Health status and access to health services among the urban homeless.

Robertson, Marjorie J.; Cousineau, Michael R.

doi:10.2105/ajph.76.5.561

Cited by 125 publications

(57 citation statements)

References 3 publications

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“…Considerable research has shown a lack of access to primary care and/or inappropriate use of health care services among general samples of homeless or unstably housed persons (Aday 2001;D'Amore, Hung et al 2001;Douglass et al 1999;Kushel et al 2001;Lim et al 2002;Robertson and Cousineau 1986). Limited or inadequate health care utilization has also been reported among unstably housed persons living with HIV (Arno et al 1996;Conover and Whetten-Goldstein 2002;Cunningham et al 2007;Douaihy et al 2005;Masson et al 2004;Pulvirenti et al 2003;Smith et al 2000;Stewart et al 2005).…”

Section: Introductionmentioning

confidence: 99%

Housing Need, Housing Assistance, and Connection to HIV Medical Care

et al. 2007

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HIV infection has become a chronic condition that for most persons can be effectively managed with regular monitoring and appropriate medical care. However, many HIV positive persons remain unconnected to medical care or have less optimal patterns of health care utilization than recommended by good clinical practice standards. This paper investigates housing status as a contextual factor affecting access and maintenance in appropriate HIV medical care. Data provided from 5,881 interviews conducted from 1994 to 2006 with a representative sample of 1,661 persons living with HIV/AIDS in New York City demonstrated a strong and consistent relationship between housing need and remaining outside of or marginal to HIV medical care. In contrast, housing assistance increased access and retention in medical care and appropriate treatment. The relationship between housing and medical care outcomes remain controlling for client demographics, health status, insurance coverage, co-occurring mental illness, and problem drug use and the receipt of supportive services to address co-occurring conditions. Findings provide strong evidence that housing needs are a significant barrier to consistent, appropriate HIV medical care, and that receipt of housing assistance has an independent, direct impact on improved medical care outcomes.

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Section: Introductionmentioning

confidence: 99%

Housing Need, Housing Assistance, and Connection to HIV Medical Care

et al. 2007

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“…2 Numerous reports have described the health care needs of various homeless subgroups, with most addressing the health problems of adult individuals and children. [3][4][5][6][7][8][9][10][11][12] Surprisingly, the literature offers little information about the health status and service use patterns of homeless female heads of household and how their health and health care patterns compare with those of their housed counterparts. Although several descriptive reports and studies on homeless adult individuals have included female heads of household as part of the sample, 3,4,7,10 they have not reported specifically on the health needs of these women.…”

mentioning

confidence: 99%

Health characteristics and medical service use patterns of sheltered homeless and low-income housed mothers

Weinreb

Goldberg

Perloff³

1998

J Gen Intern Med

122

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OBJECTIVE:To compare the health characteristics and service utilization patterns of homeless women and low-income housed women who are heads of household. DESIGN:Case-control study. SETTING: Community of Worcester, Massachusetts.PARTICIPANTS: A sample of 220 homeless mothers and 216 low-income housed mothers receiving welfare. MEASUREMENTS AND MAIN RESULTS:Outcome measures included health status, chronic conditions, adverse lifestyle practices, outpatient and emergency department use and hospitalization rates, and use of preventive screening measures. Both homeless mothers and housed mothers demonstrated low levels of physical and role functioning and high levels of bodily pain. Prevalence rates of asthma, anemia, and ulcer disease were high in both groups. More than half of both groups were current smokers. Compared with the housed mothers, homeless mothers reported more HIV risk behaviors. Although 90% of the homeless mothers had been screened for cervical cancer, almost one third had not been screened for tuberculosis. After controlling for potential confounding factors, the homeless mothers, compared with the housed mothers, had more frequent emergency department visits in the past year (adjusted mean, homeless vs housed, 1.41 vs .95, p ‫؍‬ .10) and were significantly more likely to be hospitalized in the past year (adjusted odds ratio 2.22; 95% confidence interval 1.13, 4.38). CONCLUSIONS:Both homeless mothers and low-income housed mothers had lower health status, more chronic health problems, and higher smoking rates than the general population. High rates of hospitalization, emergency department visits, and more risk behaviors among homeless mothers suggest that they are at even greater risk of adverse health outcomes. Efforts to address gaps in access to primary care and to integrate psychosocial supports with health care delivery may improve health outcomes for homeless mothers and reduce use of costly medical care services. H omelessness remains a persistent and growing problem nationwide. A telephone survey of 1,507 household-based participants published in 1994 reported that 13.5 million (7.4%) of adult Americans had experienced homelessness at some point in their lives. 1 Most agree that homeless families, the majority of which are headed by women, are increasing in number and now constitute more than one third of the overall homeless population. 2 Numerous reports have described the health care needs of various homeless subgroups, with most addressing the health problems of adult individuals and children. 3-12 Surprisingly, the literature offers little information about the health status and service use patterns of homeless female heads of household and how their health and health care patterns compare with those of their housed counterparts. Although several descriptive reports and studies on homeless adult individuals have included female heads of household as part of the sample, 3,4,7,10 they have not reported specifically on the health needs of these women. A few studies have examined general h...

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“…In the Birmingham sample, unmet need was somewhat more common among women and persons characterized as non-Black, a finding not explained by this analysis. Several characteristics associated with unmet need were more prevalent in 2005 (and are relevant in other research 3,22,32,[35][36][37]42 ). These included older age, higher competing priority scores, higher physical symptom count, and greater proportions with some chronic diseases.…”

Section: Discussionmentioning

confidence: 81%