often-debilitating circumstances. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  7. The impact of economic downturns and budget cuts on homelessness claim rates across 323 local authorities in England, 2004-12.

    Science.gov (United States)

    Loopstra, Rachel; Reeves, Aaron; Barr, Ben; Taylor-Robinson, David; McKee, Martin; Stuckler, David

    2016-09-01

    It is unclear why rates of homelessness claims in England have risen since 2010. We used variations in rates across local authorities to test the impact of economic downturns and budget cuts. Using cross-area fixed effects models of data from 323 UK local authorities between 2004 and 2012, we evaluated associations of changes in statutory homelessness rates with economic activity (Gross Value Added per capita), unemployment, and local and central government expenditure. Each 10% fall in economic activity was associated with an increase of 0.45 homelessness claims per 1000 households (95% CI: 0.10-0.80). Increasing rates of homelessness were also strongly linked with government reductions in welfare spending. Disaggregating types of welfare expenditure, we found that strongest associations with reduced homelessness claims were spending on social care, housing services, discretionary housing payments and income support for older persons. Recession and austerity measures are associated with significant increases in rates of homelessness assistance. These findings likely understate the full burden of homelessness as they only capture those who seek aid. Future research is needed to investigate what is happening to vulnerable groups who may not obtain assistance, including those with mental health problems and rough sleepers. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health.

  8. Early Care and Education for Young Children Experiencing Homelessness. Best Practices in Homeless Education Brief Series

    Science.gov (United States)

    National Center for Homeless Education at SERVE, 2013

    2013-01-01

    Given the number of young children experiencing homelessness and its devastating impacts on development, preschool programs play a critical role in meeting these children's need for quality early care and education; yet, most young homeless children do not receive early childhood services. Many barriers limit access to early childhood programs for…

  9. 77 FR 60897 - Safety Zone: America's Cup World Series Finish-Line, San Francisco, CA

    Science.gov (United States)

    2012-10-05

    ... navigable waters of the San Francisco Bay in vicinity of San Francisco West Yacht Harbor Light 2... vicinity of San Francisco West Yacht Harbor Light 2. Unauthorized persons or vessels are prohibited from... San Francisco West Yacht Harbor Light 2. This safety zone establishes a temporary restricted area on...

  10. “Wearing the Clothing of the Saint". Afro Characteristics in the Personality of San Baltazar through some Rites in his Cult in Argentina

    OpenAIRE

    Cirio, Norberto Pablo

    2014-01-01

    Through its history, one can see traces of African roots in the popular cult of San Baltazar in Argentina. In spite of starting as an imposed devotion by the clergy and the Spanish Crown to the slaves in the middle of 18th Century, early the later could insert their own cultural traditions, producing a sort of sui generis syncretism. Now days, those traditions are present in some religious ceremonies, especially in the devotional area. So far they consider that he is the patron saint of the j...

  11. Actors, observers, and causal attributions of homelessness: Differences in attribution for the causes of homelessness among domiciled and homeless people in Madrid (Spain).

    Science.gov (United States)

    Vázquez, José Juan; Panadero, Sonia; Zúñiga, Claudia

    2017-01-01

    The study analyzes the differences in causal attributions of homelessness and attributions of responsibility among the members of 3 groups: homeless group, consisting of a representative sample of homeless people in Madrid, Spain (n = 188); domiciled service-users group, consisting of people at risk of homelessness (n = 164); and domiciled nonservice-users group, consisting of people at no imminent risk of homelessness (n = 180). The domiciled service-users group and domiciled nonservice-users group were matched to the homeless group or sex, age, and nationality. The article also analyzes homeless people's causal attributions as regards their own situation. The results show that compared with the domiciled nonservice-users group, a higher percentage of members of the homeless group and domiciled service-users group attributed homelessness to individualistic causes and they blamed homeless people for their situation to a greater extent. The results also show that there was no "actor-observer bias" in causal attributions for homelessness in Madrid. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Homeless Point-In-Time (2007-2016)

    Data.gov (United States)

    City and County of Durham, North Carolina — These raw data sets contain Point-in-Time (PIT) estimates and national PIT estimates of homelessness as well as national estimates of homelessness by state and...

  13. Homelessness and Health – Part II

    Centers for Disease Control (CDC) Podcasts

    Homelessness in the 21st century is an ongoing problem, increasing due to the country's recent economic downturn, especially in urban areas. This podcast discusses how homelessness impacts health and what public health professionals can do about it.

  14. Homeless and Policy – Part I

    Centers for Disease Control (CDC) Podcasts

    Homelessness in the 21st century is an ongoing problem, increasing due to the country's recent economic downturn, especially in urban areas. This podcast discusses how homelessness impacts policy and what public health professionals can do about it.

  15. Homeless and Policy – Part II

    Centers for Disease Control (CDC) Podcasts

    Homelessness in the 21st century is an ongoing problem, increasing due to the country's recent economic downturn, especially in urban areas. This podcast discusses how homelessness impacts policy and what public health professionals can do about it.

  16. Homelessness and Health – Part I

    Centers for Disease Control (CDC) Podcasts

    Homelessness in the 21st century is an ongoing problem, increasing due to the country's recent economic downturn, especially in urban areas. This podcast discusses how homelessness impacts health and what public health professionals can do about it.

  17. Homelessness as social and individual problem – possibilities and prevention

    OpenAIRE

    Małgorzata Piechowicz

    2012-01-01

    This article consists of several parts. The first part includes definitional considerations over the notion of homelessness. It also describes social situation of the homeless, whereas the second part concentrates on both the analysis of causes and effects of homelessness and on the attempt to show the scale of this phenomenon. The last part of the article focuses on the prevention of homelessness. It emphasizes the importance of interdisciplinarity of preventive and compensatory actions in t...

  18. Transforming Teacher Constructs of Children and Families Who Are Homeless

    Science.gov (United States)

    Powers-Costello, Beth; Swick, Kevin J.

    2011-01-01

    The focus of this article is on articulating the importance of teacher development of constructs about homeless children and families and examining factors that influence teachers' perceptions of children and families who are homeless or at high-risk of becoming homeless. The article also explores some strategies to support teachers in…

  19. Homelessness in the Elementary School Classroom: Social and Emotional Consequences

    Science.gov (United States)

    Chow, Kirby A.; Mistry, Rashmita S.; Melchor, Vanessa L.

    2015-01-01

    This study examined elementary school teachers' experiences working with homeless students. Specifically, we focused on the psychosocial impacts of homelessness on students and their teachers. Qualitative, semi-structured interviews were conducted with 28 teachers who worked at designated public schools for family homeless shelters. A prominent…

  20. Homeless High School Students in America: Who Counts?

    Science.gov (United States)

    Cumming, John M.; Gloeckner, Gene W.

    2012-01-01

    After interviewing homeless high school students, the research team in a Colorado school district discovered that many students had not revealed their true living conditions (homelessness) to anyone in the school district. This research team developed an anonymous survey written around the homeless categories identified in the McKinney-Vento…

  1. Homeless Adolescents' Perceptions of Positive Development: A Comparative Study

    Science.gov (United States)

    Nott, Brooke Dolenc; Vuchinich, Samuel

    2016-01-01

    Background: While some recent research has addressed homeless youth from a strengths-based approach, comparative studies of homeless and non-homeless youth from a strengths perspective are few; research that includes youth's views on positive youth development are also limited. Objective: Addressing these gaps and using an inductive approach,…

  2. Supporting Children and Families Experiencing Homelessness: CCDF State Guide

    Science.gov (United States)

    Bires, Carie; Garcia, Carmen; Zhu, Julia

    2015-01-01

    Homelessness has a devastating impact on children. Research has shown that homelessness puts children at increased risk of health problems, developmental delays, academic underachievement and mental health problems. Homelessness also has a disproportionate impact on the youngest children, who account for more than half of all children in…

  3. What Kind of School Board Member Would Help Homeless Children?

    Science.gov (United States)

    Harrington-Lueker, Donna

    1989-01-01

    Homelessness is a growing problem in every part of the United States. Federal legislation requires state plans for educating homeless children, but will provide less than $23 per child. Summarizes some of the state plans and suggests steps school boards can take to provide homeless children with public education. (MLF)

  4. Exploring the Lived Experiences of Homeless Families with Young Children

    Science.gov (United States)

    Hinton, Stephanie; Cassel, Darlinda

    2013-01-01

    This study researched the experiences of homeless families with young children between the ages of four and eight. Many families experience homelessness every year; therefore, it is important for early childhood educators to have an understanding of how homelessness affects families with young children so that educators can effectively serve the…

  5. From substance use to homelessness or vice versa?

    NARCIS (Netherlands)

    McVicar, Duncan; Moschion, Julie; van Ours, Jan

    Homelessness is associated with substance use, but whether substance use precedes or follows homelessness is unclear. We investigate the nature of the relationship between homelessness and substance use using data from the unique Australian panel dataset Journeys Home collected in 4 surveys over the

  6. Hosting a Tent City: Student Engagement and Homelessness

    Science.gov (United States)

    McKinney, Jennifer; Snedker, Karen A.

    2017-01-01

    In response to increasing homelessness in our city, Seattle Pacific University invited a homeless encampment (Tent City) to reside on our university campus for three months. This provided an opportunity to engage students on issues of poverty and inequality. Building from a service-learning model, we devised course work around homelessness and…

  7. Simple mathematical models for housing allocation to a homeless ...

    African Journals Online (AJOL)

    We present simple mathematical models for modelling a homeless population and housing allocation. We look at a situation whereby the local authority makes temporary accommodation available for some of the homeless for a while and we examine how this affects the number of families homeless at any given time.

  8. The Heterogeneity of Homelessness and the Consequences for Service Provision

    DEFF Research Database (Denmark)

    Koch-Nielsen, Inger; Børner Stax, Tobias

    Based on a literature study this chapter reflects upon the concept of homelessness and related terms in a Danish context. We then presents different types of accommodations for the homeless that is currently used. The chapter is taken from an anthology which deals with understandings and measures...... directed towards the homeless people in different European countries....

  9. Meeting the Housing and Care Needs of Older Homeless Adults: A Permanent Supportive Housing Program Targeting Homeless Elders

    OpenAIRE

    Brown, Rebecca T.; Thomas, M. Lori; Cutler, Deborah F.; Hinderlie, Mark

    2013-01-01

    The homeless population is aging faster than the general population in the United States. As this vulnerable population continues to age, addressing complex care and housing needs will become increasingly important. This article reviews the often-overlooked issue of homelessness among older adults, including their poor health status and unique care needs, the factors that contribute to homelessness in this population, and the costs of homelessness to the U.S. health care system. Permanent sup...

  10. Life Goals Over Time Among Homeless Adults in Permanent Supportive Housing.

    Science.gov (United States)

    Wenzel, S L; Rhoades, H; Moore, H; Lahey, J; Henwood, B; La Motte-Kerr, W; Bird, M

    2018-03-14

    Permanent supportive housing (PSH) is a widely-accepted solution to the challenge of chronic homelessness. While housing support and retention, physical health, and healthcare continue to be important for formerly homeless persons in PSH, "higher-order" and humanistic needs such as thriving have received less attention and as a result are less well understood in this population. One important indicator of thriving is the ability to establish and articulate life goals. This study utilizes longitudinal data from 421 formerly homeless adults prior to their move into PSH, and at 3-, 6- and 12-months after move-in (369 respondents completed all four interviews), to examine what life goals are articulated by this population and how those goals change over time. Prior to housing, most respondents articulated housing attainment as their primary life goal, whereas at follow-up interviews health goals, housing relocation, and financial goals became more prevalent. Aspirational goals (e.g., independence, self-improvement, artistic pursuits) were also common, but demonstrated a decrease over time in housing. Relationship goals remained common and consistent over time. Findings indicate that housing is a necessary, but perhaps not sufficient, step for improving thriving among formerly homeless adults. Implications for practice and future research are discussed. © Society for Community Research and Action 2018.

  11. The power of the drug, nature of support, and their impact on homeless youth.

    Science.gov (United States)

    Hudson, Angela L; Nyamathi, Adeline; Slagle, Alexandra; Greengold, Barbara; Griffin, Deborah Koniak; Khalilifard, Farinaz; Gedzoff, Danny; Reid, Courtney

    2009-10-01

    The purpose of this study was to explore homeless youths' perspectives on the power of drugs in their lives, the preferred type of drugs used, barriers to treatment, and strategies to prevent drug initiation and abuse. This was a descriptive, qualitative study using focus groups with a purposeful sample of 24 drug-using homeless youth. The results provided insight into the lives of drug-using homeless youth. The most commonly used drugs were marijuana and alcohol. Reported reasons for drug use were parental drug use, low self-esteem, and harsh living conditions on the streets. Barriers to treatment were pleasurable enjoyment of the drug, physical dependence, and non-empathetic mental health providers. Strategies to prevent initiation and abuse of drugs were creative activities, such as art, sports, and music, and disdain for parental/family drug use and abuse. Comparative research is needed on specific personal factors that cause initiation and deterrence of drugs use/abuse among homeless youth.

  12. Vulnerability of homeless people in Tehran, Iran, to HIV, tuberculosis and viral hepatitis.

    Directory of Open Access Journals (Sweden)

    Fahimeh Bagheri Amiri

    Full Text Available Homeless people are at risk of contracting communicable infectious diseases, as they indulge in risky behaviours and lifestyle. This study was conducted to determine the prevalence of the aforementioned infections and related risk behaviours among homeless people in Tehran.In this study a convenience sample of 593 homeless individuals was studied. The ELISA method was used for the detection of HIV, HCV and HBV. Clinical symptoms, sputum cultures, acid fast bacilli smears, and chest X-rays were used to identify active pulmonary tuberculosis, and the Interferon Gamma Release Assay (IGRA test was used to identify latent tuberculosis.The prevalence of HIV, HBV, HCV and latent tuberculosis was 3.4%, 2.6%, 23.3% and 46.7%, respectively. Active pulmonary tuberculosis was found in 7 persons (1.2%. Injection drug use was an independent risk factor for HIV, HCV and HBV infections. Older people had a higher proportion of Mycobacterium tuberculosis infection (OR: 2.6, 95%CI: 1.9, 3.7 and HCV positivity (OR: 1.7, 95% CI: 1.1, 2.5.Our findings highlighted that much more attention needs to be paid to the health of homeless people.

  13. Economic evaluation of 'Return to Country': A remote Australian initiative to address indigenous homelessness.

    Science.gov (United States)

    Kinchin, Irina; Jacups, Susan; Hunter, Gary; Rogerson, Bernadette

    2016-06-01

    An increase in the number of Indigenous homeless persons in Cairns, Northern Australia, prompted the Queensland Police Service (QPS) to commence a pilot 'Return to Country' (R2C) program. The program was designed to assist homeless people who were voluntarily seeking to return to their home communities. This study assesses the costs of running the program and evaluates its net economic impact. Retrospective uncontrolled cost, cost-effectiveness and cost-offset analyses were undertaken from a societal perspective. All costs were expressed in 2014 AU$. The R2C program successfully assisted 140 participants to return home, reducing the prevalence of homelessness in the regional center by 9.6%. The total program cost was estimated as AU$ 135,831 or AU$ 970 per participant. The economic analysis indicated that R2C was value for money, potentially saving AU$ 2,714,460. Limitations of the study included retrospective data collection and no established alternative comparison group. R2C is a relatively simple, minimal cost program, which can be utilized by policy makers to offer one solution to homelessness. This economic evaluation informs the QPS of the effects of the R2C program in order to guide further program initiatives. The R2C model may be applied to assist temporarily stranded Indigenous people in other locations within Australia or internationally to return home. No funding was obtained for conducting this study. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Predicting homeless people's perceived health after entering the social relief system in The Netherlands.

    Science.gov (United States)

    van der Laan, Jorien; van Straaten, Barbara; Boersma, Sandra N; Rodenburg, Gerda; van de Mheen, Dike; Wolf, Judith R L M

    2018-03-01

    We explored whether changes in the perceived health of homeless people after entering the social relief system (SRS) in The Netherlands were predicted by housing, income, hours of work, social support, unmet care needs, arrests, physical and mental health, substance use, and experiences of autonomy, competence and relatedness, in addition to perceived health at baseline, demographics, suspected intellectual disability, the duration of homelessness and the company of children in the shelter facility. A hierarchical regression analysis was used to explore the significant predictors of the perceived health of 344 homeless persons 18 months after entering the social relief system. A decrease in psychological distress and an increase in hours of (paid/voluntary) work as well as competence predicted a better perceived health. Perceived health is not only influenced by objective circumstances related to work and mental health, but also self-determination, as shown by the influence of competence. Services should aim to reduce psychological distress of homeless people, support them in increasing their working hours and focus on strengthening their competence.

  15. Faith communities, social exclusion, homelessness and disability: Transforming the margins in the City of Tshwane

    Directory of Open Access Journals (Sweden)

    Thinandavha D. Mashau

    2015-11-01

    Full Text Available Social exclusion is a reality in South Africa today. Its faces are diverse and varied; social exclusion can be defined in terms of social, economic, political and religious dimensions. This diversity also applies to the context of homelessness in the City of Tshwane. The research on which this article is based sought to explore the issue of social exclusion from a religious perspective; it looked closely at how social exclusion manifests from a religious perspective in the context of homelessness and disability in the City of Tshwane. The thrust of this article is captured in the following question: how do homeless people and persons with disability experience social exclusion from faith communities? What do they say about the role that faith communities should play in addressing their marginalisation? These questions were answered by doing Contextual Bible Study of Acts 3:1–10 with the homeless in the City of Tshwane, thereby allowing them space for their voices to be heard as to how the faith community should respond to their plight. It became clear in this research that faith communities should always act as transforming agents to those in the margins.

