[Mediating effect of self-efficacy in the relationship between anger and functional health of homeless men].

PubMed

Park, Su In; Kim, Sunah

2014-08-01

The purpose of this study was to examine the mediation of self-efficacy in the relationship between anger and the functional health of homeless men in order to provide a basis for planning nursing interventions to improve the functional health of homeless persons. The participants were 137 homeless men who lived in homeless shelters or visited one center serving free meals for homeless persons in Seoul. Data were collected using self-report questionnaires and analyzed with the SPSS-WIN 20.0 program. The instruments were the Functional Health Pattern Screening Assessment Tool (FHPAST), Self-efficacy Scale (SES), and State-trait Anger Expression Inventory-Korean version (STAXI-K). The mean score for functional health was 2.41. Overall self-efficacy was 70.82. state anger was 16.53, trait anger was 19.54, and anger expression was 25.31. There were signigicant correlations among the 3 variables, functional health, self-efficacy, and anger. Also, self-efficacy had a complete mediating effect in the relationship between anger and functional health. Based on the findings of this study, health management programs focusing on anger management and self-efficacy improvement are highly recommended to promote functional health in homeless persons.

Monogamy on the Street: A Mixed Methods Study of Homeless Men

ERIC Educational Resources Information Center

Brown, Ryan A.; Kennedy, David P.; Tucker, Joan S.; Golinelli, Daniela; Wenzel, Suzanne L.

2013-01-01

In this study, we used a mixed methods approach to explore the determinants of relationship patterns and risky sex among homeless men living in downtown Los Angeles. This involved analysis of qualitative interviews focused on gender ideology and sexual events ("n" = 30) as well as structured interviews ("n" = 305) focused on…

Patterns, Predictors, and Situational Contexts of HIV Risk Behaviors among Homeless Men and Women.

ERIC Educational Resources Information Center

Somlai, Anton M.; Kelly, Jeffrey A.; Wagstaff, David A.; Whitson, Donna P.

1998-01-01

Investigates psychosocial, relationship, and situational factors associated with HIV risk in a sample of 152 inner-city homeless men and women. Results show gender differences in risk patterns. Concludes that HIV prevention efforts tailored to the different risk circumstances of men and women are needed in social services programs for homeless…

Predictors of High Level of Hostility among Homeless Men on Parole

PubMed Central

Nyamathi, Adeline; Salem, Benissa; Farabee, David; Hall, Elizabeth; Zhang, Sheldon; Khalilifard, Farinaz; Faucette, Mark; Leake, Barbara

2014-01-01

High levels of hostility present a formidable challenge among homeless ex-offenders. This cross-sectional study assessed correlates of high levels of hostility using baseline data collected on recently-released male parolees (N=472; age 18-60) participating in a randomized trial focused on prevention of illicit drug use and recidivism. Predictors of high levels of hostility included greater depressive symptomatology, lower self-esteem, having a mother who was treated for alcohol/drugs, belonging to a gang, more tangible support, having used methamphetamine and having a history of cognitive difficulties. These findings highlight the need to understand predictors of hostility among recently released homeless men and how these predictors may relate to recidivism. Research implications are discussed as these findings will shape future nurse-led harm reduction and community-based interventions. PMID:25083121

Assessing Trauma, Substance Abuse, and Mental Health in a Sample of Homeless Men

ERIC Educational Resources Information Center

Kim, Mimi M.; Ford, Julian D.; Howard, Daniel L.; Bradford, Daniel W.

2010-01-01

This study examined the impact of physical and sexual trauma on a sample of 239 homeless men. Study participants completed a self-administered survey that collected data on demographics, exposure to psychological trauma, physical health and mental health problems, and substance use or misuse. Binomial logistic regression analyses were used to…

Masculinity and HIV Risk among Homeless Men in Los Angeles

PubMed Central

Kennedy, David P.; Brown, Ryan A.; Golinelli, Daniela; Wenzel, Suzanne L.; Tucker, Joan S.; Wertheimer, Samuel R.

2012-01-01

HIV continues to be a serious public health problem for men who have sex with women (MSW), especially homeless MSW. Although consideration of gender has improved HIV prevention interventions, most of the research and intervention development has targeted how women’s HIV risk is affected by gender roles. The effect of gender roles on MSW has received relatively little attention. Previous studies have shown mixed results when investigating the association between internalization of masculine gender roles and HIV risk. These studies use a variety of scales that measure individual internalization of different aspects of masculinity. However, this ignores the dynamic and culturally constructed nature of gender roles. The current study uses cultural consensus analysis (CCA) to test for the existence of culturally agreed upon masculinity and gender role beliefs among homeless MSW in Los Angeles, as well as the relationship between these beliefs and HIV-related behaviors and attitudes. Interviews included 30 qualitative and 305 structured interviews with homeless MSW in Los Angeles’s Skid Row area. Analysis identified culturally relevant aspects of masculinity not represented by existing masculinity scales, primarily related to barriers to relationships with women. Behaviors, attitudes, and knowledge related to HIV were significantly associated with men’s level of agreement with the group about masculinity. The findings are discussed in light of implications for MSW HIV intervention development. PMID:23730216

Military sexual trauma among homeless veterans.

PubMed

Pavao, Joanne; Turchik, Jessica A; Hyun, Jenny K; Karpenko, Julie; Saweikis, Meghan; McCutcheon, Susan; Kane, Vincent; Kimerling, Rachel

2013-07-01

Military sexual trauma (MST) is the Veteran Health Administration's (VHA) term for sexual assault and/or sexual harassment that occurs during military service. The experience of MST is associated with a variety of mental health conditions. Preliminary research suggests that MST may be associated with homelessness among female Veterans, although to date MST has not been examined in a national study of both female and male homeless Veterans. To estimate the prevalence of MST, examine the association between MST and mental health conditions, and describe mental health utilization among homeless women and men. National, cross-sectional study of 126,598 homeless Veterans who used VHA outpatient care in fiscal year 2010. All variables were obtained from VHA administrative databases, including MST screening status, ICD-9-CM codes to determine mental health diagnoses, and VHA utilization. Of homeless Veterans in VHA, 39.7 % of females and 3.3 % of males experienced MST. Homeless Veterans who experienced MST demonstrated a significantly higher likelihood of almost all mental health conditions examined as compared to other homeless women and men, including depression, posttraumatic stress disorder, other anxiety disorders, substance use disorders, bipolar disorders, personality disorders, suicide, and, among men only, schizophrenia and psychotic disorders. Nearly all homeless Veterans had at least one mental health visit and Veterans who experienced MST utilized significantly more mental health visits compared to Veterans who did not experience MST. A substantial proportion of homeless Veterans using VHA services have experienced MST, and those who experienced MST had increased odds of mental health diagnoses. Homeless Veterans who had experienced MST had higher intensity of mental health care utilization and high rates of MST-related mental health care. This study highlights the importance of trauma-informed care among homeless Veterans and the success of VHA homeless

Predictors of frequent withdrawal management unit use among chronically homeless, homeless, and housed men: a retrospective cohort study.

PubMed

Svoboda, Tomislav

2013-01-01

Reports suggest that repeat users of detoxification services are less likely to get rehabilitated. The goal of this study is to determine rates and predictors of detoxification unit visits among individuals who are chronically homeless with severe drinking problems compared to those who are housed and in the general homeless population. Visit records (n = 1027) from all inner city Toronto detoxification units (n = 5) by men (n = 169) over a 6 year period were analyzed and linked to structured interview data for three populations: chronically homeless individuals with severe drinking problems (CHDP, n = 50); members of the general homeless population (GH, n = 61); and low-income housed individuals (LIH, n = 58). The CHDP group had 4.13 (3.86, 4.39) detoxification unit admissions per year, 18.1 (95% CI 12.5-23.7) and 33 (95% CI 21-46) times higher than the GH and LIH groups respectively. Admission rates were 43.8 % (95% CI 32.7-54.9%) higher in the winter than summer months for the CHDP group. The proportions of stays that involved police, leaving without discharge, and staying two days or less were 74%, 75%, and 89% among CHDP, GH, and LIH subjects. Rather than being a resource for achieving abstinence, frequent short visits, treatment non-compliance, higher winter visit rates suggest that detoxification units are more likely used by individuals as shelter; high rates of admission related police involvement suggest that they continue to be used as an alternative to judicial intervention into public inebriation. Copyright © American Academy of Addiction Psychiatry.

[Alcohol dependence in homeless men. Incidence, development and determinants].

PubMed

Dufeu, P; Podschus, J; Schmidt, L G

1996-11-01

Against the background of the complex relationship of alcoholism and homelessness, we investigated the question of whether homeless alcoholics and those with homes differed regarding biographical and clinical variables. Therefore, 49 of 72 (68.1%) homeless male visitors to a city kitchen in the center of Berlin, who had fulfilled the ICD-10 criteria for the alcohol-dependence syndrome, were compared with 141 outpatients of the addiction research unit of the Department of Psychiatry of the Free University of Berlin. It was found that homeless alcoholics had more psychosocial disadvantages than other alcoholics. They had been raised more frequently in families with an alcoholic father or mother and a higher number of children. The level of education and job qualification was lower in the homeless alcoholics. Early homelessness was predicted by a lack of sexual behavior (no partnership experienced) and a family history of alcoholism. In the interview, homeless alcoholics reported fewer symptoms of alcohol-dependence syndrome than other alcoholics; however, the first symptoms had been experienced earlier. Alcohol-related somatic and psychological consequences were reported more frequently in alcoholics with homes, whereas social problems were more common in the homeless subjects. The results are discussed in the light of methodological limitations and other reports on the topic.

The Role of Masculinity and Depressive Symptoms in Predicting Suicidal Ideation in Homeless Men.

PubMed

Genuchi, Matthew C

2018-02-20

Men's suicide rates may be influenced by difficulties recognizing externalizing depressive symptoms in men that adhere to hegemonic masculine gender role norms. The purpose of this study was to investigate the ability of externalizing depressive symptoms, internalizing depressive symptoms, and hegemonic masculinity in predicting the existence and severity of suicidal ideation. Homeless men (n = 94) completed questionnaires at a resource center in the Rocky Mountain Western United States. Internalizing symptoms predicted the existence of suicidal ideation, and both externalizing and internalizing symptoms predicted increased severity of suicidal ideation. The masculine norms violence and playboy were correlated with men's suicidal ideation. An externalizing-internalizing model of predicting suicide in men and men's adherence to certain masculine gender role norms may be valuable to further efforts in suicide assessment and prevention.

Are the mentally ill homeless a distinct homeless subgroup?

PubMed

North, C S; Smith, E M; Pollio, D E; Spitznagel, E L

1996-09-01

The question has been raised whether it is useful or meaningful to dichotomize the homeless population by mental illness - i.e., to consider the mentally ill homeless as distinct from other homeless people. The current article presents evidence from a single data set to address this question empirically. Data from a randomly sampled population of 900 homeless men and women systemically interviewed using the Diagnostic Interview Schedule were examined to determine associations of mental illness with the problems of homelessness, controlling for the presence of substance abuse in the analyses. Although a few clinically meaningful associations with mental illness were found that might suggest directions for appropriate interventions, mental illness did not differentiate individuals in many important demographic and biographic respects. Individual diagnoses did not perform much better in differentiating the homeless by mental illness. Schizophrenia and bipolar mania showed a few significant associations not identified by the "major mental illness" construct. Major depression, constituting the majority of nonsubstance Axis I disorder in the homeless, provided no association beyond that obtained with the "major mental illness" category. The data provide little support for conceptualizing homeless subgroups or homelessness in general on the basis of mental illness alone. To do so also risks neglecting the emotional distress of the majority without major mental illness and the other problems that homeless persons share regardless of psychiatric illness. While serious mental illness is overrepresented among the homeless, it represents just one of many important vulnerability factors for homelessness. Substance abuse is far more prevalent than other Axis I disorders. Media images equating homelessness with major mental illness unnecessarily stigmatize homeless people and encourage oversimplified and narrowly conceived psychiatric interventions. While continuing attention is

Active Tuberculosis among Homeless Persons, Toronto, Ontario, Canada, 1998–2007

PubMed Central

Rea, Elizabeth; McDermaid, Cameron; Stuart, Rebecca; Chambers, Catharine; Wang, Jun; Chan, Angie; Gardam, Michael; Jamieson, Frances; Yang, Jae; Hwang, Stephen W.

2011-01-01

While tuberculosis (TB) in Canadian cities is increasingly affecting foreign-born persons, homeless persons remain at high risk. To assess trends in TB, we studied all homeless persons in Toronto who had a diagnosis of active TB during 1998–2007. We compared Canada-born and foreign-born homeless persons and assessed changes over time. We identified 91 homeless persons with active TB; they typically had highly contagious, advanced disease, and 19% died within 12 months of diagnosis. The proportion of homeless persons who were foreign-born increased from 24% in 1998–2002 to 39% in 2003–2007. Among foreign-born homeless persons with TB, 56% of infections were caused by strains not known to circulate among homeless persons in Toronto. Only 2% of infections were resistant to first-line TB medications. The rise in foreign-born homeless persons with TB strains likely acquired overseas suggests that the risk for drug-resistant strains entering the homeless shelter system may be escalating. PMID:21392424

Mission Impossible? Physical Activity Programming for Individuals Experiencing Homelessness

ERIC Educational Resources Information Center

Gregg, Melanie J.; Bedard, Andrea

2016-01-01

Purpose: A pilot study was conducted to describe the physical activity experiences and perceived benefits of and barriers to physical activity participation for patrons of a homeless shelter. The resulting pilot data may be used to inform the creation of and support for physical activity and sport programs for those experiencing homelessness.…

Differences in Health and Social Support between Homeless Men and Women Entering Permanent Supportive Housing

PubMed Central

Winetrobe, Hailey; Wenzel, Suzanne; Rhoades, Harmony; Henwood, Benjamin; Rice, Eric; Harris, Taylor

2017-01-01

Background Permanent supportive housing (PSH) is the leading intervention to end chronic homelessness. Little is known, however, about gender differences, including potential disparities in physical and mental health and social support, that might inform services available through PSH. Methods 421 homeless adults, at least 39 years old, English- or Spanish-speaking, who were moving into PSH through 26 different agencies in the Los Angeles area participated. Results Compared to men entering PSH, homeless women (28% of the sample) were younger (p<0.01), less likely to have achieved at least a high school education (p<0.05), and had lower incomes (p<0.01). Women had more chronic physical health conditions (p<0.01), were more likely to have any chronic mental health condition (OR: 2.5, p<0.01), and had more chronic mental health conditions than men (p<0.01). Women had more relatives in their social networks (Coef: 0.79, p<0.01) and more relatives who provided support (Coef: 0.38, p<0.05), but also more relatives with whom they had conflict (Coef: 0.19, p<0.01). Additionally, women were less likely to have caseworkers (Coef: −0.59, p<0.001) or physical and mental healthcare providers in their networks (Coef: −0.23, p<0.01; Coef: −0.37, p<0.001, respectively). However, after correcting for multiple testing, three outcomes lost significance: number of chronic physical health conditions, number of relatives who provided any support, and number of relatives with whom there was conflict. Conclusions There is evidence of gender differences in mental health and social support among homeless adults moving into PSH. PSH cannot be a one-size-fits-all approach. Supportive services within housing should be tailored based on gender and other individual needs. PMID:28153741

The meaning of computers to a group of men who are homeless.

PubMed

Miller, Kathleen Swenson; Bunch-Harrison, Stacey; Brumbaugh, Brett; Kutty, Rekha Sankaran; FitzGerald, Kathleen

2005-01-01

The purpose of this pilot study was to explore the experience with computers and the meaning of computers to a group of homeless men living in a long-term shelter. This descriptive exploratory study used semistructured interviews with seven men who had been given access to computers and had participated in individually tailored occupation based interventions through a Work Readiness Program. Three themes emerged from analyzing the interviews: access to computers, computers as a bridge to life-skill development, and changed self-perceptions as a result of connecting to technology. Because they lacked computer knowledge and feared failure, the majority of study participants had not sought out computers available through public access. The need for access to computers, the potential use of computers as a medium for intervention, and the meaning of computers to these men who represent the digital divide are described in this study.

Differences in Health and Social Support between Homeless Men and Women Entering Permanent Supportive Housing.

PubMed

Winetrobe, Hailey; Wenzel, Suzanne; Rhoades, Harmony; Henwood, Benjamin; Rice, Eric; Harris, Taylor

Permanent supportive housing (PSH) is the leading intervention to end chronic homelessness. Little is known, however, about gender differences, including potential disparities in physical and mental health and social support, that might inform services available through PSH. This study included 421 homeless adults, at least 39 years old, English- or Spanish-speaking, who were moving into PSH through 26 different agencies in the Los Angeles area. Compared with men entering PSH, homeless women (28% of the sample) were younger (p < .01), less likely to have achieved at least a high school education (p < .05), and had lower incomes (p < .01). Women had more chronic physical health conditions (p < .01), were more likely to have any chronic mental health condition (odds ratio, 2.5; p < .01), and had more chronic mental health conditions than men (p < .01). Women had more relatives in their social networks (Coefficient, 0.79, p < .01) and more relatives who provided support (coefficient, 0.38; p < .05), but also more relatives with whom they had conflict (coefficient, 0.19; p < .01). Additionally, women were less likely to have caseworkers (coefficient, -0.59; p < .001) or physical and mental health care providers in their networks (coefficient, -0.23 [p < .01]; coefficient, -0.37 [p < .001], respectively). However, after correcting for multiple testing, three outcomes lost significance: number of chronic physical health conditions, number of relatives who provided any support, and number of relatives with whom there was conflict. There is evidence of gender differences in mental health and social support among homeless adults moving into PSH. PSH cannot be a one-size-fits-all approach. Supportive services within housing should be tailored based on gender and other individual needs. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

HIV Risk Behavior and Access to Services: What Predicts HIV Testing among Heterosexually Active Homeless Men?

ERIC Educational Resources Information Center

Wenzel, Suzanne L.; Rhoades, Harmony; Tucker, Joan S.; Golinelli, Daniela; Kennedy, David P.; Zhou, Annie; Ewing, Brett

2012-01-01

HIV is a serious epidemic among homeless persons, where rates of infection are estimated to be three times higher than in the general population. HIV testing is an effective tool for reducing HIV transmission and for combating poor HIV/AIDS health outcomes that disproportionately affect homeless persons, however, little is known about the HIV…

Methods for successful follow-up of elusive urban populations: an ethnographic approach with homeless men.

PubMed Central

Conover, S.; Berkman, A.; Gheith, A.; Jahiel, R.; Stanley, D.; Geller, P. A.; Valencia, E.; Susser, E.

1997-01-01

Public health is paying increasing attention to elusive urban populations such as the homeless, street drug users, and illegal immigrants. Yet, valid data on the health of these populations remain scarce; longitudinal research, in particular, has been hampered by poor follow-up rates. This paper reports on the follow-up methods used in two randomized clinical trials among one such population, namely, homeless men with mental illness. Each of the two trials achieved virtually complete follow-up over 18 months. The authors describe the ethnographic approach to follow-up used in these trials and elaborate its application to four components of the follow-up: training interviewers, tracking participants, administering the research office, and conducting assessments. The ethnographic follow-up method is adaptable to other studies and other settings, and may provide a replicable model for achieving high follow-up rates in urban epidemiologic studies. PMID:9211004

The Dynamics of Families Who Are Homeless: Implications for Early Childhood Educators

ERIC Educational Resources Information Center

Swick, Kevin J.

2004-01-01

Family homelessness has emerged as a serious global problem (Stronge, 2000). Over the past 25 years in the United States, the makeup of the homeless population has changed significantly. As De Angelis (1994) reports: The landscape of homelessness has changed since the early 1980s, when nearly all homeless people were men. Today,…

Gender Differences in Factors Associated with Unsheltered Status and Increased Risk of Premature Mortality among Individuals Experiencing Homelessness.

PubMed

Montgomery, Ann Elizabeth; Szymkowiak, Dorota; Culhane, Dennis

Among individuals experiencing homelessness, unsheltered status is associated with poor health and access to care and an increased risk for premature death. Insufficient research has explored gender differences in these outcomes; the objective of this study was to address this gap in the research. This study used survey data collected during the 100,000 Homes Campaign. Chi-square tests identified differences in the characteristics of women, men, and transgender individuals. Generalized linear mixed models fit with demographic, homelessness, mental/behavioral health, institutional, and income characteristics were run separately for women and men to assess correlates of unsheltered status and increased risk of premature mortality. Men reported more frequently experiencing unsheltered homelessness while women and transgender participants more frequently met the criteria for risk of premature mortality. Women reported less frequently than men a history of or current substance use, but it significantly increased their likelihood of unsheltered homelessness; reports of mental health issues were rarer among men but significantly increased their odds of unsheltered homelessness. The experience of a violent attack while homeless was most strongly related to increased risk of premature mortality for both women and men. Interventions to reduce unsheltered homelessness among men should be particularly sensitive to mental health issues while for women there may need to be increased attention to substance use. A focus on experience of trauma and the provision of trauma-informed care is essential to address the increased risk of premature mortality among both men and women experiencing homelessness. Published by Elsevier Inc.

Utilizing Participatory Mapping and GIS to Examine the Activity Spaces of Homeless Youth.

PubMed

Townley, Greg; Pearson, L; Lehrwyn, Josephine M; Prophet, Nicole T; Trauernicht, Mareike

2016-06-01

Although previous studies have informed our understanding of certain aspects of youth homelessness, few studies have critically examined the spatial and social environments utilized by youth as they navigate life on the streets. This study employed participatory mapping and Geographic Information Systems (GIS) to examine the activity spaces of homeless youth as they relate to sense of community and psychological well-being. Participants were 28 youth experiencing homelessness in Portland, Oregon, USA. Results suggest that youth engage most frequently in service-related activities, and their activity participation is significantly associated with sense of community and psychological well-being. The utility of innovative participatory methods for better understanding the diverse experiences of homeless youth is discussed alongside examination of their practical implications. © Society for Community Research and Action 2016.

Treatment preferences for resuscitation and critical care among homeless persons.

PubMed

Norris, Wendi M; Nielsen, Elizabeth L; Engelberg, Ruth A; Curtis, J Randall

2005-06-01

Homeless people are at increased risk of critical illness and are less likely to have surrogate decision makers when critically ill. Consequently, clinicians must make decisions independently or with input from others such as ethics committees or guardians. No prior studies have examined treatment preferences of homeless to guide such decision makers. Interviewer-administered, cross-sectional survey of homeless persons. Homeless shelters in Seattle, WA. Two hundred twenty-nine homeless individuals with two comparison groups: 236 physicians practicing in settings where they are likely to provide care for homeless persons and 111 patients with oxygen-dependent COPD. Participants were asked whether they would want intubation with mechanical ventilation or cardiopulmonary resuscitation in their current health, if they were in a permanent coma, if they had severe dementia, or if they were confined to bed and dependent on others for all care. Homeless men were more likely to want resuscitation than homeless women (p < 0.002) in coma and dementia scenarios. Homeless men and women were both more likely to want resuscitation in these scenarios than physicians (p < 0.001). Nonwhite homeless were more likely to want resuscitation than white homeless people (p < 0.033), and both were more likely to want resuscitation than physicians (p < 0.001). Homeless are also more likely to want resuscitation than patients with COPD. The majority (80%) of homeless who reported not having family or not wanting family to make medical decisions prefer a physician make decisions rather than a court-appointed guardian. Homeless persons are more likely to prefer resuscitation than physicians and patients with severe COPD. Since physicians may be in the position of making medical decisions for homeless patients and since physicians are influenced by their own preferences when making decisions for others, physicians should be aware that, on average, homeless persons prefer more aggressive care

Mental and Physical Health among Homeless Sexual and Gender Minorities in a Major Urban US City.

PubMed

Flentje, Annesa; Leon, Armando; Carrico, Adam; Zheng, Debbie; Dilley, James

2016-12-01

Sexual and gender minorities have been shown to have greater rates of mental health, substance use disorders, and specific types of health problems compared to heterosexuals. Among the homeless population in several US urban areas, sexual and gender minorities are overrepresented but few studies have examined the mental and physical health status of homeless sexual and gender minorities, with studies on homeless gender minorities being particularly hard to find. Using survey data obtained from the city and county of San Francisco (2015 Homeless Survey), this study examined differences in causes of homelessness, physical and mental health problems, and domestic violence among homeless sexual and gender minorities and their heterosexual and cisgender (i.e., non-transgender) counterparts, respectively. Lesbians and bisexual women, and gay and bisexual men did not differ from their cisgender heterosexual counterparts. Cisgender men who identified as queer or "other" in response to sexual orientation questions had higher rates of psychiatric problems and posttraumatic stress disorder, while cisgender women who identified as queer or "other" had higher rates of psychiatric problems and drug and alcohol use. Transgender men who were homeless were found to be particularly at risk for physical health problems, mental health problems, and domestic violence or abuse. Transgender women were more likely to report posttraumatic stress disorder. This study suggests that transgender men and cisgender sexual minority men and women who identify as queer or "other" are groups among the homeless that may benefit from increased outreach and services.

Correlates of Depressive Symptoms among Homeless Men on Parole

PubMed Central

Nyamathi, Adeline; Leake, Barbara; Albarrán, Cynthia R.; Zhang, Sheldon; Hall, Elizabeth; Farabee, David; Marlow, Elizabeth; Marfisee, Mary; Khalilifard, Farinaz; Faucette, Mark

2012-01-01

This study describes correlates of high levels of depressive symptoms among recently paroled men in Los Angeles who reside in a community substance abuse treatment program and report homelessness. Cross-sectional data were obtained from male residents who were released on parole within the last 30 days (N=157) to assess parental relationship, self-esteem, social support, coping behaviors, drug and alcohol use behaviors, depressive symptoms, and sociodemographic information. Results indicated that 40% of participants were classified as experiencing high levels of depressive symptoms (CES-D ≥ 10). Results of a logistic regression analysis showed that the following were predictors of depressive symptoms (p < .05): physical abuse in childhood, non-residential alcohol treatment, violent behaviors, low self-esteem, and disengagement coping. Being Mexican-American, Mexican, American Indian, or Asian) and not displaying cognitive problems was inversely related to depressive symptoms in the final model (B = −2.39, p < .05). Findings support proper use of both prison and community assessment services to at-risk individuals eligible for parole to increase self-esteem and coping. PMID:21767252

Housing first for homeless persons with active addiction: are we overreaching?

PubMed

Kertesz, Stefan G; Crouch, Kimberly; Milby, Jesse B; Cusimano, Robert E; Schumacher, Joseph E

2009-06-01

More than 350 communities in the United States have committed to ending chronic homelessness. One nationally prominent approach, Housing First, offers early access to permanent housing without requiring completion of treatment or, for clients with addiction, proof of sobriety. This article reviews studies of Housing First and more traditional rehabilitative (e.g., "linear") recovery interventions, focusing on the outcomes obtained by both approaches for homeless individuals with addictive disorders. According to reviews of comparative trials and case series reports, Housing First reports document excellent housing retention, despite the limited amount of data pertaining to homeless clients with active and severe addiction. Several linear programs cite reductions in addiction severity but have shortcomings in long-term housing success and retention. This article suggests that the current research data are not sufficient to identify an optimal housing and rehabilitation approach for an important homeless subgroup. The research regarding Housing First and linear approaches can be strengthened in several ways, and policymakers should be cautious about generalizing the results of available Housing First studies to persons with active addiction when they enter housing programs.

Nutrition and health services needs among the homeless.

PubMed Central

Wiecha, J L; Dwyer, J T; Dunn-Strohecker, M

1991-01-01

This review discusses nutrition and related health problems among homeless Americans, summarizes recent information, and identifies needs for services and future research. The nature of homelessness today provides a context for the discussion. Many homeless persons eat fewer meals per day, lack food more often, and are more likely to have inadequate diets and poorer nutritional status than housed U.S. populations. Yet many homeless people eligible for food stamps do not receive them. While public and private agencies provide nutritious food and meals for homeless persons, availability of the services to homeless persons is limited. Many homeless people lack appropriate health care, and certain nutrition-related health problems are prevalent among them. Compared with housed populations, alcoholism, anemia, and growth problems are more common among homeless persons, and pregnancy rates are higher. The risks vary among homeless persons for malnutrition, nutrition-related health problems, drug and alcohol abuse, and mental illness. For example, among homeless persons, fewer heads of families than single adults are substance abusers, and mental illness varies in prevalence among single men, single women, and parents in homeless families. Homeless persons need improved access to food, nutrition, and health services. More nutrition education needs to be available to them and to service providers. Use of representative samples and validation of self-reported nutrition and health data will help future investigators to clarify the relationships between the characteristics of the homeless and their nutritional status. PMID:1908587

Housing First for Homeless Persons with Active Addiction: Are We Overreaching?

PubMed Central

Kertesz, Stefan G; Crouch, Kimberly; Milby, Jesse B; Cusimano, Robert E; Schumacher, Joseph E

2009-01-01

Context More than 350 communities in the United States have committed to ending chronic homelessness. One nationally prominent approach, Housing First, offers early access to permanent housing without requiring completion of treatment or, for clients with addiction, proof of sobriety. Methods This article reviews studies of Housing First and more traditional rehabilitative (e.g., “linear”) recovery interventions, focusing on the outcomes obtained by both approaches for homeless individuals with addictive disorders. Findings According to reviews of comparative trials and case series reports, Housing First reports document excellent housing retention, despite the limited amount of data pertaining to homeless clients with active and severe addiction. Several linear programs cite reductions in addiction severity but have shortcomings in long-term housing success and retention. Conclusions This article suggests that the current research data are not sufficient to identify an optimal housing and rehabilitation approach for an important homeless subgroup. The research regarding Housing First and linear approaches can be strengthened in several ways, and policymakers should be cautious about generalizing the results of available Housing First studies to persons with active addiction when they enter housing programs. PMID:19523126

Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study.

PubMed

Brown, Rebecca T; Goodman, Leah; Guzman, David; Tieu, Lina; Ponath, Claudia; Kushel, Margot B

2016-01-01

Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (<18 years), young adulthood (ages 18-25), and middle adulthood (ages 26-49). We used a structured modeling approach to identify experiences associated with first adult homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment) and lower attainment of adult milestones (i.e., marriage, full-time employment) compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs.

Use of Activity Space in a Tuberculosis Outbreak: Bringing Homeless Persons Into Spatial Analyses.

PubMed

Worrell, Mary Claire; Kramer, Michael; Yamin, Aliya; Ray, Susan M; Goswami, Neela D

2017-01-01

Tuberculosis (TB) causes significant morbidity and mortality in US cities, particularly in poor, transient populations. During a TB outbreak in Fulton County, Atlanta, GA, we aimed to determine whether local maps created from multiple locations of personal activity per case would differ significantly from traditional maps created from single residential address. Data were abstracted for patients with TB disease diagnosed in 2008-2014 and receiving care at the Fulton County Health Department. Clinical and activity location data were abstracted from charts. Kernel density methods, activity space analysis, and overlay with homeless shelter locations were used to characterize case spatial distribution when using single versus multiple addresses. Data were collected for 198 TB cases, with over 30% homeless US-born cases included. Greater spatial dispersion of cases was found when utilizing multiple versus single addresses per case. Activity spaces of homeless and isoniazid (INH)-resistant cases were more spatially congruent with one another than non-homeless and INH-susceptible cases ( P < .0001 and P < .0001, respectively). Innovative spatial methods allowed us to more comprehensively capture the geography of TB-infected homeless persons, who made up a large portion of the Fulton County outbreak. We demonstrate how activity space analysis, prominent in exposure science and chronic disease, supports that routine capture of multiple location TB data may facilitate spatially different public health interventions than traditional surveillance maps. © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Suicide and unintentional injury mortality among homeless people: a Danish nationwide register-based cohort study.

