A Population-Based Assessment of the Health of Homeless Families in New York City, 2001–2003

Kerker, Bonnie D.; Bainbridge, Jay; Kennedy, Joseph; Bennani, Yussef; Agerton, Tracy B.; Marder, Dova; Forgione, Lisa A.; Faciano, Andrew; Thorpe, Lorna E.

doi:10.2105/ajph.2010.193102

Cited by 55 publications

(38 citation statements)

References 12 publications

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“…The one study by Kerker and her colleagues that examines mortality among this major subgroup of the homeless population finds that factors and outcomes related to mortality were very different for adults who were homeless as part of families, to the point that they should be considered separately from adults who were homeless as single adults. These findings, also based upon a NYC shelter population, found their mortality rates to be comparable to other low-income adults, 40 and lower than that of the single adult population. 14 These differential mortality rates underscore other fundamental differences between adults in homeless families and their single adult counterparts.…”

Section: Introductionmentioning

confidence: 50%

The Impact of Shelter Use and Housing Placement on Mortality Hazard for Unaccompanied Adults and Adults in Family Households Entering New York City Shelters: 1990–2002

et al. 2011

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This study examines mortality among New York City (NYC) homeless shelter users, assessing the relationships between mortality hazard and time in shelter, patterns of homelessness, and subsequent housing exits for both adults in families and single adults. Administrative records from the NYC shelter system were matched with death records from the Social Security Administration for 160,525 persons. Crude mortality rates and life tables were calculated, and survival analyses were undertaken using these data. Life expectancy was 64.2 and 68.6 years for single adult males and single adult females, respectively, and among adults in families, life expectancy was 67.2 and 70.1 years for males and females, respectively. For both groups, exits to stable housing (subsidized or non-subsidized) were associated with reduced mortality hazard. And while mortality hazard was substantially reduced for the time adults were in shelters, extended shelter use patterns were associated with increased mortality hazard. Differences between single homelessness and family homelessness extend to disparities in mortality rates. Although causal links cannot be established here, results suggest that, for both subgroups of the homeless population, prompt resolution of homelessness and availability of housing interventions may contribute to reduced mortality.

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Section: Introductionmentioning

confidence: 50%

The Impact of Shelter Use and Housing Placement on Mortality Hazard for Unaccompanied Adults and Adults in Family Households Entering New York City Shelters: 1990–2002

et al. 2011

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“…Studies 3,10,11,16,17,25,27 conducted in several different cities around the world showed that the prevalence of HIV infection among homeless people is signifi cantly higher than in the general population. In the present study, however, this rate was as high as in those population groups most affected by the HIV/AIDS epidemic in Brazil such as sex workers 23 (4.8%) and MSM 13 (13.6%).…”

Section: Discussionmentioning

confidence: 99%

“…It might be consequential to the extreme vulnerability that is inherent to living on the streets, 1,15,28 and such a condition overlaps with other factors typically associated with poverty and social inequality in the general population. In other words, living on the streets and insecurity related to having no housing 7,11,20,28 are per se factors that bring about situations of greater exposure to HIV such as violence and no access to services. 14,26,29 These same particularities may largely explain the study fi nding that young, female and homeless individuals engaging in homosexual sex are more vulnerable to HIV infection.…”

Section: Discussionmentioning

confidence: 99%

“…All these factors strongly affect homeless people in Brazil, 3,a,b and in other countries. 7,11,16,20 Studies assessing the impact of the HIV/AIDS epidemic on homeless people are scarce in Brazil. 2,3,b There is little information on HIV prevalence rates, risk factors associated with HIV infection, and other aspects that may guide specifi c prevention actions in this group.…”

Section: Introductionmentioning

confidence: 99%

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Prevalência e vulnerabilidade à infecção pelo HIV de moradores de rua em São Paulo, SP