  16. Modeling minority stress effects on homelessness and health disparities among young men who have sex with men.

    Science.gov (United States)

    Bruce, Douglas; Stall, Ron; Fata, Aimee; Campbell, Richard T

    2014-06-01

    Sexual minority youth are more likely to experience homelessness, and homeless sexual minority youth report greater risk for mental health and substance abuse symptoms than homeless heterosexual youth, yet few studies have assessed determinants that help explain the disparities. Minority stress theory proposes that physical and mental health disparities among sexual minority populations may be explained by the stress produced by living in heterosexist social environments characterized by stigma and discrimination directed toward sexual minority persons. We used data from a sample of 200 young men who have sex with men (YMSM) (38 % African American, 26.5 % Latino/Hispanic, 23.5 % White, 12 % multiracial/other) to develop an exploratory path model measuring the effects of experience and internalization of sexual orientation stigma on depression and substance use via being kicked out of home due to sexual orientation and current homelessness. Direct significant paths were found from experience of sexual orientation-related stigma to internalization of sexual orientation-related stigma, having been kicked out of one's home, experiencing homelessness during the past year, and major depressive symptoms during the past week. Having been kicked out of one's home had a direct significant effect on experiencing homelessness during the past 12 months and on daily marijuana use. Internalization of sexual orientation-related stigma and experiencing homelessness during the past 12 months partially mediated the direct effect of experience of sexual orientation-related stigma on major depressive symptoms. Our empirical testing of the effects of minority stress on health of YMSM advances minority stress theory as a framework for investigating health disparities among this population.

  17. Mobile phone technology: a new paradigm for the prevention, treatment, and research of the non-sheltered "street" homeless?

    Science.gov (United States)

    Eyrich-Garg, Karin M

    2010-05-01

    Individuals experiencing homelessness have disproportionately high rates of health problems. Those who perceive themselves as having greater access to their social support networks have better physical and mental health outcomes as well as lower rates of victimization. Mobile phones offer a connection to others without the physical constraints of landlines and, therefore, may make communication (e.g., access to one's social support networks) more feasible for homeless individuals. This, in turn, could lead toward better health outcomes. This exploratory study examined mobile phone possession and use among a sample of 100 homeless men and women who do not use the shelter system in Philadelphia, PA. Interviews were comprised of the Homeless Supplement to the Diagnostic Interview Schedule, a technology module created for this investigation, and the substance use and psychiatric sections of the Addiction Severity Index. Almost half (44%) of the sample had a mobile phone. In the past 30 days, 100% of those with mobile phones placed or received a call, over half (61%) sent or received a text message, and one fifth (20%) accessed the Internet via their mobile phone. Participants possessed and used mobile phones to increase their sense of safety, responsibility (employment, stable housing, personal business, and sobriety or "clean time"), and social connectedness. Mobile phones could potentially be used by public health/health care providers to disseminate information to the street homeless, to enhance communication between the street homeless and providers, and to increase access for the street homeless to prevention, intervention, and aftercare services. Finally, this technology could also be used by researchers to collect data with this transient population.

  18. Perceptions on work: analysis of conceptions of homeless people

    Directory of Open Access Journals (Sweden)

    Isabela Aparecida de Oliveira Lussi

    2017-12-01

    Full Text Available Introduction: We are facing alarming levels of structural unemployment that become exponentially larger when we analyze the layers excluded from the right to work, as the people living in the street. Objective: To identify the conceptions about the work of people living in the street. Method: The participants were ten men sheltered in a religious institution that welcomes homeless people, located in the interior of the state of São Paulo. This is a qualitative study that used the semi-structured interview for data collection and the thematic analysis technique to analyze them. Results: The participants link the work to financial issues, since the money was recognized by them as a means to satisfy material desires and support family. They also link it to the use of psychoactive substances, indicated as the main reason for the loss of jobs. However, we observed that the work was also indicated as a possibility of (reconstruction of future life projects, being an important component of daily life. Participants associated the work with the viability of their social networks, which in many cases were fragile or non-existent and conceived as an emancipatory strategy, whether personal, family or financial. Conclusion: Research into social assistance equipment for the homeless people is important, since it broadens the knowledge about the equipment itself, the users and their demands, favoring the creation and implementation of social policies, as well as supporting Occupational Therapy practices along with this population, which are still scarce.

  19. Gardening for the mental well-being of homeless women.

    Science.gov (United States)

    Grabbe, Linda; Ball, Janell; Goldstein, Allison

    2013-12-01

    To explore the perceptions of homeless women regarding their experience in a shelter-based garden project to promote mental wellness. Participants planted and tended the vegetable garden and prepared and ate the fruits of their labor. A qualitative descriptive design with a conventional content analysis of narrative data. Data were gathered in semistructured interviews. Participants were homeless daytime shelter guests who had participated in at least eight gardening sessions over 4 weeks. The project was started in the fall of 2010 and the interviews were conducted over 2 months in the summer of 2011. Two polarized themes were identified in the narratives, clustering around negative and positive thoughts. The "dark" theme centered on marginalization and the oppressiveness of shelter life. The "light" theme centered on stress relief, feeling socially included, and personal change. The gardening experience interrupted the participants' negative ruminations, offering stress relief and elements of social inclusion and self-actualization. Gardening is an inexpensive and positive intervention for a population with a high incidence of mental illness and distress.

  20. "Homelessness and trauma go hand-in-hand": pathways to homelessness among women veterans.

    Science.gov (United States)

    Hamilton, Alison B; Poza, Ines; Washington, Donna L

    2011-01-01

    Veterans comprise a disproportionate fraction of the nation's homeless population, with women veterans up to four times more likely to be homeless than non-veteran women. This paper provides a grounded description of women veterans' pathways into homelessness. Three focus groups were held in Los Angeles, California, with a total of 29 homeless women veterans. Five predominant "roots" (precipitating experiences) initiated pathways toward homelessness: 1) childhood adversity, 2) trauma and/or substance abuse during military service, 3) post-military abuse, adversity, and/or relationship termination, 4) post-military mental health, substance abuse, and/or medical problems, and 5) unemployment. Contextual factors, which promoted development of homelessness in the setting of primary roots, included women veterans' "survivor instinct," lack of social support and resources, sense of isolation, pronounced sense of independence, and barriers to care. These contextual factors also reinforced persistence of the roots of post-military adversity and mental health and substance abuse problems, serving to maintain cycles of chronic homelessness. Collectively, these multiple, interacting roots and contextual factors form a "web of vulnerability" that is a target for action. Multiple points along the pathways to homelessness represent critical junctures for VA and community-based organizations to engage in prevention or intervention efforts on behalf of women veterans. Considering the multiple, interconnected challenges that these women veterans described, solutions to homelessness should address multiple risk factors, include trauma-informed care that acknowledges women veterans' traumatic experiences, and incorporate holistic responses that can contribute to healing and recovery. Published by Elsevier Inc.

  1. Financing Cocaine Use in a Homeless Population

    Directory of Open Access Journals (Sweden)

    Carol S. North

    2017-10-01

    Full Text Available Background: Cocaine use is highly prevalent among homeless populations, yet little is known about how it is financed. This study examined associations of income sources with cocaine use and financing of drugs in a longitudinal evaluation of a homeless sample. Methods: A homeless sample was recruited systematically in St. Louis in 1999–2001 and longitudinally assessed annually over two years using the Diagnostic Interview Schedule and the Homeless Supplement, with urine drug testing. Results: More than half (55% of participants with complete follow-up data (N = 255/400 had current year cocaine use. Current users spent nearly $400 (half their income in the last month on drugs at baseline. Benefits, welfare, and disability were negatively associated and employment and income from family/friends, panhandling, and other illegal activities were positively associated with cocaine use and monetary expenditures for cocaine. Conclusions: Findings suggest that illegal and informal income-generating activities are primary sources for immediate gratification with cocaine use and public entitlements do not appear to be primary funding sources used by homeless populations. Policy linking drug testing to benefits is likely to have little utility, and public expenditures on measures to unlink drug use and income might be more effectively used to fund employment and treatment programs.

  2. Mental Health, Substance Abuse, and Suicide Among Homeless Adults.

    Science.gov (United States)

    Lee, Kyoung Hag; Jun, Jung Sim; Kim, Yi Jin; Roh, Soonhee; Moon, Sung Seek; Bukonda, Ngoyi; Hines, Lisa

    2017-01-01

    This study explored the role of mental health and substance abuse problems on the suicidal ideation and suicide attempts of 156 homeless adults. The logistic regression results indicated that homeless adults with anxiety were significantly more likely than those without anxiety to have both suicidal ideation and suicide attempts. Also, homeless adults with drug abuse were significantly more likely than those without drug abuse to have suicidal ideation. The study suggests that to reduce the suicide of the homeless, case managers need to screen mental health and substance abuse issues and to provide appropriate treatment services at homeless shelters.

  3. College Access and Success for Students Experiencing Homelessness: A Toolkit for Educators and Service Providers

    Science.gov (United States)

    Dukes, Christina

    2013-01-01

    This toolkit serves as a comprehensive resource on the issue of higher education access and success for homeless students, including information on understanding homeless students, assisting homeless students in choosing a school, helping homeless students pay for application-related expenses, assisting homeless students in finding financial aid…

  4. 76 FR 22785 - Direct Certification and Certification of Homeless, Migrant and Runaway Children for Free School...

    Science.gov (United States)

    2011-04-25

    ... [FNS-2008-0001] RIN 0584-AD60 Direct Certification and Certification of Homeless, Migrant and Runaway... concerning the certification of certain children who are homeless, runaway, or migratory. This rule affects... children who are homeless, runaway, or migratory, as determined by the homeless coordinator for homeless or...

  5. Risk of psychiatric disorders in offspring of parents with a history of homelessness during childhood and adolescence in Denmark

    DEFF Research Database (Denmark)

    Nilsson, Sandra Feodor; Laursen, Thomas Munk; Hjorthøj, Carsten

    2017-01-01

    Background Children and adolescents from deprived backgrounds have high rates of psychiatric problems. Parental and social factors are crucial for children's healthy and positive development, but whether psychiatric morbidity is associated with parental social marginalisation is unknown. We aimed...... of homelessness, and 56 330 (5%) children and adolescents were diagnosed with any psychiatric disorder during the study period. The incidence of any psychiatric disorder was 15·1 cases per 1000 person-years (95% CI 14·4–15·8) in offspring with at least one parent with a history of homelessness, compared with 6...... to analyse the association between mother's and father's history of homelessness and the offspring's risk of psychiatric disorders, including substance use disorder, during childhood and adolescence. Methods We did a nationwide, register-based cohort study of 1 072 882 children and adolescents aged 0...

  6. Risk of psychatric disorders in offspring of parents with a history of homelessness during childhood and adolescence in Denmark

    DEFF Research Database (Denmark)

    Nilsson, Sandra Feodor; Munk Laursen, Thomas; Hjorthøj, Carsten

    2017-01-01

    BACKGROUND:Children and adolescents from deprived backgrounds have high rates of psychiatric problems. Parental and social factors are crucial for children's healthy and positive development, but whether psychiatric morbidity is associated with parental social marginalisation is unknown. We aimed...... of homelessness, and 56 330 (5%) children and adolescents were diagnosed with any psychiatric disorder during the study period. The incidence of any psychiatric disorder was 15·1 cases per 1000 person-years (95% CI 14·4-15·8) in offspring with at least one parent with a history of homelessness, compared with 6...... to analyse the association between mother's and father's history of homelessness and the offspring's risk of psychiatric disorders, including substance use disorder, during childhood and adolescence. METHODS:We did a nationwide, register-based cohort study of 1 072 882 children and adolescents aged 0...

  7. The psychosocial profile of adolescent risk of homelessness.

    Science.gov (United States)

    Bearsley-Smith, Cate A; Bond, Lyndal M; Littlefield, Lyn; Thomas, Lyndal R

    2008-06-01

    To contrast the psychosocial profile of adolescents with risk factors for homelessness, identified using Chamberlain and MacKenzie's self-report scale, compared to the profiles of homeless adolescents. Multinomial logistic regression analyses were conducted contrasting profiles for (a) 137 homeless adolescents, (b) 766 secondary students reporting risk factors for homelessness, and (c) 4,844 students not reporting risks for homelessness. Fourteen percent of a representative population of at-school adolescents, from Victoria, Australia, showed elevated risk of homelessness. These adolescents showed depressive symptoms at least equivalent to homeless adolescents (RR 6.0, 95% CI: 4.9, 7.3, and RR 3.5, 95% CI: 2.1, 5.8, respectively). In multivariate analyses, homeless and at risk adolescents reported equivalent levels of family conflict, early problem behaviour and low opportunities and rewards for family involvement. Compared to adolescents not at risk, at risk adolescents were more likely to be female and to show poorer social skills/assertiveness and depressive symptoms. Compared to at risk adolescents, homeless adolescents showed additional family, school, peer and individual risks, but lower depressive symptomatology. The findings highlight the potential we have to quickly and simply detect adolescents showing significant risk of homelessness. This sizable minority of adolescents report risks often equivalent to homeless adolescents. It is hoped that stakeholders working with young people will utilise this screening potential to identify and intervene effectively with this significant subpopulation of youth, and their families, while they are still at home and school.

  8. Achieving Citizenship and Recognition through Blogging about Homelessness

    Directory of Open Access Journals (Sweden)

    Barbara Schneider

    2014-09-01

    Full Text Available This article describes a blog written by four men who were homeless in a western Canadian city in 2010. The blog was an attempt to promote communication between homeless people and the domiciled public, to assert the agency of homeless people, and to promote social integration through their participation in public discourse about homelessness. The bloggers explicitly set out to engage in civic action. In doing this they positioned themselves as advocates and therefore citizens—people with the right and responsibility to describe the “realities” of homelessness, critique existing social structures, take part in public dialogue about homelessness, advocate for change, and stand up for homeless people. This was a subject position that was not previously available to them. The blog project is an example of “lived citizenship,” citizenship as active participatory practice, and a way to achieve what Nancy Fraser calls a politics of recognition.

  9. Who Are the Homeless? Numbers, Trends and Characteristics of Those Without Homes in Calgary

    Directory of Open Access Journals (Sweden)

    Ronald D. Kneebone

    2015-03-01

    Full Text Available In 2008, Calgary was the first city in Canada to institute a 10-year plan to end homelessness. The plan was introduced in part due to the steady and rapid growth in homelessness in the city since 1992. Since 2008 growth in the number of homeless people has stopped despite a rapidly growing city. The number of people enumerated as homeless by point-in-time counts has fallen from 304 persons per 100,000 population to 256 persons per 100,000 population in 2014, a drop of more than 15 per cent. Looking beyond simple counts of the number of homeless people, we examine how people who are homeless use emergency shelters. Tracking shelter use over a five year period by nearly 33,000 individuals, we find that, contrary to what might be thought to be true, the great majority (86% of people who use emergency shelters in Calgary do so very infrequently and for only short periods of time. Visiting shelters less than twice (on average, these “transitional” users stayed in shelters for an average of only 15 days spread during the five years of our study. Another 12% of people used emergency shelters more frequently; an average of 8 times spread over five years. These “episodic” users stayed for a total of 113 days on average. Only a tiny minority, just 1.6% of all shelter users, stayed in shelters for very long periods. These “chronic” users visited shelters an average of three and a half times and stayed a total of 928 days over the five years of our study. Because they stay in shelters for long periods, chronic shelter users occupy one-third of shelter beds. The implication of this is that finding stable, supportive housing for just 1.6% of those experiencing homeless – a total of about 900 individuals in Calgary -- would free-up one-third of beds in emergency shelters. Providing supportive housing for episodic users as well would free-up another one-third of beds and so enable shelter providers to focus on their main function as providers of

  10. Ubuntu is homeless: An urban theological reflection

    Directory of Open Access Journals (Sweden)

    Stephanus F. de Beer

    2015-06-01

    Full Text Available This article is reading ubuntu in the light of homelessness in the cities and towns of South Africa. It suggests that ubuntu itself is homeless and displaced as a way of being human together. Instead of the mediation of dignity and justice through an ubuntu-solidarity, street homeless people and others living vulnerably and in precarious circumstances are violated and excluded through a displacement of ubuntu-values. It also suggests a growing disconnect between the philosophy of ubuntu and its actual embodiment in the local urban political economy, local faith communities and local universities. Acknowledging the aspirational edge of ubuntu, the article then concludes to envision going beyond mere abstractions in the said spheres � the political economy, faith communities and local universities � in order to seek for concrete expressions of ubuntu-solidarity, asserting and mediating respect, dignity and justice.

  11. Assessing sexual trauma histories in homeless women.

    Science.gov (United States)

    Weinrich, Sally; Hardin, Sally; Glaser, Dale; Barger, Mary; Bormann, Jill; Lizarraga, Cabiria; Terry, Micheal; Criscenzo, Jeeni; Allard, Carolyn B

    2016-01-01

    Almost 1 out of every 3 homeless women (32%) in the United States, United Kingdom, and Australia has experienced childhood sexual trauma. We assessed lifetime sexual trauma histories among 29 homeless women from three Southern California community sites: one residential safe house and two safe parking areas. More than half of the women (54%) reported a history of sexual trauma. That rate was higher (86%) among women living at the safe home than among women staying at the safe parking sites (only 42%). All four of the women who had served in the military reported having experienced military sexual trauma. The high percentages of sexual trauma found in homeless women highlight the need for effective interventions for sexual trauma.

  12. Effects of a nurse-managed program on hepatitis A and B vaccine completion among homeless adults.

    Science.gov (United States)

    Nyamathi, Adeline; Liu, Yihang; Marfisee, Mary; Shoptaw, Steven; Gregerson, Paul; Saab, Sammy; Leake, Barbara; Tyler, Darlene; Gelberg, Lillian

    2009-01-01

    Hepatitis B virus (HBV) infection constitutes a major health problem for homeless persons. Ability to complete an HBV vaccination series is complicated by the need to prioritize competing needs, such as addiction issues, safe places to sleep, and food, over health concerns. The objectives of this study were to evaluate the effectiveness of a nurse-case-managed intervention compared with that of two standard programs on completion of the combined hepatitis A virus (HAV) and HBV vaccine series among homeless adults and to assess sociodemographic factors and risk behaviors related to the vaccine completion. A randomized, three-group, prospective, quasi-experimental design was conducted with 865 homeless adults residing in homeless shelters, drug rehabilitation sites, and outdoor areas in the Skid Row area of Los Angeles. The programs included (a) nurse-case-managed sessions plus targeted hepatitis education, incentives, and tracking (NCMIT); (b) standard targeted hepatitis education plus incentives and tracking (SIT); and (c) standard targeted hepatitis education and incentives only (SI). Sixty-eight percent of the NCMIT participants completed the three-series vaccine at 6 months, compared with 61% of SIT participants and 54% of SI participants. NCMIT participants had almost 2 times greater odds of completing vaccination than those of participants in the SI program. Completers were more likely to be older, to be female, to report fair or poor health, and not to have participated in a self-help drug treatment program. Newly homeless White adults were significantly less likely than were African Americans to complete the vaccine series. The use of vaccination programs incorporating nurse case management and tracking is critical in supporting adherence to completion of a 6-month HAV/HBV vaccine. The finding that White homeless persons were the least likely to complete the vaccine series suggests that programs tailored to address their unique cultural issues are needed.