PubMed

Feodor Nilsson, Sandra; Hjorthøj, Carsten Rygaard; Erlangsen, Annette; Nordentoft, Merete

2014-02-01

Homeless people have elevated mortality, especially due to external causes. We aimed to examine suicide and unintentional injury mortality levels and identify predictors in the homeless population. A nationwide, register-based cohort study of homeless people aged 16 years and older was carried out using the Danish Homeless Register, 1999-2008. In all, 32 010 homeless people (70.5% men) were observed. For men, the mortality rate was 174.4 [95% confidence interval (CI) = 150.6-198.1] per 100 000 person-years for suicide and 463.3 (95% CI = 424.6-502.0) for unintentional injury. For women, the corresponding rates were 111.4 (95% CI = 81.7-141.1) for suicide and 241.4 (95% CI = 197.6-285.1) for unintentional injury. Schizophrenia spectrum, affective, personality and substance use disorders were strongly associated with increased risk of suicide; the highest risk estimates were found for schizophrenia spectrum disorders among both men [hazard ratio (HR) = 3.1, 95% CI = 2.0-4.9] and women (HR = 15.5, 95% CI = 4.5-54.0). Alcohol and drug use disorders were predictors of death by unintentional injury for both men and women, whereas schizophrenia spectrum disorders and personality disorders were only significant predictors among men; the highest risk estimates were found for drug use disorders among men (HR = 2.2, 95% CI = 1.8-2.8) and women (HR = 3.1, 95% CI = 1.8-5.4). A history of psychiatric admission and emergency room contact were predictors for dying by suicide and unintentional injury. People in the homeless shelter population with a history of a psychiatric disorder constitute a high-risk group regarding the elevated suicide and unintentional injury mortality.

Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study

PubMed Central

Brown, Rebecca T.; Goodman, Leah; Guzman, David; Tieu, Lina; Ponath, Claudia; Kushel, Margot B.

2016-01-01

Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (<18 years), young adulthood (ages 18–25), and middle adulthood (ages 26–49). We used a structured modeling approach to identify experiences associated with first adult homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment) and lower attainment of adult milestones (i.e., marriage, full-time employment) compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs. PMID:27163478

An Examination of Criminal Behavior among the Homeless.

ERIC Educational Resources Information Center

Solarz, Andrea

Homelessness is a significant social problem in the United States, with an estimated 2.5 million homeless people in this country today. While criminal activity may become a means for the homeless to obtain resources needed for basic survival, little is known about the level of criminal activity among the homeless or about the types of crimnal…

The New Homelessness Revisited

PubMed Central

Lee, Barrett A.; Tyler, Kimberly A.; Wright, James D.

2014-01-01

The ‘new homelessness’ has drawn sustained attention from scholars over the past three decades. Definitional inconsistencies and data limitations rendered early work during this period largely speculative in nature. Thanks to conceptual, theoretical, and methodological progress, however, the research literature now provides a fuller understanding of homelessness. Contributions by sociologists and other social scientists since the mid-1990s differentiate among types of homelessness, provide credible demographic estimates, and show how being homeless affects a person's life chances and coping strategies. Agreement also exists about the main macro- and micro-level causes of homelessness. Active lines of inquiry examine public, media, and governmental responses to the problem as well as homeless people's efforts to mobilize on their own behalf. Despite the obstacles faced when studying a stigmatized population marked by high turnover and weak anchors to place, recent investigations have significantly influenced homelessness policy. A greater emphasis on prevention should further strengthen the research-policy nexus. PMID:24910495

Becoming homeless, being homeless, and resolving homelessness among women.

PubMed

Finfgeld-Connett, Deborah

2010-07-01

The purpose of this investigation was to more comprehensively articulate the experiences of homeless women and make evidence-based inferences regarding optimal social services. This study was conducted using qualitative meta-synthesis methods. As youth, homeless women experience challenging circumstances that leave them ill-prepared to prevent and resolve homelessness in adulthood. Resolution of homelessness occurs in iterative stages: crisis, assessment, and sustained action. To enhance forward progression through these stages, nurses are encouraged to promote empowerment in concordance with the Transtheoretical and Harm Reduction Models. Services that are highly valued include physical and mental health care and child care assistance.

A Comparison of Weight-Related Behaviors among High School Students Who Are Homeless and Non-Homeless

ERIC Educational Resources Information Center

Fournier, Mary E.; Austin, S. Bryn; Samples, Cathryn L.; Goodenow, Carol S.; Wylie, Sarah A.; Corliss, Heather L.

2009-01-01

Background: Previous research has shown that youth who are homeless engage in high-risk behaviors. However, there has been little information published on nutritional and physical activity behaviors in this population, and studies comparing homeless youth in school with their non-homeless peers are scarce. This study compares weight-related risk…

Social and recovery capital amongst homeless hostel residents who use drugs and alcohol.

PubMed

Neale, Joanne; Stevenson, Caral

2015-05-01

Homeless people who use drugs and alcohol have been described as one of the most marginalised groups in society. In this paper, we explore the relationships of homeless drug and alcohol users who live in hostels in order to ascertain the nature and extent of their social and recovery capital. Data were collected during 2013 and 2014 from three hostels. Each hostel was in a different English city and varied in size and organisational structure. Semi-structured interviews were conducted with 30 residents (21 men; 9 women) who self-reported current drink and/or drug problems. Follow-up interviews were completed after 4-6 weeks with 22 residents (16 men; 6 women). Audio recordings of all interviews were transcribed verbatim, systematically coded and analysed using Framework. Participants' main relationships involved family members, professionals, other hostel residents, friends outside of hostels, current and former partners, and enemies. Social networks were relatively small, but based on diverse forms of, often reciprocal, practical and emotional support, encompassing protection, companionship, and love. The extent to which participants' contacts provided a stable source of social capital over time was, nonetheless, uncertain. Hostel residents who used drugs and alcohol welcomed and valued interaction with, and assistance from, hostel staff; women appeared to have larger social networks than men; and hostels varied in the level of enmity between residents and antipathy towards staff. Homeless hostel residents who use drugs and alcohol have various opportunities for building social capital that can in turn foster recovery capital. Therapies that focus on promoting positive social networks amongst people experiencing addiction seem to offer a valuable way of working with homeless hostel residents who use drugs and alcohol. Gains are, however, likely to be maximised where hostel management and staff are supportive of, and actively engage with, therapy delivery

A 5-year comparison of ED visits by homeless and nonhomeless patients.

PubMed

Tadros, Allison; Layman, Shelley M; Brewer, Marissa Pantaleone; Davis, Stephen M

2016-05-01

A 2005 study examined emergency department (ED) utilization by homeless patients in the United States. Within the following 5 years, unemployment increased by 5%. The objective was to analyze changes in ED utilization between 2005 and 2010 by homeless patients and compare with nonhomeless visits. Data from the 2010 National Hospital Ambulatory Medical Care Survey were evaluated. Approximately 679854 visits were made by homeless patients, the majority of which were made by men (72.3%) and patients between the ages of 45 and 64 (50.5%). Homeless patients were twice as likely to be uninsured. ED visits by homeless patients had increased by 44% during the 5-year period. Arrival to the ED by ambulance increased by 14% between the study years, and homeless patients were less likely to be admitted. The number of visits by homeless patients in the ED increased proportionally to an overall increase in ED visits between 2005 and 2010. Copyright © 2016 Elsevier Inc. All rights reserved.

The Role of Institutional Placement, Family Conflict, and Homosexuality in Homelessness Pathways Among Latino LGBT Youth in New York City.

PubMed

Castellanos, H Daniel

2016-01-01

Despite the overrepresentation of Lesbian, Gay, Bisexual, and Transgender (LGBT) youth among the homeless, the processes leading to their homelessness are understudied. This ethnographic study sought to elucidate the role of sexual orientation in the pathway to housing instability among young gay men. Fieldwork included 18 months of participant observations in public spaces and at a homeless LGBT youth organization in New York City, as well as formal semistructured interviews with 14 Latino young men and five staff. Three distinct pathways emerged. Some youth became homeless after placement in state systems of care disrupted their social support systems, while others became homeless after extreme family conflict over sexual orientation. Nonetheless, most youths became homeless as a result of long-term processes of family disintegration in which normative adolescent development and disclosure of homosexuality exacerbated preexisting conflict. These findings suggest the need to examine the accumulation of risks before disclosure exacerbates family conflict and increases their risk of homelessness.

Characteristics and Use of Services Among Literally Homeless and Unstably Housed U.S. Veterans With Custody of Minor Children.

PubMed

Tsai, Jack; Rosenheck, Robert A; Kasprow, Wesley J; Kane, Vincent

2015-10-01

The study examined the number of homeless veterans with minor children in their custody ("children in custody"), compared sociodemographic and clinical characteristics among homeless veterans with and without children in custody, and observed differences in referral and admission patterns among veterans with and without children in custody for a variety of U.S. Department of Veterans Affairs (VA) programs for homeless veterans. Data were obtained from the VA Homeless Operations Management and Evaluation System for 89,142 literally homeless and unstably housed veterans. Sociodemographic, housing, health, and psychosocial characteristics of veterans were analyzed. Among literally homeless veterans, 9% of men and 30% of women had children in custody; among unstably housed veterans, 18% of men and 45% of women had children in custody. Both male and female veterans with children in custody were younger and less likely to have chronic general medical conditions and psychiatric disorders compared with other veterans, but, notably, 11% of homeless veterans with children in custody had psychotic disorders. Veterans with children in custody were more likely than other veterans to be referred and admitted to the VA's permanent supported housing program, and women were more likely than men to be admitted to the program. A substantial proportion of homeless veterans served by the VA have severe mental illness and children in custody, which raises concerns about the parenting environment for their children. Particular focus should be directed at VA's supported-housing program, and the practical and ethical implications of serving homeless parents and their children need to be considered.

Homelessness in a national sample of incarcerated veterans in state and federal prisons.

PubMed

Tsai, Jack; Rosenheck, Robert A; Kasprow, Wesley J; McGuire, James F

2014-05-01

The Veterans Health Administration (VHA) has been increasing efforts to reach out to assist incarcerated veterans. While previous studies have shown strong associations between incarceration and homelessness, few studies have examined distinctive characteristics of incarcerated homeless and non-homeless veterans. National administrative data on 30,348 incarcerated veterans served by the Health Care for Re-entry Veterans (HCRV) program were analyzed. Incarcerated veterans were classified into four groups based on their history of past homelessness: not homeless, transiently homeless, episodically homeless, and chronically homeless. Multinomial logistic regression was used to compare groups on sociodemographic characteristics, criminal justice status, clinical status, and their interest in using VHA services. Of the sample, 70 % were classified as not homeless, 8 % as transiently homeless, 11 % as episodically homeless, and 11 % as chronically homeless. Thus, 30 % of the sample had a homeless history, which is five times the 6 % rate of past homelessness among adult men in the general population. Compared to non-homeless incarcerated veterans, all three homeless groups reported significantly more mental health problems, more substance abuse, more times arrested in their lifetime, more likely to be incarcerated for a non-violent offense, and were more interested in receiving VHA services after release from prison. Together, these findings suggest re-entry programs, like HCRV, can address relevant mental health-related service needs, especially among formerly homeless veterans and veterans in need of services are receptive to the offer of assistance.

Hepatitis A/B vaccine completion among homeless adults with history of incarceration.

PubMed

Nyamathi, Adeline M; Marlow, Elizabeth; Branson, Catherine; Marfisee, Mary; Nandy, Karabi

2012-03-01

Hepatitis B virus (HBV) vaccination rates for incarcerated adults remain low despite their high risk for infection. This study determined predictors of vaccine completion in homeless adults (N= 297) who reported histories of incarceration and who participated in one of three nurse-led hepatitis programs of different intensity. Moreover time since release from incarceration was also considered. Just over half of the former prisoners completed the vaccine series. Older age (≥40), having a partner, and chronic homelessness were associated with vaccine completion. Recent research has documented the difficulty in providing vaccine services to younger homeless persons and homeless males at risk for HBV. Additional strategies are needed to achieve HBV vaccination completion rates greater than 50% for formerly incarcerated homeless men. © 2012 International Association of Forensic Nurses.

Services Receipt Following Veteran Outpatients' Positive Screen for Homelessness.

PubMed

Montgomery, Ann E; Dichter, Melissa E; Thomasson, Arwin M; Roberts, Christopher B

2016-03-01

The Veterans Health Administration seeks to reduce homelessness among Veterans by identifying, and providing prevention and supportive services to, patients with housing concerns. The objectives of this study were to assess the proportion of Veterans Health Administration patients who received homeless or social work services within 6 months of a positive screen for homelessness or risk in the Veterans Health Administration and the demographic and clinical characteristics that predicted services utilization. Data were from a cohort of 27,403 Veteran outpatients who screened positive for homelessness or risk between November 1, 2012 and January 31, 2013. During 2013, AORs were calculated using a mixed-effects logistic regression to estimate the likelihood of patients' receipt of VHA homeless or social work services based on demographic and clinical characteristics. The majority of patients received services within 6 months post-screening; predictors of services utilization varied by gender. Among women, diagnosis of drug abuse and psychosis predicted receipt of services, being unmarried increased the odds of using services among those screening positive for homelessness, and a diagnosis of post-traumatic stress disorder increased the odds of receiving services for at-risk women. Among men, being younger, unmarried, not service-connected/Medicaid-eligible, and having a medical or behavioral health condition predicted receipt of services. Receipt of housing support services among Veterans post-homelessness screening differs by patient demographic and clinical characteristics. Future research should investigate the role that primary and secondary prevention interventions play in Veterans' resolution of risk for homelessness and experience of homelessness. Published by Elsevier Inc.

Gender Differences in Victimized Homeless Adolescents

ERIC Educational Resources Information Center

Johnson, Regina Jones; Rew, Lynn; Kouzekanani, Kamiar

2006-01-01

Most of what we know about sexual abuse comes from efforts to examine female children victimized by men. Although some researchers have identified similarities between male and female victims of sexual abuse, few studies have examined gender-specific factors associated with sexual health practices among homeless adolescents. The aim of this study…

Comparisons of family environment between homeless and non-homeless individuals with schizophrenia in Xiangtan, Hunan.

PubMed

Chen, Jinliang; Chen, Jindong; Li, Shuchun; Liu, Jun; Ouyang, Guohua; Luo, Wenxuan; Guo, Xiaofeng; Li, Ting; Li, Kaijie; Li, Zhenkuo; Wang, Gan

2015-06-25

Homelessness is an increasingly important problem for individuals with serious mental illness in China. Identify the characteristics of families that are associated with homelessness among individuals with schizophrenia. Participants were 1856 homeless individuals with schizophrenia (defined as those who had no place of residence or involved caregivers for 7 consecutive days) and 1728 non-homeless individuals with schizophrenia from Xiangtan, Hunan. The self-completion Family Environment Scale-Chinese Version (FES-CV) was administered to these participants after their acute psychotic symptoms resolved. Compared to individuals in the non-homeless group, those in the homeless group were older and more likely to be non-locals (i.e., from outside of Xiangtan), be residents of rural (versus urban) communities, have temporary (versus permanent) jobs, be married, and have a low level of education. After controlling for demographic differences using multivariate logistic regression models, homelessness was independently associated higher scores in the FES-CV intellectual-cultural orientation, organization, achievement orientation, and control subscales and with lower scores in the FES-CV cohesion, moralreligious emphasis, independence, and active-recreational orientation subscales. After controlling for sociodemographic factors, certain aspects of the family environment areassociated with being homeless among patients with schizophrenia in China. Further work is needed to identify interventions that can reduce the risk of homelessness in high-risk individuals.

Residential patterns in older homeless adults: Results of a cluster analysis.

PubMed

Lee, Christopher Thomas; Guzman, David; Ponath, Claudia; Tieu, Lina; Riley, Elise; Kushel, Margot

2016-03-01

Adults aged 50 and older make up half of individuals experiencing homelessness and have high rates of morbidity and mortality. They may have different life trajectories and reside in different environments than do younger homeless adults. Although the environmental risks associated with homelessness are substantial, the environments in which older homeless individuals live have not been well characterized. We classified living environments and identified associated factors in a sample of older homeless adults. From July 2013 to June 2014, we recruited a community-based sample of 350 homeless men and women aged fifty and older in Oakland, California. We administered structured interviews including assessments of health, history of homelessness, social support, and life course. Participants used a recall procedure to describe where they stayed in the prior six months. We performed cluster analysis to classify residential venues and used multinomial logistic regression to identify individual factors prior to the onset of homelessness as well as the duration of unstable housing associated with living in them. We generated four residential groups describing those who were unsheltered (n = 162), cohabited unstably with friends and family (n = 57), resided in multiple institutional settings (shelters, jails, transitional housing) (n = 88), or lived primarily in rental housing (recently homeless) (n = 43). Compared to those who were unsheltered, having social support when last stably housed was significantly associated with cohabiting and institution use. Cohabiters and renters were significantly more likely to be women and have experienced a shorter duration of homelessness. Cohabiters were significantly more likely than unsheltered participants to have experienced abuse prior to losing stable housing. Pre-homeless social support appears to protect against street homelessness while low levels of social support may increase the risk for becoming homeless immediately after

The Role of Institutional Placement, Family Conflict, and Homosexuality in Homelessness Pathways Among Latino LGBT Youth in New York City

PubMed Central

Castellanos, H. Daniel

2016-01-01

Despite the overrepresentation of LGBT youth among the homeless, the processes leading to their homelessness are understudied. This ethnographic study sought to elucidate the role of sexual orientation in the pathway to housing instability among young gay men. Fieldwork included eighteen months of participant observations in public spaces and at a homeless LGBT youth organization in New York City, as well as formal semi-structured interviews with 14 Latino young men and 5 staff. Three distinct pathways emerged. Some youth became homeless after placement in state systems of care disrupted their social support systems while others after extreme family conflict over sexual orientation. Nonetheless, most youths became homeless as a result of long-term processes of family disintegration in which normative adolescent development and disclosure of homosexuality exacerbated pre-existing conflict. These findings suggest the need to examine the accumulation of risks before disclosure exacerbates family conflict and increases their risk of homelessness. PMID:26503713

Elderly homeless veterans in Los Angeles: chronicity and precipitants of homelessness.

PubMed

van den Berk-Clark, Carissa; McGuire, James

2013-12-01

We compared the characteristics of chronically homeless and acutely homeless elderly veterans to better understand precipitants of homelessness. We conducted interviews with 33 chronically and 26 acutely homeless veterans aged 65 years and older receiving transitional housing services in Los Angeles, California, between 2003 and 2005. We asked questions regarding their sociodemographic characteristics and other social status measures. Other precipitants of homelessness were acquired via observation and open-ended and structured questions. Both veterans groups were more similar than different, with substantial levels of physical, psychiatric, and social impairment. They differed significantly in homelessness history, with chronically homeless veterans having more homelessness episodes and more total time homeless. They were also less educated and had smaller social networks. In response to open-ended questioning, elderly homeless veterans revealed how health and substance use issues interacted with loss of social support and eviction to exacerbate homelessness. Assessment of a range of factors is needed to address risk factors and events leading to homelessness. Further research with larger samples is needed to confirm the characteristics and needs of the elderly homeless veteran population.

Management of chronic kidney disease and dialysis in homeless persons.

PubMed

Podymow, Tiina; Turnbull, Jeff

2013-05-01

End-stage renal disease and dialysis are complicated illnesses to manage in homeless persons, who often suffer medical comorbidities, psychiatric disease, cognitive impairment and addictions; descriptions of this population and management strategies are lacking. A retrospective review of dialysis patients who were homeless or unstably housed was undertaken at an urban academic Canadian center from 2001 to 2011. Electronic hospital records were analyzed for demographic, housing, medical, and psychiatric history, dialysis history, adherence to treatment, and outcomes. Two detailed cases of homeless patients with chronic kidney disease are presented. Eleven homeless dialysis patients with a mean age of 52.7±12.3 years, mostly men and mostly from minority groups were dialyzed for 41.1±29.2 months. Most resided permanently in shelters, eventually obtained fistula access, and were adherent to dialysis schedules. Patients were often nonadherent to pre-dialysis management, resulting in emergency starts. Many barriers to care for homeless persons with end-stage kidney disease and on dialysis are identified, and management strategies are highlighted. Adherence is optimized with shelter-based health care and intensive team-oriented case management.

Elderly Homeless Veterans in Los Angeles: Chronicity and Precipitants of Homelessness

PubMed Central

van den Berk-Clark, Carissa; McGuire, James

2013-01-01

Objectives. We compared the characteristics of chronically homeless and acutely homeless elderly veterans to better understand precipitants of homelessness. Methods. We conducted interviews with 33 chronically and 26 acutely homeless veterans aged 65 years and older receiving transitional housing services in Los Angeles, California, between 2003 and 2005. We asked questions regarding their sociodemographic characteristics and other social status measures. Other precipitants of homelessness were acquired via observation and open-ended and structured questions. Results. Both veterans groups were more similar than different, with substantial levels of physical, psychiatric, and social impairment. They differed significantly in homelessness history, with chronically homeless veterans having more homelessness episodes and more total time homeless. They were also less educated and had smaller social networks. In response to open-ended questioning, elderly homeless veterans revealed how health and substance use issues interacted with loss of social support and eviction to exacerbate homelessness. Conclusions. Assessment of a range of factors is needed to address risk factors and events leading to homelessness. Further research with larger samples is needed to confirm the characteristics and needs of the elderly homeless veteran population. PMID:24148059

Refugees and Homeless: Nomads of the World.

ERIC Educational Resources Information Center

Steiner, Stanley F.; Cobiskey, Lane

1998-01-01

The United States has the most homeless people of the industrialized nations, and children are the fastest growing segment of the homeless. This article discusses refugees and homeless persons and presents an annotated bibliography of picture books, fiction, and nonfiction for grades K-12. Suggests class activities in drama, language arts, and…

Causes of homelessness prevalence: Relationship between homelessness and disability.

PubMed

Nishio, Akihiro; Horita, Ryo; Sado, Tadahiro; Mizutani, Seiko; Watanabe, Takahiro; Uehara, Ryosuke; Yamamoto, Mayumi

2017-03-01

Many studies have reported that the prevalence of mental illness and cognitive disability is higher among homeless individuals compared to the general population, and the rates of mental illness among the homeless population have recently increased. This study: (i) compares causes of homelessness or barriers to escaping homelessness for people with/without mental illness/cognitive disability; (ii) reveals problems with the Japanese homeless policy; and (iii) proposes an effective and necessary support system. The participants were 114 homeless individuals. A psychiatric diagnostic interview and the Wechsler Adult Intelligence Scale, version III were used to measure participants' mental health and cognitive abilities. A questionnaire was administered comprising 17 items related to the causes of their homelessness and barriers to escaping from it. Participants were divided into four groups - with/without mental illness or cognitive disability - and Fisher's exact test was used to compare the questionnaire results. Individuals with cognitive disabilities considered bad relationships with their family members to be the cause of their homelessness. Conversely, normal individuals considered their homelessness to be the result of debt more so than did individuals with mental problems. Individuals with mental illness had more difficulties escaping homelessness than did either normal individuals or individuals with cognitive disability. This tendency was observed most strongly among individuals with both mental illness and cognitive disability. Most homeless individuals considered economic problems to be the cause of their homelessness; however, difficulties with human relationships were also important factors and were more difficult for participants to acknowledge. Furthermore, these difficulties were exacerbated among those individuals with mental problems. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

Characteristics of people attending psychiatric clinics in inner Sydney homeless hostels.

PubMed

Nielssen, Olav B; Stone, William; Jones, Naidene M; Challis, Sarah; Nielssen, Amelia; Elliott, Gordon; Burns, Nicholas; Rogoz, Astrid; Cooper, Lucy E; Large, Matthew M

2018-03-05

To describe the characteristics of people attending mental health clinics at shelters for the homeless in inner city Sydney. Retrospective review of medical records of homeless hostel clinic attenders. Mental health clinics located in three inner city homeless hostels. Consecutive series of clinic attenders, 21 July 2008 - 31 December 2016. Demographic characteristics; social, medical and mental health histories of homeless people. 2388 individual patients were seen at the clinics during the 8.5-year study period. Their mean age was 42 years (standard deviation, 13 years), 93% were men, and 56% were receiving disability support pensions. 59% of attenders had been homeless for more than a year, and 34% of all attenders reported sleeping in the open. The most common diagnoses were substance use disorder (66%), psychotic illness (51%), acquired brain injury (14%), and intellectual disability (5%). Most patients had more than one diagnosis. Early life and recent trauma was reported by 42% of patients. Pathways to homelessness included release from prison (28% of the homeless), discharge from a psychiatric hospital (21%), loss of public housing tenancy (21%), and inability to pay rent because of problem gambling. The high rates of substance use and mental disorder among homeless people in inner Sydney confirms the need for increased access to treatment for these conditions in this setting. Homelessness among those with mental illness might be reduced by developing alternative housing models, and supporting people with multiple problems to retain tenancy.

Attributions about homelessness in homeless and domiciled people in Madrid, Spain: "Why are they homeless people?".

PubMed

Vázquez, José Juan; Panadero, Sonia; Zúñiga, Claudia

2018-01-01

Causal attributions of homelessness may affect both the design and acceptance of public policies aimed at improving the situation of homeless people and the strategies that homeless people themselves decide to adopt in order to cope with their situation. This article analyzes the differences in causal attributions of homelessness based on gender, age, nationality, educational background, perceived social class, evolution of personal economic situation, and future expectations between the members of 2 groups: (a) "homeless group", consisting of a representative sample of homeless people in Madrid, Spain (n = 188); and (b) "domiciled group", consisting of a sample of people in Madrid at no risk of homelessness (n = 180), matched for sex, age and nationality. Results show that among domiciled population, women, older people, those without university education, those considering themselves to belong to lower income social classes, those who considered their economic situation to have worsened, and those who expressed negative expectations for the future attributed homelessness to individualistic courses to a greater extent. Meanwhile, among homeless group, younger people, those without university education, those considering themselves to belong to higher social classes, those who perceived their economic situation as having improved in recent years, and those who expressed positive expectations for the future generally attributed homelessness to individualistic courses to a greater extent. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Psychopharmacologic Services for Homeless Veterans: Comparing Psychotropic Prescription Fills Among Homeless and Non-Homeless Veterans with Serious Mental Illness.

PubMed

Hermes, Eric; Rosenheck, Robert

2016-02-01

Using national Veterans Health Administration (VHA) administrative data, this study evaluated differences in psychotropic medication use between homeless and non-homeless adults with serious mental illness (SMI) who used VHA services in 2010. The adjusted mean number of psychotropic prescription fills associated with homeless individuals were identified using regression models adjusted for socio-demographics, diagnoses, and use of health services. Of the 876,989 individuals with SMI using VHA services, 7.2 % were homeless at some time during 2010. In bivariate analysis, homeless individuals filled more psychotropic medication prescriptions compared with non-homeless individuals. However, after adjusting for potentially confounding variables, homeless individuals were found to have filled 16.2 % fewer prescriptions than non-homeless individuals when all psychotropics were analyzed together (F = 6947.1, p < .001) and for most individual classes of psychotropics. Greater use of residential/inpatient mental health services by the homeless was the most important single factor associated with filling more psychotropic prescriptions than non-homeless individuals.

Social exclusion, health and hidden homelessness.

PubMed

Watson, J; Crawley, J; Kane, D

2016-10-01

Homelessness and poverty are extreme forms of social exclusion which extend beyond the lack of physical or material needs. The purpose of this study was to explore and expand the concept of social exclusion within the social determinants of health perspective - to understand how the social environment, health behaviours and health status are associated with material and social deprivation. Fundamental qualitative description with tones of focused ethnography. Participants who identified as hidden homeless described their everyday living conditions and how these everyday conditions were impacted and influenced by their social environments, coping/health behaviours and current health status. Research Ethics Board approval was granted and informed consents were obtained from 21 participants prior to the completion of individual interviews. Qualitative content analysis examined the descriptions of men and women experiencing hidden homelessness. Participants described the 'lack of quality social interactions and supports' and their 'daily struggles of street life'. They also shared the 'pain of addiction' and how coping strategies influenced health. Participants were hopeful that their insights would 'better the health of homeless people' by helping shape public policy and funding of community resources that would reduce barriers and improve overall health. Health professionals who understand health behaviours as coping mechanisms for poor quality social environments can provide more comprehensive and holistic care. The findings of this study can be used to support the importance of housing as a key factor in the health and well-being of people experiencing poverty, homelessness and social exclusion; and consequently, reinforces the need for a national housing strategy. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Long-term and chronic homelessness in homeless women and women with children.

PubMed

Zlotnick, Cheryl; Tam, Tammy; Bradley, Kimberly

2010-09-01

The Chronic Homelessness initiative has directed millions of federal dollars to services for single "unaccompanied homeless" individuals, specifically excluding women living with their children. Using a data set with a nationally representative sample of homeless adults, we calculated the prevalence rates and profiles of long-term homelessness in homeless women (n = 849). With the exception of the criterion of being a single "unaccompanied individual," many women, including women with children, met the criteria for chronic homelessness including having a disability of mental health or substance abuse problems. Our findings suggest that the federal definition of chronic homelessness needs to be revised.

Desired Destinations of Homeless Women: Realizing Aspirations Within the Context of Homelessness.

PubMed

Biederman, Donna J; Forlan, Nicole

2016-08-01

Despite recent decreases, homelessness remains a substantial problem in the United States. Homelessness is associated with poor health, and homeless women experience earlier mortality than their housed counterparts. Understanding the aspirations of homeless women may offer service providers avenues for intervention to increase well-being among this vulnerable population. This study, a secondary analysis of transcribed interviews (n = 20), provides insight into the aspirations of homeless women. Opportunities for service providers to intervene on these aspirations within the context of homelessness are offered.

Nursing case management, peer coaching, and hepatitis a and B vaccine completion among homeless men recently released on parole: randomized clinical trial.

PubMed

Nyamathi, Adeline; Salem, Benissa E; Zhang, Sheldon; Farabee, David; Hall, Betsy; Khalilifard, Farinaz; Leake, Barbara

2015-01-01

Although hepatitis A virus (HAV) and hepatitis B virus (HBV) infections are vaccine-preventable diseases, few homeless parolees coming out of prisons and jails have received the hepatitis A and B vaccination series. The study focused on completion of the HAV and HBV vaccine series among homeless men on parole. The efficacy of three levels of peer coaching (PC) and nurse-delivered interventions was compared at 12-month follow-up: (a) intensive peer coaching and nurse case management (PC-NCM); (b) intensive PC intervention condition, with minimal nurse involvement; and (c) usual care (UC) intervention condition, which included minimal PC and nurse involvement. Furthermore, we assessed predictors of vaccine completion among this targeted sample. A randomized control trial was conducted with 600 recently paroled men to assess the impact of the three intervention conditions (PC-NCM vs. PC vs. UC) on reducing drug use and recidivism; of these, 345 seronegative, vaccine-eligible subjects were included in this analysis of completion of the Twinrix HAV/HBV vaccine. Logistic regression was added to assess predictors of completion of the HAV/HBV vaccine series and chi-square analysis to compare completion rates across the three levels of intervention. Vaccine completion rate for the intervention conditions were 75.4% (PC-NCM), 71.8% (PC), and 71.9% (UC; p = .78). Predictors of vaccine noncompletion included being Asian and Pacific Islander, experiencing high levels of hostility, positive social support, reporting a history of injection drug use, being released early from California prisons, and being admitted for psychiatric illness. Predictors of vaccine series completion included reporting having six or more friends, recent cocaine use, and staying in drug treatment for at least 90 days. Findings allow greater understanding of factors affecting vaccination completion in order to design more effective programs among the high-risk population of men recently released from

Youth Homelessness 2006

ERIC Educational Resources Information Center

MacKenzie, David; Chamberlain, Chris

2008-01-01

The third national census of homeless school students, conducted in 2006, found that the number of homeless students had decreased since 2001. There were 9,389 homeless students in 2006 compared with 12,227 in 2001. Three groups were over-represented in the homeless population: Indigenous students, young people from single parent and blended…

Prevalence of mental illness, intellectual disability, and developmental disability among homeless people in Nagoya, Japan: A case series study.

