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.

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Persons with SUD can achieve residential stability in supportive housing that does not require SUD treatment before admission.

Supportive housing placement was associated with improved housing stability and reduced preventable health care visits among homeless families.

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This study examined factors associated with being paid for sick leave after implementation of the New York City (NYC) paid sick leave law. A random sample of NYC residents was surveyed by telephone multiple times over a 2-year period. Participants (n = 1195) reported socio-demographics, awareness of the law, income, work hours per week, and payment for sick time off work. In the year after implementation of the law, part-time workers were significantly more likely to attend work while sick than full-time workers (relative risk = 1.25, 95% CI = 1.1, 1.4). Seventy percent of workers who missed work due to illness (n = 249) were paid for sick leave. Part-time workers, respondents not aware of the benefit (30% of workers), and workers without a college degree were the least likely to be paid for sick days. More than one third (37%) of persons not paid for sick leave worked in retail, food service, or health care. Although 70% of respondents were paid for sick leave after implementation of the law, part-time workers and workers with low education were least likely to access the benefit and more likely to work while sick. The disparity in paid sick leave may have public health consequences as many persons not paid for sick leave had occupations that carry a high risk of disease transmission to others.

ObjectiveHurricane Sandy made landfall on October 29, 2012, causing a coastal storm surge and extensive flooding, which led to the closure of several health care facilities in New York City (NYC) and prolonged interruptions in service delivery. The impact on mental health–related emergency department (ED) and inpatient hospital service utilization was studied.MethodsData came from the New York Statewide Planning and Research Cooperative System. We obtained mental health–related data among NYC residents from 2010 to 2013. Patients were grouped into 5 geographic areas, including service areas of closed hospitals, the Hurricane Sandy evaluation zone, and all of NYC. The Farrington method was used to detect increases in ED visits and hospitalizations for the post-Sandy period.ResultsOpen hospitals experienced a substantial increase in psychiatric ED visits from patients living in the service areas of closed hospitals. This surge in psychiatric ED visits persisted for 4 to 6 months after Hurricane Sandy. However, the increase in psychiatric hospitalizations was observed for 1 to 3 months.ConclusionsSeveral NYC hospitals received a substantially larger number of ED patients from service areas of closed hospitals after Hurricane Sandy, unlike other hospitals that experienced a decrease. Because of potential surges in the number of psychiatric ED visits, resource allocation to hospitals should be considered. (Disaster Med Public Health Preparedness. 2016;10:512–517)

Objective: Homeless persons are at high risk for poor oral health. Supportive housing can improve housing stability for persons with behavioural health conditions, but its impact on dental service use has been little studied. Methods: Data for this evaluation come from matched public service records for eligible applicants to a New York City supportive housing program (NY III) targeting chronic homelessness. NY III tenants (N = 5678) were compared with applicants not placed in housing (N = 6536) and applicants placed in other supportive housing programmes (N = 4823). Regression analysis was used to assess the association between supportive housing, primary care use, clinical severity and the likelihood of dental visits. Results: Over four observation years, 71% of applicants had at least one dental visit for any cause and 57% for preventive dental care. Incidence of dental visits was lower for persons with physical disability (IRR = 0.91; 95% CI = 0.85, 0.97, P = .003), psychiatric hospital stays (IRR = 0.78; 95% CI = 0.68, 0.88, P < .001) and age over 54.