  13. Suicide risk among homeless population

    Directory of Open Access Journals (Sweden)

    Fran Calvo-García

    2016-06-01

    Full Text Available There exists little scientific production on autolytic behaviour in homeless people, despite the fact that it is one of the groups that is more at risk. The aim of this study is to determine the prevalence of previous attempted suicide and suicide risk and its connection with the main risk factors. In order to do so, central tendency and dispersion measures, correlations, contingence tables, and average comparison tables according to type of variable and normality were used. The Plutchik suicide-risk test was used in order to determine the risk of suicide, and specific tests for the main risk factors analysed. The main results show a 24.7% suicide rate and 45.2% (n = 66 displayed suicide risk. The main predictive factor of the risk of suicide was the daily consumption of alcohol (OR = 1.011, p less than .001, followed by being a woman (OR = 1.381, p = .021. It is necessary to design and apply suicide prevention strategies for this population.

  14. Other tobacco product and electronic cigarette use among homeless cigarette smokers.

    Science.gov (United States)

    Baggett, Travis P; Campbell, Eric G; Chang, Yuchiao; Rigotti, Nancy A

    2016-09-01

    We determined the prevalence and correlates of other tobacco product and electronic cigarette (e-cigarette) use in a clinic-based sample of homeless cigarette smokers. In April-July 2014, we used time-location sampling to conduct a cross-sectional, in-person survey of 306 currently homeless adult cigarette smokers recruited from 5 clinical sites at Boston Health Care for the Homeless Program. We assessed past-month use of large cigars, little cigars, smokeless tobacco, and e-cigarettes. Among those who had used e-cigarettes, we assessed the reasons for doing so. We used logistic regression analysis to identify the participant characteristics associated with the use of each product. Eighty-six percent of eligible individuals participated in the survey. In the past month, 37% of respondents used large cigars, 44% used little cigars, 8% used smokeless tobacco, 24% used an e-cigarette, and 68% used any of these products. Reasons for e-cigarette use included curiosity (85%) and to help quit conventional cigarettes (69%). In multivariable regression analyses, homeless smokers with greater subsistence difficulties were more likely to use little cigars (p=0.01) and less likely to use e-cigarettes (p=0.001). Non-Hispanic black (p=0.01), Hispanic (pcigars. Readiness to quit was not associated with other tobacco product use but was significantly associated with e-cigarette use to help quit smoking (p=0.02). Health care providers who serve homeless people should consider routine screening for the use of other tobacco products and e-cigarettes to help guide smoking cessation discussions and tobacco treatment planning. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Attitudes, experiences, and beliefs affecting end-of-life decision-making among homeless individuals.

    Science.gov (United States)

    Tarzian, Anita J; Neal, Maggie T; O'Neil, J Anne

    2005-02-01

    Individuals who are homeless may encounter various barriers to obtaining quality end-of-life (EOL) care, including access barriers, multiple sources of discrimination, and lack of knowledge among health care providers (HCPs) of their preferences and decision-making practices. Planning for death with individuals who have spent so much energy surviving requires an understanding of their experiences and preferences. This study sought to increase HCPs' awareness and understanding of homeless or similarly marginalized individuals' EOL experiences and treatment preferences. Focus groups were conducted with homeless individuals using a semi-structured interview guide to elicit participants' EOL experiences, decision-making practices, and personal treatment preferences. Five focus groups were conducted with 20 inner-city homeless individuals (4 per group) at a free urban health care clinic for homeless individuals in the United States. Sixteen of the 20 participants were African American; 4 were Caucasian. None were actively psychotic. All had experienced multiple losses and drug addiction. Five main themes emerged: valuing an individual's wishes; acknowledging emotions; the primacy of religious beliefs and spiritual experience; seeking relationship-centered care; and reframing advance care planning. The narrative process of this qualitative study uncovered an approach to EOL decision-making in which participants' reasoning was influenced by emotions, religious beliefs, and spiritual experience. Relationship-centered care, characterized by compassion and respectful, two-way communication, was obvious by its described absence--reasons for this are discussed. Recommendations for reframing advance care planning include ways for HCPs to transform advance care planning from that of a legal document to a process of goal-setting that is grounded in human connection, respect, and understanding.

  16. Posttraumatic Stress Symptoms and Their Association With Smoking Outcome Expectancies Among Homeless Smokers in Boston.

    Science.gov (United States)

    Baggett, Travis P; Campbell, Eric G; Chang, Yuchiao; Magid, Leah M; Rigotti, Nancy A

    2016-06-01

    Cigarette smoking and traumatic life experiences are each common among homeless adults, but the prevalence and correlates of posttraumatic stress disorder (PTSD) symptoms among homeless smokers are not known. We assessed symptoms of PTSD and their association with smoking outcome expectancies in a sample of homeless smokers in Boston. We used time-location sampling to conduct an in-person survey of homeless adult smokers using Boston Health Care for the Homeless Program clinical services. We assessed symptoms of PTSD with the PTSD Checklist-Civilian version and considered scores at least 14 as positive. We used the Smoking Effects Questionnaire to assess positive and negative smoking outcome expectancies. We modeled the associations between PTSD screening status and smoking expectancies using design-adjusted linear regression. Eighty-six percent of eligible individuals participated (N = 306). Sixty-eight percent of participants screened positive for PTSD. Screen-positive respondents were younger (P = .001), more likely to report fair/poor health (P = .01), chronic obstructive pulmonary disease (P = .02), and past-month hallucinations (P = .004), and had greater drug (P smokers and strongly associated with positive smoking outcome expectancies. Tobacco cessation programs for this population should consider screening for PTSD and fostering a trauma-sensitive treatment environment. In this study of homeless cigarette smokers in Boston, over two-thirds of participants screened positive for PTSD. PTSD screen-positive respondents more strongly endorsed multiple positive smoking outcome expectancies than screen-negative individuals. These findings suggest that the psychological sequelae of trauma may be a pervasive but under-recognized factor impacting the persistence of smoking among homeless people. Tobacco cessation programs for this population should consider screening for PTSD, fostering a trauma-sensitive treatment environment, and incorporating strategies that have

  17. Les sans-abris des quais d’Austerlitz

    Directory of Open Access Journals (Sweden)

    Guillaume Lannerée

    2008-03-01

    Full Text Available Les pratiques spatiales des « sans domicile fixe » sont méconnues : nous avons donc tenté, en les interrogeant, d’amorcer une réflexion sur leur spatialité qui s’apparente à un combat perpétuel. Contraints à la mobilité par des expulsions à répétition, la sédentarité gouverne néanmoins leur mode de vie. Ce phénomène s’est accentué avec les tentes qui contribuent à la visibilité des SDF aux yeux de la société. Par la restauration de leur visibilité et donc de leur spatialité, les SDF s’échappent un moment de ce nulle part dans lequel il est si tentant de les exiler.The homeless' spatial practices are not well-known: that's why we tried, relying on several interviews, to study their spatiality which is similar to a perpetual fight. Forced to move by frequent explusions, yet their way of life is sedentary. This sedentarity has been increased by the use of tents which contribute to the homeless visibility in society. Through restoration of their visibility and of their spatiality, the homeless escape for a while from this "nowhere" where one easily banishes them.

  18. Impact of Supported Housing on Social Relationships Among Homeless Veterans.

    Science.gov (United States)

    O'Connell, Maria J; Kasprow, Wesley J; Rosenheck, Robert A

    2017-02-01

    This study examined social network structure and function among a sample of 460 homeless veterans who participated in an experimental trial of the Housing and Urban Development-Veterans Affairs Supported Housing (HUD-VASH) program. Participants were randomly assigned to HUD-VASH (housing subsidies and case management), case management only, or standard care. Mixed-model longitudinal analysis was used to compare treatment groups on social network outcomes over 18 months. Veterans in HUD-VASH reported significantly greater increases in social support than veterans in the two other groups, as well as greater frequency of contacts, availability of tangible and emotional support, and satisfaction with nonkin relationships over time. These gains largely involved relationships with providers and other veterans encountered in treatment. Supported housing may play a pivotal role in fostering constructive new relationships with persons associated with service programs but may have a more limited impact on natural support networks.

  19. Maternal depression as a risk factor for family homelessness.

    Science.gov (United States)

    Curtis, Marah A; Corman, Hope; Noonan, Kelly; Reichman, Nancy E

    2014-09-01

    We estimated the effects of maternal depression during the postpartum year, which is often an unexpected event, on subsequent homelessness and risk of homelessness in a national sample of urban, mostly low-income mothers. We used logistic regression models to estimate associations between maternal depression during the postpartum year and both homelessness and risk of homelessness 2 to 3 years later, controlling for maternal and family history of depression, prenatal housing problems, and other covariates. Risk factors for homelessness included experiencing evictions or frequent moves and moving in with family or friends and not paying rent. We found robust associations between maternal depression during the postpartum year and subsequent homelessness and risk of homelessness, even among mothers who had no history of mental illness, whose own mothers did not have a history of depressive symptoms, and who had no previous housing problems. This study provides robust evidence that maternal mental illness places families with young children at risk for homelessness, contributes to the scant literature elucidating directional and causal links between mental illness and homelessness, and contributes to a stagnant but important literature on family homelessness.

  20. Tackling Health Disparities for People Who Are Homeless? Start with Social Determinants

    OpenAIRE

    Amanda Stafford; Lisa Wood

    2017-01-01

    Background: Homelessness is associated with enormous health inequalities, including shorter life expectancy, higher morbidity and greater usage of acute hospital services. Viewed through the lens of social determinants, homelessness is a key driver of poor health, but homelessness itself results from accumulated adverse social and economic conditions. Indeed, in people who are homeless, the social determinants of homelessness and health inequities are often intertwined, and long term homeless...

  1. Increasing Access to Higher Education for Unaccompanied Homeless Youth: Information for Colleges and Universities. Best Practices in Homeless Education Brief Series

    Science.gov (United States)

    National Center for Homeless Education at SERVE, 2012

    2012-01-01

    Each year, more than a million young people in the United States experience homelessness; some of these young people, known as unaccompanied homeless youth, will face the challenges of homelessness while living on their own without the support of a caring adult. Unaccompanied homeless youth face the same struggles as other young people: trying to…

  2. Helping the Homeless in School and Out

    Science.gov (United States)

    Holgersson-Shorter, Helena

    2010-01-01

    However much the recession might be receding, the effects remain deep and cruel to families living in poverty. Many have fallen through their communities' social safety nets. Today, families with young children comprise 41% of the nation's homeless population. According to the Institute of Children and Poverty, more than 1.35 million kids in the…

  3. Resilience and Suicidality among Homeless Youth

    Science.gov (United States)

    Cleverley, Kristin; Kidd, Sean A.

    2011-01-01

    Homeless and street-involved youth are considered an extremely high risk group, with many studies highlighting trajectories characterized by abusive, neglectful, and unstable family histories, victimization and criminal involvement while on the streets, high rates of physical and mental illness, and extremely high rates of mortality. While there…

  4. How to Program to the Homeless.

    Science.gov (United States)

    Polzer, Christopher M.

    1995-01-01

    Recreation leaders recommend reaching out to homeless individuals and providing programs that may help improve their health, bring them some fun and happiness, and boost their quality of life. The paper describes how one North Carolina county addressed the issue through recreation programs and other activities. (SM)

  5. Social exclusion, health and hidden homelessness.

    Science.gov (United States)

    Watson, J; Crawley, J; Kane, D

    2016-10-01

    Homelessness and poverty are extreme forms of social exclusion which extend beyond the lack of physical or material needs. The purpose of this study was to explore and expand the concept of social exclusion within the social determinants of health perspective - to understand how the social environment, health behaviours and health status are associated with material and social deprivation. Fundamental qualitative description with tones of focused ethnography. Participants who identified as hidden homeless described their everyday living conditions and how these everyday conditions were impacted and influenced by their social environments, coping/health behaviours and current health status. Research Ethics Board approval was granted and informed consents were obtained from 21 participants prior to the completion of individual interviews. Qualitative content analysis examined the descriptions of men and women experiencing hidden homelessness. Participants described the 'lack of quality social interactions and supports' and their 'daily struggles of street life'. They also shared the 'pain of addiction' and how coping strategies influenced health. Participants were hopeful that their insights would 'better the health of homeless people' by helping shape public policy and funding of community resources that would reduce barriers and improve overall health. Health professionals who understand health behaviours as coping mechanisms for poor quality social environments can provide more comprehensive and holistic care. The findings of this study can be used to support the importance of housing as a key factor in the health and well-being of people experiencing poverty, homelessness and social exclusion; and consequently, reinforces the need for a national housing strategy. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  6. Voices from the street: exploring the realities of family homelessness.

    Science.gov (United States)

    Gültekin, Laura; Brush, Barbara L; Baiardi, Janet M; Kirk, Keri; VanMaldeghem, Kelley

    2014-11-01

    Homelessness threatens the health and well-being of thousands of families in the United States, yet little is known about their specific needs and how current services address them. To fill this knowledge gap, we explored the experiences of homelessness families in Detroit, Michigan. We targeted homeless mothers and their caseworkers for study to see if the perceptions of needs and services were in alignment. Using focus groups and content analysis, we identified four overarching themes that illustrate homeless mothers' experience with homelessness. We then analyzed data from caseworkers to look specifically for similarities and differences in their perceptions. Key findings included reports of family histories of violence, poverty, social isolation, and a lack of informal support as contributing to homelessness. The differing perspectives of mothers and their caseworkers regarding how best to move forward highlight how current programs and services may not be meeting the needs of this growing and vulnerable cohort. © The Author(s) 2014.

  7. The Economics of Homelessness: The Evidence from North America

    OpenAIRE

    Quigley, John M.; Raphael, Steven

    2002-01-01

    It is generally believed that the increased incidence of homelessness in the US has arisen from broad societal factors – changes in the institutionalization of the mentally ill, increases in drug addiction and alcohol usage, etc. This paper reports on a comprehensive test of the alternate hypothesis that variations in homelessness arise from changed circumstances in the housing market and in the income distribution. We utilize essentially all the systematic information available on homeless...

  8. Unsuccessful immigration: the peculiarities of homeless Lithuanians’ lives in London

    OpenAIRE

    Malinauskas, Gedas; Blažytė, Vilma

    2010-01-01

    Using the data of a pilot study, this article deals with unsuccessful cases of Lithuanian immigration, i.e., lifestyle peculiarities of Lithuanians who became homeless in the capital of Great Britain. While analyzing the phenomenon in a descriptive manner, the authors sought an answer the question of why Lithuanian emigrants who had family and work in their homeland became homeless after they had come to search for a better life. The issues of homeless Lithuanians‘ daily life and life princip...

  9. Creating a science of homelessness during the Reagan era.

    Science.gov (United States)

    Jones, Marian Moser

    2015-03-01

    POLICY POINTS: A retrospective analysis of federally funded homeless research in the 1980s serves as a case study of how politics can influence social and behavioral science research agendas today in the United States. These studies of homeless populations, the first funded by the National Institute of Mental Health, demonstrated that only about a third of the homeless population was mentally ill and that a diverse group of people experienced homelessness. This groundbreaking research program set the mold for a generation of research and policy characterizing homelessness as primarily an individual-level problem rather than a problem with the social safety net. A decade after the nation's Skid Rows were razed, homelessness reemerged in the early 1980s as a health policy issue in the United States. While activists advocated for government-funded programs to address homelessness, officials of the Reagan administration questioned the need for a federal response to the problem. In this climate, the National Institute of Mental Health (NIMH) launched a seminal program to investigate mental illness and substance abuse among homeless individuals. This program serves as a key case study of the social and behavioral sciences' role in the policy response to homelessness and how politics has shaped the federal research agenda. Drawing on interviews with former government officials, researchers, social activists, and others, along with archival material, news reports, scientific literature, and government publications, this article examines the emergence and impact of social and behavioral science research on homelessness. Research sponsored by the NIMH and other federal research bodies during the 1980s produced a rough picture of mental illness and substance abuse prevalence among the US homeless population, and private foundations supported projects that looked at this group's health care needs. The Reagan administration's opposition to funding "social research," together

  10. Causes of homelessness among older people in Melbourne, Australia.

    Science.gov (United States)

    Rota-Bartelink, Alice; Lipmann, Bryan

    2007-06-01

    A comparative study of the causes of new episodes of homelessness among people aged 50 years and over has been undertaken in Australia, the United States and England. Semi-structured questionnaires were used to collect information on the circumstances and problems that contributed to homelessness. This paper presents the findings from Australia, where information was obtained from 125 older homeless people (aged 50+ years) and their key workers in Melbourne. All three participating nations followed identical research methodologies. The factors most frequently reported by respondents as contributing to their homelessness were problems with people with whom they lived, followed by physical and mental ill-health and problems associated with the housing itself. The most frequently reported factors by case workers were problems with alcohol, followed by physical and mental health factors. This study demonstrates a significant under-utilisation of housing and support services among recently homeless older people and provides evidence that people who had previously been homeless appear to be more resigned to their homelessness than do those who had not experienced homelessness before. Significant issues relating to depression and gambling were also noted. The findings support the need for more targeted, specialised services to be developed or improved such that older homeless people can readily gain access to them and for improved collaboration or information exchange among housing providers and welfare agencies.

  11. Homelessness as social and individual problem – possibilities and prevention

    Directory of Open Access Journals (Sweden)

    Małgorzata Piechowicz

    2012-12-01

    Full Text Available This article consists of several parts. The first part includes definitional considerations over the notion of homelessness. It also describes social situation of the homeless, whereas the second part concentrates on both the analysis of causes and effects of homelessness and on the attempt to show the scale of this phenomenon. The last part of the article focuses on the prevention of homelessness. It emphasizes the importance of interdisciplinarity of preventive and compensatory actions in the scope of the discussed phenomenon.