PubMed

Nishio, Akihiro; Yamamoto, Mayumi; Ueki, Hirofumi; Watanabe, Takahiro; Matsuura, Kenshin; Tamura, Osamu; Uehara, Ryosuke; Shioiri, Toshiki

2015-09-01

While it has been reported that the prevalence of mental illness is higher in homeless people than in the national population, few studies have investigated the prevalence of intellectual and developmental disability among the homeless. In this study, we conducted a survey to comprehensively assess these mental problems among homeless people in Nagoya, Japan. The subjects were 18 homeless men. Mental illness was diagnosed with semi-structured interviews conducted by psychiatrists. We used the Wechsler Adult Intelligence Scale III to diagnose intellectual disability. Discrepancies between Wechsler Adult Intelligence Scale III subtest scores were used as criteria for developmental disability. Eleven of the 18 participants were diagnosed with mental illness: six with mood disorder, two with psychotic disorder, and six with alcohol problems. The mean IQ of all subjects was 83.4 ± 27.4. The 95% confidence interval (CI) was 96.2-69.1. Seven participants were found to have intellectual disability. Three men showed discrepancies of more than 10 between subtest scores, and all of them were diagnosed with a mental illness. We divided the participants into four groups: those with mental illness only; those with intellectual disability only; those with both problems; and those without diagnosis. The men with intellectual disability only were significantly younger and had been homeless since a younger age than the other groups. Participants diagnosed with a mental illness had been homeless for longer than those without mental health problems. Although the sample size was limited, this study revealed the high prevalence of mental illness and intellectual disability, 61% (95%CI, 35-83%) and 39% (95%CI, 17-64%), respectively, in homeless people in Nagoya, Japan. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

Risk factors associated with recurrent homelessness after a first homeless episode.

PubMed

McQuistion, Hunter L; Gorroochurn, Prakash; Hsu, Eustace; Caton, Carol L M

2014-07-01

Alcohol and drug use are commonly associated with the experience of homelessness. In order to better understand this, we explored the prevalence of drug and alcohol use as it related to successful re-housing within a sample of first-time single homeless adults at municipal shelters. From within this sample, we compared the features of recurrent homelessness with those of chronic homelessness and of being stably housed. We interviewed 344 subjects upon shelter entry and followed each one every six months for 18 months using standardized social and mental health measures. We analyzed baseline assessments relative to housing experiences during follow-up using Chi square and multinomial logistic regression. Eighty-one percent (N = 278) obtained housing over 18 months, of which 23.7 % (N = 66) experienced homelessness again. Recurrent homelessness was more common among those with a high school education and if initially re-housed with family. Bivariate analysis resulted in the observation of the highest rate of alcohol and other drug use among this recurrent group and multinomial logistic regression supported this only with the coupling of arrest history and diagnosed antisocial personality disorder. With relatively high rates of recurrent homelessness, there were differences between subjects who experienced recurrent homelessness compared to those who were stably housed and with chronic homelessness. That alcohol and other substance use disorders were associated with recurrent homelessness only if they were linked to other risk factors highlights the complexity of causes for homelessness and a resultant need to organize them into constellations of causal risk factors. Consistent with this, there should be initiatives that span bureaucratic boundaries so as to flexibly meet multiple complex service needs, thus improving outcomes concerning episodes of recurrent homelessness.

Actors, observers, and causal attributions of homelessness: Differences in attribution for the causes of homelessness among domiciled and homeless people in Madrid (Spain).

PubMed

Vázquez, José Juan; Panadero, Sonia; Zúñiga, Claudia

2017-01-01

The study analyzes the differences in causal attributions of homelessness and attributions of responsibility among the members of 3 groups: homeless group, consisting of a representative sample of homeless people in Madrid, Spain (n = 188); domiciled service-users group, consisting of people at risk of homelessness (n = 164); and domiciled nonservice-users group, consisting of people at no imminent risk of homelessness (n = 180). The domiciled service-users group and domiciled nonservice-users group were matched to the homeless group or sex, age, and nationality. The article also analyzes homeless people's causal attributions as regards their own situation. The results show that compared with the domiciled nonservice-users group, a higher percentage of members of the homeless group and domiciled service-users group attributed homelessness to individualistic causes and they blamed homeless people for their situation to a greater extent. The results also show that there was no "actor-observer bias" in causal attributions for homelessness in Madrid. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Older people experiencing homelessness show marked impairment on tests of frontal lobe function.

PubMed

Rogoz, Astrid; Burke, David

2016-03-01

Reported rates of mild and moderate cognitive impairment in older people experiencing homelessness range from 5-80%. The objective of this study was to determine the prevalence and characteristics of cognitive impairment in older people experiencing homelessness in the inner city of Sydney, Australia. Men and women experiencing homelessness aged 45 years and over in the inner city were screened for cognitive impairment. Participants who scored 26 or below on the mini-mental state examination and/or were impaired on any one of the clock-drawing test, the verbal fluency test and the trail-making test, part B were then assessed with a semi-structured interview, including the 21-item Depression Anxiety Stress Scale and the 12-item General Health Questionnaire. Screening of 144 men and 27 women aged between 45 years and 93 years identified cognitive impairment in 78%. Subsequently, high rates of mental and physical illness were identified, and 75% of subjects who were cognitively impaired performed poorly on frontal lobe tests. The trail-making test, part B was the most sensitive measure of frontal function. This study demonstrated that a large majority of older people experiencing homelessness, in the inner city of a high-income country, showed impairment on tests of frontal lobe function, a finding that could have significant implications for any medical or psychosocial intervention. Copyright © 2015 John Wiley & Sons, Ltd.

Life Shocks and Homelessness

PubMed Central

Corman, Hope; Noonan, Kelly; Reichman, Nancy E.

2014-01-01

We exploited an exogenous health shock—namely, the birth of a child with a severe health condition—to investigate the effect of a life shock on homelessness in large cities in the United States as well as the interactive effects of the shock with housing market characteristics. We considered a traditional measure of homelessness, two measures of housing instability thought to be precursors to homelessness, and a combined measure that approximates the broadened conceptualization of homelessness under the 2009 Homeless Emergency Assistance and Rapid Transition to Housing Act (2010). We found that the shock substantially increases the likelihood of family homelessness, particularly in cities with high housing costs. The findings are consistent with the economic theory of homelessness, which posits that homelessness results from a conjunction of adverse circumstances in which housing markets and individual characteristics collide. PMID:23868747

Veterans and Homelessness

DTIC Science & Technology

2011-04-01

definition of “homeless individual” under McKinney-Vento. The Homeless Emergency Assistance and Rapid Transition to Housing ( HEARTH ) Act was enacted...as part of the Helping Families Save Their Homes Act of 2009 (P.L. 111-22) on May 20, 2009. The changes in the HEARTH Act were to take effect at the...definition of homelessness, continue in place.10 The HEARTH Act amended Section 103(a) of McKinney-Vento to broaden the definition of homeless individuals

Comparison of insight and clinical variables in homeless and non-homeless psychiatric inpatients in China.

PubMed

Fu, Yan-Nan; Cao, Xiao-Lan; Hou, Cai-Lan; Ng, Chee H; Ungvari, Gabor S; Chiu, Helen F K; Lin, Yong-Qiang; Wang, Lihui; Zheng, Xiaocong; Jia, Fu-Jun; Xiang, Yu-Tao

2017-09-01

There are no published data on insight in homeless patients with psychiatric disorders in China. This study examined insight in homeless and non-homeless Chinese psychiatric inpatients in relation to demographic and clinical variables. A total of 278 homeless and 222 non-homeless inpatients matched in age and gender were included in the study. Demographic and clinical characteristics were collected based on a review of medical charts and a clinical interview with standardized instruments. Insight was evaluated with the Insight and Treatment Attitudes Questionnaire. Altogether 20.5% of homeless inpatients and 43.7% of the non-homeless controls had good insight. Compared with homeless inpatients with impaired insight, homeless inpatients with good insight had higher physical quality of life, longer duration of illness and less severe positive and negative symptoms. Impaired insight appeared more common in homeless psychiatric inpatients in China. Further studies should address the need for effective therapeutic interventions that promote homeless patients' insight. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Homelessness as culture: How transcultural nursing theory can assist caring for the homeless.

PubMed

Law, Kate; John, William

2012-11-01

The concepts of culture and homelessness are both complex and contested. This paper examines homelessness through the lens of transcultural nursing theory, increasing understanding of both homelessness and transcultural theory. We argue that homelessness can be usefully conceptualised as a culture and that the application of transcultural theory to caring for homeless people will add further to the utility of these theories. The application of transcultural theory can add to the repertoire of skills the nurse needs to care for not only homeless clients, but, for a diverse range of client groups. Copyright © 2012 Elsevier Ltd. All rights reserved.

Correlates of Serious Violent Crime for Recently Released Parolees With a History of Homelessness

PubMed Central

Nyamathi, Adeline; Marfisee, Mary; Khalilifard, Farinaz; Leake, Barbara; Marlow, Elizabeth; Zhang, Sheldon; Hall, Elizabeth; Farabee, David; Faucette, Mark

2013-01-01

This study used baseline data on recently-released homeless paroled men who are homeless (N = 157), residing in a residential drug treatment program, and enrolled in a longitudinal study to examine personal, developmental, and social correlates of parolees who are homeless and parolees who have committed serious violent offenses. Having experienced childhood sexual abuse, poor parental relationships, and early-onset incarceration (prior to 21 years of age) were important correlates of serious violent crimes. These findings highlight the need for interventions that address offenders’ prior adult and childhood victimization, and suggest that policies for reentering violent offenders should encompass an understanding of the broader family contexts in which these patterns of maltreatment often occur. PMID:23155727

Homelessness in America.

ERIC Educational Resources Information Center

Baumohl, Jim, Ed.

This book about homelessness in the United States offers 16 chapters in three parts. Part 1, "History Definitions, and Causes," includes: (1) "Redefining the Cursed Word: A Historical Interpretation of American Homelessness" (Kim Hopper and Jim Baumohl); (2) "Homelessness: Definitions and Counts" (Martha R. Burt); (3)…

Homelessness and the Homeless: Responses and Innovations. A Canadian Contribution to IYSH 1987.

ERIC Educational Resources Information Center

Oberlander, H. Peter; Fallick, Arthur L.

This report presents descriptions of successful Canadian public and private programs to aid the homeless and alleviate homelessness as part of participation in the International Year of Shelter for the Homeless (IYSH). Part 1, "The International Year of Shelter for the Homeless," includes the following: (1) objectives; (2) global…

Gender differences in sexual risk and sexually transmitted infections correlate with gender differences in social networks among San Francisco homeless youth.

PubMed

Valente, Annie M; Auerswald, Colette L

2013-10-01

To explore whether gender differences in sexual risk and sexually transmitted infections (STIs) among homeless youth may be explained in part by gender differences in their social networks. Our sample includes 258 youth (64% male) recruited in San Francisco from street venues and transitional programs. Participants completed an audio computer-administered self-interview survey regarding their housing status and risk behaviors and an interviewer-administered survey regarding their social networks, and were tested for STIs (chlamydia and gonorrhea). We examined relationships between sexual risk and STI rates and social network characteristics by gender. Condom use was lower in young women than in young men, whereas young women were more likely to have an injection drug user (IDU) sex partner and to be diagnosed with an STI. Homeless young men were more likely to have stably housed contacts and same-sex friendships in their social networks than were young women. Stably housed network contacts were associated with increased condom use and decreased STI prevalence in young men. Same-sex friends were associated with increased condom use in young women. No young woman with a family member in her network had an IDU sex partner. Having a network member who had been recently incarcerated was associated with having an IDU sex partner for young women. Homeless young women's networks may place them at greater risk for STIs than young men. Increasing mainstream contacts and same-gender friendships may protect all homeless youth from STIs. Interventions addressing homeless young women's social networks may decrease their gender-disparate STI risk. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Double Jeopardy: Homeless & Illiterate.

ERIC Educational Resources Information Center

BCEL Newsletter for the Business Community, 1988

1988-01-01

For the first time, federal funding for literacy services will focus new attention on the plight of the homeless. Under the McKinney Homeless Assistance Act, each state will receive funds for literacy for the homeless. Although there are no firm estimates on how many persons are homeless, a number of indicators point to a problem of major and…

Homelessness as viewed by incarcerated women: participatory research.

PubMed

Martin, Ruth Elwood; Hanson, Debra; Hemingway, Christine; Ramsden, Vivian; Buxton, Jane; Granger-Brown, Alison; Condello, Lara-Lisa; Macaulay, Ann; Janssen, Patti; Hislop, T Gregory

2012-01-01

The purpose of this paper is to describe the development, by incarcerated women who were members of a prison participatory health research team, of a survey tool regarding homelessness and housing, the survey findings and recommendations for policy. A survey was developed by incarcerated women in a minimum/medium security women's prison in Canada. Associations were examined between socio-demographic factors and reports of difficulty finding housing upon release, homelessness contributing to a return to crime, and a desire for relocation to another city upon release. Open-ended questions were examined to look for recurrent themes and to illuminate the survey findings. In total, 83 women completed the survey, a 72 per cent response rate. Of the 71 who were previously incarcerated, 56 per cent stated that homelessness contributed to their return to crime. Finding housing upon release was a problem for 63 per cent and 34 per cent desired relocation to another city upon release. Women indicated that a successful housing plan should incorporate flexible progressive staged housing. The present study focuses only on incarcerated women but could be expanded in future to include men. Incarcerated women used the findings to create a housing proposal for prison leavers and created a resource database of the limited housing resources for women prison leavers. Lack of suitable housing is a major factor leading to recidivism. This study highlights the reality of the cycle of homelessness, poverty, crime for survival, street-life leading to drug use and barriers to health, education and employment that incarcerated women face. Housing is a recognized basic determinant of health. No previous studies have used participatory research to address homelessness in a prison population.

Nursing Case Management, Peer Coaching, and Hepatitis A and B Vaccine Completion Among Homeless Men Recently Released on Parole: Randomized Clinical Trial

PubMed Central

Nyamathi, Adeline; Salem, Benissa E.; Zhang, Sheldon; Farabee, David; Hall, Betsy; Khalilifard, Farinaz; Leake, Barbara

2015-01-01

Background Although hepatitis A virus (HAV) and hepatitis B virus (HBV) infections are vaccine-preventable diseases, few homeless parolees coming out of prisons and jails have received the hepatitis A and B vaccination series. Objectives The study focused on completion of the HAV and HBV vaccine series among homeless men on parole. The efficacy of three levels of peer coaching and nurse-delivered interventions was compared at 12-month follow up: (a) intensive peer coaching and nurse case management (PC-NCM); (b) intensive peer coaching (PC) intervention condition, with minimal nurse involvement; and a (c) usual care (UC) intervention condition, which included minimal PC and nurse involvement. Further, we assessed predictors of vaccine completion among this targeted sample. Methods A randomized control trial was conducted with 600 recently paroled men to assess the impact of the three intervention conditions (PC-NCM vs. PC vs. UC) on reducing drug use and recidivism; of these, 345 seronegative, vaccine-eligible subjects were included in this analysis of completion of the Twinrix HAV/HAB vaccine. Logistic regression was added to assess predictors of completion of the HAV/HBV vaccine series and chi-squared analysis to compare completion rates across the three levels of intervention. Results Vaccine completion rate for the intervention conditions were 75.4% (PC-NCM), 71.8% (PC), and 71.9% (UC) (p =. 78). Predictors of vaccine noncompletion included being Asian and Pacific Islander, experiencing high levels of hostility, positive social support, reporting a history of injection drug use, being released early from California prisons, and being admitted for psychiatric illness. Predictors of vaccine series completion included reporting six or more friends, recent cocaine use, and staying in drug treatment for at least 90 days. Discussion Findings allow greater understanding of factors affecting vaccination completion in order to design more effective programs among the

Educating Homeless Students.

ERIC Educational Resources Information Center

Berliner, BethAnn

2002-01-01

Over the past decade, the number of homeless children in America has more than doubled. Educators, however, are still legally obligated to enroll and support them, because of the passage of the "No Child Left Behind" Act of 2001, which reauthorized the McKinney-Vento Homeless Assistance Act. Although schools cannot solve homelessness,…

Veterans and Homelessness

DTIC Science & Technology

2013-11-29

veterans in general (8.7% in 2010).25 • Both male and female veterans were married at a higher rate than veterans served in the VA’s homeless programs—68...42,858a 6,197b 759c 23,654d Year Data Collected FY2010 FY2010 FY2009 FY2008-FY2010 Average Age 51.0 49.8 48.6 50.4 Marital Status % Married 7.1 6.3...5.6 8.5 % Divorced/Separated/Widowed 63.4e 63.3 62.0 60.5 % Never Married 29.6 30.4 32.4 25.5 Gender % Men 94.3 95.1 95.4 88.5 % Women 5.7 4.9 4.6

Subjective social status and readiness to quit among homeless smokers.

PubMed

Garey, Lorra; Reitzel, Lorraine R; Bakhshaie, Jafar; Kendzor, Darla E; Zvolensky, Michael J; Businelle, Michael S

2015-03-01

To explore the predictive value of subjective social status (SSS-US and SSS-Community) on readiness to quit among 245 homeless smokers. Hierarchical multiple regression analyses were conducted (stratified by sex). Higher SSS-US (p = .02) and SSS-Community (p < .001) predicted greater readiness to quit in the total sample. These relationships upheld for men (p's <. 01), but only SSS-Community predicted readiness to quit for women (p = .02). Higher SSS is associated with greater readiness to quit among homeless smokers. SSS-Community may be a more relevant index of SSS for women relative to SSS-US. Results suggest SSS may be a factor that contributes to smoking, disease, and health disparities.

Homeless, Not Hopeless. An Informational Guide for School Personnel: Understanding and Educating Homeless Students.

ERIC Educational Resources Information Center

Seifert, Elli; Stauffer, Carol

This guide explains how to educate homeless students within the public schools, focusing on the Saint Paul, Minnesota, public schools. Section 1 defines homelessness. Section 2 presents data on the increasing numbers of homeless students in the area. Section 3 describes common problems faced by homeless students, including family mobility,…

Recognizing the Needs of the Homeless.

ERIC Educational Resources Information Center

France, Joseph B.

This paper summarizes reports and research on the homeless in the United States, presents findings of a survey of Red Cross chapters on services to the homeless, and describes programs for the homeless of selected Red Cross chapters. Section 1 discusses definitions of homelessness and methodologies used to count homeless people. The homeless are…

The challenge of pregnancy among homeless youth: reclaiming a lost opportunity.

PubMed

Smid, Marcela; Bourgois, Philippe; Auerswald, Colette L

2010-05-01

Young, homeless women often become pregnant, but little is known about how street youth experience their pregnancies. We documented 26 pregnancy outcomes among 13 homeless women (ages 18-26) and eight homeless men through interviews and participant-observation. Eight pregnancies were voluntarily terminated, three were miscarried, and fifteen were carried to term. Regardless of pregnancy outcome, street youths' narratives focused on ambivalence about parenting, traumatic childhood experiences, and current challenges. Despite significant obstacles, almost all were convinced of their personal capacity to change their lives. While most wanted to be parents, the majority lost custody of their newborns and consequently associated contact with medical and social services with punitive outcomes. Most of the youth who chose to terminate successfully sought safe medical care. We offer recommendations for changing the approach of services to take full advantage of pregnancy as a potential catalyst event for change in this highly vulnerable and underserved population.

The Challenge of Pregnancy among Homeless Youth: Reclaiming a Lost Opportunity

PubMed Central

Smid, Marcela; Bourgois, Philippe; Auerswald, Colette L.

2011-01-01

Young, homeless women often become pregnant, but little is known about how street youth experience their pregnancies. We documented 26 pregnancy outcomes among 13 homeless women (ages 18–26) and eight homeless men through interviews and participant-observation. Eight pregnancies were voluntarily terminated, three were miscarried, and fifteen were carried to term. Regardless of pregnancy outcome, street youths’ narratives focused on ambivalence about parenting, traumatic childhood experiences, and current challenges. Despite significant obstacles, almost all were convinced of their personal capacity to change their lives. While most wanted to be parents, the majority lost custody of their newborns and consequently associated contact with medical and social services with punitive outcomes. Most of the youth who chose to terminate successfully sought safe medical care. We offer recommendations for changing the approach of services to take full advantage of pregnancy as a potential catalyst event for change in this highly vulnerable and underserved population. PMID:20453382

The Rights of Homeless Students.

ERIC Educational Resources Information Center

Strong, Penny

This booklet presents information concerning homelessness and the education of homeless children nationwide and in Illinois. Estimates of the number of homeless children vary widely. Reasons for homeless children's failure to attend school include school residency requirements, delays in transfer of documents, and lack of transportation. The…

Intellectual disability and homelessness.

PubMed

Mercier, C; Picard, S

2011-04-01

The association between poverty and intellectual disability (ID) has been well documented. However, little is known about persons with ID who face circumstances of extreme poverty, such as homelessness. This paper describes the situation of persons with ID who were or are homeless in Montreal and are currently receiving services from a team dedicated to homeless persons. (1) To describe the characteristics, history and current situation of these persons; and (2) to report within-group differences as a function of gender and current residential status. The data were collected from files using an anonymous chart summary. Descriptive statistics on the whole sample (n = 68) and inferential statistics on cross-tabulations by gender and residential status were performed. Persons with ID exhibited several related problems. Some of these persons, primarily women, experienced relatively short periods of homelessness and their situations stabilised once they were identified and followed up. Other persons with ID experienced chronic homelessness that appeared to parallel the number and severity of their other problems. When compared with a previous epidemiological study of the homeless in Montreal, the population of homeless persons with ID differed from the overall homeless population in a number of respects. The results suggest prevention and intervention targets. The need for epidemiological research appears particularly clear in light of the fact that below-average intellectual functioning has been identified as a risk factor for homelessness and a predisposing factor for vulnerability among street people. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.

Characteristics of the Highest Users of Emergency Services in Veterans Affairs Hospitals: Homeless and Non-Homeless.

PubMed

Gundlapalli, Adi V; Jones, Audrey L; Redd, Andrew; Suo, Ying; Pettey, Warren B P; Mohanty, April; Brignone, Emily; Gawron, Lori; Vanneman, Megan; Samore, Matthew H; Fargo, Jamison D

2017-01-01

Efforts are underway to understand recent increases in emergency department (ED) use and to offer case management to those patients identified as high utilizers. Homeless Veterans are thought to use EDs for non-emergent conditions. This study identifies the highest users of ED services in the Department of Veterans Affairs and provides descriptive analyses of these Veterans, the diagnoses for which they were seen in the ED, and differences based on their homeless status. Homeless Veterans were more likely than non-homeless Veterans to have >10 visits in the 2014 calendar year (12% vs. <1%). Homeless versus non-homeless Veterans with >10 visits were more often male, <age 60, and non-married. Non-homeless Veterans with >10 ED visits were often treated for chest and abdominal pain, and back problems, whereas homeless Veterans were frequently treated for mental health/substance use. Tailored case management approaches may be needed to better link homeless Veterans with high ED use to appropriate outpatient care.

"Homelessness and trauma go hand-in-hand": pathways to homelessness among women veterans.

PubMed

Hamilton, Alison B; Poza, Ines; Washington, Donna L

2011-01-01

Veterans comprise a disproportionate fraction of the nation's homeless population, with women veterans up to four times more likely to be homeless than non-veteran women. This paper provides a grounded description of women veterans' pathways into homelessness. Three focus groups were held in Los Angeles, California, with a total of 29 homeless women veterans. Five predominant "roots" (precipitating experiences) initiated pathways toward homelessness: 1) childhood adversity, 2) trauma and/or substance abuse during military service, 3) post-military abuse, adversity, and/or relationship termination, 4) post-military mental health, substance abuse, and/or medical problems, and 5) unemployment. Contextual factors, which promoted development of homelessness in the setting of primary roots, included women veterans' "survivor instinct," lack of social support and resources, sense of isolation, pronounced sense of independence, and barriers to care. These contextual factors also reinforced persistence of the roots of post-military adversity and mental health and substance abuse problems, serving to maintain cycles of chronic homelessness. Collectively, these multiple, interacting roots and contextual factors form a "web of vulnerability" that is a target for action. Multiple points along the pathways to homelessness represent critical junctures for VA and community-based organizations to engage in prevention or intervention efforts on behalf of women veterans. Considering the multiple, interconnected challenges that these women veterans described, solutions to homelessness should address multiple risk factors, include trauma-informed care that acknowledges women veterans' traumatic experiences, and incorporate holistic responses that can contribute to healing and recovery. Published by Elsevier Inc.

An inexpensive, interdisciplinary, methodology to conduct an impact study of homeless persons on hospital based services.

PubMed

Parker, R David; Regier, Michael; Brown, Zachary; Davis, Stephen

2015-02-01

Homelessness is a primary concern for community health. Scientific literature on homelessness is wide ranging and diverse. One opportunity to add to existing literature is the development and testing of affordable, easily implemented methods for measuring the impact of homeless on the healthcare system. Such methodological approaches rely on the strengths in a multidisciplinary approach, including providers, both healthcare and homeless services and applied clinical researchers. This paper is a proof of concept for a methodology which is easily adaptable nationwide, given the mandated implementation of homeless management information systems in the United States and other countries; medical billing systems by hospitals; and research methods of researchers. Adaptation is independent of geographic region, budget restraints, specific agency skill sets, and many other factors that impact the application of a consistent methodological science based approach to assess and address homelessness. We conducted a secondary data analysis merging data from homeless utilization and hospital case based data. These data detailed care utilization among homeless persons in a small, Appalachian city in the United States. In our sample of 269 persons who received at least one hospital based service and one homeless service between July 1, 2012 and June 30, 2013, the total billed costs were $5,979,463 with 10 people costing more than one-third ($1,957,469) of the total. Those persons were primarily men, living in an emergency shelter, with pre-existing disabling conditions. We theorize that targeted services, including Housing First, would be an effective intervention. This is proposed in a future study.

Housing and Homelessness: A Report.

ERIC Educational Resources Information Center

National Alliance to End Homelessness, Washington, DC.

This report focuses on options for rehousing the individuals and families who are currently homeless in America, and on strategies for preventing homelessness of additional people. As many as 736,000 persons are estimated to be homeless on any given night, and between 1.3 million and 2 million different individuals may experience homelessness at…

The reality of homeless mobility and implications for improving care.

PubMed

Parker, R David; Dykema, Shana

2013-08-01

Homeless persons are perceived as a highly mobile population, and have high rates of co-morbid conditions, including mental health and substance use issues. This study sought to determine the characteristics of the mobility and reported health conditions of homeless persons. The sample for this cross sectional study (n = 674) accounted for 88 % of the homeless population in a medium sized southern city in the United States. Participants were recruited from a homeless shelter operating during the winter season. Homeless persons were less mobile than the general state population (46.11 % were born in-state vs. 40.7 % of the general population) and less transient than the general state population (78 % reported an in-state zip code for the last permanent residence). 31.9 % reported a disabling condition of a serious and long term nature. These findings challenge the concept that homeless persons are primarily a mobile population. Furthermore, homeless persons in this sample were more likely to remain in the state where they lived after becoming homeless. Thus, provider perceptions that homeless persons would not benefit from referral to a regular source of outpatient care may be misinformed. As homeless persons often seek care in emergency departments for conditions that could be addressed through outpatient care, if a medical care system implemented standard practices specifically for homeless patients, this could decrease recidivism. Such interventions represent significant opportunities to reduce costs, conserve resources, and improve care through policy modification that ensures a focus on a successful, active linkage to outpatient care and programs specific to the homeless population.

75 FR 22164 - Urban Non-Urban Homeless Female Veterans and Homeless Veterans With Families' Reintegration Into...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-27

... Non-Urban Homeless Female Veterans and Homeless Veterans With Families' Reintegration Into Employment... addresses complex problems facing Homeless Female Veterans and/or Veterans with Families eligible to... (including job readiness, literacy training, and skills training) to expedite the reintegration of homeless...

Tuberculosis and homelessness in Montreal: a retrospective cohort study

PubMed Central

2011-01-01

Background Montreal is Canada's second-largest city, where mean annual tuberculosis (TB) incidence from 1996 to 2007 was 8.9/100,000. The objectives of this study were to describe the epidemiology of TB among homeless persons in Montreal and assess patterns of transmission and sharing of key locations. Methods We reviewed demographic, clinical, and microbiologic data for all active TB cases reported in Montreal from 1996 to 2007 and identified persons who were homeless in the year prior to TB diagnosis. We genotyped all available Mycobacterium tuberculosis isolates by IS6110 restriction fragment length polymorphism (IS6110-RFLP) and spoligotyping, and used a geographic information system to identify potential locations for transmission between persons with matching isolates. Results There were 20 cases of TB in homeless persons, out of 1823 total reported from 1996-2007. 17/20 were Canadian-born, including 5 Aboriginals. Homeless persons were more likely than non-homeless persons to have pulmonary TB (20/20), smear-positive disease (17/20, odds ratio (OR) = 5.7, 95% confidence interval (CI): 1.7-20), HIV co-infection (12/20, OR = 14, 95%CI: 4.8-40), and a history of substance use. The median duration from symptom onset to diagnosis was 61 days for homeless persons vs. 28 days for non-homeless persons (P = 0.022). Eleven homeless persons with TB belonged to genotype-defined clusters (OR = 5.4, 95%CI: 2.2-13), and ten potential locations for transmission were identified, including health care facilities, homeless shelters/drop-in centres, and an Aboriginal community centre. Conclusions TB cases among homeless persons in Montreal raise concerns about delayed diagnosis and ongoing local transmission. PMID:22034944

Pennsylvania's Rural Homeless Reality.

ERIC Educational Resources Information Center

Center for Rural Pennsylvania, Harrisburg.

The Center for Rural Pennsylvania analyzed data from the Pennsylvania Department of Public Welfare concerning rural homelessness for fiscal years 1997 through 1999. Findings indicate that rural Pennsylvania has a homeless population and it is growing. In 1999, more than 21,700 clients received homeless assistance in rural areas, 44 percent of whom…

One-year incidence and predictors of homelessness among 300,000 U.S. Veterans seen in specialty mental health care.

PubMed

Tsai, Jack; Hoff, Rani A; Harpaz-Rotem, Ilan

2017-05-01

The Department of Veterans Affairs (VA) is committed to preventing and ending homelessness among U.S. veterans, but there have been few estimates of the incidence of veteran homelessness and prospective studies to identify predictors of homelessness. This study examines the 1-year incidence of homelessness among veterans seen in VA specialty mental health clinics and identified sociodemographic and clinical predictors of homelessness. Using a retrospective cohort study design, data were extracted from the VA medical records of 306,351 veterans referred to anxiety and posttraumatic stress disorder clinics across 130 VA facilities from 2008-2012 and followed for 1 year after referral. Homeless incidence was defined as new use of any VA homeless services or a documented International Classification of Diseases (9th rev.) V60.0 (lack of housing) code during the year. Of the total sample, 5.6% (7.8% for women and 5.4% for men) experienced homelessness within 1 year after referral to VA specialty mental health care. Veterans who were unmarried or diagnosed with a drug use disorder were more than twice as likely to become homeless; those who were Black or had annual incomes less than $25,000 were more than one and a half times as likely to become homeless. Together, these findings suggest a notable and important percentage of veterans seen in VA specialty mental health clinics newly experience homelessness annually. Monitoring early signs of housing vulnerability and preventing homelessness in this vulnerable but treatment-engaged population may be important in the VA's efforts to end veteran homelessness. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Screening for tuberculosis in an urban shelter for homeless in Switzerland: a prospective study.

