Comparing the Housing Trajectories of Different Classes Within a Diverse Homeless Population

Aubry, Tim; Klodawsky, Fran; Coulombe, Daniel

doi:10.1007/s10464-011-9444-z

Cited by 110 publications

(114 citation statements)

References 40 publications

(47 reference statements)

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“…The present study's identification of distinct subgroups of homeless frequent ED users parallels previous studies, which have identified heterogeneity among homeless individuals using latent class and cluster analyses (Aubry et al, 2012;Bonin et al, 2009;Kuhn & Culhane, 1998;Tsai, Kasprow, et al, 2013). Although differences in populations and measures used to examine heterogeneity make direct comparison difficult, our results are consistent with prior findings, which also identified relatively high-need subgroups of the homeless population with greater levels of services use.…”

Section: Discussionsupporting

confidence: 90%

Cost of health care utilization among homeless frequent emergency department users.

Mitchell

León

Byrne

et al. 2017

Psychological Services

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Research demonstrates that homelessness is associated with frequent use of emergency department (ED) services, yet prior studies have not adequately examined the relationship between frequent ED use and utilization of non-ED health care services among those experiencing homelessness. There has also been little effort to assess heterogeneity among homeless individuals who make frequent use of ED services. To address these gaps, the present study used Medicaid claims data from 2010 to estimate the association between the number of ED visits and non-ED health care costs for a cohort of 6,338 Boston Health Care for the Homeless Program patients, and to identify distinct subgroups of persons in this cohort who made frequent use of ED services based on their clinical and demographic characteristics. A series of gamma regression models found more frequent ED use to be associated with higher non-ED costs, even after adjusting for demographic and clinical characteristics. Latent class analysis was used to examine heterogeneity among frequent ED users, and the results identified 6 characteristically distinct subgroups among these persons. The subgroup of persons with trimorbid illness had non-ED costs that far exceeded members of all 5 other subgroups. Study findings reinforce the connection between frequent ED use and high health care costs among homeless individuals and suggest that different groups of homeless frequent ED users may benefit from interventions that vary in terms of their composition and intensity.

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Section: Discussionsupporting

confidence: 90%

Cost of health care utilization among homeless frequent emergency department users.

Mitchell

León

Byrne

et al. 2017

Psychological Services

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“…[10][11][12] Additionally, the proportion of study participants who expressed a desire for paid employment in the community was lower at all sites than a previous US estimate. The American National Coalition for the Homeless, in a 2009 report on homelessness and employment, indicated that 86% of a sample of 182 homeless men and women had expressed a desire to work.…”

Section: Discussionmentioning

confidence: 99%

“…1,5 Income support can reduce the prevalence of risky and costly behaviours in this population. 6,7 Research suggests that homeless people with mental illness may have difficulty accessing disability benefits 8,9 and that their rate of unemployment exceeds 80%, [10][11][12] reducing their options for subsistence. Additionally, the highly visible act of panhandling is the focus of much public attention and has a negative impact on society's opinion of this vulnerable segment of society.…”

Section: Limitationsmentioning

confidence: 99%

Employment and Income of People Who Experience Mental Illness and Homelessness in a Large Canadian Sample