  12. Characteristics, clinical course, and outcomes of homeless and non-homeless patients admitted to ICU: A retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Orla M Smith

    Full Text Available Little is known about homeless patients in intensive care units (ICUs.To compare clinical characteristics, treatments, and outcomes of homeless to non-homeless patients admitted to four ICUs in a large inner-city academic hospital.63 randomly-selected homeless compared to 63 age-, sex-, and admitting-ICU-matched non-homeless patients.Compared to matched non-homeless, homeless patients (average age 48±12 years, 90% male, 87% admitted by ambulance, 56% mechanically ventilated, average APACHE II 17 had similar comorbidities and illness severity except for increased alcohol (70% vs 17%,p<0.001 and illicit drug(46% vs 8%,p<0.001 use and less documented hypertension (16% vs 40%,p = 0.005 or prescription medications (48% vs 67%,p<0.05. Intensity of ICU interventions was similar except for higher thiamine (71% vs 21%,p<0.0001 and nicotine (38% vs 14%,p = 0.004 prescriptions. Homeless patients exhibited significantly lower Glasgow Coma Scores and significantly more bacterial respiratory cultures. Longer durations of antibiotics, vasopressors/inotropes, ventilation, ICU and hospital lengths of stay were not statistically different, but homeless patients had higher hospital mortality (29% vs 8%,p = 0.005. Review of all deaths disclosed that withdrawal of life-sustaining therapy occurred in similar clinical circumstances and proportions in both groups, regardless of family involvement. Using multivariable logistic regression, homelessness did not appear to be an independent predictor of hospital mortality.Homeless patients, admitted to ICU matched to non-homeless patients by age and sex (characteristics most commonly used by clinicians, have higher hospital mortality despite similar comorbidities and illness severity. Trends to longer durations of life supports may have contributed to the higher mortality. Additional research is required to validate this higher mortality and develop strategies to improve outcomes in this vulnerable population.

  13. How Do We Measure Success in Homelessness Services? : Critically Assessing the Rise of the Homelessness Outcomes Star

    OpenAIRE

    Johnson, Guy; Pleace, Nicholas

    2016-01-01

    The Homelessness Outcomes Star (HOS) is probably the most widespread form of outcome measurement employed by homelessness service providers. Developed in the UK, the HOS is now being used by homelessness services in other European countries and Australia, while being promoted internationally as a validated set of key performance indicators. This paper examines the ideological framework that underpins the HOS, as well as the theoretical and methodological approaches that inform its operation. ...

  14. "Not Homeless Yet. I'm Kind of Couch Surfing": Finding Identities for People at a Homeless Shelter.

    Science.gov (United States)

    Terui, Sachiko; Hsieh, Elaine

    2016-01-01

    The meanings of homelessness are fluid and socially constructed, providing resources and limitations for individuals to negotiate their identities and relationships in everyday life. In this study, we examine the strategies and corresponding resources utilized by people who are homeless to cope with the labeling of a homeless identity and to redefine their identities. We used constant comparative analysis to examine in-depth interviews with 16 participants (male = 11, female = 5) who access a local homeless shelter in the southwest United States for resources. We identified three strategies that homeless people adopt to cope with the labeling of homeless identity: (a) differentiating oneself from others who are homeless, (b) prioritizing certain aspects of life, and (c) embracing the status of homelessness. Although these strategies have been identified in previous literature, the authors extend this line of research by identifying the common resources people who are homeless utilize when adopting these strategies, which entail important implications for theory development and practical implications.

  15. Explaining excess morbidity amongst homeless shelter users

    DEFF Research Database (Denmark)

    Benjaminsen, Lars; Birkelund, Jesper Fels

    2018-01-01

    AIMS: This article analyses excess morbidity amongst homeless shelter users compared to the general Danish population. The study provides an extensive control for confounding and investigates to what extent excess morbidity is explained by homelessness or other risk factors. METHODS: Data set...... includes administrative micro-data for 4,068,926 Danes who were 23 years or older on 1 January 2007. Nationwide data on shelter use identified 14,730 individuals as shelter users from 2002 to 2006. Somatic diseases were measured from 2007 to 2011 through diagnosis data from hospital discharges. The risk...... of somatic diseases amongst shelter users was analysed through a multivariate model that decomposed the total effect into a direct effect and indirect effects mediated by other risk factors. RESULTS: The excess morbidity associated with shelter use is substantially lower than in studies that did not include...

  16. The prevalence of mental disorders among the homeless in western countries: systematic review and meta-regression analysis.

    Directory of Open Access Journals (Sweden)

    Seena Fazel

    2008-12-01

    Full Text Available BACKGROUND: There are well over a million homeless people in Western Europe and North America, but reliable estimates of the prevalence of major mental disorders among this population are lacking. We undertook a systematic review of surveys of such disorders in homeless people. METHODS AND FINDINGS: We searched for surveys of the prevalence of psychotic illness, major depression, alcohol and drug dependence, and personality disorder that were based on interviews of samples of unselected homeless people. We searched bibliographic indexes, scanned reference lists, and corresponded with authors. We explored potential sources of any observed heterogeneity in the estimates by meta-regression analysis, including geographical region, sample size, and diagnostic method. Twenty-nine eligible surveys provided estimates obtained from 5,684 homeless individuals from seven countries. Substantial heterogeneity was observed in prevalence estimates for mental disorders among the studies (all Cochran's chi(2 significant at p 85%. The most common mental disorders were alcohol dependence, which ranged from 8.1% to 58.5%, and drug dependence, which ranged from 4.5% to 54.2%. For psychotic illness, the prevalence ranged from 2.8% to 42.3%, with similar findings for major depression. The prevalence of alcohol dependence was found to have increased over recent decades. CONCLUSIONS: Homeless people in Western countries are substantially more likely to have alcohol and drug dependence than the age-matched general population in those countries, and the prevalences of psychotic illnesses and personality disorders are higher. Models of psychiatric and social care that can best meet these mental health needs requires further investigation.

  17. The Prevalence of Mental Disorders among the Homeless in Western Countries: Systematic Review and Meta-Regression Analysis

    Science.gov (United States)

    Fazel, Seena; Khosla, Vivek; Doll, Helen; Geddes, John

    2008-01-01

    Background There are well over a million homeless people in Western Europe and North America, but reliable estimates of the prevalence of major mental disorders among this population are lacking. We undertook a systematic review of surveys of such disorders in homeless people. Methods and Findings We searched for surveys of the prevalence of psychotic illness, major depression, alcohol and drug dependence, and personality disorder that were based on interviews of samples of unselected homeless people. We searched bibliographic indexes, scanned reference lists, and corresponded with authors. We explored potential sources of any observed heterogeneity in the estimates by meta-regression analysis, including geographical region, sample size, and diagnostic method. Twenty-nine eligible surveys provided estimates obtained from 5,684 homeless individuals from seven countries. Substantial heterogeneity was observed in prevalence estimates for mental disorders among the studies (all Cochran's χ2 significant at p 85%). The most common mental disorders were alcohol dependence, which ranged from 8.1% to 58.5%, and drug dependence, which ranged from 4.5% to 54.2%. For psychotic illness, the prevalence ranged from 2.8% to 42.3%, with similar findings for major depression. The prevalence of alcohol dependence was found to have increased over recent decades. Conclusions Homeless people in Western countries are substantially more likely to have alcohol and drug dependence than the age-matched general population in those countries, and the prevalences of psychotic illnesses and personality disorders are higher. Models of psychiatric and social care that can best meet these mental health needs requires further investigation. PMID:19053169

  18. [Physical activities adapted to homeless people].

    Science.gov (United States)

    Mainguet, Brigitte

    2018-03-01

    Around ten homeless people were invited to take part in a programme of physical activities to improve their health status. Only motricity and walking pathways were followed assiduously for eight weeks. The assessment of the physical condition and quality of life showed an improvement in these areas, in particular for one of the participants. However, the lack of motivation and assiduity remains an obstacle to regular activity. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  19. Learning from Families Experiencing Homelessness--How School Leaders Can Make a Difference through Transformative Leadership

    Science.gov (United States)

    Warke, Amy L.

    2012-01-01

    Homelessness is a growing phenomenon, especially among women and children (Hulchanski, 2009). This study was conducted because of the increase in families experiencing homelessness registering in my school. In none of the current studies about homelessness have the researchers spoken to the families and children experiencing homelessness. This…

  20. Homelessness among Lesbian, Gay, and Bisexual Youth: Implications for Subsequent Internalizing and Externalizing Symptoms

    Science.gov (United States)

    Rosario, Margaret; Schrimshaw, Eric W.; Hunter, Joyce

    2012-01-01

    Although lesbian, gay, and bisexual (LGB) youth with a history of homelessness (running away or being evicted from their homes by parents) report more psychological symptoms than homeless heterosexual peers, it is unclear whether symptoms are due to homelessness, given the absence of a non-homeless comparison group. This study longitudinally…

  1. Factors Contributing to Academic Resilience of Former Homeless High School Students: A Phenomenological Study

    Science.gov (United States)

    Hart, Linda M.

    2017-01-01

    Homelessness is an increasing epidemic afflicting the United States. Of the millions of homeless in the United States, over two million are children (National Alliance to End Homelessness, 2009; Slesnick, Dashora, Letcher, Erden, & Serocivh, 2009). It is reported that over 1.2 million of homeless students are enrolled in public schools…

  2. The Dynamics of Families Who Are Homeless: Implications for Early Childhood Educators

    Science.gov (United States)

    Swick, Kevin J.

    2004-01-01

    Family homelessness has emerged as a serious global problem (Stronge, 2000). Over the past 25 years in the United States, the makeup of the homeless population has changed significantly. As De Angelis (1994) reports: The landscape of homelessness has changed since the early 1980s, when nearly all homeless people were men. Today,…

  3. Multilevel Considerations of Family Homelessness and Schooling in the Recession Era

    Science.gov (United States)

    Miller, Peter; Schreiber, James

    2012-01-01

    This mixed methods investigation of homeless education in a major urban region identified a number of significant developments and dilemmas amid the larger homeless crisis in the United States. We found that the wider community demographics of homelessness have shifted in recent years, resulting in a higher number of homeless families--many of…

  4. Homeless and in Need of Special Education. Exceptional Children at Risk: CEC Mini-Library.

    Science.gov (United States)

    Heflin, L. Juane; Rudy, Kathryn

    This booklet examines the plight of homeless families who have children who need special educational services. It explores the magnitude of homelessness among families, provides empirical descriptions of homeless populations, and identifies factors contributing to the rising incidence of homelessness in the United States. Specific effects of…

  5. Homeless Education and Social Capital: An Examination of School and Community Leaders

    Science.gov (United States)

    Miller, Peter M.

    2011-01-01

    Background/Context: This study contributes to the literature on the schooling of homeless and highly mobile students. Although previous work has detailed the demographics of homelessness, the effects of homelessness on academic progress, and particular legal issues in homeless education, this research focused on how individual and institutional…

  6. Arizona Head Start for Homeless Children and Families Project. 1994-95 Evaluation Report.

    Science.gov (United States)

    Mulholland, Lori; Greene, Andrea

    Homeless families with children comprise the fastest growing segment of the United States homeless population. This study evaluated Year 1 of the Arizona Head Start for Homeless Children and Families Project, designed to meet educational and social needs of homeless children and families, and to assist Head Start agencies in developing effective…

  7. Arizona Head Start for Homeless Children and Families Project. 1995-96 Evaluation Report.

    Science.gov (United States)

    Mulholland, Lori

    Homeless families with children constitute the fastest growing segment of the United States homeless population. This study evaluated Year 2 of the Arizona Head Start for Homeless Children and Families Project, designed to meet educational and social needs of homeless children and families, and to assist Head Start agencies in developing effective…

  8. Distal Stressors and Depression among Homeless Men.

    Science.gov (United States)

    Coohey, Carol; Easton, Scott D

    2016-05-01

    Depression is a common problem among homeless men that may interfere with functional tasks, such as securing stable housing, obtaining employment, and accessing health services. Previous research on depression among homeless men has largely focused on current psychosocial resources, substance abuse, and past victimization. Guided by Ensel and Lin's life course stress process model, the authors examined whether distal stressors, including victimization and exposure to parent problems in childhood, contributed to men's depression above and beyond current (or proximal) stressors, such as substance abuse and health problems, and social resources. The sample consisted of 309 homeless men who had entered a federally funded emergency shelter. Using the Burns Depression Checklist, the authors found that one out of three men met the threshold for moderate to severe depression during the past week. The logistic regression showed that past exposure to parent problems was related to depression after accounting for current stressors and social resources (number of close adult relationships and whether their emotional support needs were met). Past victimization was not related to depression. To address men's depression, workers should concurrently provide services that meet men's basic needs (for example, housing) and address their relationship needs, including their need for emotional support.

  9. Envisioning Democracy: Participatory Filmmaking with Homeless Youth.

    Science.gov (United States)

    Kennelly, Jacqueline

    2018-05-01

    This paper explores the democratic potential for participatory filmmaking with homeless youth, as well as the constraints and dilemmas associated with this visual method. Theorizing democracy through the work of Hannah Arendt and Pierre Bourdieu, the paper approaches democracy not as an end, but rather as a process that seeks to lessen social injustice. Bourdieu's work helps us appreciate, however, that this process is constrained by structures of inequality that shape access to the political dispositions that enable such engagement. Consistent with other research on low-income and marginalized young people, this study found that homeless youth engage with democracy through forms of community participation and mutual support, and are disinclined to orient toward liberal democratic structures such as voting and political parties, which they see as harmful or problematic. With a focus on one particular dilemma faced by the research team-namely, the question of how to make sense of and represent the issue of legalizing marijuana, which had been signaled by the youth participants as of primary political importance to them-the paper uses Arendt and Bourdieu to discuss how participatory filmmaking can help to expand the space of appearances available to homeless youth in Canadian society, and create a space at a shared table of understanding with middle class power brokers. © 2018 Canadian Sociological Association/La Société canadienne de sociologie.

  10. Shelter-based convalescence for homeless adults in Amsterdam: a descriptive study

    Directory of Open Access Journals (Sweden)

    Klazinga Niek

    2009-11-01

    Full Text Available Abstract Background Adequate support for homeless populations includes shelter and care to recuperate from illness and/or injury. This is a descriptive analysis of diagnoses and use of shelter-based convalescence in a cohort of homeless adults in Amsterdam. Methods Demographics of ill homeless adults, diagnoses, referral pattern, length of stay, discharge locations, and mortality, were collected by treating physicians during outreach care provision in a shelter-based convalescence care facility in Amsterdam, from January 2001 through October 2007. Results 629 individuals accounted for 889 admissions to the convalescence care facility. 83% were male and 53% were born in the Netherlands. The mean age was 45 years (SD 10 years. The primary physical problems were skin disorders (37%, respiratory disorders (33%, digestive disorders (24% and musculoskeletal disorders (21%. Common chronic conditions included addictions 78%, mental health disorders 20%, HIV/AIDS 11% and liver cirrhosis 5%. Referral sources were self-referred (18%, general hospitals (21% and drug clinics (27%. The median length of stay was 20 days. After (selfdischarge, 63% went back to the previous circumstances, 10% obtained housing, and 23% went to a medical or nursing setting. By March 2008, one in seven users (n = 83; 13% were known to have died, the Standard Mortality Ratio was 7.5 (95% CI: 4.1-13.5. Over the years, fewer men were admitted, with significantly more self neglect, personality disorders and cocaine use. Lengths of stay increased significantly during the study period. Conclusion Over the last years, the shelter-based convalescence care facility users were mainly homeless single males, around 45 years of age, with chronic problems due to substance use, mental health disorders and a frail physical condition, many of whom died a premature death. The facility has been flexible and responsive to the needs of the users and services available.

  11. When it happens again: impact of future San Francisco Bay area earthquakes

    Science.gov (United States)

    Zoback, M.; Boatwright, J.; Kornfield, L.; Scawthorn, C.; Rojahn, C.

    2005-12-01

    San Francisco Bay area earthquakes, like major floods and hurricanes, have the potential for massive damage to dense urban population centers concentrated in vulnerable zones-along active faults, in coastal regions, and along major river arteries. The recent destruction of Hurricane Katrina does have precedent in the destruction following the 1906 "San Francisco" earthquake and fire in which more than 3000 people were killed and 225,000 were left homeless in San Francisco alone, a city of 400,000 at the time. Analysis of a comprehensive set of damage reports from the magnitude (M) 7.9 1906 earthquake indicates a region of ~ 18,000 km2 was subjected to shaking of Modified Mercalli Intensity of VIII or more - motions capable of damaging even modern, well-built structures; more than 60,000 km2 was subjected to shaking of Intensity VII or greater - the threshold for damage to masonry and poorly designed structures. By comparison, Katrina's hurricane force winds and intense rainfall impacted an area of ~100,000 km2 on the Gulf Coast. Thus, the anticipated effects of a future major Bay Area quake to lives, property, and infrastructure are comparable in scale to Katrina. Secondary hazards (levee failure and flooding in the case of Katrina and fire following the 1906 earthquake) greatly compounded the devastation in both disasters. A recent USGS-led study concluded there is a 62% chance of one or more damaging (M6.7 or greater) earthquakes striking the greater San Francisco Bay area over the next 30 years. The USGS prepared HAZUS loss estimates for the 10 most likely forecast earthquakes which range in size from a M6.7 event on a blind thrust to the largest anticipated event, a M7.9 repeat of the 1906 earthquake. The largest economic loss is expected for a repeat of the 1906 quake. Losses in the Bay region for this event are nearly double those predicted for a M6.9 rupture of the entire Hayward Fault in the East Bay. However, because of high density of population along the

  12. Homeless Mentally Ill: Problems and Options in Estimating Numbers and Trends. Report to the Chairman, Committee on Labor and Human Resources, U.S. Senate.

    Science.gov (United States)

    General Accounting Office, Washington, DC. Program Evaluation and Methodology Div.

    In response to a request by the United States Senate Committee on Labor and Human Resources, the General Accounting Office (GAO) examined the methodological soundness of current population estimates of the number of homeless chronically mentally ill persons, and proposed several options for estimating the size of this population. The GAO reviewed…

  13. Risk and Resilience Factors Associated with Formal and Informal Income Generation among Homeless Young Adults in Three U.S. Cities

    Science.gov (United States)

    Ferguson, Kristin M.; Bender, Kimberly; Thompson, Sanna J.