PubMed

Janssens, Jean-Paul; Wuillemin, Timothee; Adler, Dan; Jackson, Yves

2017-05-16

Whereas high risk groups such as asylum seekers are systematically screened for active tuberculosis (TB) upon entry in Switzerland, this strategy does not apply to homeless persons despite a reported high risk. Geneva health and social authorities implemented an intersectoral project to screen for active TB in homeless persons. We aimed to assess acceptability of this program and prevalence of active TB in this group. This prospective study targeted all homeless adults registering for shelter accommodation in Geneva during winter 2015. Applicants were proposed a questionnaire-based screening ( www.tb-screen.ch ) exploring epidemiological and clinical risk factors for active TB. Participants with a positive score underwent diagnostic procedures at Geneva University Hospital. Enhanced TB surveillance targeting homeless persons in the community was continued 3 months after the study termination. Overall, 726/832 (87.3%) homeless persons accepted the screening procedure. Most were young male migrants without access to care in Switzerland. Male gender (adjusted OR: 2.14; 95% confidence interval: 1.27-3.62), age below 25 years (aOR: 4.16; 95% CI: 1.27-13.64) and short duration of homelessness (aOR: 1.75; 95% CI: 1.06-2.87) were predictors of acceptance. Thirty (4.1%) had positive screening scores but none of the 24 who underwent further testing had active TB. Post-study surveillance did not identify any incident case in Geneva. Active TB screening targeting highly mobile homeless persons in shelters was well accepted and feasible. The participants' sociodemographic profile highlighted the heterogeneity of homeless groups in Europe and the null TB prevalence the variability of their active TB risks. These findings underline the feasibility of health programs targeting this hard to reach group and the need for close monitoring of this social group considering the rapid changes in international mobility patterns to tailor preventive and screening strategies to the local

"Not Homeless Yet. I'm Kind of Couch Surfing": Finding Identities for People at a Homeless Shelter.

PubMed

Terui, Sachiko; Hsieh, Elaine

2016-01-01

The meanings of homelessness are fluid and socially constructed, providing resources and limitations for individuals to negotiate their identities and relationships in everyday life. In this study, we examine the strategies and corresponding resources utilized by people who are homeless to cope with the labeling of a homeless identity and to redefine their identities. We used constant comparative analysis to examine in-depth interviews with 16 participants (male = 11, female = 5) who access a local homeless shelter in the southwest United States for resources. We identified three strategies that homeless people adopt to cope with the labeling of homeless identity: (a) differentiating oneself from others who are homeless, (b) prioritizing certain aspects of life, and (c) embracing the status of homelessness. Although these strategies have been identified in previous literature, the authors extend this line of research by identifying the common resources people who are homeless utilize when adopting these strategies, which entail important implications for theory development and practical implications.

Coping and resilience among ethnoracial individuals experiencing homelessness and mental illness.

PubMed

Paul, Sayani; Corneau, Simon; Boozary, Tanya; Stergiopoulos, Vicky

2018-03-01

The multiple challenges that ethnoracial homeless individuals experiencing mental illness face are well documented. However, little is known about how this homeless subpopulation copes with the compounding stressors of racial discrimination, homelessness and mental illness. This study is an in-depth investigation of the personal perceived strengths, attitudes and coping behaviors of homeless adults of diverse ethnoracial backgrounds experiencing homelessness and mental illness in Toronto, Canada. Using qualitative methods, 36 in-depth semi-structured interviews were conducted to capture the perspectives of ethnoracial homeless participants with mental illness on coping and resilience. Transcripts were analyzed using thematic analysis. Similar to prior findings in the general homeless population, study participants recognized personal strengths and attitudes as great sources of coping and resilience, describing hope and optimism, self-esteem and confidence, insight into their challenges and spirituality as instrumental to overcoming current challenges. In addition, participants described several coping strategies, including seeking support from family, friends and professionals; socializing with peers; engaging in meaningful activities; distancing from overwhelming challenges; and finding an anchor. Findings suggest that homeless adults with mental illness from ethnoracial groups use similar coping strategies and sources of resilience with the general homeless population and highlight the need for existing services to foster hope, recognize and support individual coping strategies and sources of resilience of homeless individuals experiencing complex challenges.

Heart to Heart Art: Empowering Homeless Children and Youth

ERIC Educational Resources Information Center

Shepard, Jerri; Booth, Deborah

2009-01-01

This article describes Heart to Heart Art, an after-school program developed for homeless children and youth at the YWCA in Spokane, Washington. Pre-service teacher candidates from a local university create meaningful activities that engage homeless students in visual art, music, drama, cooking, and community service. Heart to Heart Art was…

Feminist and community psychology ethics in research with homeless women.

PubMed

Paradis, E K

2000-12-01

This paper presents a feminist and community psychology analysis of ethical concerns that can arise throughout the process of doing research with women who are homeless. The unique contexts of the lives of women who are homeless demand that researchers redefine traditional ethical constructs such as consent, privacy, harm, and bias. Research that fails to do this may perpetuate the stereotyping, marginalization, stigmatization, and victimization homeless women face. Feminist and community research ethics must go beyond the avoidance of harm to an active investment in the well-being of marginalized individuals and communities. Using feminist and community psychology ethics, this paper addresses some common problems in research with women who are homeless, and argues for the transformation of research from a tool for the advancement of science into a strategy for the empowerment of homeless women and their communities.

Tuberculosis Containment among the Homeless in Metropolitan Jackson, Mississippi.

PubMed

Azevedo, Mario J; Conwill, David E; Lawrence, Shonda; Jackson, Ann; Bhuiyan, Azad R; Hall, Dianne; Anderson, Brian; Franklin, Donald; Brown, David; Wilkerson, Patricia; Beckett, Gloria

2015-08-01

Preventing tuberculosis among the homeless has emerged as an especially difficult challenge. We assessed a 2008-2009 tuberculosis (TB) outbreak ad subsequent prevention strategies among homeless persons in metropolitan Jackson, Hinds County, Mississippi. We compared data about cases and subclinical TB infections (LTBI) among homeless persons during the outbreak and post-outbreak years, interviewed involved homeless persons, compiled observations from visits to Jackson homeless shelters and conducted literature reviews on homelessness and infectious diseases. We reviewed homeless shelter TB prevention methods adopted by other municipalities, guidelines developed by the Centers for Disease Control and Prevention (CDC), and recommendations from other official and ad hoc groups and considered their applicability to metropolitan Jackson. The Mississippi State Department of Health TB Program assisted by the CDC and other agencies, contained the Jackson-area outbreak by the end of 2009 as reflected by progressively lower TB rates among homeless persons thereafter. However, some follow-up activities and enforcement of shelter preventive measures have not been consistently maintained. Resources to prevent further outbreaks continue to be inadequate, and over-reliance on private organizations has continued. In the process, appreciation of the dynamic interaction enhancing TB risk among the homeless and incarcerated persons has emerged. Major outbreak contributors were lack of periodic TB screening among homeless shelter clients, preventive treatment compliance and follow-up difficulties among those with subclinical tuberculosis infections, interrupted preventive measures among infected persons incarcerated in local correctional facilities who disproportionately re-join Jackson's homeless community when released, inadequate attention to shelter environmental preventive strategies such as ultraviolet light germicidal irradiators and proper air-exchange/ventilation, costs of

Addressing Homelessness: Recent Happenings--Iowa, 2004

ERIC Educational Resources Information Center

Iowa Department of Education, 2004

2004-01-01

This guide provides information on the following resources available to the homeless in Iowa: (1) Funding Sources for School District Programs Serving Homeless Students; (2) Local Educational Liaison for Homeless Children and Youth; (3) Homeless Advisory Committee; (4) Identification, Counting, and Maintaining Data at the Local School District…

Lifetime substance use and HIV sexual risk behaviors predict treatment response to contingency management among homeless, substance-dependent MSM.

PubMed

Reback, Cathy J; Peck, James A; Fletcher, Jesse B; Nuno, Miriam; Dierst-Davies, Rhodri

2012-01-01

Homeless, substance-dependent men who have sex with men (MSM) continue to suffer health disparities, including high rates of HIV. One-hundred and thirty one homeless, substance-dependent MSM were randomized into a contingency management (CM) intervention to increase substance abstinence and health-promoting behaviors. Participants were recruited from a community-based, health education/risk reduction HIV prevention program and the research activities were also conducted at the community site. Secondary analyses were conducted to identify and characterize treatment responders (defined as participants in a contingency management intervention who scored at or above the median on three primary outcomes). Treatment responders were more likely to be Caucasian/White (p < .05), report fewer years of lifetime methamphetamine, cocaine, and polysubstance use (p < or = .05), and report more recent sexual partners and high-risk sexual behaviors than nonresponders (p < .05). The application of evidence-based interventions continues to be a public health priority, especially in the effort to implement effective interventions for use in community settings. The identification of both treatment responders and nonresponders is important for intervention development tailored to specific populations, both in service programs and research studies, to optimize outcomes among highly impacted populations.

Gender, coping strategies, homelessness stressors, and income generation among homeless young adults in three cities.

PubMed

Ferguson, Kristin M; Bender, Kimberly; Thompson, Sanna J

2015-06-01

This study examined gender differences among homeless young adults' coping strategies and homelessness stressors as they relate to legal (e.g., full-time employment, selling personal possessions, selling blood/plasma) and illegal economic activity (e.g., selling drugs, theft, prostitution). A sample of 601 homeless young adults was recruited from 3 cities (Los Angeles, CA [n = 200], Austin, TX [n = 200], and Denver, CO [n = 201]) to participate in semi-structured interviews from March 2010 to July 2011. Risk and resilience correlates of legal and illegal economic activity were analyzed using six Ordinary Least Squares regression models with the full sample and with the female and male sub-samples. In the full sample, three variables (i.e., avoidant coping, problem-focused coping, and mania) were associated with legal income generation whereas eight variables (i.e., social coping, age, arrest history, transience, peer substance use, antisocial personality disorder [ASPD], substance use disorder [SUD], and major depressive episode [MDE]) were associated with illegal economic activity. In the female sub-sample, three variables (i.e., problem-focused coping, race/ethnicity, and transience) were correlated with legal income generation whereas six variables (i.e., problem-focused coping, social coping, age, arrest history, peer substance use, and ASPD) were correlated with illegal economic activity. Among males, the model depicting legal income generation was not significant yet seven variables (i.e., social coping, age, transience, peer substance use, ASPD, SUD, and MDE) were associated with illegal economic activity. Understanding gender differences in coping strategies and economic activity might help customize interventions aimed at safe and legal income generation for this population. Copyright © 2015 Elsevier Ltd. All rights reserved.

An Analysis of Homeless Veterans Participating in the Homeless Veteran Reintegration Program

ERIC Educational Resources Information Center

Campbell, Katrina Lanelle

2010-01-01

The purpose of this study was to conduct an analysis on ex post facto data of the federal grant supported Homeless Veterans Reintegration Program (HVRP) administered at Goodwill Industries of Lower South Carolina. Pre-existing data on variables such as performance goals, training activities, support services, and demographics from program years…

Homelessness in Augusta, Georgia. Preliminary Report.

ERIC Educational Resources Information Center

George, Shirley A.; Bennett, Gerald

Two studies examined homelessness in Augusta, Georgia. The Key Informant Survey, conducted in 1987, involved interviewing individuals (N=42) knowledgeable about homeless people in the community. In the Shelter and Street Surveys of homeless people, conducted in March (N=51) and July (N=71) of 1988, homeless subjects were interviewed concerning…

The diversity of case management needs for the care of homeless persons.

PubMed Central

Stephens, D; Dennis, E; Toomer, M; Holloway, J

1991-01-01

Health care providers have been attempting to meet the special needs of homeless people on a national level since 1984. The need to implement strategies specific to serving the diversity of services required by homeless people has been apparent. To devise appropriate strategies, clinical information was drawn from the Health Resources and Services Administration-Health Care for the Homeless (HRSA-HCH) projects, which were created in 1987 primarily to fill such a need. In addition, data gathered by the HCH projects (1984-87) funded by the Robert Wood Johnson and Pew Memorial Trust were used. It is suggested that the past mode of providing health care for the homeless has been found to be inadequate when confronting the complex problems of the homeless person of today. In general, health care providers need to focus more on case management activities, which may include activities not necessarily associated with the provision of health care services (for example, finding and providing food, clothing, shelter, and assessing entitlement eligibility) to achieve the ultimate goal--stabilization--and when possible, reintegration of the homeless person back into society. PMID:1899934

Educating Homeless Youth in Texas: The McKinney-Vento Homeless Education Assistance Improvements Act of 2001.

PubMed

Windsor, Liliane Cambraia; Thompson, Sanna J

2008-07-01

This paper discusses homeless youth in the US focusing on educational issues addressed by the implementation of the McKinney-Vento Homeless Education Assistance Improvements Act of 2001. This law requires that states ensure each homeless child has equal access to public education. Moreover, the law requires states to identify and remove barriers to homeless children's education, such as requirements for previous school records and proof of residency. Following description of homelessness, educational issues, and barriers for homeless youth, the McKinney-Vento Act is described as it is applied in Texas. Finally, the paper concludes that further development, education, and commitment from service providers in schools and other community agencies will be needed to improve outcomes for these highly vulnerable youth.

Employing people with psychiatric disabilities to engage homeless individuals through supported socialization: the Buddies Project.

PubMed

Fisk, Deborah; Frey, Jennifer

2002-01-01

This article describes the Buddies Project, a small time-limited grant that employed two part-time formerly homeless persons on a community-based mental health outreach team to participate in social activities with "difficult to engage" homeless individuals. We offer clinical examples that point to the success of this small supported socialization project. We suggest that employing people with psychiatric disabilities to participate in social activities with homeless persons with psychiatric disabilities can be an important tool to decrease homeless persons' social isolation and engage them into mental health treatment and independent housing.

34 CFR 303.17 - Homeless children.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 2 2014-07-01 2013-07-01 true Homeless children. 303.17 Section 303.17 Education... DISABILITIES General Definitions Used in This Part § 303.17 Homeless children. Homeless children means children who meet the definition given the term homeless children and youths in section 725 (42 U.S.C. 11434a...

34 CFR 303.17 - Homeless children.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 2 2012-07-01 2012-07-01 false Homeless children. 303.17 Section 303.17 Education... DISABILITIES General Definitions Used in This Part § 303.17 Homeless children. Homeless children means children who meet the definition given the term homeless children and youths in section 725 (42 U.S.C. 11434a...

34 CFR 303.17 - Homeless children.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 2 2013-07-01 2013-07-01 false Homeless children. 303.17 Section 303.17 Education... DISABILITIES General Definitions Used in This Part § 303.17 Homeless children. Homeless children means children who meet the definition given the term homeless children and youths in section 725 (42 U.S.C. 11434a...

Perceived reasons for loss of housing and continued homelessness among homeless persons with mental illness.

PubMed

Mojtabai, Ramin

2005-02-01

The objective of this study was to examine the reasons for the most recent loss of housing and for continued homelessness as perceived by homeless persons with mental illness. A total of 2,974 currently homeless participants in the 1996 National Survey of Homeless Assistance Providers and Clients (NSHAPC) were asked about the reasons for their most recent loss of housing and continued homelessness. The responses of participants who had mental illness, defined both broadly and narrowly, were compared with responses of those who were not mentally ill. The broad definition of mental illness was based on a set of criteria proposed by NSHAPC investigators. The narrow definition included past psychiatric hospitalization in addition to the NSHAPC criteria. A total of 1,620 participants (56 percent) met the broad definition of mental illness, and 639 (22 percent) met the narrow definition; 1,345 participants (44 percent) did not meet any of these criteria and were categorized as not having a mental illness. Few differences in reasons for the most recent loss of housing were noted between the participants with and without mental illness. Both groups attributed their continued homelessness mostly to insufficient income, unemployment, and lack of suitable housing. Homeless persons with mental illness mostly report the same reasons for loss of housing and continued homelessness as those who do not have a mental illness. This finding supports the view that structural solutions, such as wider availability of low-cost housing and income support, would reduce the risk of homelessness among persons with mental illness, as among other vulnerable social groups.

Veterans and Homelessness

DTIC Science & Technology

2007-05-31

increased visibility of the homeless was due, in part, to the decriminalization of actions such as public drunkenness, loitering, and vagrancy.2 Homelessness...a racial or ethnic minority, childhood poverty, parental mental illness, experience of physical or sexual abuse prior to age 18, other trauma

Homeless Health Concerns

MedlinePlus

... make it worse. That's why the health of homeless people in the United States is worse than that of the general population. Common health problems include Mental health problems Substance abuse ... and skin infections Many homeless women are victims of domestic or sexual abuse. ...

Challenges to immunization: the experiences of homeless youth.

PubMed

Doroshenko, Alexander; Hatchette, Jill; Halperin, Scott A; MacDonald, Noni E; Graham, Janice E

2012-07-04

public health interventions, it is necessary to consider the knowledge, attitudes, beliefs, and experiences of hard to reach, high risk groups. Our study shows that homeless youth are interested and capable in discussing immunization. Active targeting of homeless youth for public health immunization programs is needed. Working collaboratively with non-profit organizations that assist homeless youth provides an opportunity to increase their knowledge of infectious risks and to improve immunization strategies in this vulnerable group.

Challenges to immunization: the experiences of homeless youth

PubMed Central

2012-01-01

population. Conclusions To provide effective public health interventions, it is necessary to consider the knowledge, attitudes, beliefs, and experiences of hard to reach, high risk groups. Our study shows that homeless youth are interested and capable in discussing immunization. Active targeting of homeless youth for public health immunization programs is needed. Working collaboratively with non-profit organizations that assist homeless youth provides an opportunity to increase their knowledge of infectious risks and to improve immunization strategies in this vulnerable group. PMID:22568937

Faces of Homelessness: A Teacher's Guide.

ERIC Educational Resources Information Center

Massachusetts State Dept. of Education, Quincy.

A brief teacher's guide supplements a videotape of two 15-minute segments on homelessness. The stated objective of the video is to cover the issues of homelessness as they exist today and to dispel the stereotypes of homelessness leftover from earlier eras. A family which has found itself homeless is introduced and then aspects of the phenomenon…

Testing Alternative Definitions of Chronic Homelessness.

PubMed

Byrne, Thomas; Culhane, Dennis P

2015-09-01

This study examined the potential impact of a proposed change to the official federal definition of chronic homelessness. Using administrative data from the emergency shelters in a large U.S. city, this study estimated the number of persons identified as chronically homeless under the current definition of chronic homelessness, a proposed new federal definition, and two alternative definitions and examined shelter utilization for each group. Fewer than half as many people were considered chronically homeless under the proposed new federal definition compared with the current definition. Persons considered chronically homeless by the proposed new definition and, to a lesser extent, by the two alternative definitions, made heavier use of shelter compared with persons who met the current definition. A proposed new and two alternative definitions of chronic homelessness are better suited than the existing federal definition for identifying persons with the most protracted experiences of homelessness.

Understanding the Need for Obesity Prevention Counseling among Homeless Patients

ERIC Educational Resources Information Center

Peart, Tasha; de Leon Siantz, MaryLou

2017-01-01

Though many studies have examined the level of physician obesity prevention counseling among the general population, little is known about how homeless patients are advised about healthy eating and physical activity by their health care provider. The homeless are an at-risk population with whom physicians and other health professionals can play a…

Are social network correlates of heavy drinking similar among black homeless youth and white homeless youth?

PubMed

Wenzel, Suzanne L; Hsu, Hsun-Ta; Zhou, Annie; Tucker, Joan S

2012-11-01

Understanding factors associated with heavy drinking among homeless youth is important for prevention efforts. Social networks are associated with drinking among homeless youth, and studies have called for attention to racial differences in networks that may affect drinking behavior. This study investigates differences in network characteristics by the racial background of homeless youth, and associations of network characteristics with heavy drinking. (Heavy drinking was defined as having five or more drinks of alcohol in a row within a couple of hours on at least one day within the past 30 days.) A probability sample of 235 Black and White homeless youths ages 13-24 were interviewed in Los Angeles County. We used chi-square or one-way analysis of variance tests to examine network differences by race and logistic regressions to identify network correlates of heavy drinking among Black and White homeless youth. The networks of Black youth included significantly more relatives and students who attend school regularly, whereas the networks of White youth were more likely to include homeless persons, relatives who drink to intoxication, and peers who drink to intoxication. Having peers who drink heavily was significantly associated with heavy drinking only among White youth. For all homeless youth, having more students in the network who regularly attend school was associated with less risk of heavy drinking. This study is the first to our knowledge to investigate racial differences in network characteristics and associations of network characteristics with heavy drinking among homeless youth. White homeless youth may benefit from interventions that reduce their ties with peers who drink. Enhancing ties to school-involved peers may be a promising intervention focus for both Black and White homeless youth.

Homeless youth: a concept analysis.

PubMed

Washington, Philisie Starling

2011-07-01

INTRODUCTION. A variety of terms have been used to describe the homeless youth population. PURPOSE. The purpose of this article is to analyze the conceptual meanings of the term homeless youths by examining the evolution of the concept and its related terms in the current literature. Method. Online databases from 1990-2010 were analyzed using the Rodgers evolutionary approach. RESULTS. The 6 attributes relating to homeless youth were physical location, age, health, behavior, choice, and survival. CONCLUSION. The analysis provided insight and clarification of homeless youth from a variety of related terms in the literature.

Health-Seeking Challenges Among Homeless Youth

PubMed Central

Hudson, Angela L.; Nyamathi, Adeline; Greengold, Barbara; Slagle, Alexandra; Koniak-Griffin, Deborah; Khalilifard, Farinaz; Getzoff, Daniel

2010-01-01

Background Approximately 1.5 to 2 million homeless young persons live on the streets in the United States. With the current economic situation, research is needed on quality of services geared toward homeless young adults. Objectives The objective of this study was to explore homeless young adults' perspectives on barriers and facilitators of health-care-seeking behavior and their perspectives on improving existing programs for homeless persons. Methods This article is a descriptive qualitative study using focus groups, with a purposeful sample of 24 homeless drug-using young adults. Results Identified themes were failing access to care based on perceived structural barriers (limited clinic sites, limited hours of operation, priority health conditions, and long wait times) and social barriers (perception of discrimination by uncaring professionals, law enforcement, and society in general). Discussion Results provide insight into programmatic and agency resources that facilitate health-seeking behaviors among homeless young adults and include implications for more research with providers of homeless health and social services. PMID:20404776

Pregnancy and Mental Health of Young Homeless Women

PubMed Central

Crawford, Devan M.; Trotter, Emily C.; Hartshorn, Kelley J. Sittner; Whitbeck, Les B.

2012-01-01

Pregnancy rates among women in the U.S. who are homeless are much higher than rates among women who are housed (Greene & Ringwalt, 1998). Yet little research has addressed mental health, risk and resilience among young mothers who are homeless. This study utilizes a sample of women from the Midwest Longitudinal Study of Homeless Adolescents (MLSHA) to investigate pregnancy and motherhood over three years among unaccompanied homeless young mothers. Our data are supplemented by in-depth interviews with a subset of these women. Results show that almost half of sexually active young women (n = 222, µ age = 17.2) had been pregnant at baseline (46.4%), and among the longitudinal subsample of 171 women (µ age = 17.2), almost 70.0% had been pregnant by the end of the study. Among young mothers who are homeless, only half reported that they helped to care for their children consistently over time, and one-fifth of the women reported never seeing their children. Of the young women with children in their care at the last interview of the study (Wave 13), almost one-third met criteria for lifetime major depressive episode (MDE), lifetime posttraumatic stress disorder (PTSD), and lifetime drug abuse, and one-half met criteria for lifetime antisocial personality disorder (APD). Twelve-month diagnoses are also reported. The impacts of homelessness on maternal and child outcomes are discussed, including the implications for practice, policy, and research. PMID:21486259

Homelessness Experiences, Sexual Orientation, and Sexual Risk Taking among High School Students in Los Angeles

PubMed Central

Rice, Eric; Barman-Adhikari, Anamika; Rhoades, Harmony; Winetrobe, Hailey; Fulginiti, Anthony; Astor, Roee; Montoya, Jorge; Plant, Aaron; Kordic, Timothy

2013-01-01

Purpose Prior studies reported homeless adolescents engage in more sexual risk than their housed peers. However, these comparisons are typically made post hoc by comparing homeless adolescent community-based samples with high school probability samples. This study utilizes a random sample of high school students to examine homelessness experiences and sexual risk behaviors. Methods A supplemental survey to the Youth Risk Behavior Survey containing questions regarding homelessness and sexual health was administered to Los Angeles high school students (N=1,839). Multivariate logistic regressions assessed the associations between demographics, past year homelessness experiences (i.e., place of nighttime residence), and being sexually active and condom use at last intercourse. Results Homelessness experiences consisted of staying in a shelter (10.4%), a public place (10.1%), and with a stranger (5.6%). Lesbian, gay, bisexual, transgender, questioning (LGBTQ), younger, and male adolescents were more likely to experience homelessness. LGBTQ adolescents were also more likely to report staying with a stranger and less likely to report staying in a shelter. Compared to adolescents who stayed in shelters, adolescents who stayed with strangers and in public places were more likely to engage in unprotected sex at last intercourse. Conclusions Adolescents who report sexual activity and sexual risk taking are more likely to report homelessness experiences. With regard to sexual health, staying with strangers could be a particularly risky form of homelessness; LGBTQ and Black adolescents are more likely to experience this form of homelessness. Efforts to reduce homelessness and sexual risk-taking need to recognize the specific vulnerabilities faced by these populations. PMID:23360897

Physical and Mental Health Issues among Homeless Youth in British Columbia, Canada: Are they Different from Older Homeless Adults?

PubMed

Saddichha, Sahoo; Linden, Isabelle; Krausz, Michael Reinhardt

2014-09-01

Youth homelessness is on the rise in North America, yet this vulnerable population is rarely studied and compared with adults. This paper aimed to study the homeless youth and identify specific vulnerabilities, which rendered them different from the adult homeless population. It also aimed to describe the youth homeless population and their significant co-morbidities. DATA WAS DERIVED FROM THE BC HEALTH OF THE HOMELESS STUDY (BCHOHS), CARRIED OUT IN THREE CITIES IN BRITISH COLUMBIA, CANADA: the large urban centre Vancouver (n=250); the mid-sized city and capital of the province Victoria (n=150). Measures included socio-demographic information, the Maudsley Addiction Profile (MAP), the Childhood Trauma Questionnaire (CTQ) and the Mini International Neuropsychiatric Interview (MINI) Plus. Youth constituted 16.5% (n=82) of the homeless population. Compared to the adult homeless, the homeless youth were more often female (55%), were Aboriginal (47.6%), had greater substance abuse of alcohol (70.7%), amphetamines (8.5%) and cannabis (75.6%). A lower prevalence of sexually transmitted diseases (0.2%) and psychotic disorders (13.4%) was also observed. The prevalence of traumatic experiences, other psychiatric disorders and physical illnesses were similar between the adult and homeless youth. Homeless youth have high rates of physical and psychiatric comorbidity, similar to the adult homeless, despite being 20 years younger. An urgent need for interventions that go beyond the standardized ones being offered to homeless populations as a whole, and to derive specific strategies that target this vulnerable population is required.

Psychache and Suicide Ideation among Men Who Are Homeless: A Test of Shneidman's Model

ERIC Educational Resources Information Center

Patterson, Allisha A.; Holden, Ronald R.

2012-01-01

Suicide ideation among the homeless is 10 times more common than in the general population. Cognitive theories of depression and hopelessness propose to explain suicidality; however, as yet, none of these fully account for the phenomenon. Shneidman has suggested a theory of psychache or unbearable psychological pain to explain suicidality. This…

Are Social Network Correlates of Heavy Drinking Similar Among Black Homeless Youth and White Homeless Youth?

PubMed Central

Wenzel, Suzanne L.; Hsu, Hsun-Ta; Zhou, Annie; Tucker, Joan S.