et al. 2012

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OBJETIVO: Analisar a prevalência e o perfil de vulnerabilidade ao HIV de moradores de rua. MÉTODOS: Estudo transversal com amostra não probabilística de 1.405 moradores de rua usuários de instituições de acolhimento de São Paulo, SP, de 2006 a 2007. Foi realizado teste anti-HIV e aplicado questionário estruturado. O perfil de vulnerabilidade foi analisado pela frequência do uso do preservativo, considerando mais vulneráveis os que referiram o uso nunca ou às vezes. Foram utilizadas regressões logística e multinomial para estimar as medidas de efeito e intervalos de 95% de confiança. RESULTADOS: Houve predominância do sexo masculino (85,6%), média de 40,9 anos, ter cursado o ensino fundamental (72,0%) e cor não branca (71,5%). A prática homo/bissexual foi referida por 15,7% e a parceria ocasional por 62,0%. O número médio de parcerias em um ano foi de 5,4 e mais da metade (55,7%) referiu uso de drogas na vida, dos quais 25,7% relataram uso frequente. No total, 39,6% mencionaram ter tido uma doença sexualmente transmissível e 38,3% relataram o uso do preservativo em todas as relações sexuais. A prevalência do HIV foi de 4,9% (17,4% dos quais apresentaram também sorologia positiva para sífilis). Pouco mais da metade (55,4%) tinha acesso a ações de prevenção. A maior prevalência do HIV esteve associada a ser mais jovem (OR 18 a 29 anos = 4,0 [IC95% 1,54;10,46]), história de doença sexualmente transmissível (OR = 3,3 [IC95% 1,87;5,73]); prática homossexual (OR = 3,0 [IC95% 1,28;6,92]) e à presença de sífilis (OR = 2,4 [IC95% 1,13;4,93]). O grupo de maior vulnerabilidade foi caracterizado por ser mulher, jovem, ter prática homossexual, número reduzido de parcerias, parceria fixa, uso de drogas e álcool e não ter acesso a ações de prevenção e apoio social. CONCLUSÕES: O impacto da epidemia entre moradores de rua é elevado, refletindo um ciclo que conjuga exclusão, vulnerabilidade social e acesso limitado à prevenção.

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“…(6) The feeling of not being supported can lead to abandonment of therapy. For this reason, it is necessary to recognize and consider social, economic and family aspects, in order to establish autonomy and co-responsibility of health care.…”

Section: Discussionmentioning

confidence: 99%

Opinião dos profissionais de saúde sobre os serviços de controle da tuberculose

2015

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Objective: To analyze, based on the perspective of health professionals, the performance of services for tuberculosis control in relation to focus on family and community guidance. Methods: This cross-sectional study included 134 primary care health professionals. For each variable a mean score was determined, and the results were then submitted to analysis of variance. Results: The dimension of focus on family had a satisfactory score, and only the variable "giving a sputum test container for contacts" was classified as fair. The dimension "community guidance" was classified as unsatisfactory; however, the dimensions "performance of educational actions" and "looking for respiratory symptoms in the community" were scored as fair. Conclusion: According to professionals, the performance of health services in tuberculosis control with relation to focus on family is satisfactory, but guidance actions for the community are unsatisfactory. ResumoObjetivo: Analisar, na perspectiva dos profissionais de saúde, o desempenho dos serviços de controle a tuberculose em relação ao enfoque na família e a orientação para comunidade. Métodos: Estudo transversal que incluiu 134 profissionais de saúde da atenção primária. Para cada variável foi determinado um escore médio, posteriormente, submetido à análise de variância. Resultados: A dimensão enfoque na família obteve escore satisfatório e apenas a "variável entrega do pote de exame de escarro aos comunicantes" foi classificada como regular. A dimensão orientação para a comunidade foi classificada como insatisfatória, porém a "realização de trabalhos educativos" e a "busca de sintomáticos respiratórios na comunidade" atingiram escore regular. Conclusão: De acordo com os profissionais, o desempenho dos serviços de saúde para o controle da tuberculose em relação ao enfoque na família é satisfatório, porém as ações de orientação para a comunidade são insatisfatórias.

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A Population-Based Assessment of the Health of Homeless Families in New York City, 2001–2003

Abstract: Morbidity and mortality levels were comparable between homeless and low-income adults; homeless children's slightly higher risk on some measures possibly reflects the impact of poverty and poor-quality, unstable housing.

Cited by 55 publications

References 12 publications

The Impact of Shelter Use and Housing Placement on Mortality Hazard for Unaccompanied Adults and Adults in Family Households Entering New York City Shelters: 1990–2002

The Impact of Shelter Use and Housing Placement on Mortality Hazard for Unaccompanied Adults and Adults in Family Households Entering New York City Shelters: 1990–2002

Prevalência e vulnerabilidade à infecção pelo HIV de moradores de rua em São Paulo, SP

Opinião dos profissionais de saúde sobre os serviços de controle da tuberculose

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