et al. 2015

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Objectives:Research suggests that homeless people with mental illness may have difficulty obtaining employment and disability benefits. Our study provides a comprehensive description of sources of income and employment rates in a large Canadian sample.Methods: Participants (n = 2085) from the 5 sites of the At Home/Chez Soi study were asked about their income, employment, and desire for work during the pre-baseline period. The proportion of participants employed, receiving government support, and relying on income from other activities were compared across sites, as were total income and income from different sources. Generalized linear models were used to identify participant characteristics associated with total income.Results: Unemployment ranged from 93% to 98% across 5 sites. The per cent of participants who wanted to work ranged from 61% to 83%. Participants relied predominantly on government assistance, with 29.5% relying exclusively on welfare, and 46.2% receiving disability benefits. Twenty-eight per cent of participants received neither social assistance nor disability income. Among the 2085 participants, 6.8% reported income from panhandling, 2.1% from sex trade, and 1.2% from selling drugs. Regression models showed that income differed significantly among sites and age groups, and was significantly lower for people with psychotic illnesses. Conclusion:These results suggest that homeless people with mental illness are predominantly unemployed, despite expressing a desire to work. In Canada, this group relies predominantly on welfare, but has access to disability benefits and employment insurance. These findings highlight the importance of developing effective interventions to support employment goals and facilitate access to benefits. W W W Emploi et revenu des personnes sans abri souffrant de maladie mentale dans un vaste échantillon canadienObjectifs : La recherche suggère que les personnes sans abri souffrant de maladie mentale peuvent éprouver des difficultés à obtenir un emploi et des prestations d'invalidité. Notre étude offre une description détaillée des sources de revenu et des taux d'emploi dans un vaste échantillon canadien. Méthodes :Les participants (n = 2085) de 5 sites de l'étude At Home/Chez Soi ont été interrogés au sujet de leur revenu, leur emploi, et leur désir de travailler durant la période d'avant-départ de l'étude. La proportion des participants employés, recevant un soutien du gouvernement, et s'appuyant sur le revenu d'autres activités a été comparée entre les sites, tout comme le revenu total et le revenu de différentes sources. Des modèles linéaires généralisés ont servi à identifier les caractéristiques des participants associées au revenu total.Résultats : Le chômage se situait de 93 % à 98 % dans les 5 sites. Le pourcentage de participants qui voulaient travailler allait de 61 % à 83 %. Les participants se fiaient principalement sur l'aide du gouvernement, 29,5 % vivant exclusivement de l'aide sociale, et 46,2 % recevant des prestations d'invalidité. Vingt-huit pour cent...

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“…In addition to having higher rates of drug use and drug use disorders, homeless populations may also experience added societal consequences due to their drug use. For example, among homeless individuals, those with drug use problems were shown to be less likely to achieve housing stability after two years, even when compared to homeless individuals with other physical and nondrug-related mental health disorders (12). To this end, beyond the adverse health risks of drug use, drug use is a strong barrier to establishing independent housing and is associated with the age at homelessness onset and duration of homelessness (12).…”

Section: Introductionmentioning

confidence: 99%

Drug use patterns and predictors among homeless youth: Results of an ecological momentary assessment

Maria

Padhye

Yang

et al. 2017

The American Journal of Drug and Alcohol Abuse

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Background. Alcohol and drug use is associated with significant morbidity and mortality and is highly prevalent among homeless youth. Ecological Momentary Assessments (EMA) have been used to examine the effect of urges on drug use, though not among homeless youth. Objectives. We assessed the patterns of drug use and the correlation between real-time contextual factors and drug use using EMA collected daily. We identified predictors of drug use among a sample of homeless youth 18-25 years old in Houston, Texas. Methods. Homeless youth (n = 66, 62% male) were recruited from a drop-in center between September 2015 and May 2016. We used generalized linear mixed models and cross-validation methods to determine the best predictive model of drug use. Results. The overall drug use was high: 61% and 32% of participants reported using drugs or alcohol at least one day, respectively. Marijuana and synthetic marijuana use (i.e., Kush, K2, incense packs) were reported most frequently; 86% and 13% of the total drug use EMAs, respectfully. Drug use urge was reported on 26% of days and was the highest on drug use days. Drug use was predicted by discrimination, pornography use, alcohol use, and urges for drugs, alcohol, and to steal. Conclusions. EMA can be used to predict drug use among homeless youth. Drug use treatment among homeless youth should address the role of experiencing discrimination, pornography and alcohol use, and urge management strategies on drug use. Research is needed to determine if EMA informed just-in-time interventions targeting these predictors can reduce use.

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Comparing the Housing Trajectories of Different Classes Within a Diverse Homeless Population

Cited by 110 publications

References 40 publications

Cost of health care utilization among homeless frequent emergency department users.

Cost of health care utilization among homeless frequent emergency department users.

Employment and Income of People Who Experience Mental Illness and Homelessness in a Large Canadian Sample

Drug use patterns and predictors among homeless youth: Results of an ecological momentary assessment

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