2012-01-01

Objective: Understanding factors associated with heavy drinking among homeless youth is important for prevention efforts. Social networks are associated with drinking among homeless youth, and studies have called for attention to racial differences in networks that may affect drinking behavior. This study investigates differences in network characteristics by the racial background of homeless youth, and associations of network characteristics with heavy drinking. (Heavy drinking was defined as having five or more drinks of alcohol in a row within a couple of hours on at least one day within the past 30 days.) Method: A probability sample of 235 Black and White homeless youths ages 13–24 were interviewed in Los Angeles County. We used chi-square or one-way analysis of variance tests to examine network differences by race and logistic regressions to identify network correlates of heavy drinking among Black and White homeless youth. Results: The networks of Black youth included significantly more relatives and students who attend school regularly, whereas the networks of White youth were more likely to include homeless persons, relatives who drink to intoxication, and peers who drink to intoxication. Having peers who drink heavily was significantly associated with heavy drinking only among White youth. For all homeless youth, having more students in the network who regularly attend school was associated with less risk of heavy drinking. Conclusions: This study is the first to our knowledge to investigate racial differences in network characteristics and associations of network characteristics with heavy drinking among homeless youth. White homeless youth may benefit from interventions that reduce their ties with peers who drink. Enhancing ties to school-involved peers may be a promising intervention focus for both Black and White homeless youth. PMID:23036205

Drug problems among homeless individuals in Toronto, Canada: prevalence, drugs of choice, and relation to health status

PubMed Central

2010-01-01

Background Drug use is believed to be an important factor contributing to the poor health and increased mortality risk that has been widely observed among homeless individuals. The objective of this study was to determine the prevalence and characteristics of drug use among a representative sample of homeless individuals and to examine the association between drug problems and physical and mental health status. Methods Recruitment of 603 single men, 304 single women, and 284 adults with dependent children occurred at homeless shelters and meal programs in Toronto, Canada. Information was collected on demographic characteristics and patterns of drug use. The Addiction Severity Index was used to assess whether participants suffered from drug problems. Associations of drug problems with physical and mental health status (measured by the SF-12 scale) were examined using regression analyses. Results Forty percent of the study sample had drug problems in the last 30 days. These individuals were more likely to be single men and less educated than those without drug problems. They were also more likely to have become homeless at a younger age (mean 24.8 vs. 30.9 years) and for a longer duration (mean 4.8 vs. 2.9 years). Marijuana and cocaine were the most frequently used drugs in the past two years (40% and 27%, respectively). Drug problems within the last 30 days were associated with significantly poorer mental health status (-4.9 points, 95% CI -6.5 to -3.2) but not with poorer physical health status (-0.03 points, 95% CI -1.3 to 1.3)). Conclusions Drug use is common among homeless individuals in Toronto. Current drug problems are associated with poorer mental health status but not with poorer physical health status. PMID:20181248

No Homeless Child Left behind

ERIC Educational Resources Information Center

Saxberg, David

2011-01-01

Although it is difficult to determine the precise number of homeless children, the National Coalition for the Homeless reports that there are more than 1.3 million children lacking a permanent residence on any given night. Further, 39 percent of the homeless population was comprised of children under the age of 18 in July 2009, the most recent…

Correlates of Heroin and Methamphetamine Use among Homeless Male Ex-Jail and Prison Offenders

PubMed Central

Nyamathi, Adeline; Salem, Benissa E.; Farabee, David; Hall, Elizabeth; Zhang, Sheldon; Marfisee, Mary; Khalilifard, Farinaz; Musto, Stefanie; Leake, Barbara

2014-01-01

Homeless men exiting California State jails and prisons are a heterogeneous community with varied childhood, incarceration and drug use histories. This cross-sectional study assessed whether homeless men who were discharged from either jail or prison into a residential substance abuse treatment program, differed in terms of methamphetamine and heroin use. This study utilized baseline data collected on 540 recently paroled men randomized to one of three programs that assessed the impact of a peer coaching intervention on subsequent drug use and re-incarceration. We found that younger ex-offenders exiting prisons and jails were more likely to have used methamphetamine alone, whereas African American ex-offenders were less likely to have used methamphetamine alone when compared to other ethnic groups. Further, ex-offenders exiting jails and self-reporting use of heroin only at baseline were significantly more likely than their counterparts to have been removed from home before age 18. For men exiting jails, there was an association between lower self-esteem and having used methamphetamine but not heroin. However, having used both heroin and methamphetamine was associated with both violent crime and cognitive problems in both jail and prison samples. Our findings showcase the need to understand unique correlates of both heroin and methamphetamine as they relate to jail and prison populations. PMID:25489295

A Comprehensive Assessment of Health Care Utilization Among Homeless Adults Under a System of Universal Health Insurance

PubMed Central

Chambers, Catharine; Chiu, Shirley; Katic, Marko; Kiss, Alex; Redelmeier, Donald A.; Levinson, Wendy

2013-01-01

Objectives. We comprehensively assessed health care utilization in a population-based sample of homeless adults and matched controls under a universal health insurance system. Methods. We assessed health care utilization by 1165 homeless single men and women and adults in families and their age- and gender-matched low-income controls in Toronto, Ontario, from 2005 to 2009, using repeated-measures general linear models to calculate risk ratios and 95% confidence intervals (CIs). Results. Homeless participants had mean rates of 9.1 ambulatory care encounters (maximum = 141.1), 2.0 emergency department (ED) encounters (maximum = 104.9), 0.2 medical–surgical hospitalizations (maximum = 14.9), and 0.1 psychiatric hospitalizations per person-year (maximum = 4.8). Rate ratios for homeless participants compared with matched controls were 1.76 (95% CI = 1.58, 1.96) for ambulatory care encounters, 8.48 (95% CI = 6.72, 10.70) for ED encounters, 4.22 (95% CI = 2.99, 5.94) for medical–surgical hospitalizations, and 9.27 (95% CI = 4.42, 19.43) for psychiatric hospitalizations. Conclusions. In a universal health insurance system, homeless people had substantially higher rates of ED and hospital use than general population controls; these rates were largely driven by a subset of homeless persons with extremely high-intensity usage of health services. PMID:24148051

Characteristics, clinical course, and outcomes of homeless and non-homeless patients admitted to ICU: A retrospective cohort study

PubMed Central

Kaur, Maninder; Ashraf, Said

2017-01-01

Background Little is known about homeless patients in intensive care units (ICUs). Objectives To compare clinical characteristics, treatments, and outcomes of homeless to non-homeless patients admitted to four ICUs in a large inner-city academic hospital. Methods 63 randomly-selected homeless compared to 63 age-, sex-, and admitting-ICU-matched non-homeless patients. Results Compared to matched non-homeless, homeless patients (average age 48±12 years, 90% male, 87% admitted by ambulance, 56% mechanically ventilated, average APACHE II 17) had similar comorbidities and illness severity except for increased alcohol (70% vs 17%,p<0.001) and illicit drug(46% vs 8%,p<0.001) use and less documented hypertension (16% vs 40%,p = 0.005) or prescription medications (48% vs 67%,p<0.05). Intensity of ICU interventions was similar except for higher thiamine (71% vs 21%,p<0.0001) and nicotine (38% vs 14%,p = 0.004) prescriptions. Homeless patients exhibited significantly lower Glasgow Coma Scores and significantly more bacterial respiratory cultures. Longer durations of antibiotics, vasopressors/inotropes, ventilation, ICU and hospital lengths of stay were not statistically different, but homeless patients had higher hospital mortality (29% vs 8%,p = 0.005). Review of all deaths disclosed that withdrawal of life-sustaining therapy occurred in similar clinical circumstances and proportions in both groups, regardless of family involvement. Using multivariable logistic regression, homelessness did not appear to be an independent predictor of hospital mortality. Conclusions Homeless patients, admitted to ICU matched to non-homeless patients by age and sex (characteristics most commonly used by clinicians), have higher hospital mortality despite similar comorbidities and illness severity. Trends to longer durations of life supports may have contributed to the higher mortality. Additional research is required to validate this higher mortality and develop strategies to improve outcomes

Vision Problems in Homeless Children.

PubMed

Smith, Natalie L; Smith, Thomas J; DeSantis, Diana; Suhocki, Marissa; Fenske, Danielle

2015-08-01

Vision problems in homeless children can decrease educational achievement and quality of life. To estimate the prevalence and specific diagnoses of vision problems in children in an urban homeless shelter. A prospective series of 107 homeless children and teenagers who underwent screening with a vision questionnaire, eye chart screening (if mature enough) and if vision problem suspected, evaluation by a pediatric ophthalmologist. Glasses and other therapeutic interventions were provided if necessary. The prevalence of vision problems in this population was 25%. Common diagnoses included astigmatism, amblyopia, anisometropia, myopia, and hyperopia. Glasses were required and provided for 24 children (22%). Vision problems in homeless children are common and frequently correctable with ophthalmic intervention. Evaluation by pediatric ophthalmologist is crucial for accurate diagnoses and treatment. Our system of screening and evaluation is feasible, efficacious, and reproducible in other homeless care situations.

Heterosexual anal intercourse among men in Long Beach, California.

PubMed

Hess, Kristen L; Reynolds, Grace L; Fisher, Dennis G

2014-01-01

Anal intercourse poses a greater risk for human immunodeficiency virus (HIV) transmission than vaginal intercourse, and in recent years there has been a growing understanding that heterosexual anal intercourse (HAI) is not uncommon. However, the majority of the anal intercourse literature has focused on men who have sex with men. The little research on HAI has mostly looked at women, with limited work among men. This analysis examined the association between HAI and high-risk behaviors (N = 1,622) and sexual sensation seeking (N = 239) in a sample of men recruited from 2001 to 2012 in Long Beach, California. Almost half of the sample was non-Hispanic Black. The median age was 42 years, 42% were homeless, and 20% reported recent HAI. Men who reported HAI were likely to be Hispanic, were likely to be homeless, had a male partner, engaged in sex exchange, and used cocaine or amphetamines during sex. Men who reported HAI scored higher on the Sexual Sensation Seeking scale. This research supports other work showing the relationship between HAI and high-risk behaviors. More important, it contributes new knowledge by demonstrating the association between HAI and sexual sensation seeking. This research highlights the importance of personality traits when trying to understand sexual behavior and when developing HIV prevention interventions.

Meeting the Housing and Care Needs of Older Homeless Adults: A Permanent Supportive Housing Program Targeting Homeless Elders.

PubMed

Brown, Rebecca T; Thomas, M Lori; Cutler, Deborah F; Hinderlie, Mark

2013-01-01

The homeless population is aging faster than the general population in the United States. As this vulnerable population continues to age, addressing complex care and housing needs will become increasingly important. This article reviews the often-overlooked issue of homelessness among older adults, including their poor health status and unique care needs, the factors that contribute to homelessness in this population, and the costs of homelessness to the U.S. health care system. Permanent supportive housing programs are presented as a potential solution to elder homelessness, and Hearth, an outreach and permanent supportive housing model in Boston, is described. Finally, specific policy changes are presented that could promote access to housing among the growing older homeless population.

Meeting the Housing and Care Needs of Older Homeless Adults: A Permanent Supportive Housing Program Targeting Homeless Elders

PubMed Central

Brown, Rebecca T.; Thomas, M. Lori; Cutler, Deborah F.; Hinderlie, Mark

2014-01-01

The homeless population is aging faster than the general population in the United States. As this vulnerable population continues to age, addressing complex care and housing needs will become increasingly important. This article reviews the often-overlooked issue of homelessness among older adults, including their poor health status and unique care needs, the factors that contribute to homelessness in this population, and the costs of homelessness to the U.S. health care system. Permanent supportive housing programs are presented as a potential solution to elder homelessness, and Hearth, an outreach and permanent supportive housing model in Boston, is described. Finally, specific policy changes are presented that could promote access to housing among the growing older homeless population. PMID:24729832

Sex drugs, peer connections, and HIV: Use and risk among African American, Latino, and Multiracial young men who have sex with men (YMSM) in Los Angeles and New York

PubMed Central

Mutchler, Matt G.; McKay, Tara; Candelario, Norman; Liu, Honghu; Stackhouse, Bill; Bingham, Trista; Ayala, George

2011-01-01

African American and Latino young men who have sex with men are at high risk for HIV infection. We administered brief intercept surveys (N=416) at 18 Black and Latino gay pride events in Los Angeles and New York in 2006 and 2007. Ordinal logistic regressions were used to model the effects of substance use during sex, peer connectedness, relationship status, and homelessness on condom use. Alcohol use, crystal use, homelessness, and having a primary relationship partner were negatively associated with condom use, while peer connectedness and marijuana use during sex were positively associated with condom use. Implications for service providers and future research are discussed. PMID:21731406

Sex drugs, peer connections, and HIV: Use and risk among African American, Latino, and Multiracial young men who have sex with men (YMSM) in Los Angeles and New York.

PubMed

Mutchler, Matt G; McKay, Tara; Candelario, Norman; Liu, Honghu; Stackhouse, Bill; Bingham, Trista; Ayala, George

2011-01-01

African American and Latino young men who have sex with men are at high risk for HIV infection. We administered brief intercept surveys (N=416) at 18 Black and Latino gay pride events in Los Angeles and New York in 2006 and 2007. Ordinal logistic regressions were used to model the effects of substance use during sex, peer connectedness, relationship status, and homelessness on condom use. Alcohol use, crystal use, homelessness, and having a primary relationship partner were negatively associated with condom use, while peer connectedness and marijuana use during sex were positively associated with condom use. Implications for service providers and future research are discussed.

Addressing the health needs of the homeless.

PubMed

John, William; Law, Kate

2011-03-01

Several authors have alluded to the complex health needs of the homeless population in the UK. The correlation between homelessness and a wide range of health problems has been explored in the literature. This paper presents a literature review exploring the biological, psychosocial and sexual health needs of single homeless people. The relationship between health and homelessness is analysed in relation to theories of health inequalities, which suggest that being homeless may be both a cause and a consequence of ill health. The contemporary nurse can play a vital role in helping to overcome the barriers that homeless people face when accessing health services. This paper explores the skills and approaches that nurses in a wide variety of settings can employ in addressing the health issues of homeless clients.

The effects of the therapeutic workplace and heavy alcohol use on homelessness among homeless alcohol-dependent adults.

PubMed

Carlson, Emily; Holtyn, August F; Fingerhood, Michael; Friedman-Wheeler, Dara; Leoutsakos, Jeannie-Marie S; Silverman, Kenneth

2016-11-01

A clinical trial demonstrated that a therapeutic workplace could promote alcohol abstinence in homeless, alcohol-dependent adults. This secondary-data analysis examined rates of homelessness and their relation to the therapeutic workplace intervention and alcohol use during the trial. In the trial, homeless, alcohol-dependent adults could work in a therapeutic workplace for 6 months and were randomly assigned to Unpaid Training, Paid Training, or Contingent Paid Training groups. Unpaid Training participants were not paid for working. Paid Training participants were paid for working. Contingent Paid Training participants were paid for working if they provided alcohol-negative breath samples. Rates of homelessness during the study were calculated for each participant and the three groups were compared. Mixed-effects regression models were conducted to examine the relation between alcohol use (i.e., heavy drinking, drinks per drinking day, and days of alcohol abstinence) and homelessness. Unpaid Training, Paid Training, and Contingent Paid Training participants did not differ in the percentage of study days spent homeless (31%, 28%, 17%; respectively; F(2,94)=1.732, p=0.183). However, participants with more heavy drinking days (b=0.350, p<0.001), more drinks per drinking day (b=0.267, p<0.001), and fewer days of alcohol abstinence (b=-0.285, p<0.001) spent more time homeless. Reducing heavy drinking and alcohol use may help homeless, alcohol-dependent adults transition out of homelessness. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Psychological distress among homeless adults.

PubMed

Gelberg, L; Linn, L S

1989-05-01

Recent studies have reported a high prevalence of mental illness among the homeless. As part of a community-based survey of 529 homeless adults, we developed and tested a model to increase our understanding of the factors related to their psychological distress. Using a previously validated and reliable scale of perceived psychological distress, we found that homeless adults were more likely to report psychological distress than the general population (80% vs. 49%). Distress levels were not associated with most demographic or homeless characteristics or general appearance. However, distress was related to unemployment, greater cigarette and alcohol use, worse physical health, fewer social supports, and perceived barriers to obtaining needed medical care. Since mental, physical, and social health are strongly related among homeless adults, alleviating distress among them may be most effectively done by implementing a broad-based health services package coupled with employment programs provided in an accessible service delivery setting.

Can Better National Policy End Family Homelessness?

ERIC Educational Resources Information Center

Roman, Nan

2010-01-01

An understanding of the close link between federal policy and family homelessness is critical for ensuring that one day no child in the United States is homeless. This article discusses the nature of family homelessness, the national policy framework that exists to help vulnerable families, the homeless assistance system that federal policy has…

Personal Hygiene Practices among Urban Homeless Persons in Boston, MA.

PubMed

Leibler, Jessica H; Nguyen, Daniel D; León, Casey; Gaeta, Jessie M; Perez, Debora

2017-08-18

Persons experiencing homelessness in the United States experience significant barriers to self-care and personal hygiene, including limited access to clean showers, laundry and hand washing facilities. While the obstacles to personal hygiene associated with homelessness may increase risk of infectious disease, hygiene-related behaviors among people experiencing homelessness has received limited attention. We conducted a cross-sectional study of individuals experiencing homelessness in Boston, MA ( n = 194) to identify hygiene-related self-care practices and risk factors for reduced hygiene in this population. Most participants (72%) reported taking a daily shower. More than 60% reported hand washing with soap five or more times each day, and use of hand sanitizer was widespread (89% reported using sanitizer in the last week). A majority (86%) used a laundromat or laundry machine to wash clothing, while 14% reported washing clothing in the sink. Heavy drinking, injection drug use, and sleeping outdoors were identified as significant risk factors for reduced hygiene practices. People experiencing homelessness who also engage in these activities may be among the most difficult to reach for intervention, yet targeted efforts may decrease illness risk associated with reduced hygiene. Housed friends and family play a critical role in assisting homeless individuals maintain hygiene by providing showers and laundry facilities.

Personal Hygiene Practices among Urban Homeless Persons in Boston, MA

PubMed Central

Leibler, Jessica H.; León, Casey; Gaeta, Jessie M.; Perez, Debora

2017-01-01

Persons experiencing homelessness in the United States experience significant barriers to self-care and personal hygiene, including limited access to clean showers, laundry and hand washing facilities. While the obstacles to personal hygiene associated with homelessness may increase risk of infectious disease, hygiene-related behaviors among people experiencing homelessness has received limited attention. We conducted a cross-sectional study of individuals experiencing homelessness in Boston, MA (n = 194) to identify hygiene-related self-care practices and risk factors for reduced hygiene in this population. Most participants (72%) reported taking a daily shower. More than 60% reported hand washing with soap five or more times each day, and use of hand sanitizer was widespread (89% reported using sanitizer in the last week). A majority (86%) used a laundromat or laundry machine to wash clothing, while 14% reported washing clothing in the sink. Heavy drinking, injection drug use, and sleeping outdoors were identified as significant risk factors for reduced hygiene practices. People experiencing homelessness who also engage in these activities may be among the most difficult to reach for intervention, yet targeted efforts may decrease illness risk associated with reduced hygiene. Housed friends and family play a critical role in assisting homeless individuals maintain hygiene by providing showers and laundry facilities. PMID:28820454

Overrepresentation of Women Veterans Among Homeless Women

PubMed Central

Gamache, Gail; Rosenheck, Robert; Tessler, Richard

2003-01-01

Objectives. This study estimated the proportion of veterans among homeless women and their risk of homelessness relative to that of nonveterans. Methods. Data came from 2 surveys of homeless women (1 clinical and 1 nonclinical) and 1 survey of domiciled women. Results. The proportion of veterans (4.4%, 3.1%) among homeless women was greater than the proportion among domiciled women (1.3%, 1.2%). When we computed odds ratios for being a veteran among homeless women compared with nonhomeless women, homeless women were significantly more likely than nonhomeless women to be veterans. Conclusions. Women veterans are at greater risk for homelessness than are nonveterans. Further study is needed to determine whether increased risks for veterans are a product of military service or reflect volunteers’ self-selection into the armed forces. (Am J Public Health. 2003;93:1132–1136) PMID:12835198

Inner resources for survival: integrating interpersonal psychotherapy with spiritual visualization with homeless youth.

PubMed

Mastropieri, Biagio; Schussel, Lorne; Forbes, David; Miller, Lisa

2015-06-01

Homeless youth have particular need to develop inner resources to confront the stress, abusive environment of street life, and the paucity of external resources. Research suggests that treatment supporting spiritual awareness and growth may create a foundation for coping, relationships, and negotiating styles to mitigate distress. The current pilot study tests the feasibility, acceptability, and helpfulness of an interpersonal spiritual group psychotherapy, interpersonal psychotherapy (IPT) integrated with spiritual visualization (SV), offered through a homeless shelter, toward improving interpersonal coping and ameliorating symptoms of depression, distress, and anxiety in homeless youth. An exploratory pilot of integrative group psychotherapy (IPT + SV) for homeless young adults was conducted in a New York City on the residential floor of a shelter-based transitional living program. Thirteen young adult men (mean age 20.3 years, SD = 1.06) participated in a weekly evening psychotherapy group (55 % African-American, 18 % biracial, 18 % Hispanic, 9 % Caucasian). Measures of psychological functioning were assessed at pre-intervention and post-intervention using the General Health Questionnaire (GHQ-12), Patient Health Questionnaire (PHQ-9, GAD-7), and the Inventory of Interpersonal Problems (IIP-32). A semi-structured exit interview and a treatment satisfaction questionnaire were also employed to assess acceptability following treatment. Among homeless young adults to participate in the group treatment, significant decreases in symptoms of general distress and depression were found between baseline and termination of treatment, and at the level of a trend, improvement in overall interpersonal functioning and levels of general anxiety. High utilization and treatment satisfaction showed the intervention to be both feasible and acceptable. Offered as an adjunct to the services-as-usual model at homeless shelters serving young adults, interpersonal psychotherapy

77 FR 56712 - Agency Information Collection (Homeless Providers Grant and Per Diem Program) Activities Under...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-13

... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0554] Agency Information Collection (Homeless...-7316. Please refer to ``OMB Control No. 2900-0554'' in any correspondence. FOR FURTHER INFORMATION... . Please refer to ``OMB Control No. 2900-0554.'' SUPPLEMENTARY INFORMATION: Titles: a. Homeless Providers...

Perceptions of homelessness in older homeless veterans, VA homeless program staff liaisons, and housing intervention providers.

PubMed

Molinari, Victor A; Brown, Lisa M; Frahm, Kathryn A; Schinka, John A; Casey, Roger

2013-05-01

To understand the needs and challenges encountered by older homeless veterans. We conducted six focus groups of older veterans, two focus groups, and one semi-structured interview of VA staff liaisons, and two focus groups and one semi-structured interview of housing intervention providers. Major themes for older veterans: 1) negative homelessness experience; 2) benefits of the structured transitional housing program; 3) importance of peer outreach; and 4) need for age-tailored job placement programs. Major themes for VA staff liaison/housing intervention providers: 1) belief that the transitional housing program has made a positive change; 2) need for individualized criteria to address the unique needs of veterans; 3) distinct differences between older and younger homeless veterans; 4) outreach services; 5) permanent housing issues; and 6) coordination of services. Compared with younger veterans, older veterans have less social support, greater employment and health challenges, and, perhaps greater motivation to change.

Parenting while Being Homeless

ERIC Educational Resources Information Center

Swick, Kevin J.; Williams, Reginald; Fields, Evelyn

2014-01-01

This article explores the dynamics of parenting while being in a homeless context. The mosaic of stressors involved in this homeless parenting process are explicated and discussed. In addition, resources and strategies that may support parenting are presented and discussed.

Runaway and Homeless Youth: FY 1984 Annual Report to the Congress.

ERIC Educational Resources Information Center

Administration for Children, Youth, and Families (DHHS), Washington, DC.

This report describes the activities of the Administration for Children, Youth and Families in the Department of Health and Human Services, and the status and accomplishments of runaway and homeless youth centers funded during fiscal year 1984 under the Runaway and Homeless Youth Act. The report also examines the status, operations, and…

Understanding the Homeless: From Research to Action.

ERIC Educational Resources Information Center

Baumann, Donald; Grigsby, Charles

A study was conducted to examine the homeless population of Austin, Texas and to determine who the homeless were, how they became homeless, how they saw themselves and others, what their needs were, and how they were being served by agencies. Survey data were collected from 500 homeless persons. This document summarizes findings from 3 years of…

Risk Factors for Homelessness Among US Veterans

PubMed Central

Tsai, Jack; Rosenheck, Robert A.

2015-01-01

Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. PMID:25595171

Prevalence of Homelessness in the Emergency Department Setting.

PubMed

Feldman, Brett J; Calogero, Cristina G; Elsayed, Kareem S; Abbasi, Osman Z; Enyart, Joshua; Friel, Timothy J; Abunamous, Yasir H; Dusza, Stephen W; Greenberg, Marna Rayl

2017-04-01

According to the National Alliance to End Homelessness, the national rate of homelessness has been cited as 17.7 homeless people/10,000 people in the general population, and 24.8 homeless veterans/10,000 veterans in the general population. However, it is unknown what the prevalence of homelessness is in the emergency department (ED) setting. We set out to determine the prevalence of homelessness or at risk for homelessness in the ED setting. Using a five-question screening tool derived from the U.S. Department of Housing and Urban Development, Health and Human Services and the Veterans Administration definition for homelessness, we surveyed all patients meeting inclusion/exclusion criteria on scheduled shifts in one of three EDs in Northeastern Pennsylvania. To participate, subjects had to be a registered patient in the ED, be 18 years or older, speak English, have the capacity to answer survey questions, not be critically ill, be willing to participate, and not have taken the survey before. We selected two survey periods to represent seasonal variations. We included 4,395 subjects in the analysis. The mean age of those who screened positive for homelessness or at risk for homelessness was 43.1 (SD 16.6). Overall, 136 (3.1%) participants screened positive for at risk for homelessness and 309 (7.0%) screened positive for homelessness. A total of 103 subjects (9.8%) screened positive for homelessness or at risk for homelessness on weekends and 312 (10.3%) on weekdays (p=0.64). The proportion of those screening positive for homelessness or at risk for homelessness varied by site: 145 (7.5%) at the trauma center, 151(9.1%) at the suburban site, and 149 (18.7%) at the center city site, p<0.001.There was no statistical significance to the difference between the trauma center and the suburban site (p=.088), but there was statistical significance between both the suburban and the trauma center when compared to the center city site (both p<0.0001). The proportion of those

Comparison of Homeless and Non-Homeless Problem Drug Users Recruited from Primary Care Safety-Net Clinics.

PubMed

Krupski, Antoinette; Graves, Meredith C; Bumgardner, Kristin; Roy-Byrne, Peter

2015-11-01

The present study of homeless non-treatment-seeking problem drug users was designed to complement and extend previous studies which focused exclusively on treatment-seeking homeless problem drug users. Data were available for 866 primary care patients with drug problems, 30% homeless and 70% housed. In the 2 years prior to baseline, homeless participants had less chronic medical co-morbidity than problem drug users who were housed yet were significantly more likely to have used emergency department services, to have used them more frequently, and at higher cost. Compared to their housed counterparts, homeless participants were also more likely to have been admitted to specialized chemical dependency treatment and/or detoxification services, to have been arrested for a felony or gross misdemeanor, and to report having psychiatric problems in the prior 30 days. Additional support may be necessary for homeless patients presenting in primary care to benefit from substance abuse treatment given their more severe drug use problems coupled with their co-morbid health, psychiatric, and psychosocial problems. Copyright © 2015 Elsevier Inc. All rights reserved.

Homelessness and Its Effects on Children.

ERIC Educational Resources Information Center

Hart-Shegos, Ellen

Homelessness influences every facet of children's lives, inhibiting their physical, emotional, cognitive, social, and behavioral development. Homeless women face such obstacles to healthy pregnancies as chemical abuse, chronic health problems, and lack of prenatal care. Homeless infants are more likely to have low birth weights and are at greater…

34 CFR 300.19 - Homeless children.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false Homeless children. 300.19 Section 300.19 Education... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.19 Homeless children. Homeless children has the...

34 CFR 300.19 - Homeless children.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true Homeless children. 300.19 Section 300.19 Education... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.19 Homeless children. Homeless children has the...

34 CFR 300.19 - Homeless children.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 2 2013-07-01 2013-07-01 false Homeless children. 300.19 Section 300.19 Education... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.19 Homeless children. Homeless children has the...

34 CFR 300.19 - Homeless children.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 2 2014-07-01 2013-07-01 true Homeless children. 300.19 Section 300.19 Education... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.19 Homeless children. Homeless children has the...

34 CFR 300.19 - Homeless children.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 2 2012-07-01 2012-07-01 false Homeless children. 300.19 Section 300.19 Education... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.19 Homeless children. Homeless children has the...

Tuberculosis among the homeless, United States, 1994-2010.

PubMed

Bamrah, S; Yelk Woodruff, R S; Powell, K; Ghosh, S; Kammerer, J S; Haddad, M B

2013-11-01

1) To describe homeless persons diagnosed with tuberculosis (TB) during the period 1994-2010, and 2) to estimate a TB incidence rate among homeless persons in the United States. TB cases reported to the National Tuberculosis Surveillance System were analyzed by origin of birth. Incidence rates were calculated using the US Department of Housing and Urban Development homeless population estimates. Analysis of genotyping results identified clustering as a marker for transmission among homeless TB patients. Of 270,948 reported TB cases, 16,527 (6%) were homeless. The TB incidence rate among homeless persons ranged from 36 to 47 cases per 100,000 population in 2006-2010. Homeless TB patients had over twice the odds of not completing treatment and of belonging to a genotype cluster. US- and foreign-born homeless TB patients had respectively 8 and 12 times the odds of substance abuse. Compared to the general population, homeless persons had an approximately 10-fold increase in TB incidence, were less likely to complete treatment and more likely to abuse substances. Public health outreach should target homeless populations to reduce the excess burden of TB in this population.

Disparities in Cancer Incidence, Stage, and Mortality at Boston Health Care for the Homeless Program

PubMed Central

Baggett, Travis P.; Chang, Yuchiao; Porneala, Bianca C.; Bharel, Monica; Singer, Daniel E.; Rigotti, Nancy A.

2015-01-01

Introduction Homeless people have a high burden of cancer risk factors and suboptimal rates of cancer screening, but the epidemiology of cancer has not been well described in this population. We assessed cancer incidence, stage, and mortality in homeless adults relative to general population standards. Methods We cross-linked a cohort of 28,033 adults seen at Boston Health Care for the Homeless Program in 2003–2008 to Massachusetts cancer registry and vital registry records. We calculated age-standardized cancer incidence and mortality ratios (SIRs and SMRs). We examined tobacco use among incident cases and estimated smoking-attributable fractions. Trend tests were used to compare cancer stage distributions with those in Massachusetts adults. Analyses were conducted in 2012–2015. Results During 90,450 person-years of observation, there were 361 incident cancers (SIR=1.13, 95% CI=1.02, 1.25) and 168 cancer deaths (SMR=1.88, 95% CI=1.61, 2.19) among men, and 98 incident cancers (SIR=0.93, 95% CI=0.76, 1.14) and 38 cancer deaths (SMR=1.61, 95% CI=1.14, 2.20) among women. For both sexes, bronchus and lung cancer was the leading type of incident cancer and cancer death, exceeding Massachusetts estimates more than twofold. Oropharyngeal and liver cancer cases and deaths occurred in excess among men, whereas cervical cancer cases and deaths occurred in excess among women. About one third of incident cancers were smoking-attributable. Colorectal, female breast, and oropharyngeal cancers were diagnosed at more-advanced stages than in Massachusetts adults. Conclusions Efforts to reduce cancer disparities in homeless people should include addressing tobacco use and enhancing participation in evidence-based screening. PMID:26143955

Latent homeless risk profiles of a national sample of homeless veterans and their relation to program referral and admission patterns.

PubMed

Tsai, Jack; Kasprow, Wesley J; Rosenheck, Robert A

2013-12-01

We identified risk and need profiles of homeless veterans and examined the relation between profiles and referrals and admissions to Department of Veterans Affairs (VA) homeless service programs. We examined data from the VA's new Homeless Operations Management and Evaluation System on 120,852 veterans from 142 sites nationally in 2011 and 2012 using latent class analyses based on 9 homeless risk factors. The final 4-class solution compared both referral and admission to VA homeless services. We identified 4 latent classes: relatively few problems, dual diagnosis, poverty-substance abuse-incarceration, and disabling medical problems. Homeless veterans in the first group were more likely to be admitted to the VA's permanent supportive housing program, whereas those in the second group were more likely to be admitted to more restrictive VA residential treatment. Homeless veterans in the third group were more likely to be admitted to the VA's prisoner re-entry program, and those in the fourth group were more likely to be directed to VA medical services. The heterogeneous risk and need profiles of homeless veterans supported the diversity of VA homeless services and encouraged the development of specialized services to meet their diverse needs.

The Second Student-Run Homeless Shelter

ERIC Educational Resources Information Center

Seider, Scott C.

2012-01-01

From 1983-2011, the Harvard Square Homeless Shelter (HSHS) in Cambridge, Massachusetts, was the only student-run homeless shelter in the United States. However, college students at Villanova, Temple, Drexel, the University of Pennsylvania, and Swarthmore drew upon the HSHS model to open their own student-run homeless shelter in Philadelphia,…

Newly homeless youth typically return home.

PubMed

Milburn, Norweeta G; Rosenthal, Doreen; Rotheram-Borus, Mary Jane; Mallett, Shelley; Batterham, Philip; Rice, Eric; Solorio, Rosa

2007-06-01

Newly homeless adolescents from Melbourne, Australia (n = 165) and Los Angeles, United States (n = 261) were surveyed and followed for 2 years. Most newly homeless adolescents returned home (70% U.S., 47% Australia) for significant amounts of time (39% U.S., 17% Australia more than 12 months) within 2 years of becoming homeless.

Health status of homeless persons: a pilot study in the Padua municipal dorm.