    2018-01-01

    This study used the risk and resilience framework to examine predictors of formal and informal sources of income among homeless young adults. Formal sources of income generation consisted of full-time, part-time, or paid, temporary work. Informal sources included earning money from selling personal possessions, selling drugs, and theft. In all,…

  14. The State of Homeless Children in the United States

    Science.gov (United States)

    Kabler, Brenda; Weinstein, Elana

    2009-01-01

    Across America, the numbers of homeless children and families are growing as a result of many factors including the recent economic crisis, home foreclosures, and natural disasters. Because of an increase in the number of homeless children throughout the United States, this population has unmet needs that can be targeted in school settings under…

  15. Perceptions of Resiliency and Coping: Homeless Young Adults Speak Out

    Science.gov (United States)

    Thompson, Sanna J.; Ryan, Tiffany N.; Montgomery, Katherine L.; Lippman, Angie Del Prado; Bender, Kimberly; Ferguson, Kristin

    2016-01-01

    This study explored the perceptions of resilience and coping among homeless young adults, a focus that differs from previous research by considering the unconventional resilience and coping of this high-risk population. Semistructured qualitative interviews were conducted with 45 homeless young adults. Individual interviews were audio recorded,…

  16. Spaces of Trauma: Young People, Homelessness and Violence

    Science.gov (United States)

    Jordan, Lucinda

    2012-01-01

    Little contemporary research has examined young people's experiences of violence and homelessness in detail within the Australian context. This article draws upon qualitative research with 33 homeless youth in Melbourne and seeks to enhance understanding of the impact of violence on young people. It argues that everyday experiences of violence…

  17. The Characteristics and Needs of Families Experiencing Homelessness

    Science.gov (United States)

    National Center on Family Homelessness (NJ1), 2011

    2011-01-01

    This fact sheet was developed to help you understand the scope, causes, and impact of homelessness on children and families. You are encouraged to use it as well as the publications cited in its footnotes as tools more about homelessness. (Contains 78 endnotes.)

  18. Predicting Overt and Covert Antisocial Behaviors: Parents, Peers, and Homelessness

    Science.gov (United States)

    Tompsett, Carolyn J.; Toro, Paul A.

    2010-01-01

    Parental deviance, parental monitoring, and deviant peers were examined as predictors of overt and covert antisocial behaviors. Homeless (N=231) and housed (N=143) adolescents were assessed in adolescence and again in early adulthood. Homelessness predicted both types of antisocial behaviors, and effects persisted in young adulthood. Parental…

  19. A Critical Analysis of the Research on Student Homelessness

    Science.gov (United States)

    Miller, Peter M.

    2011-01-01

    Since the onset of the economic recession, rates of student homelessness have increased rapidly in urban, suburban, and rural school districts throughout the United States. Despite the widespread urgency of the issue, there is a lack of general coherence in the research about how diverse conditions of homelessness affect students and how schools…

  20. Attitudes toward the Homeless: A U.S.-Japan Comparison.

    Science.gov (United States)

    Guzewicz, Tony D.; Takooshian, Harold

    1993-01-01

    Compares attitudes toward the homeless in Japan and the United States through a survey of 268 Japanese and 254 U.S. adults and adolescents interviewed in public places. In Japan, homelessness is seldom discussed, and poverty, which may be as widespread as in the United States, is often not recognized. (SLD)

  1. Homelessness in America: What Should We Do? Public Talk Series.

    Science.gov (United States)

    Niedergang, Mark; McCoy, Martha, Ed.

    This program guide provides a forum for discussing the different beliefs that influence public policy about homelessness as well as policy goals. The central question is addressed in two parts: (1) what society ought to do for homeless people; and (2) laying out a range of possible answers for part 1. Four possible answers are discussed: help only…

  2. Homeless Families' Education Networks: An Examination of Access and Mobilization

    Science.gov (United States)

    Miller, Peter M.

    2011-01-01

    Purpose: This study sought deeper understanding of how sheltered families accessed and mobilized educationally related relationships and resources during periods of homelessness. Such work is posited to be especially relevant considering that there is a growing crisis of family homelessness in the United States and school- and community-based…

  3. American Nightmare: A Decade of Homelessness in the United States.

    Science.gov (United States)

    National Coalition for the Homeless, Washington, DC.

    A 1989 national survey of the dimensions of homelessness found that at least three million Americans are homeless and that the shortage of affordable housing was cited as the chief cause. Information was gathered from a telephone survey of emergency shelter providers, housing advocacy organizations, and local governments in 26 communities, ranging…

  4. Mission Impossible? Physical Activity Programming for Individuals Experiencing Homelessness

    Science.gov (United States)

    Gregg, Melanie J.; Bedard, Andrea

    2016-01-01

    Purpose: A pilot study was conducted to describe the physical activity experiences and perceived benefits of and barriers to physical activity participation for patrons of a homeless shelter. The resulting pilot data may be used to inform the creation of and support for physical activity and sport programs for those experiencing homelessness.…

  5. Constantly Compromised: The Impact of Homelessness on Children.

    Science.gov (United States)

    Molnar, Janice M.; And Others

    1990-01-01

    Summarizes the small body of research to date that focuses on the effects of homelessness on children. In matters related to health, development, and education, homeless children are at a grave disadvantage, many from birth. Policy implications are outlined, concluding that children need permanent housing if they are to thrive. (DM)

  6. A New Challenge for School Counselors: Children Who Are Homeless.

    Science.gov (United States)

    Strawser, Sherri; Markos, Patricia A.; Yamaguchi, Barbara J.; Higgins, Kyle

    2000-01-01

    Reviews the legislative provisions and mandates governing the education of children and youth who are homeless and the barriers to education presented by school requirements. Highlights the effects of homelessness on children and youth and the role the school counselor should play in the provision of services for them. (Contains 55 references.)…

  7. Visible Voices: Literacy Identity and the Invisible Homeless

    Science.gov (United States)

    Juchniewicz, Melissa M.

    2012-01-01

    Despite calls for increased awareness of and sensitivity to diverse students and their in- and out-of-school literacies, the "invisible homeless"--those who often decline to self-identify--receive inadequate scholarly attention. They are often individuals who fear the stigma associated with homelessness as they navigate workplace, academic, and…

  8. Young People, Drug Use and Family Conflict: Pathways into Homelessness

    Science.gov (United States)

    Mallett, Shelley; Rosenthal, Doreen; Keys, Deborah

    2005-01-01

    Young people who experience homelessness, in Australia and in other western contexts (US, Canada, England), are widely perceived to use and abuse alcohol and drugs. The available research indicates that homeless young people use all drug types, whether injected or otherwise, more frequently than their home-based peers. Debate exists in the…

  9. Pregnancy and Sexual Health among Homeless Young Injection Drug Users

    Science.gov (United States)

    Hathazi, Dodi; Lankenau, Stephen E.; Sanders, Bill; Bloom, Jennifer Jackson

    2009-01-01

    Research on pregnancy and sexual health among homeless youth is limited. In this study, qualitative interviews were conducted with 41 homeless young injection drug users (IDUs) in Los Angeles with a history of pregnancy. The relationship between recent pregnancy outcomes, contraception practices, housing status, substance use, utilization of…

  10. Predictors of Social Network Composition among Homeless and Runaway Adolescents

    Science.gov (United States)

    Johnson, K.D.; Whitbeck, L.B.; Hoyt, D.R.

    2005-01-01

    Recent research on the social support networks of homeless and runaway youth suggest the social networks of runaway youth are made up largely of transient deviant peer relationships. This paper examined social network characteristics of 428 homeless and runaway adolescents from small-to moderate-sized cities in four Midwestern states. We…

  11. Bringing It Home: Understanding the Lives of Homeless Youth

    Science.gov (United States)

    Tierney, William G.

    2015-01-01

    In this commentary, the author reflects on a special issue that explores how educational institutions serve homeless and highly mobile students as well as their families. The number of homeless youth continues to rise, leading the author to question why structural constraints have not been removed. In addition to reflecting on the articles, he…

  12. The Impact of Homelessness on the Health of Families

    Science.gov (United States)

    Morris, Rita I.; Strong, Linda

    2004-01-01

    Qualitative research using the symbolic interactionism framework and grounded theory methodology was employed to discover the perceived health problems and dangers that homeless families with children endure. Data were collected using semistructured interviews from 34 homeless volunteer participants with 87 children. An in-depth analysis of the…

  13. Homelessness Coverage in Major Canadian Newspapers, 1987 – 2007

    NARCIS (Netherlands)

    M.S. Richter (Solina); K. Kovacs Burns (Kathy); Y. Mao (Yuping); J. Chaw-Kant (Jean); M. Calder (Moira); S. Mogale (Shirley); L. Goin (Lyla); K. Schnell (Kerry)

    2011-01-01

    textabstractThis article describes how the Canadian printed news media depicted the homeless and their situations between 1987 and 2007. Our study used a descriptive, cross-sectional design and a content analysis was conducted on selected newspaper articles on homelessness issues. The main themes

  14. Constructive Conflict Management and Coping in Homeless Children and Adolescents.

    Science.gov (United States)

    Horowitz, Sandra V.; And Others

    1994-01-01

    Presents findings concerning conflict management and coping behavior of homeless adolescents. Interviews with 176 families (mother-adolescent dyads) indicate peer conflict was the worst problem of the previous month. Homeless adolescents demonstrated conflict management and coping patterns differing in certain aspects from that described in the…

  15. HIV and the urban homeless in Johannesburg | Lohrmann ...

    African Journals Online (AJOL)

    city homeless and marginally housed individuals in South Africa. Methods. We recruited 136 adults from a Johannesburg inner-city homeless clinic; mean age was 32.4 years, 129 (95%) were male, and 90 (66%) were of South African ...

  16. Young Children Experiencing Homelessness: The Overlooked Medium of Play

    Science.gov (United States)

    Schlembach, Sue

    2017-01-01

    The number of mothers with young children experiencing homelessness and seeking shelter has increased in the USA over the past decade. Shelters are often characterized as environments offering few opportunities for appropriate play experiences. This article delineates the important role of play for young children experiencing homelessness and…

  17. Contextualizing the Impacts of Homelessness on Academic Growth

    Science.gov (United States)

    Pavlakis, Alexandra E.; Goff, Peter; Miller, Peter M.

    2017-01-01

    Background/Context: Students experiencing homelessness are also often living in poverty and may share many of the same characteristics and experiences with children in low-income housing. Scholars aim to understand the impacts of homelessness above and beyond the effects of poverty, but studies are mixed. Contextual factors--such as the localized…

  18. [Alcohol dependence in homeless men. Incidence, development and determinants].

    Science.gov (United States)

    Dufeu, P; Podschus, J; Schmidt, L G

    1996-11-01

    Against the background of the complex relationship of alcoholism and homelessness, we investigated the question of whether homeless alcoholics and those with homes differed regarding biographical and clinical variables. Therefore, 49 of 72 (68.1%) homeless male visitors to a city kitchen in the center of Berlin, who had fulfilled the ICD-10 criteria for the alcohol-dependence syndrome, were compared with 141 outpatients of the addiction research unit of the Department of Psychiatry of the Free University of Berlin. It was found that homeless alcoholics had more psychosocial disadvantages than other alcoholics. They had been raised more frequently in families with an alcoholic father or mother and a higher number of children. The level of education and job qualification was lower in the homeless alcoholics. Early homelessness was predicted by a lack of sexual behavior (no partnership experienced) and a family history of alcoholism. In the interview, homeless alcoholics reported fewer symptoms of alcohol-dependence syndrome than other alcoholics; however, the first symptoms had been experienced earlier. Alcohol-related somatic and psychological consequences were reported more frequently in alcoholics with homes, whereas social problems were more common in the homeless subjects. The results are discussed in the light of methodological limitations and other reports on the topic.

  19. Planet Homeless : Governance arrangements in Amsterdam, Copenhagen and Glasgow

    NARCIS (Netherlands)

    Boesveldt, N.F.|info:eu-repo/dai/nl/162503199

    2015-01-01

    Homelessness is a complex policy issue that all local governments face. But, at the same time, local authorities often have very little influence on the causes of homelessness, such as de-institutionalization, drug addiction, and release from detention or evictions. Seen in a European context,

  20. Deja Vu: Family Homelessness in New York City.

    Science.gov (United States)

    Institute for Children and Poverty, New York, NY.

    This report describes family homelessness in New York City, which has risen sharply since 1980. Currently, the City's family shelter system is at capacity. Homeless children are typically raised by single mothers who receive no child support, are 27 years old, are unemployed and receiving welfare, and have had at least one public assistance…

  1. Social networks, time homeless, and social support: A study of men on Skid Row.

    Science.gov (United States)

    Green, Harold D; Tucker, Joan S; Golinelli, Daniela; Wenzel, Suzanne L

    2013-12-18

    Homeless men are frequently unsheltered and isolated, disconnected from supportive organizations and individuals. However, little research has investigated these men's social networks. We investigate the structure and composition of homeless men's social networks, vis-a-vis short- and long-term homelessness with a sample of men drawn randomly from meal lines on Skid Row in Los Angeles. Men continuously homeless for the past six months display networks composed of riskier members when compared to men intermittently homeless during that time. Men who report chronic, long-term homelessness display greater social network fragmentation when compared to non-chronically homeless men. While intermittent homelessness affects network composition in ways that may be addressable with existing interventions, chronic homelessness fragments networks, which may be more difficult to address with those interventions. These findings have implications for access to social support from network members which, in turn, impacts the resources homeless men require from other sources such as the government or NGOs.

  2. Mental disorders and the use of primary health care services among homeless shelter users in the Helsinki metropolitan area, Finland.

    Science.gov (United States)

    Stenius-Ayoade, Agnes; Haaramo, Peija; Erkkilä, Elisabet; Marola, Niko; Nousiainen, Kirsi; Wahlbeck, Kristian; Eriksson, Johan G

    2017-06-21

    Homelessness is associated with increased morbidity, mortality and health care use. The aim of this study was to examine the role of mental disorders in relation to the use of 1) daytime primary health care services and 2) after hours primary health care emergency room (PHER) services among homeless shelter users in the Helsinki Metropolitan Area, Finland. The study cohort consists of all 158 homeless persons using the four shelters operating in the study area during two selected nights. The health records were analyzed over a period of 3 years prior to the sample nights and data on morbidity and primary health care visits were gathered. We used negative binomial regression to estimate the association between mental disorders and daytime visits to primary health care and after hours visits to PHERs. During the 3 years the 158 homeless persons in the cohort made 1410 visits to a physician in primary health care. The cohort exhibited high rates of mental disorders, including substance use disorders (SUDs); i.e. 141 persons (89%) had a mental disorder. We found dual diagnosis, defined as SUD concurring with other mental disorder, to be strongly associated with daytime primary health care utilization (IRR 11.0, 95% CI 5.9-20.6) when compared with those without any mental disorder diagnosis. The association was somewhat weaker for those with only SUDs (IRR 4.9, 95% CI 2.5-9.9) or with only other mental disorders (IRR 5.0, 95% CI 2.4-10.8). When focusing upon the after hours visits to PHERs we observed that both dual diagnosis (IRR 14.1, 95% CI 6.3-31.2) and SUDs (11.5, 95% CI 5.7-23.3) were strongly associated with utilization of PHERs compared to those without any mental disorder. In spite of a high numbers of visits, we found undertreatment of chronic conditions such as hypertension and diabetes. Dual diagnosis is particularly strongly associated with primary health care daytime visits among homeless persons staying in shelters, while after hours visits to primary

  3. Feminist and community psychology ethics in research with homeless women.

    Science.gov (United States)

    Paradis, E K

    2000-12-01

    This paper presents a feminist and community psychology analysis of ethical concerns that can arise throughout the process of doing research with women who are homeless. The unique contexts of the lives of women who are homeless demand that researchers redefine traditional ethical constructs such as consent, privacy, harm, and bias. Research that fails to do this may perpetuate the stereotyping, marginalization, stigmatization, and victimization homeless women face. Feminist and community research ethics must go beyond the avoidance of harm to an active investment in the well-being of marginalized individuals and communities. Using feminist and community psychology ethics, this paper addresses some common problems in research with women who are homeless, and argues for the transformation of research from a tool for the advancement of science into a strategy for the empowerment of homeless women and their communities.

  4. Perceptions of masculinity and fatherhood among men experiencing homelessness.

    Science.gov (United States)

    Rice, Alexander; Kim, Ji Youn Cindy; Nguyen, Christopher; Liu, William Ming; Fall, Kevin; Galligan, Patrick

    2017-05-01

    This study explored the perceptions of fatherhood held by 11 men living in a homeless shelter. Using consensual qualitative research methodology (CQR; Hill, 2012), we investigated perceptions of masculinity and fatherhood among fathers experiencing homelessness. Participants described (a) their perceptions of masculinity and fatherhood and changes resulting from homelessness, (b) physical and psychological challenges of being a father experiencing homelessness, and (c) expectations of homeless fathers. The fathers generally expressed feelings of low self-esteem related to their perceived difficulty fulfilling the role of providers for their family; however, they also adapted their view of fatherhood to include roles suited to their situation, such as that of guide, teacher, and role model. Suggestions are made for clinicians in helping fathers navigate and develop these roles, and limitations and directions for future research are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. Promoting Resilience in Youth Experiencing Homelessness through Implementation of the McKinney-Vento Homeless Assistance Act

    Science.gov (United States)

    Clemens, Elysia; Hess, Robyn S.; Strear, Molly M.; Rue, Lisa; Rizzolo, Sonja; Henninger, Janessa

    2018-01-01

    This Consensual Qualitative Research study explored experiences of youth, families, and homeless liaisons to better understand how educational environments can foster resilience among youth experiencing homelessness. The purpose of the study was to provide educational stakeholders with guidance on how to actualize the McKinney-Vento Homeless…

  6. Taking a leap of faith: Meaningful participation of people with experiences of homelessness in solutions to address homelessness

    Directory of Open Access Journals (Sweden)

    Trudy Laura Norman

    2015-12-01

    Full Text Available Participation of people with experiences of homelessness is critical to the development of meaningful strategies to end homelessness. The purpose of this study was to gain insights from people who have been homeless in a mid-sized Canadian city, as to strategies that facilitate meaningful participation in solutions to end homelessness. Within an overarching framework of collaborative research, we collected data through seven focus groups and employed interpretive description as our approach to data analysis. In our analysis, we identified both exclusionary and inclusionary forces that impact participation. Exclusionary forces included being ‘caught in the homelessness industry’, ‘homelessness is a full time job’ and facing stigma/discrimination that make participation a ‘leap of faith’. Inclusionary forces included earning respect and building trust to address unequal power relations, and restoring often ‘taken for granted’ social relations. Specific strategies to enhance participation include listening, valuing skills and stories, and supporting advocacy efforts. The study findings illuminate ways in which power imbalances are lived out in the daily lives of people who experience homelessness, as well as mitigating forces that provide direction as to strategies for addressing power inequities that seek to make participation and social inclusion meaningful. Keywords: homelessness, social policy, social exclusion, social inclusion, advocacy

  7. The effects of the therapeutic workplace and heavy alcohol use on homelessness among homeless alcohol-dependent adults.

