Homelessness and Hunger

Lee, Barrett; Greif, Meredith J.

doi:10.1177/002214650804900102

Cited by 61 publications

(77 citation statements)

References 34 publications

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“…This finding is concordant with prior work demonstrating a high burden of food insecurity among chronically homeless individuals, further disputing the notion that the accumulated "street wisdom" of entrenched homelessness might endow a protective effect against lacking food because of increased knowledge about how to acquire it. 4 Instead, the clustering of food, shelter, and safety concerns documented in this study suggests that difficulty in meeting one basic subsistence need predicts difficulties with others.…”

Section: Discussionmentioning

confidence: 59%

“…Competing demands for food are common among homeless individuals and may influence health care utilization patterns. [4][5][6] Homeless people who do not get enough food to eat may postpone or forego needed medical care until later stages of illness, [6][7][8][9] choose to buy food over medications, [10][11][12] or have difficulty managing health conditions and adhering to treatment plans. [13][14][15] In some cases, homeless people may use health services in order to get food.…”

Section: Introductionmentioning

confidence: 99%

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Food Insufficiency and Health Services Utilization in a National Sample of Homeless Adults

et al. 2011

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BACKGROUND:Homeless people have high rates of hospitalization and emergency department (ED) use. Obtaining adequate food is a common concern among homeless people and may influence health care utilization. OBJECTIVE: We tested the hypothesis that food insufficiency is related to higher rates of hospitalization and ED use in a national sample of homeless adults. DESIGN: We analyzed data from the 2003 Health Care for the Homeless (HCH) User Survey. PARTICIPANTS: Participants were 966 adults surveyed at 79 HCH clinic sites throughout the US. The study sample was representative of over 436,000 HCH clinic users nationally. MEASURES: We determined the prevalence and characteristics of food insufficiency among respondents. Using multivariable logistic regression, we examined the association between food insufficiency and four past-year acute health services utilization outcomes: (1) hospitalization for any reason, (2) psychiatric hospitalization, (3) any ED use, and (4) high ED use (≥4 visits). RESULTS: Overall, 25% of respondents reported food insufficiency. Among them, 68% went a whole day without eating in the past month. Chronically homeless (p = 0.01) and traumatically victimized (p = 0.001) respondents were more likely to be food insufficient. In multivariable analyses, food insufficiency was associated with significantly greater odds of hospitalization for any reason (AOR 1.59, 95% CI 1.07, 2.36), psychiatric hospitalization (AOR 3.12, 95% CI 1.73, 5.62), and high ED utilization (AOR 2.83, 95% CI 1.32, 6.08). CONCLUSIONS: One-fourth of homeless adults in this national survey were food insufficient, and this was associated with increased odds of acute health services utilization. Addressing the adverse health services utilization patterns of homeless adults will require attention to the social circumstances that may contribute to this issue.KEY WORDS: homelessness; food insufficiency; health services utilization.

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Section: Discussionmentioning

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Food Insufficiency and Health Services Utilization in a National Sample of Homeless Adults

et al. 2011

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“…Using a sample of households in Los Angeles County, Furness et al (2004) found that a history of homelessness is associated with food insecurity. Lee and Greif (2008) used data from the National Survey of Homeless Assistance Providers and Clients (NSHAPC) and found that homeless individuals were at higher risk of experiencing food insecurity. Some limitations of these studies are their cross-sectional design and the possibility that the findings could be due to selection.…”

Section: Introductionmentioning

confidence: 99%

Food insecurity and housing instability in vulnerable families

King

2016

Rev Econ Household

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Reducing the prevalence of household food insecurity has been a long-standing objective of the federal government. Previous research has found many negative consequences of food insecurity for families and households but has not examined its relationship with housing instability. Using longitudinal data from the Fragile Families and Child Wellbeing Study, difference-in-difference models show that food insecurity is associated with housing instability. The association remains statistically significant after accounting for potential selection and unobserved heterogeneity using propensity score matching and excluding households that experienced prior housing instability from the sample. Examining potential mediating factors, I find that material hardship explains about half of this association. These findings suggest that maintaining a strong social safety net would reduce the risk that families experience material hardship and housing instability, which may also reduce the risk of homelessness.

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“…Homeless adults represent a marginalized, neglected segment of the population and are known to experience poorer physical health than the general population. 9,10 Because adults who are chronically homeless lack a stable, secure residence and often cannot afford regular, healthy meals, [11][12][13] they are presumed to be underweight. However, this assumption has not been empirically examined, and there is evidence to suggest there may be an obesity problem among the homeless.…”

mentioning

confidence: 99%

Obesity among Chronically Homeless Adults: Is it a Problem?

Tsai

Rosenheck

2013

Public Health Rep

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Objective. We examined rates of obesity and associated characteristics in the chronically homeless population to explore how a range of factors, including sociodemographics, housing, food source, physical and mental health, and health service use, were related to being overweight or obese.Methods. We conducted multivariate regression analyses on a community sample of 436 chronically homeless adults across 11 U.S. cities to examine the prevalence of obesity.results. The majority (57%) of chronically homeless adults were overweight or obese. Chronically homeless adults who were female or Hispanic appeared to be at particular risk for obesity. There were few differences on physical and mental health by weight group. Although overweight and obese chronically homeless adults were more likely to discuss exercise with a health-care provider, they reported engaging in less exercise than those who were underweight or normal weight.conclusion. These findings underscore the need for greater attention to obesity in chronically homeless adults and demonstrate a food insecurity-obesity paradox or poverty-obesity link.

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Homelessness and Hunger

Cited by 61 publications

References 34 publications

Food Insufficiency and Health Services Utilization in a National Sample of Homeless Adults

Food Insufficiency and Health Services Utilization in a National Sample of Homeless Adults

Food insecurity and housing instability in vulnerable families

Obesity among Chronically Homeless Adults: Is it a Problem?

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