PubMed

Levorato, S; Bocci, G; Troiano, G; Messina, G; Nante, N

2017-01-01

Homeless persons can be considered a vulnerable group and several studies showed in this group an higher prevalence of chronic and infectious diseases, a lower mental health status, and a higher abuse of alcohol. The aim of our study was to investigate the health status of homeless in Padua, Italy, administering a questionnaire composed by SF-36 and EQ-5D. We conducted a cross-sectional study from 15 December 2015 to 15 February 2016. We enrolled in our study 73 homeless persons welcomed in the municipal dorm of Padua. 5 persons refused to participate in the study; 9 had a mental status incompatible with the participation to the study. We administered to the participants a questionnaire composed by three parts: in the first part we asked sociodemographic information (gender, age, nationality, qualification, height and weight) to calculate BMI, time spent at the dorm, period of homelessness, alcohol intake, smoking habit, availability of a general practitioner, emergency room visits in the last year, admissions in the last year, pre-existing conditions and in act, participation in screening programs. The second part was represented by the Short Form 36 questionnaire. The third part by the EQ-5D questionnaire. Our sample was composed by 79% men and 21% women. 54.7% were Italian. The mean age was 48 years. 72.8% were smoker and 60,3% drunk alcohol. In this latter group 28.8% drunk more than 1 liter of wine per day. Non Italian homeless smoke less than the Italian: this difference is statistically significant (OR = 3.7 p = 0.032 ). Only 9 foreigners had a general practitioner compared to 30 Italian homeless: this difference is statistically significant (OR = 60 P < 0.01). 43 of the 59 respondents (72.8 % ) said to suffer from some disease. No one reported a history of tuberculosis. The most represented diseases were pneumonia (30%), myocardial infarction (17%), hepatitis C (13.5%). Participation in screening programs was very low. From the analysis of the SF-36 results

Homeless Students at the School Door.

ERIC Educational Resources Information Center

Pawlas, George E.

1994-01-01

The United States has about 225,000 to 500,000 homeless children. In 1987, Congress passed a comprehensive law to provide emergency and long-term assistance for homeless persons. Under the Stewart B. McKinney Act, states receive funding to investigate homeless children's needs, identify education obstacles, and develop plans to overcome them. Tips…

The Allegheny initiative for mental health integration for the homeless: integrating heterogeneous health services for homeless persons.

PubMed

Gordon, Adam J; Montlack, Melissa L; Freyder, Paul; Johnson, Diane; Bui, Thuy; Williams, Jennifer

2007-03-01

The Allegheny Initiative for Mental Health Integration for the Homeless (AIM-HIGH) was a 3-year urban initiative in Pennsylvania that sought to enhance integration and coordination of medical and behavioral services for homeless persons through system-, provider-, and client-level interventions. On a system level, AIM-HIGH established partnerships between several key medical and behavioral health agencies. On a provider level, AIM-HIGH conducted 5 county-wide conferences regarding homeless integration, attended by 637 attendees from 72 agencies. On a client level, 5 colocated medical and behavioral health care clinics provided care to 1986 homeless patients in 4084 encounters, generating 1917 referrals for care. For a modest investment, AIM-HIGH demonstrated that integration of medical and behavioral health services for homeless persons can occur in a large urban environment.

The Allegheny Initiative for Mental Health Integration for the Homeless: Integrating Heterogeneous Health Services for Homeless Persons

PubMed Central

Gordon, Adam J.; Montlack, Melissa L.; Freyder, Paul; Johnson, Diane; Bui, Thuy; Williams, Jennifer

2007-01-01

The Allegheny Initiative for Mental Health Integration for the Homeless (AIM-HIGH) was a 3-year urban initiative in Pennsylvania that sought to enhance integration and coordination of medical and behavioral services for homeless persons through system-, provider-, and client-level interventions. On a system level, AIM-HIGH established partnerships between several key medical and behavioral health agencies. On a provider level, AIM-HIGH conducted 5 county-wide conferences regarding homeless integration, attended by 637 attendees from 72 agencies. On a client level, 5 colocated medical and behavioral health care clinics provided care to 1986 homeless patients in 4084 encounters, generating 1917 referrals for care. For a modest investment, AIM-HIGH demonstrated that integration of medical and behavioral health services for homeless persons can occur in a large urban environment. PMID:17267708

The psychosocial profile of adolescent risk of homelessness.

PubMed

Bearsley-Smith, Cate A; Bond, Lyndal M; Littlefield, Lyn; Thomas, Lyndal R

2008-06-01

To contrast the psychosocial profile of adolescents with risk factors for homelessness, identified using Chamberlain and MacKenzie's self-report scale, compared to the profiles of homeless adolescents. Multinomial logistic regression analyses were conducted contrasting profiles for (a) 137 homeless adolescents, (b) 766 secondary students reporting risk factors for homelessness, and (c) 4,844 students not reporting risks for homelessness. Fourteen percent of a representative population of at-school adolescents, from Victoria, Australia, showed elevated risk of homelessness. These adolescents showed depressive symptoms at least equivalent to homeless adolescents (RR 6.0, 95% CI: 4.9, 7.3, and RR 3.5, 95% CI: 2.1, 5.8, respectively). In multivariate analyses, homeless and at risk adolescents reported equivalent levels of family conflict, early problem behaviour and low opportunities and rewards for family involvement. Compared to adolescents not at risk, at risk adolescents were more likely to be female and to show poorer social skills/assertiveness and depressive symptoms. Compared to at risk adolescents, homeless adolescents showed additional family, school, peer and individual risks, but lower depressive symptomatology. The findings highlight the potential we have to quickly and simply detect adolescents showing significant risk of homelessness. This sizable minority of adolescents report risks often equivalent to homeless adolescents. It is hoped that stakeholders working with young people will utilise this screening potential to identify and intervene effectively with this significant subpopulation of youth, and their families, while they are still at home and school.

Immediate Enrollment under McKinney-Vento: How Schools Can Keep Homeless Students Safe. Best Practices in Homeless Education

ERIC Educational Resources Information Center

National Center for Homeless Education at SERVE, 2007

2007-01-01

Children and youth in homeless situations, particularly unaccompanied youth and survivors of domestic violence, are at a high risk for experiencing violence and victimization. Frequently, unaccompanied youth become homeless after leaving abusive or destructive home environments. In turn, their homelessness, which often involves "couch…

Messages for men: the efficacy of EPPM-based messages targeting men's physical activity.

PubMed

Hatchell, Alexandra C; Bassett-Gunter, Rebecca L; Clarke, Marie; Kimura, Stacey; Latimer-Cheung, Amy E

2013-01-01

The majority of men are insufficiently active. Men's tendencies to participate in risky behaviors and their inactivity likely contribute to their increased risk of morbidity and mortality. Physical activity decreases the risk of developing many chronic diseases and may be an optimal behavior to target in men's health interventions. However, educational resources promoting physical activity for men are lacking. To address this gap, we tested the efficacy of messages based upon the Extended Parallel Process Model (EPPM; Witte, 1992) to increase men's physical activity intentions and behaviors. Men who were not meeting physical activity guidelines (n = 611) were randomly assigned to read high or low efficacy physical activity messages paired with high or no health risk information. Participants read four brief messages on four consecutive days. Intentions were assessed at baseline and the first follow-up (Day 5). Manipulation check measures were assessed at Day 5. Behavior was assessed at baseline and the second follow-up (Day 14). Overall, the messages had small sized effects. A completer analysis revealed that although men's intentions to be active increased over the course of the study regardless of the messages they received, only men who received risk information significantly increased their physical activity. Men who received low efficacy and risk information were less likely to meet the physical activity guidelines at Day 14 than men who only received low efficacy information. From these results, we suggest preliminary recommendations for the development of physical activity messages for men and areas for future EPPM-based research. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Facilitating risk reduction among homeless and street-involved youth.

PubMed

Busen, Nancy H; Engebretson, Joan C

2008-11-01

The purposes of this evaluation project were to describe a group of homeless adolescents and street-involved youth who utilized a mobile unit that provided medical and mental healthcare services and to assess the efficacy of the services provided in reducing their health risk behaviors. The records of 95 youth aged 15-25 years who used the medical mobile unit for an average of 14 months were examined and evaluated according to the national health indicators related to risk reduction. Current literature related to health risk behavior among homeless youth was reviewed, synthesized, and provided the background for this article. Data were obtained from the records of mostly heterosexual youth with a mean age of 20.5 years. Approximately one third of the participants were high school graduates and most were without health insurance. Living situations were transient including friends, shelters, crash pads, or the streets. Abuse accounted for the majority leaving home. Psychiatric conditions and substance abuse were common. Medical conditions were related to transient living situations, substance abuse, and sexual activity. Success of the program was associated with sustained counseling, stabilizing youth on psychotropic medications, decreasing substance use, providing birth control and immunizations, and treating medical conditions. Homeless youth are one of the most underserved vulnerable populations in the United States with limited access and utilization of appropriate healthcare services. Nurse practitioners often serve as care providers but are also in a position to effectively lobby to improve health care for homeless youth through professional organizations and community activism. Furthermore, when designing and evaluating healthcare services, multidisciplinary teams need to consider risk reduction for homeless youth in the context of their environment.

Risk factors for homelessness among US veterans.

PubMed

Tsai, Jack; Rosenheck, Robert A

2015-01-01

Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Measuring pain in the context of homelessness

PubMed Central

Matter, Rebecca; Kline, Susan; Cook, Karon F.; Amtmann, Dagmar

2009-01-01

Purpose The primary objective of this study was to inform the development of measures of pain impact appropriate for all respondents, including homeless individuals, so that they can be used in clinical research and practice. The secondary objective was to increase understanding about the unique experience of homeless people with pain. Methods Seventeen homeless individuals with chronic health conditions (often associated with pain) participated in cognitive interviews to test the functioning of 56 pain measurement items and provided information about their experience living with and accessing treatment for pain. Results The most common problems identified with items were that they lacked clarity or were irrelevant in the context of homelessness. Items that were unclear, irrelevant and/or had other identified problems made it difficult for participants to respond. Participants also described multiple ways in which their pain was exacerbated by conditions of homelessness and identified barriers to accessing appropriate treatment. Conclusions Results suggested that the majority of items were problematic for the homeless and require substantial modifications to make the pain impact bank relevant to this population. Additional recommendations include involving homeless in future item bank development, conducting research on the topic of pain and homelessness, and using cognitive interviewing in other types of health disparities research. PMID:19582592

Latent Homeless Risk Profiles of a National Sample of Homeless Veterans and Their Relation to Program Referral and Admission Patterns

PubMed Central

Kasprow, Wesley J.; Rosenheck, Robert A.

2013-01-01

Objectives. We identified risk and need profiles of homeless veterans and examined the relation between profiles and referrals and admissions to Department of Veterans Affairs (VA) homeless service programs. Methods. We examined data from the VA’s new Homeless Operations Management and Evaluation System on 120 852 veterans from 142 sites nationally in 2011 and 2012 using latent class analyses based on 9 homeless risk factors. The final 4-class solution compared both referral and admission to VA homeless services. Results. We identified 4 latent classes: relatively few problems, dual diagnosis, poverty–substance abuse–incarceration, and disabling medical problems. Homeless veterans in the first group were more likely to be admitted to the VA’s permanent supportive housing program, whereas those in the second group were more likely to be admitted to more restrictive VA residential treatment. Homeless veterans in the third group were more likely to be admitted to the VA’s prisoner re-entry program, and those in the fourth group were more likely to be directed to VA medical services. Conclusions. The heterogeneous risk and need profiles of homeless veterans supported the diversity of VA homeless services and encouraged the development of specialized services to meet their diverse needs. PMID:24148048

Finding shelter: two-year housing trajectories among homeless youth.

PubMed

Tevendale, Heather D; Comulada, W Scott; Lightfoot, Marguerita A

2011-12-01

The aim of this study was to (1) identify trajectories of homeless youth remaining sheltered or returning to shelter over a period of 2 years, and (2) to identify predictors of these trajectories. A sample of 426 individuals aged 14-24 years receiving services at homeless youth serving agencies completed six assessments over 2 years. Latent class growth analysis was applied to the reports of whether youth had been inconsistently sheltered (i.e., living on the street or in a squat, abandoned building, or automobile) or consistently sheltered (i.e., not living in any of those settings) during the past 3 months. Three trajectories of homeless youth remaining sheltered or returning to shelter were identified: consistently sheltered (approximately 41% of the sample); inconsistently sheltered, short-term (approximately 20%); and inconsistently sheltered, long-term (approximately 39%). Being able to go home and having not left of one's own accord predicted greater likelihood of membership in the short-term versus the long-term inconsistently sheltered trajectory. Younger age, not using drugs other than alcohol or marijuana, less involvement in informal sector activities, being able to go home, and having been homeless for <1 year predicted membership in the consistently sheltered groups versus the long-term inconsistently sheltered groups in the multivariate analyses. Findings suggest that being able to return home is more important than the degree of individual impairment (e.g., substance use or mental health problems) when determining the likelihood that a homeless youth follows a more or a less chronically homeless pathway. Copyright © 2011. Published by Elsevier Inc.

Tuberculosis and homelessness in the United States, 1994-2003.

PubMed

Haddad, Maryam B; Wilson, Todd W; Ijaz, Kashef; Marks, Suzanne M; Moore, Marisa

2005-06-08

Tuberculosis (TB) rates among US homeless persons cannot be calculated because they are not included in the US Census. However, homelessness is often associated with TB. To describe homeless persons with TB and to compare risk factors and disease characteristics between homeless and nonhomeless persons with TB. Cross-sectional analysis of all verified TB cases reported into the National TB Surveillance System from the 50 states and the District of Columbia from 1994 through 2003. Number and proportion of TB cases associated with homelessness, demographic characteristics, risk factors, disease characteristics, treatment, and outcomes. Of 185,870 cases of TB disease reported between 1994 and 2003, 11,369 were among persons classified as homeless during the 12 months before diagnosis. The annual proportion of cases associated with homelessness was stable (6.1%-6.7%). Regional differences occurred with a higher proportion of TB cases associated with homelessness in western and some southern states. Most homeless persons with TB were male (87%) and aged 30 to 59 years. Black individuals represented the highest proportion of TB cases among the homeless and nonhomeless. The proportion of homeless persons with TB who were born outside the United States (18%) was lower than that for nonhomeless persons with TB (44%). At the time of TB diagnosis, 9% of homeless persons were incarcerated, usually in a local jail; 3% of nonhomeless persons with TB were incarcerated. Compared with nonhomeless persons, homeless persons with TB had a higher prevalence of substance use (54% alcohol abuse, 29.5% noninjected drug use, and 14% injected drug use), and 34% of those tested had coinfection with human immunodeficiency virus. Compared with nonhomeless persons, TB disease in homeless persons was more likely to be infectious but not more likely to be drug resistant. Health departments managed 81% of TB cases in homeless persons. Directly observed therapy, used for 86% of homeless patients

Intellectual Disability and Homelessness

ERIC Educational Resources Information Center

Mercier, C.; Picard, S.

2011-01-01

Background: The association between poverty and intellectual disability (ID) has been well documented. However, little is known about persons with ID who face circumstances of extreme poverty, such as homelessness. This paper describes the situation of persons with ID who were or are homeless in Montreal and are currently receiving services from a…

Where Do You Go from Nowhere: Homelessness in Maryland.

ERIC Educational Resources Information Center

Health and Welfare Council of Central Maryland, Inc., Baltimore.

This report assesses the extent of homelessness in Maryland. Data are provided in the following areas: (1) the number of homeless people; (2) causes of homelessness; (3) distribution of the homeless and characteristics of those sheltered; (4) shelter beds available; (5) what is needed to address the problems of homelessness; (6) the extent of the…

Geriatric Conditions in a Population-Based Sample of Older Homeless Adults.

PubMed

Brown, Rebecca T; Hemati, Kaveh; Riley, Elise D; Lee, Christopher T; Ponath, Claudia; Tieu, Lina; Guzman, David; Kushel, Margot B

2017-08-01

Older homeless adults living in shelters have high rates of geriatric conditions, which may increase their risk for acute care use and nursing home placement. However, a minority of homeless adults stay in shelters and the prevalence of geriatric conditions among homeless adults living in other environments is unknown. We determined the prevalence of common geriatric conditions in a cohort of older homeless adults, and whether the prevalence of these conditions differs across living environments. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling in Oakland, CA. We evaluated participants for common geriatric conditions. We assessed living environment using a 6-month follow-back residential calendar, and used cluster analysis to identify participants' primary living environment over the prior 6 months. Participants stayed in 4 primary environments: unsheltered locations (n = 162), multiple locations including shelters and hotels (n = 88), intermittently with family/friends (n = 57), and, in a recently homeless group, rental housing (n = 43). Overall, 38.9% of participants reported difficulty performing 1 or more activities of daily living, 33.7% reported any falls in the past 6 months, 25.8% had cognitive impairment, 45.1% had vision impairment, and 48.0% screened positive for urinary incontinence. The prevalence of geriatric conditions did not differ significantly across living environments. Geriatric conditions were common among older homeless adults living in diverse environments, and the prevalence of these conditions was higher than that seen in housed adults 20 years older. Services that address geriatric conditions are needed for older homeless adults living across varied environments. Published by Oxford University Press on behalf of the Gerontological Society of America 2016.

Homelessness in the U.S.: A Historical Analysis

ERIC Educational Resources Information Center

Murphy, Joseph; Tobin, Kerri

2014-01-01

In this article, the authors examine homelessness across time and examine, in an introductory way, homelessness today. The authors start by examining important themes that ribbon homelessness in America over the last 300 years. Next, they provide a period analysis of homelessness from the birth of the country through the late 1970s. In the last…

How to Program to the Homeless.

ERIC Educational Resources Information Center

Polzer, Christopher M.

1995-01-01

Recreation leaders recommend reaching out to homeless individuals and providing programs that may help improve their health, bring them some fun and happiness, and boost their quality of life. The paper describes how one North Carolina county addressed the issue through recreation programs and other activities. (SM)

Increasing Access to Higher Education for Unaccompanied Homeless Youth: Information for Colleges and Universities. Best Practices in Homeless Education Brief Series

ERIC Educational Resources Information Center

National Center for Homeless Education at SERVE, 2012

2012-01-01

Each year, more than a million young people in the United States experience homelessness; some of these young people, known as unaccompanied homeless youth, will face the challenges of homelessness while living on their own without the support of a caring adult. Unaccompanied homeless youth face the same struggles as other young people: trying to…

Mobile phone technology: a new paradigm for the prevention, treatment, and research of the non-sheltered "street" homeless?

PubMed

Eyrich-Garg, Karin M

2010-05-01

Individuals experiencing homelessness have disproportionately high rates of health problems. Those who perceive themselves as having greater access to their social support networks have better physical and mental health outcomes as well as lower rates of victimization. Mobile phones offer a connection to others without the physical constraints of landlines and, therefore, may make communication (e.g., access to one's social support networks) more feasible for homeless individuals. This, in turn, could lead toward better health outcomes. This exploratory study examined mobile phone possession and use among a sample of 100 homeless men and women who do not use the shelter system in Philadelphia, PA. Interviews were comprised of the Homeless Supplement to the Diagnostic Interview Schedule, a technology module created for this investigation, and the substance use and psychiatric sections of the Addiction Severity Index. Almost half (44%) of the sample had a mobile phone. In the past 30 days, 100% of those with mobile phones placed or received a call, over half (61%) sent or received a text message, and one fifth (20%) accessed the Internet via their mobile phone. Participants possessed and used mobile phones to increase their sense of safety, responsibility (employment, stable housing, personal business, and sobriety or "clean time"), and social connectedness. Mobile phones could potentially be used by public health/health care providers to disseminate information to the street homeless, to enhance communication between the street homeless and providers, and to increase access for the street homeless to prevention, intervention, and aftercare services. Finally, this technology could also be used by researchers to collect data with this transient population.

Young and Homeless: Exploring the Education, Life Experiences and Aspirations of Homeless Youth

ERIC Educational Resources Information Center

Byrom, Tina; Peart, Sheine

2017-01-01

Why do young people become homeless, and what might be done about it? This new study is important reading for academics and students of education, sociology or social work who wish to explore and understand the experiences of homeless young people. Their stories about their aspirations, experiences of schooling and the family breakdowns that…

Immediate Enrollment under McKinney-Vento: How Local Liaisons Can Keep Homeless Students Safe. Best Practices in Homeless Education

ERIC Educational Resources Information Center

National Center for Homeless Education at SERVE, 2007

2007-01-01

Children and youth in homeless situations, particularly unaccompanied youth and survivors of domestic violence, are at a high risk for experiencing violence and victimization. Frequently, unaccompanied youth become homeless after leaving abusive or destructive home environments. In turn, their homelessness, which often involves "couch…

Homelessness and Housing Insecurity Among Former Prisoners

PubMed Central

HERBERT, CLAIRE W.; MORENOFF, JEFFREY D.; HARDING, DAVID J.

2016-01-01

The United States has experienced dramatic increases in both incarceration rates and the population of insecurely housed or homeless persons since the 1980s. These marginalized populations have strong overlaps, with many people being poor, minority, and from an urban area. That a relationship between homelessness, housing insecurity, and incarceration exists is clear, but the extent and nature of this relationship is not yet adequately understood. We use longitudinal, administrative data on Michigan parolees released in 2003 to examine returning prisoners’ experiences with housing insecurity and homelessness. Our analysis finds relatively low rates of outright homelessness among former prisoners, but very high rates of housing insecurity, much of which is linked to features of community supervision, such as intermediate sanctions, returns to prison, and absconding. We identify risk factors for housing insecurity, including mental illness, substance use, prior incarceration, and homelessness, as well as protective “buffers” against insecurity and homelessness, including earnings and social supports. PMID:26913294

Tuberculosis among the homeless, United States, 1994–2010

PubMed Central

Bamrah, S.; Yelk Woodruff, R. S.; Powell, K.; Ghosh, S.; Kammerer, J. S.; Haddad, M. B.

2016-01-01

SUMMARY OBJECTIVES 1) To describe homeless persons diagnosed with tuberculosis (TB) during the period 1994–2010, and 2) to estimate a TB incidence rate among homeless persons in the United States. METHODS TB cases reported to the National Tuberculosis Surveillance System were analyzed by origin of birth. Incidence rates were calculated using the US Department of Housing and Urban Development homeless population estimates. Analysis of genotyping results identified clustering as a marker for transmission among homeless TB patients. RESULTS Of 270 948 reported TB cases, 16 527 (6%) were homeless. The TB incidence rate among homeless persons ranged from 36 to 47 cases per 100 000 population in 2006–2010. Homeless TB patients had over twice the odds of not completing treatment and of belonging to a genotype cluster. US- and foreign-born homeless TB patients had respectively 8 and 12 times the odds of substance abuse. CONCLUSIONS Compared to the general population, homeless persons had an approximately 10-fold increase in TB incidence, were less likely to complete treatment and more likely to abuse substances. Public health outreach should target homeless populations to reduce the excess burden of TB in this population. PMID:24125444

Suicidality in Young Men Who Have Sex with Men: A Systematic Review of the Literature.

PubMed

Luong, Casey T; Rew, Lynn; Banner, Matthew

2018-01-01

This systematic literature review addresses risk and protective factors associated with suicidal ideation and attempts in young men who have sex with men (YMSM). The Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, PsychArticles, and PsychInfo yielded 14 articles. Risk factors included (1) not being enrolled in school, (2) earlier sexual debut, (3) substance use/abuse, (4) homelessness, (5) bullying and victimization, (6) fear of community violence, (7) and parental abuse. Protective factors included (1) positive sexual minority LGBT stereotypes, (2) family acceptance, (3) school and peer support, (4) high self-esteem, and (5) adaptive coping mechanisms.

Substance use and homelessness among emergency department patients.

PubMed

Doran, Kelly M; Rahai, Neloufar; McCormack, Ryan P; Milian, Jacqueline; Shelley, Donna; Rotrosen, John; Gelberg, Lillian

2018-05-22

Homelessness and substance use often coexist, resulting in high morbidity. Emergency department (ED) patients have disproportionate rates of both homelessness and substance use, yet little research has examined the overlap of these issues in the ED setting. We aimed to characterize alcohol and drug use in a sample of homeless vs. non-homeless ED patients. A random sample of urban hospital ED patients were invited to complete an interview regarding housing, substance use, and other health and social factors. We compared substance use characteristics among patients who did vs. did not report current literal (streets/shelter) homelessness. Additional analyses were performed using a broader definition of homelessness in the past 12-months. Patients who were currently homeless (n = 316, 13.7%) versus non-homeless (n = 1,993, 86.3%) had higher rates of past year unhealthy alcohol use (44.4% vs. 30.5%, p < .0001), any drug use (40.8% vs. 18.8%, p < .0001), heroin use (16.7% vs. 3.8%, p < .0001), prescription opioid use (12.5% vs. 4.4%, p < .0001), and lifetime opioid overdose (15.8% vs. 3.7%, p < .0001). In multivariable analyses, current homelessness remained significantly associated with unhealthy alcohol use, AUDIT scores among unhealthy alcohol users, any drug use, heroin use, and opioid overdose; past 12-month homelessness was additionally associated with DAST-10 scores among drug users and prescription opioid use. Patients experiencing homelessness have higher rates and greater severity of alcohol and drug use than other ED patients across a range of measures. These findings have implications for planning services for patients with concurrent substance use and housing problems. Copyright © 2018 Elsevier B.V. All rights reserved.

Posthumously Assessing a Homeless Population: Services Use and Characteristics.

PubMed

Metraux, Stephen; Manjelievskaia, Janna; Treglia, Dan; Hoffman, Roy; Culhane, Dennis P; Ku, Bon S

2016-12-01

Data on services use, characteristics, and geographic distribution of homeless individuals who died in Philadelphia from 2009 to 2011 provided perspective on assessments of the homeless population that rely on conventional counts and surveys. Data from the City of Philadelphia Medical Examiner's Office were used to parse homeless decedents into three groups on the basis of use of homelessness services (known users, occasional users, and nonusers), and differences among the groups were assessed by using descriptive and multivariate methods. Of 141 adult decedents, 49% made substantial use of the homelessness services system (known users), 27% made occasional use of these services (occasional users), and 24% had no record of use of homelessness services (nonusers). Compared with known users, nonusers and occasional users were less likely to have had a severe mental illness diagnosis or to have received either disability benefits or Medicaid coverage and were more likely to be white. Nonusers and occasional users were also more likely than known users to have died in outlying parts of the city. More conventional homeless surveys and enumerations miss a substantial portion of the homeless population. Including these "hidden homeless" persons would alter perceptions about the composition of Philadelphia's homeless population, lowering estimates of the incidence of psychiatric disability and increasing estimates of racial diversity.

The Invisible Homeless: A New Urban Ecology.

ERIC Educational Resources Information Center

Ropers, Richard H.

Contemporary homelessness is the result of increasing social and economic inequality faced by those in American society who are most vulnerable to individual, family, and economic instability. This case study of the homeless population of Los Angeles (California), based on two surveys conducted in 1984, views the homeless as a segment of the…

Education for Homeless Adults: Strategies for Implementation.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Office of Workplace Preparation and Continuing Education.

This instructional guide is intended for use by adult education teachers who deal with homeless students either on an occasional or an exclusive basis. An introduction defines homelessness, describes how education can help, and offers a mission statement. The second section focuses on what teachers of the homeless need. It defines categories of…

Prescription drug misuse among homeless youth.

PubMed

Rhoades, Harmony; Winetrobe, Hailey; Rice, Eric

2014-05-01

Prescription drug misuse (PDM) is highly prevalent among youth in the U.S., and can have serious health consequences. Homeless youth are a particularly vulnerable population with high rates of substance use. However, PDM has not been studied in a sample comprised exclusively of homeless youth. A sample of 451 homeless youth recruited from drop-in centers in Los Angeles, CA, provided information on substance use, mental health, service utilization, trauma, and sexual risk behavior. Multivariable logistic regression assessed correlates of past month PDM. Nearly 50% reported lifetime PDM and 21.6% reported PDM in the past month. The most frequently used prescriptions in the past month were: opioids only (24.5%), sedatives only (23.4%), and stimulants only (10.6%); 14.9% used some combination of these three types of prescription medications. Homeless youth reported that prescriptions were most commonly obtained for free from friends or relatives (24.5%). Foster care involvement was associated with decreased PDM, while hard drug use, suicidal ideation, and unprotected sex were associated with increased PDM. Homeless youth report high rates of PDM, and access these medications most frequently from friends and family. PDM among homeless youth clusters with other risk factors, including hard drug use, unprotected sex, and suicidal ideation. Surprisingly, foster care history was associated with decreased PDM. Programs aimed at preventing PDM among homeless youth should recognize the clustering of risk behaviors, assess prescription use/access when providing mental health services, and educate the general public about proper disposal of prescriptions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Homeless adults engagement in art: first steps towards identity, recovery and social inclusion.

PubMed

Thomas, Yvonne; Gray, Marion; McGinty, Sue; Ebringer, Sally

2011-12-01

The Australian policy on homelessness identifies participation in structured activities as the first step towards social inclusion and increasing the likelihood of permanently leaving a homeless lifestyle. Art interventions increase interpersonal function and social participation and provide a means of expression and transformation with people who are homeless. This study explores the value of an art programme provided by a non-government agency for homeless adults. Qualitative methods including participant observation and purposive interviews were analysed inductively and thematically to gain an understanding of the participants' experience of art and its value. Interviews with stakeholders provided additional information and triangulation of the data. The study demonstrates that art occupations provide a starting point for participation in community and a positive experience that encourages the construction of new identities, routines and roles. Furthermore, art provides an alternative from the problems associated with homelessness, mental health and substance abuse and allows for public recognition and social inclusion. Health professionals should work towards the social inclusion of homeless people through providing occupational opportunities for participation in safe settings as a first step to community engagement. © 2011 The Authors. Australian Occupational Therapy Journal © 2011 Occupational Therapy Australia.

76 FR 76917 - Homeless Management Information Systems Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-09

...-P-01] Homeless Management Information Systems Requirements AGENCY: Office of the Assistant Secretary... for the establishment of regulations for Homeless Management Information Systems (HMIS), which are the... community development, Homeless, Information technology system, Management system, Nonprofit organizations...

Youth Homelessness and Individualised Subjectivity

ERIC Educational Resources Information Center

Farrugia, David

2011-01-01

This article aims to contribute to understandings of youth homelessness and subjectivity by analysing identity construction in terms of young people's negotiation of the structural and institutional environment of youth homelessness. I suggest that while existing literature on this topic concentrates mainly on micro-social encounters, the…

Homeless youth: Barriers and facilitators for service referrals.

PubMed

Black, Emma B; Fedyszyn, Izabela E; Mildred, Helen; Perkin, Rhianna; Lough, Richard; Brann, Peter; Ritter, Cheryl

2018-06-01

Young people who are homeless and experiencing mental health issues are reluctant to use relevant services for numerous reasons. Youth are also at risk of disengaging from services at times of referral to additional or alternative services. This study aimed to identify barriers and facilitators for inter-service referrals for homeless youth with mental health issues who have already engaged with a service. Qualitative, semi-structured interviews were conducted with homeless youth (n = 10), homelessness support workers (n = 10), and mental health clinicians (n = 10). Barriers included: resource shortages; programs or services having inflexible entry criteria; complexity of service systems; homeless youth feeling devalued; and a lack of communication between services, for example, abrupt referrals with no follow up. Referral facilitators included: services providers offering friendly and client-centred support; supported referrals; awareness of other services; and collaboration between services. Relationships with service providers and inter-service collaboration appeared essential for successful referrals for homeless youth. These facilitating factors may be undermined by sector separation and siloing, as well as resource shortages in both the homelessness and mental health sectors. Service transitions may be conceptualised as a genuine service outcome for homeless youth, and as a basis for successful future service provision. Copyright © 2018 Elsevier Ltd. All rights reserved.

Creating a science of homelessness during the Reagan era.