    Science.gov (United States)

    Carlson, Emily; Holtyn, August F; Fingerhood, Michael; Friedman-Wheeler, Dara; Leoutsakos, Jeannie-Marie S; Silverman, Kenneth

    2016-11-01

    A clinical trial demonstrated that a therapeutic workplace could promote alcohol abstinence in homeless, alcohol-dependent adults. This secondary-data analysis examined rates of homelessness and their relation to the therapeutic workplace intervention and alcohol use during the trial. In the trial, homeless, alcohol-dependent adults could work in a therapeutic workplace for 6 months and were randomly assigned to Unpaid Training, Paid Training, or Contingent Paid Training groups. Unpaid Training participants were not paid for working. Paid Training participants were paid for working. Contingent Paid Training participants were paid for working if they provided alcohol-negative breath samples. Rates of homelessness during the study were calculated for each participant and the three groups were compared. Mixed-effects regression models were conducted to examine the relation between alcohol use (i.e., heavy drinking, drinks per drinking day, and days of alcohol abstinence) and homelessness. Unpaid Training, Paid Training, and Contingent Paid Training participants did not differ in the percentage of study days spent homeless (31%, 28%, 17%; respectively; F(2,94)=1.732, p=0.183). However, participants with more heavy drinking days (b=0.350, phomeless. Reducing heavy drinking and alcohol use may help homeless, alcohol-dependent adults transition out of homelessness. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Translating Universal Health Care for the Homeless: Barriers and potential facilitating factors for accessing health care amongst street dwellers in India

    Directory of Open Access Journals (Sweden)

    V Prasad

    2012-04-01

    Full Text Available Urban health policy has remained a neglected area in India, and amongst the urban poor, the homeless remain the most deprived, neglected and stigmatized group. While they suffer from a large burden of disease, there are a variety of reasons that prevent them from accessing the available health care services – particularly in the public health sector. These barriers have been poorly understood and documented. This report, based upon a detailed study of homeless participants in New Delhi, India, seeks to highlight the systemic changes that would be required within public health systems to enable street dwellers to avail of their services and realise the conceptual ambit of ' health for all' in the context of homeless persons

  9. [Improving Mental Health Care in People at Risk for Getting Homeless].

    Science.gov (United States)

    Salize, Hans Joachim; Arnold, Maja; Uber, Elisa; Hoell, Andreas

    2017-01-01

    Objective: Overall aim was to reduce the untreated prevalence in persons with untreated mental disorders and at risk for loosing accommodation and descending into homelessness. Primary aim was treatment initiation and treatment adherence by motivational interviewing. Secondary aims were to reduce social or financial problems. Methods: Persons at risk were identified in social welfare services or labour agencies, diagnosed and motivated to initiate treatment in a community mental health service. Results: 58 persons were included, 24 were referred to regular mental health care, 8 were stabilized enough after the initial motivational to refrain from acute treatment, 26 dropped out. During a 6-month follow-up quality of life and social support was improved (partly statistically significant) and psycho-social needs for care decreased. Conclusion: Motivational interviewing is likely to increase insight into illness and acceptance of mental health care in untreated persons with mental disorders at risk for social decline. © Georg Thieme Verlag KG Stuttgart · New York.

  10. The Contribution of the Emotional Intelligence on Social Services for the Homeless People

    Directory of Open Access Journals (Sweden)

    Gabriela Duret

    2015-05-01

    Full Text Available Insuring the access to an adequate housing is frequently a pre-condition for the exercise of many other basic rights that any individual must gain. Lacking the access to civilized living conditions probably signifies the most serious manifestation of social exclusion. Lacking a home is synonymous to the extreme poverty, in fact, representing more than a life contingency but the extreme frame of a deficit of means and opportunities. The term ”homeless” defines a human condition which is hard to believe that someone would have problems in understanding it. However, almost everybody who uses this term uses a different definition to define it. These definitions become mere ”instruments” which justify the action or the lack of it depending on who uses it. The condition of an adult homeless person presupposes a series of attributes which define it. Therefore, the state of isolation, marginalization, alienation and social exclusion have extreme outcomes within the frame of emotional, relational and social integration. In this respect, there must be built and improved new programmes and social services for the benefit of the homeless persons. As a result of the work experience with these homeless persons I identified some stages of the adaptation to the street life. It is self-evident that the psycho-social degradation is a process and not a gradual evolution. The intervention of the specialists through the specialized services is vital for the improvement of the quality of life for these beneficiaries of welfare work. The present research develops a strategy related to the social services in Braila offered as a method of social reinsertion of the street life, especially those from the municipality of Braila.

  11. Risk of psychiatric disorders in offspring of parents with a history of homelessness during childhood and adolescence in Denmark: a nationwide, register-based, cohort study.

    Science.gov (United States)

    Nilsson, Sandra Feodor; Laursen, Thomas Munk; Hjorthøj, Carsten; Thorup, Anne; Nordentoft, Merete

    2017-12-01

    Children and adolescents from deprived backgrounds have high rates of psychiatric problems. Parental and social factors are crucial for children's healthy and positive development, but whether psychiatric morbidity is associated with parental social marginalisation is unknown. We aimed to analyse the association between mother's and father's history of homelessness and the offspring's risk of psychiatric disorders, including substance use disorder, during childhood and adolescence. We did a nationwide, register-based cohort study of 1 072 882 children and adolescents aged 0-16 years, who were living or born in Denmark between Jan 1, 1999, and Dec 31, 2015. Parental homelessness was the primary exposure, data on which were obtained from the Danish Homeless Register. The Danish Civil Registration System was used to extract the population and link offspring to parental information, and the outcome, psychiatric disorders in the offspring, was obtained from the Danish Psychiatric Central Research Register and the Danish National Patient Register. We analysed the association between parental history of homelessness and risk of psychiatric disorders in offspring by survival analysis using Poisson regression and incidence rate ratios (IRRs), adjusted for year and offspring characteristics, and additionally adjusted for parental factors (age at offspring's birth and parental psychiatric disorders). 17 238 (2%) offspring had either one or two parents with a history of homelessness, and 56 330 (5%) children and adolescents were diagnosed with any psychiatric disorder during the study period. The incidence of any psychiatric disorder was 15·1 cases per 1000 person-years (95% CI 14·4-15·8) in offspring with at least one parent with a history of homelessness, compared with 6·0 per 1000 person-years (95% CI 6·0-6·1) in those whose parents had no such history (IRR 2·5 [95% CI 2·3-2·7] for mother homeless, 2·3 [2·2-2·5] for father homeless, and 2·8 [2·4-3·2

  12. Risk of psychiatric disorders in offspring of parents with a history of homelessness during childhood and adolescence in Denmark: a nationwide, register-based, cohort study

    Directory of Open Access Journals (Sweden)

    Sandra Feodor Nilsson, MSc

    2017-12-01

    Full Text Available Summary: Background: Children and adolescents from deprived backgrounds have high rates of psychiatric problems. Parental and social factors are crucial for children's healthy and positive development, but whether psychiatric morbidity is associated with parental social marginalisation is unknown. We aimed to analyse the association between mother's and father's history of homelessness and the offspring's risk of psychiatric disorders, including substance use disorder, during childhood and adolescence. Methods: We did a nationwide, register-based cohort study of 1 072 882 children and adolescents aged 0–16 years, who were living or born in Denmark between Jan 1, 1999, and Dec 31, 2015. Parental homelessness was the primary exposure, data on which were obtained from the Danish Homeless Register. The Danish Civil Registration System was used to extract the population and link offspring to parental information, and the outcome, psychiatric disorders in the offspring, was obtained from the Danish Psychiatric Central Research Register and the Danish National Patient Register. We analysed the association between parental history of homelessness and risk of psychiatric disorders in offspring by survival analysis using Poisson regression and incidence rate ratios (IRRs, adjusted for year and offspring characteristics, and additionally adjusted for parental factors (age at offspring's birth and parental psychiatric disorders. Findings: 17 238 (2% offspring had either one or two parents with a history of homelessness, and 56 330 (5% children and adolescents were diagnosed with any psychiatric disorder during the study period. The incidence of any psychiatric disorder was 15·1 cases per 1000 person-years (95% CI 14·4–15·8 in offspring with at least one parent with a history of homelessness, compared with 6·0 per 1000 person-years (95% CI 6·0–6·1 in those whose parents had no such history (IRR 2·5 [95

  13. A Teacher's Journey: A First-Person Account of How a Gay, Cambodian Refugee Navigated Myriad Barriers to Become Educated in the United States

    Science.gov (United States)

    Sam, Kosal; Finley, Susan

    2015-01-01

    Educational institutions, like most social service organizations, need to recognize intersectionality and complexity and move away from monolithic conceptions of homelessness--if they recognize homelessness at all. This first person account of a gay, Cambodian refugee illustrates the enormous complexity schools face in forming institutional…

  14. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: a multi-site focus group study.

    Science.gov (United States)

    Palepu, Anita; Hubley, Anita M; Russell, Lara B; Gadermann, Anne M; Chinni, Mary

    2012-08-15

    The aim of this study was to identify what is most important to the quality of life (QoL) of those who experience homelessness by directly soliciting the views of homeless and hard-to-house Canadians themselves. These individuals live within a unique social context that differs considerably from that of the general population. To understand the life areas that are most important to them, it is critical to have direct input from target populations of homeless and hard-to-house persons. Focus groups were conducted with 140 individuals aged 15 to 73 years who were homeless or hard-to-house to explore the circumstances in which they were living and to capture what they find to be important and relevant domains of QoL. Participants were recruited in Toronto, Ottawa, Montreal, and Vancouver. Content analysis was used to analyze the data. Six major content themes emerged: Health/health care; Living conditions; Financial situation; Employment situation; Relationships; and Recreational and leisure activities. These themes were linked to broader concepts that included having choices, stability, respect, and the same rights as other members of society. These findings not only aid our understanding of QoL in this group, but may be used to develop measures that capture QoL in this population and help programs and policies become more effective in improving the life situation for persons who are homeless and hard-to-house. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study.

  15. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study

    Directory of Open Access Journals (Sweden)

    Palepu Anita

    2012-08-01

    Full Text Available Abstract Background The aim of this study was to identify what is most important to the quality of life (QoL of those who experience homelessness by directly soliciting the views of homeless and hard-to-house Canadians themselves. These individuals live within a unique social context that differs considerably from that of the general population. To understand the life areas that are most important to them, it is critical to have direct input from target populations of homeless and hard-to-house persons. Methods Focus groups were conducted with 140 individuals aged 15 to 73 years who were homeless or hard-to-house to explore the circumstances in which they were living and to capture what they find to be important and relevant domains of QoL. Participants were recruited in Toronto, Ottawa, Montreal, and Vancouver. Content analysis was used to analyze the data. Results Six major content themes emerged: Health/health care; Living conditions; Financial situation; Employment situation; Relationships; and Recreational and leisure activities. These themes were linked to broader concepts that included having choices, stability, respect, and the same rights as other members of society. Conclusions These findings not only aid our understanding of QoL in this group, but may be used to develop measures that capture QoL in this population and help programs and policies become more effective in improving the life situation for persons who are homeless and hard-to-house. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study.

  16. Social, structural and behavioral determinants of overall health status in a cohort of homeless and unstably housed HIV-infected men.

    Directory of Open Access Journals (Sweden)

    Elise D Riley

    Full Text Available Previous studies indicate multiple influences on the overall health of HIV-infected persons; however, few assess and rank longitudinal changes in social and structural barriers that are disproportionately found in impoverished populations. We empirically ranked factors that longitudinally impact the overall health status of HIV-infected homeless and unstably housed men.Between 2002 and 2008, a cohort of 288 HIV+ homeless and unstably housed men was recruited and followed over time. The population was 60% non-Caucasian and the median age was 41 years; 67% of study participants reported recent drug use and 20% reported recent homelessness. At baseline, the median CD4 cell count was 349 cells/µl and 18% of eligible persons (CD490% ranked 5th for its positive influence on mental health, and viral load ranked 4th for its negative influence on physical health.The inability to meet food, hygiene, and housing needs was the most powerful predictor of poor physical and mental health among homeless and unstably housed HIV-infected men in an urban setting. Impoverished persons will not fully benefit from progress in HIV medicine until these barriers are overcome, a situation that is likely to continue fueling the US HIV epidemic.

  17. Making a home for the homeless in hate crime legislation.

    Science.gov (United States)

    Al-Hakim, Mohamad

    2015-06-01

    Several jurisdictions in the United States (e.g., Florida and Washington) have recently incorporated the status of "homeless" under the protection of hate crime legislation. This was largely promoted by new data and reports by the National Coalition for the Homeless urging added protection for the homeless. The issue of whether the homeless belong under hate crime provisions raises the following question: What criteria must a group meet to be eligible for its inclusion? What similarities do the homeless have with other protected groups? Finally, what implications does the recognition of economic status have on other economic groups, particularity the top wealthy 1%? In this article, I explore some of the issues raised by including the homeless as a protected group. I survey several rationales offered for the selection of protected characteristics. I argue that the rationales currently offered suffer from descriptive inadequacy by either being under- or over-inclusive. I turn instead to the political conception of "disadvantage" for an identity marker that better explains the link between the various protected groups and identities under hate crime legislation. Moreover, the use of disadvantage allows for the inclusion of the homeless without the need for incorporating other socio-economic identities. © The Author(s) 2014.

  18. Youth Homelessness: The Impact of Supportive Relationships on Recovery.

    Science.gov (United States)

    Gasior, Sara; Forchuk, Cheryl; Regan, Sandra

    2018-03-01

    Background Homeless youth are the fastest growing sub-group within the homeless population. They face impaired access to health services and are often left unsupported. They lack social and family support or relationships with service providers. Unsupported homeless youth often become homeless adults. Purpose To test a model based on Peplau's Theory of Interpersonal Relations, examining the influence of a network of service providers, perceptions of social supports, and family relations on a homeless youth's perceptions of recovery. Methods This study is a secondary analysis and used a sample (n = 187) of data collected as part of the original Youth Matters in London study. A cross-sectional design was used to analyze the relationship between variables. Participants were interviewed at 6-month intervals over a 2.5-year period. Hierarchical multiple regression analysis was used. Results Network of service providers, perceived social supports, and perceived family relations explained 21.8% of the variance in homeless youth perceptions of recovery. Perceived social support and family relations were significantly, positively correlated to perceptions of recovery. Network of service providers was not significantly correlated to perceptions of recovery. Conclusions The findings suggest that stronger social supports and family relations may contribute to increased perceptions of recovery among homeless youth.

  19. Prevalence of Mental Illness, Cognitive Disability, and Their Overlap among the Homeless in Nagoya, Japan.

    Directory of Open Access Journals (Sweden)

    Akihiro Nishio

    Full Text Available While the prevalence of mental illness or cognitive disability is higher among homeless people than the general population in Western countries, few studies have investigated its prevalence in Japan or other Asian countries. The present study conducted a survey to comprehensively assess prevalence of mental illness, cognitive disability, and their overlap among homeless individuals living in Nagoya, Japan.Participants were 114 homeless individuals. Mental illness was diagnosed based on semi-structured interviews conducted by psychiatrists. The Wechsler Adult Intelligence Scale-III (WAIS-III, simplified version was used to diagnose intellectual/ cognitive disability.Among all participants, 42.1% (95% CI 33.4-51.3% were diagnosed with a mental illness: 4.4% (95% CI 1.9-9.9% with schizophrenia or other psychotic disorder, 17.5% (95% CI 11.6-25.6% with a mood disorder, 2.6% (95% CI 0.9-7.5% with an anxiety disorder, 14.0% (95% CI 8.8-21.6% with a substance-related disorder, and 3.5% (95% CI 1.4-8.8% with a personality disorder. Additionally, 34.2% (95% CI 26.1-43.3% demonstrated cognitive disability: 20.2% (95% CI 13.8-28.5% had mild and 14.0% (95% CI 8.8-21.6% had moderate or severe disability. The percent overlap between mental illness and cognitive disability was 15.8% (95% CI 10.2-23.6%. Only 39.5% (95% CI 26.1-43.3% of the participants were considered to have no psychological or cognitive dysfunction. Participants were divided into four groups based on the presence or absence of mental illness and/or cognitive disability. Only individuals with a cognitive disability reported a significant tendency toward not wanting to leave their homeless life.This is the first report showing that the prevalence of mental illness and/or cognitive disability among homeless individuals is much higher than in the general Japanese population. Appropriate support strategies should be devised and executed based on the specificities of an individual's psychological

  20. Prevalence of Mental Illness, Cognitive Disability, and Their Overlap among the Homeless in Nagoya, Japan.

    Science.gov (United States)

    Nishio, Akihiro; Yamamoto, Mayumi; Horita, Ryo; Sado, Tadahiro; Ueki, Hirofumi; Watanabe, Takahiro; Uehara, Ryosuke; Shioiri, Toshiki

    2015-01-01

    While the prevalence of mental illness or cognitive disability is higher among homeless people than the general population in Western countries, few studies have investigated its prevalence in Japan or other Asian countries. The present study conducted a survey to comprehensively assess prevalence of mental illness, cognitive disability, and their overlap among homeless individuals living in Nagoya, Japan. Participants were 114 homeless individuals. Mental illness was diagnosed based on semi-structured interviews conducted by psychiatrists. The Wechsler Adult Intelligence Scale-III (WAIS-III, simplified version) was used to diagnose intellectual/ cognitive disability. Among all participants, 42.1% (95% CI 33.4-51.3%) were diagnosed with a mental illness: 4.4% (95% CI 1.9-9.9%) with schizophrenia or other psychotic disorder, 17.5% (95% CI 11.6-25.6%) with a mood disorder, 2.6% (95% CI 0.9-7.5%) with an anxiety disorder, 14.0% (95% CI 8.8-21.6%) with a substance-related disorder, and 3.5% (95% CI 1.4-8.8%) with a personality disorder. Additionally, 34.2% (95% CI 26.1-43.3%) demonstrated cognitive disability: 20.2% (95% CI 13.8-28.5%) had mild and 14.0% (95% CI 8.8-21.6%) had moderate or severe disability. The percent overlap between mental illness and cognitive disability was 15.8% (95% CI 10.2-23.6%). Only 39.5% (95% CI 26.1-43.3%) of the participants were considered to have no psychological or cognitive dysfunction. Participants were divided into four groups based on the presence or absence of mental illness and/or cognitive disability. Only individuals with a cognitive disability reported a significant tendency toward not wanting to leave their homeless life. This is the first report showing that the prevalence of mental illness and/or cognitive disability among homeless individuals is much higher than in the general Japanese population. Appropriate support strategies should be devised and executed based on the specificities of an individual's psychological and

  1. Rehousing homeless citizens with assertive community treatment

    DEFF Research Database (Denmark)

    Benjaminsen, Lars

    professionals including a psychiatrist, a nurse, an addiction councilor, and social workers with administrative authority from the social office and the job center. In the international research literature ACT has been shown in randomized controlled trials to be a very effective method in bringing individuals...... out of homelessness and into a stable housing situation. The study is based on quantitative outcome measurement on about 80 citizens who have been assigned to the programme and who have received both a housing solution and support from the ACT-team. The study is not a randomized controlled trial...