PubMed

Jones, Marian Moser

2015-03-01

POLICY POINTS: A retrospective analysis of federally funded homeless research in the 1980s serves as a case study of how politics can influence social and behavioral science research agendas today in the United States. These studies of homeless populations, the first funded by the National Institute of Mental Health, demonstrated that only about a third of the homeless population was mentally ill and that a diverse group of people experienced homelessness. This groundbreaking research program set the mold for a generation of research and policy characterizing homelessness as primarily an individual-level problem rather than a problem with the social safety net. A decade after the nation's Skid Rows were razed, homelessness reemerged in the early 1980s as a health policy issue in the United States. While activists advocated for government-funded programs to address homelessness, officials of the Reagan administration questioned the need for a federal response to the problem. In this climate, the National Institute of Mental Health (NIMH) launched a seminal program to investigate mental illness and substance abuse among homeless individuals. This program serves as a key case study of the social and behavioral sciences' role in the policy response to homelessness and how politics has shaped the federal research agenda. Drawing on interviews with former government officials, researchers, social activists, and others, along with archival material, news reports, scientific literature, and government publications, this article examines the emergence and impact of social and behavioral science research on homelessness. Research sponsored by the NIMH and other federal research bodies during the 1980s produced a rough picture of mental illness and substance abuse prevalence among the US homeless population, and private foundations supported projects that looked at this group's health care needs. The Reagan administration's opposition to funding "social research," together

Barriers to Psychosocial Services among Homeless Women Veterans

PubMed Central

HAMILTON, ALISON B.; POZA, INES; HINES, VIVIAN; WASHINGTON, DONNA L.

2015-01-01

Veterans comprise a disproportionate fraction of the nation's homeless population, with women veterans up to four times more likely to be homeless than non-veteran women. This paper provides a grounded description of barriers to psychosocial services among homeless women veterans. Three focus groups were held in Los Angeles, CA, with a total of 29 homeless women veterans. These women described three primary, proximal (current) barriers: lack of information about services, limited access to services, and lack of coordination across services. Compared to non-veteran homeless women, women veterans potentially face additional challenges of trauma exposure during military service, post-military readjustment issues, and few services specific to women veterans. Understanding their service needs and experiences is critical to the development of relevant and appropriate services that move homeless women veterans away from vulnerability, into safety. PMID:26617471

Characterizing Stressors and Modifiable Health Risk Factors among Homeless Smokers: An Exploratory Pilot Study

ERIC Educational Resources Information Center

Kendzor, Darla E.; Reitzel, Lorraine R.; Businelle, Michael S.

2015-01-01

This pilot study was conducted to explore the associations between stressors related to homelessness and modifiable health risk factors (poor diet, insufficient physical activity, and overweight/obesity) and to provide direction for future research. Participants (N = 57) were homeless adults enrolled in a smoking cessation program. Analyses were…

Tuberculosis and Homelessness in the United States, 1994–2003

PubMed Central

Haddad, Maryam B.; Wilson, Todd W.; Ijaz, Kashef; Marks, Suzanne M.; Moore, Marisa

2017-01-01

Context Tuberculosis (TB) rates among US homeless persons cannot be calculated because they are not included in the US Census. However, homelessness is often associated with TB. Objectives To describe homeless persons with TB and to compare risk factors and disease characteristics between homeless and nonhomeless persons with TB. Design and Setting Cross-sectional analysis of all verified TB cases reported into the National TB Surveillance System from the 50 states and the District of Columbia from 1994 through 2003. Main Outcome Measures Number and proportion of TB cases associated with homelessness, demographic characteristics, risk factors, disease characteristics, treatment, and outcomes. Results Of 185 870 cases of TB disease reported between 1994 and 2003, 11 369 were among persons classified as homeless during the 12 months before diagnosis. The annual proportion of cases associated with homelessness was stable (6.1%–6.7%). Regional differences occurred with a higher proportion of TB cases associated with homelessness in western and some southern states. Most homeless persons with TB were male (87%) and aged 30 to 59 years. Black individuals represented the highest proportion of TB cases among the homeless and nonhomeless. The proportion of homeless persons with TB who were born outside the United States (18%) was lower than that for non-homeless persons with TB (44%). At the time of TB diagnosis, 9% of homeless persons were incarcerated, usually in a local jail; 3% of nonhomeless persons with TB were incarcerated. Compared with nonhomeless persons, homeless persons with TB had a higher prevalence of substance use (54% alcohol abuse, 29.5% noninjected drug use, and 14% injected drug use), and 34% of those tested had coinfection with human immunodeficiency virus. Compared with nonhomeless persons, TB disease in homeless persons was more likely to be infectious but not more likely to be drug resistant. Health departments managed 81% of TB cases in homeless

Meeting the Needs of Homeless Youth. A Report of the Homeless Youth Steering Committee.

ERIC Educational Resources Information Center

Frawley, Robert; Zafonte, Suzanne M.

This report examines the unique aspects of homelessness among youth ages 16 to 21. Section I reviews existing literature and data on the size, characteristics, and needs of homeless youth. Section II summarizes New York State's current efforts on their behalf. Section III analyzes obstacles to serving this population. Section IV outlines an action…

Supporting College Completion for Students Experiencing Homelessness. Best Practices in Homeless Education Brief Series

ERIC Educational Resources Information Center

National Center for Homeless Education at SERVE, 2015

2015-01-01

Since the College Cost Reduction and Access Act ([CCRAA], 20 U.S.C. § 1001 et seq.) was signed into law in September of 2007, the issue of college access for youth experiencing homelessness has garnered increased attention. Among other provisions, the CCRAA confers independent student status on unaccompanied homeless youth. This status allows…

Educating Homeless Students: Promising Practices.

ERIC Educational Resources Information Center

Stronge, James H., Ed.; Reed-Victor, Evelyn, Ed.

This book is for educators who serve homeless students or students temporarily sharing houses with other families. It describes many promising strategies for working with these students. The chapters are: (1) "Educating Homeless Children and Youth: An Introduction" (James H. Stronge); (2) "Meeting the Developmental and Educational Needs of…

Characteristics of Violent Deaths Among Homeless People in Maryland, 2003-2011.

PubMed

Stanley, Jennifer L; Jansson, Alexandra V; Akinyemi, Adebola A; Mitchell, Clifford S

2016-11-01

People experiencing homelessness are susceptible to many adverse health events, including violence. The purpose of this study was to provide a descriptive analysis of homeless individuals who suffered a violent death in Maryland. Characterizing these deaths will provide a basis for additional analyses that can inform violence prevention activities. This study used data from the Maryland Violent Death Reporting System to examine violent deaths of homeless people occurring from 2003 through 2011. This surveillance system collects information on all violent deaths occurring in Maryland. Victim demographics, injury and death information, precipitating circumstances contributing to deaths, and toxicology information were examined. All analyses were conducted in 2014 and 2015. Among all violent death victims from 2003 through 2011 (N=14,327), a total of 279 (2.0%) were identified as homeless victims. More than half (65.2%) of deaths were of undetermined intent, 21.2% were homicides, and 13.6% were suicides. The most common method of injury was poisoning (59.0%). Substance abuse and having a current mental health problem were among the most commonly reported circumstances relating to death. This study found substance abuse and mental health problems to be major circumstances precipitating violent death among people experiencing homelessness. This study will serve as a starting point for more in-depth analyses on experiences of violent death among homeless people that can inform violence prevention policy and programming. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

East London's Homeless: a retrospective review of an eye clinic for homeless people.

PubMed

D'Ath, Penny J; Keywood, Laura J; Styles, Elaine C; Wilson, Clare M

2016-02-16

There is very little published work on the visual needs of homeless people. This paper is the first study to investigate the visual needs of homeless people in the UK. Although similar work has been done in other countries, this study is unique because the United Kingdom is the only country with a National Health Service which provides free healthcare at the point of access. This study analysed the refractive status of the sample used, determined the demographics of homeless people seeking eye care and established if there is a need for community eye health with access to free spectacle correction in East London. This retrospective case study analysed the clinical records of 1,141 homeless people using the Vision Care for Homeless People services at one of their clinics in East London. All eye examinations were carried out by qualified optometrists and, where appropriate, spectacles were dispensed to patients. Data captured included age, gender, ethnicity and refractive error. Results were analysed using two-sample t-tests with Excel and Minitab. Demographics of age, gender and ethnicity are described. Spherical equivalents (SE) were calculated from prescription data available for 841 clinic users. Emmetropia was defined as SE-0.50DS to +1DS, myopia as SE < -0.50DS, and hyperopia as SE > +1DS. The majority of clinic users were male (79.2 %, n = 923). Approximately 80 % (n = 583) of clinic users were white, 10 % (n = 72) were 'black', 4 % (n = 29) 'Asian' and the remaining 5.6 % (n = 40) were of 'mixed ethnicity' and 'other' groups. The mean age of females attending the clinic was significantly lower than that of males (45.9 years, SD = 13.8 vs' 48.4 years, SD = 11.8) when analysed using a two-sample t-test (t (317) = 2.44, p = 0.02). One third of service users were aged between 50-59 years. Myopia and hyperopia prevalence rates were 37.0 % and 21.0 % respectively. A total of 34.8 % of homeless people were found

Perceived racial, sexual identity, and homeless status-related discrimination among Black adolescents and young adults experiencing homelessness: Relations with depressive symptoms and suicidality.

PubMed

Gattis, Maurice N; Larson, Andrea

2016-01-01

There is a dearth of empirical evidence that addresses how racial minority, sexual minority, and homeless statuses, with their accompanying experiences of stigma and discrimination, are related to mental health in adolescent and young adult populations. The current study addresses this gap by examining the associations between multiple forms of discrimination, depressive symptoms, and suicidality in a sample of 89 Black adolescents and young adults (52% female; 47% nonheterosexual, ages 16-24) experiencing homelessness. Results from a series of ordinary least squares and logistic regressions suggested that perceived homelessness stigma and racial discrimination were associated with higher levels of depressive symptoms, controlling for gender, age, and other types of discrimination, while perceived sexual identity discrimination showed no association. Having ever spent a homeless night on the street, an indicator of homelessness severity, accounted for a substantial amount of the association between homelessness stigma and depressive symptoms. In contrast, suicidality was not significantly associated with any measure of discrimination, homelessness severity, or personal characteristics. We also found no indication that the associations between perceived discrimination targeted at racial and homelessness statuses and mental health differed by sexual minority status. Our results suggest that depressive symptoms and suicidality are prevalent among Black homeless youth, and that depressive symptoms are particularly associated with racial discrimination and indicators of homelessness. The roles of discrimination and a lack of safe housing may be taken into account when designing programs and policies that address the mental health of Black adolescents and young adults experiencing homelessness. (c) 2016 APA, all rights reserved).

Homelessness in the state and federal prison population.

PubMed

Greenberg, Greg A; Rosenheck, Robert A

2008-01-01

This study sought to investigate the rates and correlates of homelessness (i.e. living on the street or in a homeless shelter), including mental illness, among US adult state and federal prison inmates (ASFPIs). Data from a national survey of ASFPIs based on a random sampling survey (N = 17,565) were used to compare the homelessness rate among AFSPIs with that in the general population. Logistic regression was then used to examine the association of homelessness among ASFPIs with factors including symptoms, treatment of mental illness, previous criminal justice involvement, specific crimes, and demographic characteristics. Nine percent of ASFPIs reported an episode of homelessness in the year prior to arrest, 4-6 times the estimated rate in the general US adult population after allowing for age, race/ethnicity, and gender. In comparison to other inmates, these homeless inmates were more likely to be currently incarcerated for a property crime, but also to have had previous criminal justice system involvement for both property and violent crimes, to suffer from mental health and/or substance abuse problems, and to be more likely to have been unemployed and with a low income. Recent homelessness is far more common among ASFPIs than the general population. Prior incarceration, mental illness, substance abuse and disadvantageous socio-demographic characteristics were all found to be associated with homelessness among prison inmates, suggesting that there are several important factors in addition to efforts to survive with limited resources through criminal acts that influence the rates of homelessness among incarcerated individuals.

Risk factors for homelessness among women with schizophrenia.

PubMed Central

Caton, C L; Shrout, P E; Dominguez, B; Eagle, P F; Opler, L A; Cournos, F

1995-01-01

A study of risk factors for homelessness among the severely mentally ill was extended to include women, and a case-control study of 100 indigent women with schizophrenia meeting criteria for literal homelessness and 100 such women with no history of homelessness was conducted. Subjects were recruited from shelters, clinics, and inpatient psychiatric programs in New York City. Clinical interviewers used standardized research instruments to probe three domains of risk factors: severity of mental illness, family background, and prior mental health service use. Findings adjusted for ethnicity revealed that homeless women had higher rates of a concurrent diagnosis of alcohol abuse, drug abuse, and antisocial personality disorder. Homeless women also had less adequate family support. PMID:7625518

The health of homeless immigrants

PubMed Central

Chiu, Shirley; Redelmeier, Donald A.; Tolomiczenko, George; Kiss, Alex; Hwang, Stephen W.

2009-01-01

Background This study examined the association between immigrant status and current health in a representative sample of 1,189 homeless people in Toronto, Canada. Methods Multivariate regression analyses were performed to examine the relationship between immigrant status and current health status (assessed using the SF-12) among homeless recent immigrants (≤10 years since immigration), non-recent immigrants (>10 years since immigration), and Canadian-born individuals recruited at shelters and meal programs (response rate 73%). Results After adjusting for demographic characteristics and lifetime duration of homelessness, recent immigrants were significantly less likely to have chronic conditions (RR 0.7, 95% CI 0.5 to 0.9), mental health problems (OR 0.4, 95% CI 0.2 to 0.7), alcohol problems (OR 0.2, 95% CI 0.1 to 0.5), and drug problems (OR 0.2, 95% CI 0.1 to 0.4) compared to non-recent immigrants and Canadian-born individuals. Recent immigrants were also more likely to have better mental health status (+3.4 points, SE ±1.6) and physical health status (+2.2 points, SE ±1.3) on scales with a mean of 50 and a standard deviation of 10 in the general population. Conclusion Homeless recent immigrants are a distinct group who are generally healthier and may have very different service needs compared to other homeless people. PMID:19654122

Costs and Effectiveness of Treating Homeless Persons with Cocaine Addiction with Alternative Contingency Management Strategies.

PubMed

Mennemeyer, Stephen T; Schumacher, Joseph E; Milby, Jesse B; Wallace, Dennis

2017-03-01

Between 1990 and 2006 in Birmingham, Alabama USA, 4 separate randomized controlled studies, called "Homeless 1" through "Homeless 4", treated cocaine substance abuse among chronically homeless adults, largely black men, many with non-psychotic mental health problems. The 4 studies had 9 treatment arms that used various counseling methods plus, in some arms, the provision of housing and work therapy usually with a contingent requirement of urine-test verified abstinence from substances. Participants in the abstinent-contingent arms who lapsed on abstinence were removed from housing and sent to an evening public shelter from which they were daily transported to day treatment until they returned to abstinence. This paper compares the cost effectiveness of the treatment arms. Societal cost per participant (in 2014 dollars) for each arm is defined as direct treatment cost plus cost of jail or hospital plus societal expense of public shelter use by lapsed participants. An untreated Base Case is defined as 5 percent abstinence with 95 percent usage of a public shelter. Incremental Cost Effectiveness Ratios (ICERs) for paired arms are defined as the change in cost per participant divided by the change in abstinence. Bootstrapping estimates confidence intervals. Average cost per participant at the end of 6 months of active treatment in 7 arms with comparable data ranged from USD 10,447 to USD 36,194 with corresponding average weeks abstinent ranging from 6.1 to 15.3 out of a possible 26 weeks. In contrast, the Base Case would cost USD 6,123 for 1.3 weeks of abstinence. Compared to the Base Case, the least expensive "DT2" treatment has an ICER of USD 901 (95% CI = USD 571 to USD 1,681) per additional week of abstinence and the most expensive "CMP4" has an ICER of USD 2,147 (95% CI = USD 1,701 to USD 2,848). Additionally, the Homeless 3 study found that the abstinent contingent housing (ACH3) treatment compared to the Non Abstinent Contingent Housing (NAC3), analogous to

Creating a Science of Homelessness During the Reagan Era

PubMed Central

JONES, MARIAN MOSER

2015-01-01

Policy Points: A retrospective analysis of federally funded homeless research in the 1980s serves as a case study of how politics can influence social and behavioral science research agendas today in the United States. These studies of homeless populations, the first funded by the National Institute of Mental Health, demonstrated that only about a third of the homeless population was mentally ill and that a diverse group of people experienced homelessness. This groundbreaking research program set the mold for a generation of research and policy characterizing homelessness as primarily an individual-level problem rather than a problem with the social safety net. Context A decade after the nation's Skid Rows were razed, homelessness reemerged in the early 1980s as a health policy issue in the United States. While activists advocated for government-funded programs to address homelessness, officials of the Reagan administration questioned the need for a federal response to the problem. In this climate, the National Institute of Mental Health (NIMH) launched a seminal program to investigate mental illness and substance abuse among homeless individuals. This program serves as a key case study of the social and behavioral sciences’ role in the policy response to homelessness and how politics has shaped the federal research agenda. Methods Drawing on interviews with former government officials, researchers, social activists, and others, along with archival material, news reports, scientific literature, and government publications, this article examines the emergence and impact of social and behavioral science research on homelessness. Findings Research sponsored by the NIMH and other federal research bodies during the 1980s produced a rough picture of mental illness and substance abuse prevalence among the US homeless population, and private foundations supported projects that looked at this group's health care needs. The Reagan administration's opposition to funding �

The Homeless in Contemporary Society.

ERIC Educational Resources Information Center

Bingham, Richard D.; And Others

This book consists of 15 chapters on understanding and helping the homeless. The first seven chapters present the "new" homeless in historical context and describe this population and its situation. The remaining eight chapters discuss policy and program options of the government and other organizations in attempting to alleviate the problems of…

Florida's Adult Homeless Literacy Training & Basic Skills Assistance Project.

ERIC Educational Resources Information Center

Florida State Dept. of Education, Tallahassee. Div. of Vocational, Adult, and Community Education.

Some facts about the homeless population in Florida are the following: (1) 40,000 persons in Florida are homeless on any given day, with 40 percent of the total being families; (2) 65 percent are new homeless (not chronic); (3) 30 percent of the homeless are addicted to drugs or alcohol and 20 percent are mentally ill; (4) causes of homelessness…

Homelessness among older african-american women: interpreting a serious social issue through the arts in community-based participatory action research.

PubMed

Feen-Calligan, Holly; Washington, Olivia G M; Moxley, David P

2009-01-01

This article describes the incorporation of the arts into a community-based participatory action research (CBPAR) project formulated to develop and test practices for helping homeless older African-American women. Studying how older African-American women become homeless has evolved into developing and testing promising interventions by the Leaving Homelessness Intervention Research Project (LHIRP). The women's participation in creative group activities helped them to communicate their experience with homelessness, express their concerns, develop personal strengths, and obtained mutual understanding. The use of multiple art forms has revealed a number of creative strengths among the participants, which have in turn inspired innovative artistic strategies and methodologies as part of the multiple methods that LHIRP incorporates. These interventions have been useful in helping participants resolve their homelessness. The role and benefit of the arts in CBPAR is described to show how creative activities help researchers and the public to better understand the complexities of homelessness.

Ethical issues in research with homeless youths.

PubMed

Ensign, Josephine; Ammerman, Seth

2008-05-01

This paper is a report of a study to document researcher, healthcare provider and programme administrators' experiences with ethical issues in research with homeless youths in North America. While there are legal and ethical guidelines for research with adolescents and with vulnerable populations in general, there are no specific guidelines for the ethical conduct of research with homeless youths. Using a web-based questionnaire, healthcare and social service providers, programme administrators and researchers working with homeless young people throughout the United States of America and Canada were surveyed in 2005. The survey group consisted of 120 individuals; a total of 72 individuals completed the survey. Survey questions included experiences with using incentives in research with homeless youths, consent and experiences with ethics review boards. Numerical data were analysed using frequencies and cross-tabulations. Text data were analysed qualitatively. Researchers doing mental health and/or substance use research tended to use money as a research incentive, whereas healthcare providers and programme administrators tended to use non-monetary incentives. The majority of respondents reported using written consent for research from homeless youths, including minors. Respondents reporting difficulties with ethics review boards were mainly involved with intervention research. Consensus is needed from a variety of stakeholders, including homeless youths and service providers, on use of various types of research incentives for different types of research, as well as use of consent for homeless youths who are minors.

Suicidal behavior among homeless people in Japan.

PubMed

Okamura, Tsuyoshi; Ito, Kae; Morikawa, Suimei; Awata, Shuichi

2014-04-01

The purpose of this study is to investigate the frequency and correlates of suicidal behavior among homeless people in Japan. A face-to-face survey was conducted in two districts of Tokyo, Japan, with 423 subjects who resided on streets and riversides and in urban parks and stations (street homeless) or who were residents of shelters, cheap hotels, or welfare homes for homeless people (sheltered homeless). When questioned about suicidal ideation in the previous 2 weeks, 51 subjects (12.2% of valid responses) had a recurring wish to die, 29 (6.9%) had frequent thoughts of suicide, and 22 (5.3%) had made suicide plans. In addition, 11 (2.9%) subjects had attempted suicide in the previous 2 weeks and 74 (17.7%) reported that they had ever attempted suicide. In univariate logistic regression analyses, street homelessness, lack of perceived emotional social support, poor subjective health perception, visual impairment, pain, insomnia, poor mental well-being, and current depression were significantly associated with recurrent thoughts of suicide in the previous 2 weeks. Among these, current depression had the greatest significance. In multivariate logistic regression analyses after controlling for depression, street homelessness and lack of perceived emotional social support were significantly associated with recurrent thoughts of suicide in the previous 2 weeks. Comprehensive interventions including housing and social support as well as mental health services might be crucial as effective strategies for suicide prevention among homeless people.

Challenges of Providing End-of-Life Care for Homeless Veterans.

PubMed

Hutt, Evelyn; Whitfield, Emily; Min, Sung-Joon; Jones, Jacqueline; Weber, Mary; Albright, Karen; Levy, Cari; O'Toole, Thomas

2016-05-01

To describe challenges of caring for homeless veterans at end of life (EOL) as perceived by Veterans Affairs Medical Center (VAMC) homeless and EOL care staff. E-mail survey. Homelessness and EOL programs at VAMCs. Programs and their ratings of personal, structural, and clinical care challenges were described statistically. Homelessness and EOL program responses were compared in unadjusted analyses and using multivariable models. Of 152 VAMCs, 50 (33%) completed the survey. The VAMCs treated an average of 6.5 homeless veterans at EOL annually. Lack of appropriate housing was the most critical challenge. The EOL programs expressed somewhat more concern about lack of appropriate care site and care coordination than did homelessness programs. Personal, clinical, and structural challenges face care providers for veterans who are homeless at EOL. Deeper understanding of these challenges will require qualitative study of homeless veterans and care providers. © The Author(s) 2015.

Pathways into homelessness among post-9/11-era veterans.

PubMed

Metraux, Stephen; Cusack, Meagan; Byrne, Thomas H; Hunt-Johnson, Nora; True, Gala

2017-05-01

Despite the scale of veteran homelessness and government-community initiatives to end homelessness among veterans, few studies have featured individual veteran accounts of experiencing homelessness. Here we track veterans' trajectories from military service to homelessness through qualitative, semistructured interviews with 17 post-9/11-era veterans. Our objective was to examine how veterans become homeless-including the role of military and postmilitary experiences-and how they negotiate and attempt to resolve episodes of homelessness. We identify and report results in 5 key thematic areas: transitioning from military service to civilian life, relationships and employment, mental and behavioral health, lifetime poverty and adverse events, and use of veteran-specific services. We found that veterans predominantly see their homelessness as rooted in nonmilitary, situational factors such as unemployment and the breakup of relationships, despite very tangible ties between homelessness and combat sequelae that manifest themselves in clinical diagnoses such as posttraumatic stress disorder. Furthermore, although assistance provided by the U.S. Department of Veterans Affairs (VA) and community-based organizations offer a powerful means for getting veterans rehoused, veterans also recount numerous difficulties in accessing and obtaining VA services and assistance. Based on this, we offer specific recommendations for more systematic and efficient measures to help engage veterans with VA services that can prevent or attenuate their homelessness. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Homelessness and the Public's Health: Legal Responses.

PubMed

Hodge, James G; DiPietro, Barbara; Horton-Newell, Amy E

2017-03-01

This commentary addresses public health issues underlying homelessness and related law, policy, and advocacy options. After framing public health issues for affected individuals and the community, legal and policy approaches and related barriers are assessed. Major topics include deficits in housing availability, the role of state-based Medicaid programs, criminalization of homelessness, and the use of emergency declarations seeking to address particular issues related to homelessness in select states and localities.

Mental Health, Substance Abuse, and Suicide Among Homeless Adults.

PubMed

Lee, Kyoung Hag; Jun, Jung Sim; Kim, Yi Jin; Roh, Soonhee; Moon, Sung Seek; Bukonda, Ngoyi; Hines, Lisa

2017-01-01

This study explored the role of mental health and substance abuse problems on the suicidal ideation and suicide attempts of 156 homeless adults. The logistic regression results indicated that homeless adults with anxiety were significantly more likely than those without anxiety to have both suicidal ideation and suicide attempts. Also, homeless adults with drug abuse were significantly more likely than those without drug abuse to have suicidal ideation. The study suggests that to reduce the suicide of the homeless, case managers need to screen mental health and substance abuse issues and to provide appropriate treatment services at homeless shelters.

Psychopathology in Young People Experiencing Homelessness: A Systematic Review

PubMed Central

Shelton, Katherine H.; van den Bree, Marianne B. M.; Los, Férenc J.

2013-01-01

Understanding mental health issues faced by young homeless persons is instrumental to the development of successful targeted interventions. No systematic review of recent published literature on psychopathology in this group has been completed. We conducted a systematic review of published research examining the prevalence of psychiatric problems among young homeless people. We examined the temporal relationship between homelessness and psychopathology. We collated 46 articles according to the PRISMA Statement. All studies that used a full psychiatric assessment consistently reported a prevalence of any psychiatric disorder from 48% to 98%. Although there was a lack of longitudinal studies of the temporal relationship between psychiatric disorders and homelessness, findings suggested a reciprocal link. Supporting young people at risk for homelessness could reduce homelessness incidence and improve mental health. PMID:23597340

Predictors of homeless services re-entry within a sample of adults receiving Homelessness Prevention and Rapid Re-Housing Program (HPRP) assistance.

PubMed

Brown, Molly; Vaclavik, Danielle; Watson, Dennis P; Wilka, Eric

2017-05-01

Local and national evaluations of the federal Homelessness Prevention and Rapid Re-Housing Program (HPRP) have demonstrated a high rate of placement of program participants in permanent housing. However, there is a paucity of research on the long-term outcomes of HPRP, and research on rehousing and prevention interventions for single adults experiencing homelessness is particularly limited. Using Homeless Management Information System data from 2009 to 2015, this study examined risk of return to homeless services among 370 permanently housed and 71 nonpermanently housed single adult HPRP participants in Indianapolis, Indiana. Kaplan-Meier survival curves were conducted to analyze time-to-service re-entry for the full sample, and the homelessness prevention and rapid rehousing participants separately. With an average follow-up of 4.5 years after HPRP exit, 9.5% of the permanently housed HPRP participants and 16.9% of those nonpermanently housed returned to homeless services. By assistance type, 5.4% of permanently housed and 15.8% of nonpermanently housed homelessness prevention recipients re-entered services, and 12.8% of permanently housed and 18.2% of nonpermanently housed rapid rehousing recipients re-entered during the follow-up period. Overall, veterans, individuals receiving rapid rehousing services, and those whose income did not increase during HPRP had significantly greater risk of returning to homeless services. Veterans were at significantly greater risk of re-entry when prevention and rehousing were examined separately. Findings suggest a need for future controlled studies of prevention and rehousing interventions for single adults, aiming to identify unique service needs among veterans and those currently experiencing homelessness in need of rehousing to inform program refinement. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Promoting Resilience in Youth Experiencing Homelessness through Implementation of the McKinney-Vento Homeless Assistance Act

ERIC Educational Resources Information Center

Clemens, Elysia; Hess, Robyn S.; Strear, Molly M.; Rue, Lisa; Rizzolo, Sonja; Henninger, Janessa

2018-01-01

This Consensual Qualitative Research study explored experiences of youth, families, and homeless liaisons to better understand how educational environments can foster resilience among youth experiencing homelessness. The purpose of the study was to provide educational stakeholders with guidance on how to actualize the McKinney-Vento Homeless…

Vulnerability of Homeless People in Tehran, Iran, to HIV, Tuberculosis and Viral Hepatitis

PubMed Central

Bagheri Amiri, Fahimeh; Gouya, Mohammad Mehdi; Saifi, Mahnaz; Rohani, Mehdi; Tabarsi, Payam; Sedaghat, Abbas; Fahimfar, Noushin; Memarnejadian, Arash; Aghasadeghi, Mohammad Reza; Haghdoost, Ali Akbar; Jahanbakhsh, Fatemeh; Nasehi, Mahshid; Mostafavi, Ehsan

2014-01-01

Background Homeless people are at risk of contracting communicable infectious diseases, as they indulge in risky behaviours and lifestyle. This study was conducted to determine the prevalence of the aforementioned infections and related risk behaviours among homeless people in Tehran. Methods In this study a convenience sample of 593 homeless individuals was studied. The ELISA method was used for the detection of HIV, HCV and HBV. Clinical symptoms, sputum cultures, acid fast bacilli smears, and chest X-rays were used to identify active pulmonary tuberculosis, and the Interferon Gamma Release Assay (IGRA) test was used to identify latent tuberculosis. Results The prevalence of HIV, HBV, HCV and latent tuberculosis was 3.4%, 2.6%, 23.3% and 46.7%, respectively. Active pulmonary tuberculosis was found in 7 persons (1.2%). Injection drug use was an independent risk factor for HIV, HCV and HBV infections. Older people had a higher proportion of Mycobacterium tuberculosis infection (OR: 2.6, 95%CI: 1.9, 3.7) and HCV positivity (OR: 1.7, 95% CI: 1.1, 2.5). Conclusion Our findings highlighted that much more attention needs to be paid to the health of homeless people. PMID:24896247

Hosting a Tent City: Student Engagement and Homelessness

ERIC Educational Resources Information Center

McKinney, Jennifer; Snedker, Karen A.

2017-01-01

In response to increasing homelessness in our city, Seattle Pacific University invited a homeless encampment (Tent City) to reside on our university campus for three months. This provided an opportunity to engage students on issues of poverty and inequality. Building from a service-learning model, we devised course work around homelessness and…

Tuberculosis infection among homeless persons and caregivers in a high-tuberculosis-prevalence area in Japan: a cross-sectional study

PubMed Central

2011-01-01

Background Tuberculosis (TB) is a major public health problem. The Airin district of Osaka City has a large population of homeless persons and caregivers and is estimated to be the largest TB-endemic area in the intermediate-prevalence country, Japan. However, there have been few studies of homeless persons and caregivers. The objective of this study is to detect active TB and to assess the prevalence and risk factors for latent TB infection among homeless persons and caregivers. Methods We conducted a cross-sectional study for screening TB infection (active and latent TB infections) using questionnaire, chest X-ray (CXR), newly available assay for latent TB infection (QuantiFERON-TB Gold In-Tube; QFT) and clinical evaluation by physicians at the Osaka Socio-Medical Center Hospital between July 2007 and March 2008. Homeless persons and caregivers, aged 30-74 years old, who had not received CXR examination within one year, were recruited. As for risk factors of latent TB infection, the odds ratios (OR) and 95% confidence intervals (95% CI) for QFT-positivity were calculated using logistic regression model. Results Complete responses were available from 436 individuals (263 homeless persons and 173 caregivers). Four active TB cases (1.5%) among homeless persons were found, while there were no cases among caregivers. Out of these four, three had positive QFT results. One hundred and thirty-three (50.6%) homeless persons and 42 (24.3%) caregivers had positive QFT results. In multivariate analysis, QFT-positivity was independently associated with a long time spent in the Airin district: ≥10 years versus <10 years for homeless (OR = 2.53; 95% CI, 1.39-4.61) and for caregivers (OR = 2.32; 95% CI, 1.05-5.13), and the past exposure to TB patients for caregivers (OR = 3.21; 95% CI, 1.30-7.91) but not for homeless persons (OR = 1.51; 95% CI, 0.71-3.21). Conclusions Although no active TB was found for caregivers, one-quarter of them had latent TB infection. In addition to

Art messaging to engage homeless young adults.