  2. Down and Out in London: Addictive Behaviors in Homelessness.

    Science.gov (United States)

    Sharman, Steve; Dreyer, Jenny; Clark, Luke; Bowden-Jones, Henrietta

    2016-06-01

    Backgrounds and aims Problem gambling occurs at higher levels in the homeless than the general population. Past work has not established the extent to which problem gambling is a cause or consequence of homelessness. This study sought to replicate recent observations of elevated rates of problem gambling in a British homeless sample, and extend that finding by characterizing (a) the temporal sequencing of the effect, (b) relationships with drug and alcohol misuse, and (c) awareness and access of treatment services for gambling by the homeless. Methods We recruited 72 participants from homeless centers in Westminster, London, and used the Problem Gambling Severity Index to assess gambling involvement, as well as DSM-IV criteria for substance and alcohol use disorders. A life-events scale was administered to establish the temporal ordering of problem gambling and homelessness. Results Problem gambling was evident in 23.6% of the sample. In participants who endorsed any gambling symptomatology, the majority were categorized as problem gamblers. Within those problem gamblers, 82.4% indicated that gambling preceded their homelessness. Participants displayed high rates of substance (31.9%) and alcohol dependence (23.6%); these were not correlated with PGSI scores. Awareness of treatment for gambling was significantly lower than for substance and alcohol use disorders, and actual access of gambling support was minimal. Discussion and conclusions Problem gambling is an under-recognized health issue in the homeless. Our observation that gambling typically precedes homelessness strengthens its role as a causal factor. Despite the elevated prevalence rates, awareness and utilization of gambling support opportunities were low compared with services for substance use disorders.

  3. Down and Out in London: Addictive Behaviors in Homelessness

    Science.gov (United States)

    Sharman, Steve; Dreyer, Jenny; Clark, Luke; Bowden-Jones, Henrietta

    2016-01-01

    Backgrounds and aims Problem gambling occurs at higher levels in the homeless than the general population. Past work has not established the extent to which problem gambling is a cause or consequence of homelessness. This study sought to replicate recent observations of elevated rates of problem gambling in a British homeless sample, and extend that finding by characterizing (a) the temporal sequencing of the effect, (b) relationships with drug and alcohol misuse, and (c) awareness and access of treatment services for gambling by the homeless. Methods We recruited 72 participants from homeless centers in Westminster, London, and used the Problem Gambling Severity Index to assess gambling involvement, as well as DSM-IV criteria for substance and alcohol use disorders. A life-events scale was administered to establish the temporal ordering of problem gambling and homelessness. Results Problem gambling was evident in 23.6% of the sample. In participants who endorsed any gambling symptomatology, the majority were categorized as problem gamblers. Within those problem gamblers, 82.4% indicated that gambling preceded their homelessness. Participants displayed high rates of substance (31.9%) and alcohol dependence (23.6%); these were not correlated with PGSI scores. Awareness of treatment for gambling was significantly lower than for substance and alcohol use disorders, and actual access of gambling support was minimal. Discussion and conclusions Problem gambling is an under-recognized health issue in the homeless. Our observation that gambling typically precedes homelessness strengthens its role as a causal factor. Despite the elevated prevalence rates, awareness and utilization of gambling support opportunities were low compared with services for substance use disorders. PMID:27348556

  4. Services Receipt Following Veteran Outpatients' Positive Screen for Homelessness.

    Science.gov (United States)

    Montgomery, Ann E; Dichter, Melissa E; Thomasson, Arwin M; Roberts, Christopher B

    2016-03-01

    The Veterans Health Administration seeks to reduce homelessness among Veterans by identifying, and providing prevention and supportive services to, patients with housing concerns. The objectives of this study were to assess the proportion of Veterans Health Administration patients who received homeless or social work services within 6 months of a positive screen for homelessness or risk in the Veterans Health Administration and the demographic and clinical characteristics that predicted services utilization. Data were from a cohort of 27,403 Veteran outpatients who screened positive for homelessness or risk between November 1, 2012 and January 31, 2013. During 2013, AORs were calculated using a mixed-effects logistic regression to estimate the likelihood of patients' receipt of VHA homeless or social work services based on demographic and clinical characteristics. The majority of patients received services within 6 months post-screening; predictors of services utilization varied by gender. Among women, diagnosis of drug abuse and psychosis predicted receipt of services, being unmarried increased the odds of using services among those screening positive for homelessness, and a diagnosis of post-traumatic stress disorder increased the odds of receiving services for at-risk women. Among men, being younger, unmarried, not service-connected/Medicaid-eligible, and having a medical or behavioral health condition predicted receipt of services. Receipt of housing support services among Veterans post-homelessness screening differs by patient demographic and clinical characteristics. Future research should investigate the role that primary and secondary prevention interventions play in Veterans' resolution of risk for homelessness and experience of homelessness. Published by Elsevier Inc.

  5. Previous Homelessness as a Risk Factor for Recovery from Serious Mental Illnesses.

    Science.gov (United States)

    Castellow, Jennifer; Kloos, Bret; Townley, Greg

    2015-08-01

    This paper argues that the experience of homelessness is inherently traumatic and thus has the potential to affect the manifestation of mental illness. The experiences related to being homeless might act as specific and unique sources of vulnerability. This study included 424 people diagnosed with serious mental illnesses living in supported housing programs in South Carolina. Three hierarchical regression analyses measuring the impact of homelessness on three types of outcomes revealed the following: (1) ever experiencing homelessness as well as the amount of time spent homeless were related to higher levels of psychiatric distress, (2) ever experiencing homelessness was related to higher levels of reported alcohol use, and (3) total amount of time spent homeless was related to lower perceived recovery from mental illness. These findings suggest that experiencing homelessness might contribute to psychosocial vulnerability to negative mental health outcomes. Future investigations examining this concept of risk and vulnerability as a result of homelessness are in order.

  6. The U.S. Homeless Student Population: Homeless Youth Education, Review of Research Classifications and Typologies, and the U.S. Federal Legislative Response

    Science.gov (United States)

    Rahman, Mai Abdul; Turner, J. Fidel; Elbedour, Salman

    2015-01-01

    Background: The drastic surge in the number of homeless families in the United States (U.S.) has resulted in an increase in the number of homeless students attending U.S. public schools. Meanwhile, the U.S. public school system is struggling to meet the educational needs of their homeless students. Objective: This study examined the historical…

  7. Prep/Tech: Volume 1, No. 1, Youth on homelessness

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-31

    PREP/TECH is a skill development, academic enrichment program of U. of Toledo in Toledo OH and The Engineers Foundation of Ohio; it addresses the mathematics, science, language, and intellectual needs of about 100 African-American and Hispanic-American 7th, 8th, and 9th graders in Toledo. This summer, after 3 weeks of classes, the 80 students returned for a second 3 week session and were divided into two groups, one studying the growing problem of homelessness in America. This group researched and published a pamphlet on homelessness. This report is divided into: myths, causes, descriptions, and solutions. Finally, a brief account is given of the homelessness project.

  8. San Francisco Accelerator Conference

    International Nuclear Information System (INIS)

    Southworth, Brian

    1991-01-01

    'Where are today's challenges in accelerator physics?' was the theme of the open session at the San Francisco meeting, the largest ever gathering of accelerator physicists and engineers

  9. For Cultural Interpretation: A Study of the Culture of Homelessness.

    Science.gov (United States)

    Fiske, John

    1991-01-01

    Attempts to demonstrate the value of conjunctural interpretive analysis (which is multilevel, multimodal, and explicitly theoretical and political) through an interpretation of the culture of homelessness in the United States. Addresses differences between positivist epistemologies. (SR)

  10. 75 FR 14633 - Homeless Veterans' Reintegration Into Employment

    Science.gov (United States)

    2010-03-26

    ... and skills training) to expedite the reintegration of homeless Veterans into the labor force.'' HVRP... of Labor/VETS. Applications submitted through http://www.grants.gov or hard copy will be accepted. If...

  11. YOUTH HOMELESSNESS: PREVENTION AND INTERVENTION EFFORTS IN PSYCHOLOGY

    Directory of Open Access Journals (Sweden)

    JHON J. SANABRIA

    2006-01-01

    Full Text Available In this paper, I review the prevention and intervention efforts addressing youth homelessness in the fieldof psychology between 1994 and 2004. Analyses of the literature revealed that the majority of papersincluding homeless youth as a population for study have focused on issues other than homelessness.These issues include HIV/AIDS and substance abuse prevention. Eleven journal articles addressing youthhomelessness were reviewed. These articles focused on outcomes, interventions, and recommendationsfor clinical practice. Literature findings revealed that demographic variables did not predict outcomesfor homeless youth; youth returning home with their parents have more positive outcomes than youthmoving into other locations, emergency shelter services improve youth’s mental health and social condition,and services should be comprehensive and move beyond the individuals. Implications for communitypsychology, policy makers, and shelters are discussed.

  12. 77 FR 1971 - Supplemental Security Income and Homeless Individuals

    Science.gov (United States)

    2012-01-12

    ... visit our Internet site, Social Security Online, at http://www.socialsecurity.gov . SUPPLEMENTARY... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2011-0087] Supplemental Security Income and Homeless Individuals AGENCY: Social Security Administration. ACTION: Notice; Request for Comments. SUMMARY...

  13. Where There Is No Hope: A Teacher's Experience with Homelessness

    Science.gov (United States)

    Nath, Veena; Hallett, Ronald E.

    2015-01-01

    Stereotypical notions of who experiences homelessness frame how educational institutions approach policy and program development. This life history of a teacher challenges assumptions by providing an in-depth look at a mother's struggle to find stability.

  14. Housing first reduces re-offending among formerly homeless adults with mental disorders: results of a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Julian M Somers

    Full Text Available BACKGROUND: Homelessness and mental illness have a strong association with public disorder and criminality. Experimental evidence indicates that Housing First (HF increases housing stability and perceived choice among those experiencing chronic homelessness and mental disorders. HF is also associated with lower residential costs than common alternative approaches. Few studies have examined the effect of HF on criminal behavior. METHODS: Individuals meeting criteria for homelessness and a current mental disorder were randomized to one of three conditions treatment as usual (reference; scattered site HF; and congregate HF. Administrative data concerning justice system events were linked in order to study prior histories of offending and to test the relationship between housing status and offending following randomization for up to two years. RESULTS: The majority of the sample (67% was involved with the justice system, with a mean of 8.07 convictions per person in the ten years prior to recruitment. The most common category of crime was "property offences" (mean=4.09. Following randomization, the scattered site HF condition was associated with significantly lower numbers of sentences than treatment as usual (Adjusted IRR=0.29; 95% CI 0.12-0.72. Congregate HF was associated with a marginally significant reduction in sentences compared to treatment as usual (Adjusted IRR=0.55; 95% CI: 0.26-1.14. CONCLUSIONS: This study is the first randomized controlled trial to demonstrate benefits of HF among a homeless sample with mental illness in the domain of public safety and crime. Our sample was frequently involved with the justice system, with great personal and societal costs. Further implementation of HF is strongly indicated, particularly in the scattered site format. Research examining interdependencies between housing, health, and the justice system is indicated. TRIAL REGISTRATION: ISRCTN57595077.

  15. The Association Between Familial Homelessness, Aggression, and Victimization Among Children.

    Science.gov (United States)

    Jetelina, Katelyn K; Reingle Gonzalez, Jennifer M; Cuccaro, Paula M; Peskin, Melissa F; Elliott, Marc N; Coker, Tumaini R; Mrug, Sylvie; Davies, Susan L; Schuster, Mark A

    2016-12-01

    The purpose of this study was to evaluate the relationship between the number of periods children were exposed to familial homelessness and childhood aggression and victimization. Survey data were obtained from 4,297 fifth-grade children and their caregivers in three U.S. cities. Children and primary caregivers were surveyed longitudinally in 7th and 10th grades. Family homelessness, measured at each wave as unstable housing, was self-reported by the caregiver. Children were categorized into four mutually exclusive groups: victim only, aggressor only, victim-aggressor, and neither victim nor aggressor at each time point using validated measures. Multinomial, multilevel mixed models were used to evaluate the relationship among periods of homelessness and longitudinal victimization, aggression, and victim aggression compared to children who were nonvictims and nonaggressors. Results suggest that children who experienced family homelessness were more likely than domiciled children to report aggression and victim aggression but not victimization only. Multivariate analyses suggested that even brief periods of homelessness were positively associated with aggression and victim aggression (relative to neither) compared to children who were never homeless. Furthermore, childhood victimization and victim aggression significantly decreased from 5th grade to 10th grade while aggression significantly increased in 10th grade. Children who experienced family homelessness for brief periods of time were significantly more likely to be a victim-aggressor or aggressor compared to those who were never homeless. Prevention efforts should target housing security and other important factors that may reduce children's likelihood of aggression and associated victimization. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  16. The Strategy Of The Homeless Survival In Surakarta

    Directory of Open Access Journals (Sweden)

    Retno Woro Kaeksi

    2004-01-01

    The factors that cause them to he homeless are the economic factor 77.78%, lack of family attention (13.33% and the willingness to he independent (80.89%. Based on the  result this research, we know that the poverty has made the children become homeless. The strategis to survive are: they are thrif (40%, add their time to work (13.13%, move to other place (11.11% and save their money (15.56%.

  17. Increasing Overall Well-Being is Salient in Treating Homelessness.

    Science.gov (United States)

    Coleman, Jennifer

    2017-04-03

    Homeless treatment programs have focused on physical solutions rather than attending to all aspects of well-being. Support services that address overall well-being have demonstrated effectiveness. Previous research suggests that overall well-being is defined as satisfaction within all life spheres. Objective life indices have been the primary evidence of success among various programs, which include food, housing, income, leisure, health, access to psychiatric and medical services, and maintenance of positive support networks. This does not account for other important subjective components, such as psychiatric symptoms and quality of life. This study was designed to assess quality of life and psychiatric symptoms among the people who were chronically and formerly chronically homeless. The people who were formerly chronically homeless are defined as individuals who were chronically homeless in the past but have successfully remained in housing for 6 months or more and have access to intensive case management services. People who are chronically homeless are homeless individuals who have lacked a residence for a year or more or have had four or more episodes in three years, are single, and have a persistent disability. Participants completed the Oxford Happiness Scale, Brief Symptom Inventory, and a brief questionnaire. All participants were disabled in accordance with the definition of chronic homelessness adopted by the U.S. Department of Housing and Urban Development. This researcher hypothesized that high quality-of-life scores, low frequency of psychiatric symptoms, and greater access to basic life indices indicate happiness overall. Additionally, it was hypothesized that people who are chronically homeless have a higher foster care rate than the general population.

  18. Homeless in America: A Children's Story. Part One.

    Science.gov (United States)

    Homes for the Homeless, Inc., New York, NY.

    In the early part of 1999, the Institute for Children and Poverty surveyed almost 2,000 families with more than 4,000 children in 24 locations to assess the state of homeless children across the United States. This report tells their story. Families account for almost 40% of U.S. homeless people, and in some cities that percentage is even higher.…

  19. Prevalence and Correlates of Youth Homelessness in the United States

    Science.gov (United States)

    Morton, Matthew H.; Dworsky, Amy; Matjasko, Jennifer L.; Curry, Susanna R.; Schlueter, David; Chávez, Raúl; Farrell, Anne F.

    2018-01-01

    Purpose Unaccompanied youth homelessness is a serious concern. Response, however, has been constrained by the absence of credible data on the size and characteristics of the population and reliable means to track youth homelessness over time. We sought to address these gaps. Methods Using a nationally representative phone-based survey (N = 26,161), we solicited household and individual reports on different types of youth homelessness. We collected household reports on adolescents aged 13–17 and young adults aged 18–25, as well as self-reports from young adults aged 18–25. Follow-up interviews with a subsample (n = 150) provided additional information on youth experiences and enabled adjustment for inclusion errors. Results Over a 12-month period, approximately 3.0% of households with 13- to 17-year-olds reported explicit youth homelessness (including running away or being asked to leave) and 1.3% reported experiences that solely involved couch surfing, resulting in an overall 4.3% household prevalence of any homelessness, broadly defined. For 18- to 25-year-olds, household prevalence estimates were 5.9% for explicitly reported homelessness, 6.6% for couch surfing only, and 12.5% overall. The 12-month population prevalence estimates, available only for 18- to 25-year-olds, were 5.2%, 4.5%, and 9.7%, respectively. Incidence rates were about half as high as prevalence rates. Prevalence rates were similar across rural and nonrural counties. Higher risk of homelessness was observed among young parents; black, Hispanic, and lesbian, gay, bisexual, or transgender (LGBT) youth; and those who did not complete high school. Conclusions The prevalence and incidence of youth homelessness reveal a significant need for prevention and youth-centric systems and services, as well as strategies to address disproportionate risks of certain subpopulations. PMID:29153445

  20. Prevalence and Correlates of Youth Homelessness in the United States.

    Science.gov (United States)

    Morton, Matthew H; Dworsky, Amy; Matjasko, Jennifer L; Curry, Susanna R; Schlueter, David; Chávez, Raúl; Farrell, Anne F

    2018-01-01

    Unaccompanied youth homelessness is a serious concern. Response, however, has been constrained by the absence of credible data on the size and characteristics of the population and reliable means to track youth homelessness over time. We sought to address these gaps. Using a nationally representative phone-based survey (N = 26,161), we solicited household and individual reports on different types of youth homelessness. We collected household reports on adolescents aged 13-17 and young adults aged 18-25, as well as self-reports from young adults aged 18-25. Follow-up interviews with a subsample (n = 150) provided additional information on youth experiences and enabled adjustment for inclusion errors. Over a 12-month period, approximately 3.0% of households with 13- to 17-year-olds reported explicit youth homelessness (including running away or being asked to leave) and 1.3% reported experiences that solely involved couch surfing, resulting in an overall 4.3% household prevalence of any homelessness, broadly defined. For 18- to 25-year-olds, household prevalence estimates were 5.9% for explicitly reported homelessness, 6.6% for couch surfing only, and 12.5% overall. The 12-month population prevalence estimates, available only for 18- to 25-year-olds, were 5.2%, 4.5%, and 9.7%, respectively. Incidence rates were about half as high as prevalence rates. Prevalence rates were similar across rural and nonrural counties. Higher risk of homelessness was observed among young parents; black, Hispanic, and lesbian, gay, bisexual, or transgender (LGBT) youth; and those who did not complete high school. The prevalence and incidence of youth homelessness reveal a significant need for prevention and youth-centric systems and services, as well as strategies to address disproportionate risks of certain subpopulations. Copyright © 2017 The Society for Adolescent Health and Medicine. All rights reserved.

  1. Homelessness and Health – Part II

    Centers for Disease Control (CDC) Podcasts

    2010-11-19

    Homelessness in the 21st century is an ongoing problem, increasing due to the country's recent economic downturn, especially in urban areas. This podcast discusses how homelessness impacts health and what public health professionals can do about it.  Created: 11/19/2010 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) and National Center for Environmental Health (NCEH).   Date Released: 11/19/2010.

  2. Homeless and Policy – Part I

    Centers for Disease Control (CDC) Podcasts

    2010-11-19

    Homelessness in the 21st century is an ongoing problem, increasing due to the country's recent economic downturn, especially in urban areas. This podcast discusses how homelessness impacts policy and what public health professionals can do about it.  Created: 11/19/2010 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) and National Center for Environmental Health (NCEH).   Date Released: 11/19/2010.

  3. Homeless and Policy – Part II

    Centers for Disease Control (CDC) Podcasts

    2010-11-19

    Homelessness in the 21st century is an ongoing problem, increasing due to the country's recent economic downturn, especially in urban areas. This podcast discusses how homelessness impacts policy and what public health professionals can do about it.  Created: 11/19/2010 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) and National Center for Environmental Health (NCEH).   Date Released: 11/19/2010.

  4. Homelessness and Health – Part I

    Centers for Disease Control (CDC) Podcasts

    2010-11-19

    Homelessness in the 21st century is an ongoing problem, increasing due to the country's recent economic downturn, especially in urban areas. This podcast discusses how homelessness impacts health and what public health professionals can do about it.  Created: 11/19/2010 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) and National Center for Environmental Health (NCEH).   Date Released: 11/19/2010.

  5. Homelessness as an independent risk factor for mortality: results from a retrospective cohort study.

    Science.gov (United States)

    Morrison, David S

    2009-06-01

    Homelessness is associated with increased risks of mortality but it has not previously been possible to distinguish whether this is typical of other socio-economically deprived populations, the result of a higher prevalence of morbidity or an independent risk of homelessness itself. The aim of this study was to describe mortality among a cohort of homeless adults and adjust for the effects of morbidity and socio-economic deprivation. Retrospective 5-year study of two fixed cohorts, homeless adults and an age- and sex-matched random sample of the local non-homeless population in Greater Glasgow National Health Service Board area for comparison. Over 5 years of observation, 1.7% (209/12 451) of the general population and 7.2% (457/6323) of the homeless cohort died. The hazard ratio of all-cause mortality in homeless compared with non-homeless cohorts was 4.4 (95% CI: 3.8-5.2). After adjustment for age, sex and previous hospitalization, homelessness was associated with an all-cause mortality hazard ratio of 1.6 (95% CI: 1.3-1.9). Homelessness had differential effects on cause-specific mortality. Among patients who had been hospitalized for drug-related conditions, the homeless cohort experienced a 7-fold increase in risk of death from drugs compared with the general population. Homelessness is an independent risk factor for deaths from specific causes. Preventive programmes might be most effectively targeted at the homeless with these conditions.

  6. Health Outcomes of Obtaining Housing Among Older Homeless Adults

    Science.gov (United States)

    Miao, Yinghui; Mitchell, Susan L.; Bharel, Monica; Patel, Mitkumar; Ard, Kevin L.; Grande, Laura J.; Blazey-Martin, Deborah; Floru, Daniella; Steinman, Michael A.

    2015-01-01

    Objectives. We determined the impact of obtaining housing on geriatric conditions and acute care utilization among older homeless adults. Methods. We conducted a 12-month prospective cohort study of 250 older homeless adults recruited from shelters in Boston, Massachusetts, between January and June 2010. We determined housing status at follow-up, determined number of emergency department visits and hospitalizations over 12 months, and examined 4 measures of geriatric conditions at baseline and 12 months. Using multivariable regression models, we evaluated the association between obtaining housing and our outcomes of interest. Results. At 12-month follow-up, 41% of participants had obtained housing. Compared with participants who remained homeless, those with housing had fewer depressive symptoms. Other measures of health status did not differ by housing status. Participants who obtained housing had a lower rate of acute care use, with an adjusted annualized rate of acute care visits of 2.5 per year among participants who obtained housing and 5.3 per year among participants who remained homeless. Conclusions. Older homeless adults who obtained housing experienced improved depressive symptoms and reduced acute care utilization compared with those who remained homeless. PMID:25973822

  7. Youth Homelessness and Vulnerability: How Does Couch Surfing Fit?

    Science.gov (United States)

    Curry, Susanna R; Morton, Matthew; Matjasko, Jennifer L; Dworsky, Amy; Samuels, Gina M; Schlueter, David

    2017-09-01

    Youth homelessness is a problem characterized by high levels of vulnerability. The extent to which couch surfing - moving from one temporary housing arrangement to another - is part of youth homelessness is not well understood. Chapin Hall's Voices of Youth Count, a national research initiative, involves a multicomponent approach to studying youth homelessness. This study reports emerging findings regarding couch surfing and homelessness primarily from a national survey of 13,113 adults with youth ages 13-25 in their households or who are themselves ages 18-25. Findings suggest that couch surfing is relatively common, particularly among the older age group. Among households with 13- to 17-year-olds and 18- to 25-year-olds, 4.0% and 20.5%, respectively, reported that any of them had couch surfed in the last 12 months. There are notable social, economic, and educational differences, on average, between youth reporting homelessness and those reporting only couch surfing. However, most youth who report experiencing homelessness also report couch surfing, and these youth who experience both circumstances present high levels of socioeconomic vulnerability. Couch surfing encompasses a range of experiences, some of which likely include need for services. Interviews currently in the field, and expanded analysis of data, will contribute more nuanced policy insights. © Society for Community Research and Action 2017.

  8. Homeless Families in the Netherlands: Intervention Policies and Practices

    Directory of Open Access Journals (Sweden)

    Catelijne Akkermans

    2011-07-01

    Full Text Available The demographics of the homeless population in many countries are currently shifting, and this cannot be explained by the different welfare systems to be found in these countries. Nevertheless, there is some evidence that the homelessness policies of some countries are converging, and we observe a combination of decentralisation, housing first, and a taylor-made, individualised approach. However, what is interesting is the question as to what extent these policies are based on a punitive dimension or on a justice dimension. This aspect is little discussed in the Netherlands where policies to combat homelessness are intended to put an end to public nuisance and to get the homeless off the street. Research into evicted families demonstrates that combining elements of (mild coercion with efforts to solve homelessness leads to problems in at least three domains: the motivation of homeless families to accept help and support, the quality of life in the individualised approach, and the matter of registration. These problems need investigating, also from an international perspective.

  9. Cardboard Boxes and Invisible Fences: Homelessness and Public Space in City of Victoria v. Adams

    Directory of Open Access Journals (Sweden)

    Sarah Buhler

    2009-02-01

    Full Text Available This paper analyzes the recent decision of the British Columbia Supreme Court in City of Victoria v. Adams. Specifically, the paper considers three interlocking themes that emerge from the decision: (1 the nature of “public space” in the context of homelessness; (2 the autonomy of homeless individuals; and (3 the meaning and value of the “homeless body.” With reference to each theme, the paper explores how the judgment in Adams grapples with the purportedly normative “Law and Economics”- type arguments put forth by the City of Victoria. By drawing on insights from Critical Legal Studies theory and feminist jurisprudence, the paper shows that Adams subverts and destabilizes certain “normative” perspectives about public space and homelessness. However, the paper goes on to argue that in its conflation of “cardboard box” shelters with the “invisible fences” envisioned by Justice Wilson in Morgentaler, Adams presents an ambiguous victory for anti-poverty advocates. The paper argues that the decision may serve to increase barriers for a broader and more progressive understanding of section 7 in the future. Dans cet article, on analyse le jugement récent de la Cour Suprême de la Colombie Britannique dans City of Victoria v. Adams. Plus précisément, on considère trois thèmes qui ressortent du jugement et qui s’entrecroisent : (1 la nature d’«espace public» dans le contexte de l’itinérance; (2 l’autonomie des sans-abri; et (3 la signification et la valeur du «corps sans abri». En rapport avec chaque thème, on explore comment l’arrêt Adams compose avec les arguments supposément normatifs du genre «La Loi et l’Économie» avancés par la ville de Victoria. En s’inspirant de perceptions tirées de la théorie des Critical Legal Studies et de la jurisprudence féministe, l’auteure démontre que l’arrêt Adams subvertit et déséquilibre certaines perspectives «normatives» au sujet de l

  10. Effect of the Economic Recession on Primary Care Access for the Homeless.

    Science.gov (United States)

    White, Brandi M; Jones, Walter J; Moran, William P; Simpson, Kit N

    2016-01-01

    Primary care access (PCA) for the homeless can prove challenging, especially during periods of economic distress. In the United States, the most recent recession may have presented additional barriers to accessing care. Limited safety-net resources traditionally used by the homeless may have also been used by the non-homeless, resulting in delays in seeking treatment for the homeless. Using hospitalizations for ambulatory care sensitivity (ACS) conditions as a proxy measure for PCA, this study investigated the recession's impact on PCA for the homeless and non-homeless in four states. The State Inpatient Databases were used to identify ACS admissions. Findings from this study indicate the recession was a barrier to PCA for homeless people who were uninsured. Ensuring that economically-disadvantaged populations have the ability to obtain insurance coverage is crucial to facilitating PCA. With targeted outreach efforts, the Affordable Care Act provides an opportunity for expanding coverage to the homeless.

  11. 78 FR 64153 - Direct Certification and Certification of Homeless, Migrant and Runaway Children for Free School...

    Science.gov (United States)

    2013-10-28

    ...-0001] RIN 0584-AD60 Direct Certification and Certification of Homeless, Migrant and Runaway Children... interim rule entitled Direct Certification and Certification of Homeless, Migrant and Runaway Children for...

  12. Prevalence of HIV infection and the correlates among homeless in Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Abbas Ostad Taghi Zadeh

    2014-01-01

    Conclusions: This study supports the idea that injection drug use is contributing to the increased spread of HIV among Iranian homeless. Harm reduction programs should be expanded, particularly among homeless injection drug users.

  13. Issues and Strategies Involved in Helping Homeless Parents of Young Children Strengthen Their Self-Esteem

    Science.gov (United States)

    Swick, Kevin J.

    2009-01-01

    Homeless parents of young children face many stressors that erode their self-esteem. This article articulates these stressors and how they negatively impact homeless parents and their children. Strategies for helping parents empower themselves and their children are explained.

  14. Reaching out to the forgotten: providing access to medical care for the homeless in Italy.

    Science.gov (United States)

    De Maio, Gianfranco; Van den Bergh, Rafael; Garelli, Silvia; Maccagno, Barbara; Raddi, Freja; Stefanizzi, Alice; Regazzo, Costantina; Zachariah, Rony

    2014-06-01

    A program for outpatient and intermediate inpatient care for the homeless was pioneered by the humanitarian organization Médecins Sans Frontières (MSF) in Milan, Italy, during the winter of 2012-2013. We aimed to document the characteristics and clinical management of inpatients and outpatients seen during this program. A clinic providing outpatient and intermediate inpatient care (24 bed capacity) was set up in an existing homeless hostel. Patients were admitted for post-hospitalization intermediate care or for illnesses not requiring secondary care. This study was a retrospective audit of the routine program data. Four hundred and fifty four individuals presented for outpatient care and 123 patients were admitted to inpatient intermediary care. On average one outpatient consultation was conducted per patient per month, most for acute respiratory tract infections (39.8%; 522/1311). Eleven percent of all outpatients suffered from an underlying chronic condition and 2.98% (38/1311) needed referral to emergency services or secondary care facilities. Most inpatients were ill patients referred through public reception centers (72.3%; 89/123), while 27.6% (34/123) were post-hospitalization patients requiring intermediate care. Out of all inpatients, 41.4% (51/123) required more than 1 week of care and 6.5% (8/123) needed counter-referral to secondary care. The observed service usage, morbidity patterns, relatively long lengths of stay, high referral completion and need for counter-referrals, all reflect the important gap-filling role played by an intermediate care facility for this vulnerable population. We recommend that in similar contexts, medical non-governmental organizations (NGOs) focus on the setup of inpatient intermediary care services; while outpatient services are covered by the public health system. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  15. Challenges to immunization: the experiences of homeless youth

    Directory of Open Access Journals (Sweden)

    Doroshenko Alexander

    2012-07-01

    Full Text Available Abstract Background Homelessness is a critical social issue, both a product of, and contributing to, poor mental and physical health. Over 150,000 young Canadians live on the streets. Homeless youth experience a high incidence of infectious diseases, many of which are vaccine preventable. Early departure from school and limited access to public health services makes them a particularly vulnerable high-risk group. This study explores challenges to obtaining essential vaccines experienced by homeless youth. Methods A qualitative research study to explore knowledge, attitudes, beliefs, and experiences surrounding immunization of hard-to-reach homeless youth was designed. Participants were recruited for focus groups from Phoenix House and Shelter, a non-profit, community-based organization assisting homeless youth in Halifax, Nova Scotia, Canada. An experienced facilitator guided the recorded discussions. Transcripts of audiotapes were analyzed using a constant comparative method until data revealed a set of exemplars and themes that best captured participants’ knowledge, attitudes, beliefs and experiences surrounding immunization and infectious diseases. Results Important themes emerged from our analysis. Considerable variability in knowledge about immunization and vaccine preventable diseases was found. The homeless youth in the study had limited awareness of meningitis in contrast to a greater knowledge about sexually transmitted infections and influenza, gained during the H1N1/09 public health campaign. They recognized their poverty as a risk for contracting infectious diseases, along with their inability to always employ known strategies to prevent infectious diseases, due to circumstances. They showed considerable insight into the detrimental effects of poor hygiene, sleeping locations and risk behaviour. Interviewed homeless youth regarded themselves as good compliers of health professional advice and offered valuable suggestions to improve

  16. A new way home: Refugee young people and homelessness in Australia

    OpenAIRE

    Jen Couch

    2011-01-01

    Abstract This article gives voice to refugee young people experiencing homelessness. It is based on a project that conducted interviews with refugee young people and consultations with service providers. The research reveals that the profoundly under-recognised phenomenon of homelessness experienced by young people of refugee background is often hidden and does not match commonly held beliefs about homeless young people. The article examines the nexus between migration and homelessness in...

  17. SANS studies of polymers

    International Nuclear Information System (INIS)

    Wignall, G.D.

    1984-10-01

    Before small-angle neutron scattering (SANS), chain conformation studies were limited to light and small angle x-ray scattering techniques, usually in dilute solution. SANS from blends of normal and labeled molecules could give direct information on chain conformation in bulk polymers. Water-soluble polymers may be examined in H 2 O/D 2 O mixtures using contrast variation methods to provide further information on polymer structure. This paper reviews some of the information provided by this technique using examples of experiments performed at the National Center for Small-Angle Scattering Research (NCSASR)

  18. Using Evidence-Based Programs to Support Children and Families Experiencing Homelessness

    Science.gov (United States)

    Siebel, Nancy L.; Bassuk, Ellen; Medeiros, Debra

    2012-01-01

    This article was originally published (November 2011) as a brief created on behalf of the Strengthening At Risk and Homeless Young Mothers and Children Coordinating Center, which is a partnership of The National Center on Family Homelessness, National Alliance to End Family Homelessness, and ZERO TO THREE. The article offers a definition of…

  19. Homeless Liaisons' Awareness about the Implementation of the McKinney-Vento Act

    Science.gov (United States)

    Wilkins, Brittany Taylor; Mullins, Mary H.; Mahan, Amber; Canfield, James P.

    2016-01-01

    The federal government enacted the McKinney--Vento Homeless Assistance Act (MVA) to equip schools with services to help alleviate the many barriers students experiencing homelessness face in pursuit of educational opportunities. Educational agencies use federally mandated liaisons to uphold the provisions of the MVA. Despite the homeless liaisons'…

  20. Developmental Status and Social-Emotional Functioning of Young Children Experiencing Homelessness

    Science.gov (United States)

    Haskett, Mary E.; Armstrong, Jenna Montgomery; Tisdale, Jennifer

    2016-01-01

    The developmental status and social-emotional functioning of young children who are homeless has received inadequate attention in spite of high rates of homelessness among families with young children and the potentially negative impact of homelessness and associated stressors on children's well-being. The aim of this study was to gain…