PubMed

Nyamathi, Adeline; Slagle, Alexandra; Thomas, Alexandra; Hudson, Angela; Kahilifard, Farinaz; Avila, Glenna; Orser, Julie; Cuchilla, Manuel

2011-01-01

Art has been shown to be an empowering and engaging entity with numerous benefits to vulnerable populations, including the homeless persons and young adults. However, little is known how homeless young adults perceive the use of art as messages that can communicate the danger of initiating or continuing drug and alcohol use. The purpose of this study was to solicit perspectives of homeless, drug-using young adults as to how art can be used to design messages for their peers about the danger of initiating or continuing drug and alcohol use. Qualitative methodology via focus group discussions was utilized to engage 24 homeless young adults enrolled from a drop-in site in Santa Monica, California. The findings revealed support for a myriad of delivery styles, including in-person communication, flyers, music, documentary film, and creative writing. The young adults also provided insight into the importance of the thematic framework of messages. Such themes ranged from empowering and hopeful messages to those designed to scare young homeless adults into not experimenting with drugs. The findings indicate that in addition to messages communicating the need to prevent or reduce drug and alcohol use, homeless young adults respond to messages that remind them of goals and dreams they once had for their future, and to content that is personal, real, and truthful. Our research indicates that messages that reinforce protective factors such as hope for the future and self-esteem may be as important to homeless young adults as information about the risks and consequences of drug use.

Homeless Children: Addressing the Challenge in Rural Schools. ERIC Digest.

ERIC Educational Resources Information Center

Vissing, Yvonne M.

Despite stereotypes to the contrary, homelessness is as prevalent in rural as urban areas. This digest examines the implications of homelessness for rural children and youth and discusses possible actions by rural educators. An estimated half of the rural homeless are families with children. Compared to urban counterparts, rural homeless families…

Homeless Children and Youth: A New American Dilemma.

ERIC Educational Resources Information Center

Kryder-Coe, Julee H., Ed.; And Others

These 11 reports focus on policy responses to the needs of very young children who are part of a homeless family, and older young people who are homeless but on their own. The following chapters are included: (1) J. M. Molnar's introduction to the relationship between chronic poverty and homelessness; (2) "Beyond the Numbers: Homeless…

High-risk sexual behavior among drug-using men.

PubMed

Seidman, S N; Sterk-Elifson, C; Aral, S O

1994-01-01

Drug-using men are at high risk for acquisition and transmission of STD, presumably due to the risky behaviors practiced in environments of drug use. To study behaviors associated with STD transmission among drug-using men. Drug outreach workers distributed vouchers to self-identified drug-using men in urban Atlanta. Vouchers could be redeemed for cash at a storefront clinic where subjects provided urine for a urethritis screening test (leukocyte esterase test) and a drug screen, and were interviewed. Of 382 voucher recipients, 252 (66%) came to the clinic. Subjects were predominantly black (92%), homeless (70%), and aged 20 to 40 (88%). All used illicit drugs; none were currently receiving drug abuse treatment. Urine drug screen confirmed recent cocaine use in 63%, and recent opiate use in 4%. Three-fourths reported a history of STD, mostly gonorrhea. In the preceding 3 months, 14% had not had sex, 80% had sex exclusively with women, 4% had sex with both men and women, and 2% had sex exclusively with men. Of the heterosexually active men, 29% had 5 or more recent partners. Compared to other heterosexually active men, these men were more likely to always use alcohol or crack before having sex (prevalence ratio [PR] = 2.0, 95% CI = 1.3-2.5) and to drink alcohol every day (PR = 2.0, 95% CI = 1.2-3.3). Daily crack use was associated with choosing partners at elevated STD risk; daily alcohol use with having more partners. Positive drug screen for cocaine was associated with self-reported crack use. Urethritis, detected in 16%, was not correlated with behavior. A substantial number of drug-using men practice high-risk sexual behavior and should be targeted for intervention. Monetary and other incentives should be considered for recruitment. Further study is needed to clarify the relationship between sexual behavior, cocaine use, and STD.

Cross-National Variations in Behavioral Profiles Among Homeless Youth

PubMed Central

Milburn, Norweeta G.; Rotheram-Borus, Mary Jane; Rice, Eric; Mallet, Shelley; Rosenthal, Doreen

2010-01-01

Cross-national comparisons of homeless youth in Melbourne, Australia, and Los Angeles, CA, United States were conducted. Newly (n = 427) and experienced (n = 864) homeless youth were recruited from each site. Compared to Australia, homeless youth in the United States were younger, more likely to be in school or jail, demonstrated fewer sexual and substance use risk acts, fewer suicidal acts, and reported less need for social services. Across sites, experienced homeless youth were more likely to be older, male, engage in sexual and substance use, report greater need for social services, and make greater use of work, substance use, and health-related services. Homeless youth have different behavioral profiles in Australia and the United States, reflecting differences in the effectiveness of service systems in the two countries in keeping youth with fewer problems out of homelessness. PMID:16680537

Cross-national variations in behavioral profiles among homeless youth.

PubMed

Milburn, Norweeta G; Rotheram-Borus, Mary Jane; Rice, Eric; Mallet, Shelley; Rosenthal, Doreen

2006-03-01

Cross-national comparisons of homeless youth in Melbourne, Australia, and Los Angeles, CA, United States were conducted. Newly (n = 427) and experienced (n = 864) homeless youth were recruited from each site. Compared to Australia, homeless youth in the United States were younger, more likely to be in school or jail, demonstrated fewer sexual and substance use risk acts, fewer suicidal acts, and reported less need for social services. Across sites, experienced homeless youth were more likely to be older, male, engage in sexual and substance use, report greater need for social services, and make greater use of work, substance use, and health-related services. Homeless youth have different behavioral profiles in Australia and the United States, reflecting differences in the effectiveness of service systems in the two countries in keeping youth with fewer problems out of homelessness.

Where do people go when they first become homeless? A survey of homeless adults in the USA.

PubMed

O'Toole, Thomas P; Conde-Martel, Alicia; Gibbon, Jeanette L; Hanusa, Barbara H; Freyder, Paul J; Fine, Michael J

2007-09-01

The longer a person is homeless, the more likely he or she is to experience poor health and be placed at higher risk for premature death. This makes interventions early in one's homelessness an important prevention strategy. However, little is known about where someone goes for help when they first become homeless and how well those sites are prepared to address the multitude of issues facing a homeless person. In order to address this question, we conducted a cross-sectional community-based survey in two US cities in 1997 using population proportionate sampling of homeless persons identified at 91 sites to identify 'first-stop' access sites and reasons for seeking help at those sites. A total of 230 persons participated in the face-to-face interview (93% response rate). From a list of 20 possible 'first-stop' sites, 105 (45.7%) reported going to a soup kitchen, 71 (30.9%) went to a welfare office, 64 (27.8%) sought admission to a detoxification centre, 60 (26.1%) met with a homeless outreach team, 57 (24.8%) went to a family member, and 54 (23.5%) went to an emergency room. Individuals with a chronic medical or mental health condition were significantly more likely to access a healthcare site (medical: 62.6% vs. 47.6%, P = 0.02; mental health: 62.4% vs. 38.8%, P < 0.01) or social service agency (medical: 64.0% vs. 43.3%, P = 0.02; mental health: 59.1% vs. 40.7%, P < 0.01). Those persons reporting a need for alcohol treatment were significantly more likely to first go to a healthcare site (46.4% vs. 29.1%, P < 0.01) and those with alcohol abuse/dependence were less likely to seek help from family or friends (66.7% vs. 81.9%, P < 0.01). Most respondents sought assistance for concerns directly associated with an immediate need as opposed to seeking care for issues causing their actual homelessness. These findings suggest the need to expand and integrate the availability of services at 'first-stop' access sites that facilitate early exits from homelessness.

Association of childhood abuse with homeless women's social networks.

PubMed

Green, Harold D; Tucker, Joan S; Wenzel, Suzanne L; Golinelli, Daniela; Kennedy, David P; Ryan, Gery W; Zhou, Annie J

2012-01-01

. The effects of childhood physical abuse should be more actively investigated in clinical settings, especially those frequented by homeless women, particularly with respect to the formation of social networks in social contexts that may expose these women to greater risks. Copyright © 2012. Published by Elsevier Ltd.

Alcoholism, Drug Abuse, and the Homeless.

ERIC Educational Resources Information Center

McCarty, Dennis; And Others

1991-01-01

Reviews policies that address substance abuse among the homeless. Recommends that the changing needs of the homeless require an integration of alcoholism and drug abuse recovery services with programs for various groups, substance-free housing, and psychological knowledge incorporated into programs for those struggling with addiction and…

Predictors of Retention in a Homeless Veteran Intervention Program

DTIC Science & Technology

2012-12-01

Educational Development /High School GPD Grant and Per Diem HCHV Health Care for Homeless Veterans HEARTH Homeless Emergency Assistance and...Planning and Public Affairs, University of Illinois at Chicago. The Homeless Emergency Assistance and Rapid Transition to Housing ( HEARTH ) Act (P.L. 111

The Changing Character of Homelessness in the United States.

ERIC Educational Resources Information Center

Axelson, Leland J.; Dail, Paula W.

1988-01-01

Describes new form of homeless persons, a growing population of homeless individuals and families who are not mentally ill, not wanderers, and may be employed. Examines changing character of homelessness and makes recommendations for a public policy response to the problem. (Author/NB)

Homelessness and money mismanagement in Iraq and Afghanistan veterans.

PubMed

Elbogen, Eric B; Sullivan, Connor P; Wolfe, James; Wagner, Henry Ryan; Beckham, Jean C

2013-12-01

We examined the empirical link between money mismanagement and subsequent homelessness among veterans. We used a random sample of Iraq and Afghanistan War era veterans from the National Post-Deployment Adjustment Survey in 2009-2011. Veterans were randomly selected from a roster of all US military service members in Operation Iraqi Freedom or Operation Enduring Freedom who were separated from active duty or in the Reserves/National Guard. Veterans (n = 1090) from 50 states and all military branches completed 2 waves of data collection 1 year apart (79% retention rate). Thirty percent reported money mismanagement (e.g., bouncing or forging a check, going over one's credit limit, falling victim to a money scam in the past year). Multivariate analysis revealed money mismanagement (odds ratio [OR] = 4.09, 95% CI = 1.87, 8.94) was associated with homelessness in the next year, as were arrest history (OR = 2.65, 95% CI = 1.33, 5.29), mental health diagnosis (OR = 2.59, 95% CI = 1.26, 5.33), and income (OR = 0.30, 95% CI = 0.13, 0.71). Money mismanagement, reported by a substantial number of veterans, was related to a higher rate of subsequent homelessness. The findings have implications for policymakers and clinicians, suggesting that financial education programs offered by the US Departments of Defense and Veterans Affairs may be targeted to effectively address veteran homelessness.

Design and validation of the Health Professionals' Attitudes Toward the Homeless Inventory (HPATHI).

PubMed

Buck, David S; Monteiro, F Marconi; Kneuper, Suzanne; Rochon, Donna; Clark, Dana L; Melillo, Allegra; Volk, Robert J

2005-01-10

Recent literature has called for humanistic care of patients and for medical schools to begin incorporating humanism into medical education. To assess the attitudes of health-care professionals toward homeless patients and to demonstrate how those attitudes might impact optimal care, we developed and validated a new survey instrument, the Health Professional Attitudes Toward the Homeless Inventory (HPATHI). An instrument that measures providers' attitudes toward the homeless could offer meaningful information for the design and implementation of educational activities that foster more compassionate homeless health care. Our intention was to describe the process of designing and validating the new instrument and to discuss the usefulness of the instrument for assessing the impact of educational experiences that involve working directly with the homeless on the attitudes, interest, and confidence of medical students and other health-care professionals. The study consisted of three phases: identifying items for the instrument; pilot testing the initial instrument with a group of 72 third-year medical students; and modifying and administering the instrument in its revised form to 160 health-care professionals and third-year medical students. The instrument was analyzed for reliability and validity throughout the process. A 19-item version of the HPATHI had good internal consistency with a Cronbach's alpha of 0.88 and a test-retest reliability coefficient of 0.69. The HPATHI showed good concurrent validity, and respondents with more than one year of experience with homeless patients scored significantly higher than did those with less experience. Factor analysis yielded three subscales: Personal Advocacy, Social Advocacy, and Cynicism. The HPATHI demonstrated strong reliability for the total scale and satisfactory test-retest reliability. Extreme group comparisons suggested that experience with the homeless rather than medical training itself could affect health

The longitudinal association between homelessness, injection drug use, and injection-related risk behavior among persons with a history of injection drug use in Baltimore, MD.

PubMed

Linton, Sabriya L; Celentano, David D; Kirk, Gregory D; Mehta, Shruti H

2013-10-01

Few studies have assessed the temporal association between homelessness and injection drug use, and injection-related risk behavior. Among a cohort of 1405 current and former injection drug users in follow-up from 2005 to 2009, we used random intercept models to assess the temporal association between homelessness and subsequent injection drug use, and to determine whether the association between homelessness and sustained injection drug use among active injectors differed from the association between homelessness and relapse among those who stopped injecting. We also assessed the association between homelessness and subsequent injection-related risk behavior among participants who injected drugs consecutively across two visits. Homelessness was categorized by duration: none, <1 month, and ≥1 month. Homelessness was reported on at least one occasion by 532 (38%) participants. The relationship between homelessness and subsequent injection drug use was different for active injectors and those who stopped injecting. Among those who stopped injecting, homelessness was associated with relapse [<1 month: AOR=1.67, 95% CI (1.01, 2.74); ≥1 month: AOR=1.34 95% CI (0.77, 2.33)]. Among active injectors, homelessness was not associated with sustained injection drug use [<1 month: AOR=1.03, 95% CI (0.71, 1.49); ≥1 month: AOR=0.81 95% CI (0.56, 1.17)]. Among those injecting drugs across two consecutive visits, homelessness ≥1 month was associated with subsequent injection-related risk behavior [AOR=1.61, 95% CI (1.06, 2.45)]. Homelessness appears to be associated with relapse and injection-related risk behavior. Strengthening policies and interventions that prevent homelessness may reduce injection drug use and injection-related risk behaviors. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

The health encounter as a treatable moment for homeless substance-using adults: the role of homelessness, health seeking behavior, readiness for behavior change and motivation for treatment.

PubMed

O'Toole, Thomas P; Pollini, Robin A; Ford, Daniel E; Bigelow, George

2008-09-01

Substance-using homeless persons frequent emergency departments and hospitals often. However, little is known about how homelessness affects when they seek care and their motivation for substance abuse treatment (SAT). We surveyed homeless (N=266) and non-homeless (N=104) substance-using adults sequentially admitted to an urban hospital medicine service, comparing demographics, readiness for change (URICA), and motivating reasons for SAT. Homeless respondents were more likely to be younger, uninsured, have hepatitis B/C, and <12th grade education. The majority in both groups were in either a precontemplative or contemplative stage of change, although more homeless respondents were in an action stage. They also had similar motivating reasons for wanting SAT, although being homeless was an additional motivator for the majority of homeless respondents. Almost half reported that being homeless caused them to delay seeking health care; paradoxically those citing physical health as a SAT motivator were 3.4 times more likely to have delayed care. While acutely ill homeless persons were at least as motivated for SAT, these data suggest the challenge is getting them to care in a timely manner and tailoring interventions during the care episode to avail of this motivation.

Quality of Health Care: The Views of Homeless Youth

PubMed Central

Ensign, Josephine

2004-01-01

Objective To develop homeless-youth-identified process and outcome measures of quality of health care. Data Sources/Study Setting Primary data collection with homeless youth from both street and clinic settings in Seattle, Washington, for calendar year 2002. Study Design The research was a focused ethnography, using key informant and in-depth individual interviews as well as focus groups with a purposeful sample of 47 homeless youth aged 12–23 years. Data Collection/Extraction Methods All interviews and focus groups were tape-recorded, transcribed, and preliminarily coded, with final coding cross-checked and verified with a second researcher. Principal Findings Homeless youth most often stated that cultural and interpersonal aspects of quality of care were important to them. Physical aspects of quality of care reported by the youth were health care sites separate from those for homeless adults, andsites that offered a choice of allopathic and complementary medicine. Outcomes of health care included survival of homelessness, functional and disease-state improvement, and having increased trust and connections with adults and with the wider community. Conclusions Homeless youth identified components of quality of care as well as how quality of care should be measured. Their perspectives will be included in a larger follow-up study to develop quality of care indicators for homeless youth. PMID:15230923

Hope as seen through the eyes of homeless children.

PubMed

Herth, K

1998-11-01

Children now constitute the largest segment of the homeless population. Multiple studies have identified the adverse effects of homelessness on children's health, development, academic success, and behaviour. Minimal literature exists that describes homeless children from the perspective of their strengths. The purpose of this study was to investigate the meaning of hope in homeless children and to identify strategies that children use in fostering and maintaining their hope. Using the technique of methodological triangulation (semi-structured interviews and drawings) the investigator collected data on a convenience sample of 60 homeless children (6 to 16 years old) currently residing in homeless shelters. Transcriptions of the audio-taped interviews were analysed following Colaizzi's method of analysis. Transcript statements were compared with the drawings. Five themes representing hope emerged from the data: connectedness, internal resources, cognitive strategies, energy, and hope objects. School age children drew story book tale characters, pre-adolescents drew real life situations, and adolescents drew future plans to represent their hopes. An understanding of hope from the perspective of homeless children could provide a basis upon which to develop interventions that engender hope and to develop programmes that build on the hopes that children had already developed.

Involving homeless persons in the leadership of a health care organization.

PubMed

Buck, David S; Rochon, Donna; Davidson, Harriett; McCurdy, Sheryl

2004-04-01

Consumer advisory boards (CABs) are a way of involving patients in their health care. To engage the homeless in the administration of a health care organization for the homeless, a service agency formed such a board comprising homeless and formerly homeless individuals. The purpose was to integrate experiences of homelessness into programmatic design and research efforts of the organization, and to promote participatory research among the homeless. A content analysis and member checking revealed four distinct themes relating to committee goals, identity definition, power, and issues and needs of the homeless. Findings indicate that participatory research provided a useful structure in which the CAB could improve self-sufficiency and self-efficacy, and contribute to the direction of the health care agency.

The impact of economic downturns and budget cuts on homelessness claim rates across 323 local authorities in England, 2004-12.

PubMed

Loopstra, Rachel; Reeves, Aaron; Barr, Ben; Taylor-Robinson, David; McKee, Martin; Stuckler, David

2016-09-01

It is unclear why rates of homelessness claims in England have risen since 2010. We used variations in rates across local authorities to test the impact of economic downturns and budget cuts. Using cross-area fixed effects models of data from 323 UK local authorities between 2004 and 2012, we evaluated associations of changes in statutory homelessness rates with economic activity (Gross Value Added per capita), unemployment, and local and central government expenditure. Each 10% fall in economic activity was associated with an increase of 0.45 homelessness claims per 1000 households (95% CI: 0.10-0.80). Increasing rates of homelessness were also strongly linked with government reductions in welfare spending. Disaggregating types of welfare expenditure, we found that strongest associations with reduced homelessness claims were spending on social care, housing services, discretionary housing payments and income support for older persons. Recession and austerity measures are associated with significant increases in rates of homelessness assistance. These findings likely understate the full burden of homelessness as they only capture those who seek aid. Future research is needed to investigate what is happening to vulnerable groups who may not obtain assistance, including those with mental health problems and rough sleepers. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health.

Local Homeless Education Liaisons: Important Information for New Liaisons. Best Practices in Homeless Education Brief Series

ERIC Educational Resources Information Center

National Center for Homeless Education at SERVE, 2015

2015-01-01

Homeless children and youth experience many challenges in enrolling and attending school and achieving educational success. The McKinney-Vento Homeless Assistance Act (reauthorized under Title X, Part C of the No Child Left Behind Act of 2001, and subsequently referred to as the McKinney-Vento Act in this brief) ensures rights and services for…

Supporting Children and Families Experiencing Homelessness: CCDF State Guide

ERIC Educational Resources Information Center

Bires, Carie; Garcia, Carmen; Zhu, Julia

2015-01-01

Homelessness has a devastating impact on children. Research has shown that homelessness puts children at increased risk of health problems, developmental delays, academic underachievement and mental health problems. Homelessness also has a disproportionate impact on the youngest children, who account for more than half of all children in…

Down and Out in London: Addictive Behaviors in Homelessness

PubMed Central

Sharman, Steve; Dreyer, Jenny; Clark, Luke; Bowden-Jones, Henrietta

2016-01-01

Backgrounds and aims Problem gambling occurs at higher levels in the homeless than the general population. Past work has not established the extent to which problem gambling is a cause or consequence of homelessness. This study sought to replicate recent observations of elevated rates of problem gambling in a British homeless sample, and extend that finding by characterizing (a) the temporal sequencing of the effect, (b) relationships with drug and alcohol misuse, and (c) awareness and access of treatment services for gambling by the homeless. Methods We recruited 72 participants from homeless centers in Westminster, London, and used the Problem Gambling Severity Index to assess gambling involvement, as well as DSM-IV criteria for substance and alcohol use disorders. A life-events scale was administered to establish the temporal ordering of problem gambling and homelessness. Results Problem gambling was evident in 23.6% of the sample. In participants who endorsed any gambling symptomatology, the majority were categorized as problem gamblers. Within those problem gamblers, 82.4% indicated that gambling preceded their homelessness. Participants displayed high rates of substance (31.9%) and alcohol dependence (23.6%); these were not correlated with PGSI scores. Awareness of treatment for gambling was significantly lower than for substance and alcohol use disorders, and actual access of gambling support was minimal. Discussion and conclusions Problem gambling is an under-recognized health issue in the homeless. Our observation that gambling typically precedes homelessness strengthens its role as a causal factor. Despite the elevated prevalence rates, awareness and utilization of gambling support opportunities were low compared with services for substance use disorders. PMID:27348556

Young Children and Families Experiencing Homelessness

ERIC Educational Resources Information Center

Wilson, Allison B.; Squires, Jane

2014-01-01

The increasing prevalence of homelessness among young children and families in the United States is described, as is the developmental impact on young children and cost to society. Although services are mandated for this population under the McKinney­-Vento Act, Education of Homeless Children and Youth Program, and the Individuals With…

Viral hepatitis in a homeless shelter in Hawai'i.

PubMed

Boyce, Daniel E C; Tice, Alan D; Ona, Fernando V; Akinaka, Kenneth T; Lusk, Heather

2009-06-01

It is estimated that as many as 21,000 people in the state of Hawai'i may be infected with HCV Most of those infected with viral hepatitis are unaware they are infected. Complications from viral hepatitis include liver cirrhosis and hepatocellular carcinoma. Hawai'i has the highest incidence of hepatocellular carcinoma in the United States. In 2003 there were over 6000 homeless and over 155,000 people at-risk of becoming homeless living in the state of Hawai'i. Risk factors for hepatitis, such as drug use, tattoos, sexual contact, and sharing of personal hygiene equipment are more prevalent in the homeless population. To determine the incidence of hepatitis B and C among a population of homeless individuals, a health fair was held at a Honolulu area homeless shelter with approximately 200 residents. The incidence of hepatitis B and C was determined by anti-HCV and HBsAg blood tests. A survey was also conducted regarding risk factors and basic demographics. Fifty-nine homeless adults volunteered for testing and took the survey. Thirty-one (52%) volunteers were born in Micronesia, twenty-four (41%) were born in the United States, two (3%) were born in Samoa, one (2%) was born in the Philippines, and one (2%) was born in the Marshall Islands. Forty adults were tested for Hepatitis C antibody, three of which tested positive. The primary risk factor among this group was jail time (100%), followed by illegal drug injection (67%), tattoos (67%), ear/body piercing (67%), snorting drugs (33%), blood transfusions (33%), and a sex partner with hepatitis (33%). Forty adults were also tested for HBsAg, One of which tested positive. This was a recent immigrant from Micronesia. Homeless people in Hawai'i are more likely to have hepatitis B or C because risk factors are common among this population. Additionally a large proportion of Hawai'i's homeless people come from the Pacific Islands, where the prevalence of hepatitis B is one of the highest in the world. In addition there

Chronic Bartonella quintana bacteremia in homeless patients.

PubMed

Brouqui, P; Lascola, B; Roux, V; Raoult, D

1999-01-21

Infection with Bartonella quintana can cause trench fever, endocarditis, bacillary angiomatosis, and peliosis. An outbreak of bacteremia due to B. quintana has been reported among homeless people in Seattle, and the seroprevalence is high among homeless people in both the United States and Europe. Body lice are known to be the vectors of B. quintana. We studied all the homeless people who presented in 1997 to the emergency departments of the University Hospital, Marseilles, France. Blood was collected for microimmunofluorescence testing for antibodies against B. quintana and for culture of the bacterium. Body lice were collected and analyzed by the polymerase chain reaction and sequencing of a portion of the citrate synthase gene of B. quintana. In 10 of 71 homeless patients (14 percent), blood cultures were positive for B. quintana, and 21 of the patients (30 percent) had high titers of antibody against the organism. A total of 17 patients (24 percent) had evidence of recent infection (bacteremia or seroconversion). Tests of lice from 3 of the 15 patients from whom they were collected were positive for B. quintana. The homeless people with B. quintana bacteremia were more likely to have been exposed to lice (P=0.002), were more likely to have headaches (P=0.03) and severe leg pain (P<0.001), and had lower platelet counts (P=0.006) than the homeless people who were seronegative for B. quintana and did not have bacteremia; 8 of the 10 patients with bacteremia were afebrile. Five patients had chronic bacteremia, as indicated by positive blood cultures over a period of several weeks. In an outbreak of urban trench fever among homeless people in Marseilles, B. quintana infections were associated with body lice in patients with nonspecific symptoms or no symptoms.

The U.S. Homeless Student Population: Homeless Youth Education, Review of Research Classifications and Typologies, and the U.S. Federal Legislative Response

ERIC Educational Resources Information Center

Rahman, Mai Abdul; Turner, J. Fidel; Elbedour, Salman

2015-01-01

Background: The drastic surge in the number of homeless families in the United States (U.S.) has resulted in an increase in the number of homeless students attending U.S. public schools. Meanwhile, the U.S. public school system is struggling to meet the educational needs of their homeless students. Objective: This study examined the historical…

[A Street Clinic in a state capital in Northeast Brazil from the perspective of homeless people].

PubMed

Ferreira, Cíntia Priscila da Silva; Rozendo, Célia Alves; Melo, Givânya Bezerra de

2016-08-08

The objective of this study was to evaluate the Street Clinic strategy in Maceió, Alagoas State, Brazil, from the perspective of its users. This was a qualitative study in coverage areas of the Street Clinic in Maceió. Research subjects were 18 homeless individuals assisted by the clinic (10 men and 8 women), ranging from 20 to 40 years of age. Data were collected from September 2014 to February 2015 using a semi-structured interview. Content analysis was applied to the data and identified two categories: the first, the Street Clinic as such, revealed the strategy's critical points, challenges, and potentialities; the second showed the Street Clinic as social support, affect, and hope for change for the homeless. The strategy was rated positively by users, providing social support on health problems and other daily issues.

A Review of the Literature on LGBTQ Adults Who Experience Homelessness.

PubMed

Ecker, John; Aubry, Tim; Sylvestre, John

2017-12-05

Little is known about lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults who experience homelessness. The current review critically analyzes the scant literature on LGBTQ adults who experience homelessness, with a particular focus on: (1) pathways into homelessness; (2) support needs; (3) targeted programming; and (4) exits out of homelessness. A total of 143 articles were identified, and 16 articles met the criteria of appropriate age range, article quality, and relevance of topic. Results from this review demonstrate that homeless LGBTQ adults have unique physical and mental health challenges, largely concerning HIV and substance use. Transgender and gender non-conforming adults who experience homelessness encounter several challenges in the homelessness system, particularly in regard to safety and gender-affirming supports. Recommendations focus on practical implications for support and suggestions for future research.

Homeless Adolescents' Perceptions of Positive Development: A Comparative Study

ERIC Educational Resources Information Center

Nott, Brooke Dolenc; Vuchinich, Samuel

2016-01-01

Background: While some recent research has addressed homeless youth from a strengths-based approach, comparative studies of homeless and non-homeless youth from a strengths perspective are few; research that includes youth's views on positive youth development are also limited. Objective: Addressing these gaps and using an inductive approach,…

Employment and Other Income Sources Among Homeless Youth.

PubMed

Slesnick, Natasha; Zhang, Jing; Yilmazer, Tansel

2018-05-12

Homeless youth report high rates of unemployment. While homeless serving agencies usually offer employment services, most homeless youth are disengaged from homeless service agencies, and a limited number of studies have examined employment and other income sources among service disconnected youth. Our study examined income sources and change in income among service disconnected youth, all of whom received Strengths-Based Outreach and Advocacy (SBOA, N = 79). Findings revealed that over time employment and legal income from non-survival behaviors increased (e.g., governmental assistance and receiving income from friends and relatives), while income from survival behaviors decreased (e.g., prostitution, stealing, selling possessions, selling blood or plasma). Although unemployment among these youth remained high (62%), income from survival behaviors reduced most drastically. Findings also suggest that employment is linked to housing stability and mental health, as is substance use and income, which suggests that mental health, housing, and substance use treatment services are important components in income stabilization for homeless youth.

Occupation-based practices and homelessness: A scoping review.

PubMed

Roy, Laurence; Vallée, Catherine; Kirsh, Bonnie H; Marshall, Carrie Anne; Marval, Rebecca; Low, Alissa

2017-04-01

Persons experiencing or at risk of homelessness have occupational needs that are seldom addressed in the Canadian system of care. The lack of documented evidence on occupational therapy practices in this field hinders the development of the profession. This article identifies current and potential practices that aim to enable or support the occupations of persons experiencing or at risk of homelessness. A scoping review was conducted, including evidence from both occupational therapy and non-occupational therapy sources. One hundred and seventy-eight papers were selected in the areas of occupational performance skills training, enrichment of occupational repertoire, employment/education, physical rehabilitation services, child/family services, community building, occupational transition from homeless to housed, literacy, and disaster relief. Occupational therapists can build environments and create opportunities that facilitate occupational engagement of individuals experiencing homelessness. Gaps in knowledge include the evaluation of occupational therapy practices, the Canadian context of family homelessness, and the cultural safety of occupational therapy interventions.

Unsheltered Homelessness Among Veterans: Correlates and Profiles.

PubMed

Byrne, Thomas; Montgomery, Ann Elizabeth; Fargo, Jamison D

2016-02-01

We identified correlates of unsheltered status among Veterans experiencing homelessness and described distinct subgroups within the unsheltered homeless Veteran population using data from a screening instrument for homelessness that is administered to all Veterans accessing outpatient care at a Veterans Health Administration (VHA) facility. Correlates of unsheltered homelessness included male gender, white race, older age, lower levels of VHA eligibility, substance use disorders, frequent use of VHA inpatient and infrequent use of VHA outpatient services, and residing in the West. We identified six distinct subgroups of unsheltered Veterans; the tri-morbid frequent users represented the highest need group, but the largest group was comprised of Veterans who made highly infrequent use of VHA healthcare services. Differences between sheltered and unsheltered Veterans and heterogeneity within the unsheltered Veteran population should be considered in targeting housing and other interventions.

Understanding pregnancy-related attitudes and behaviors: a mixed-methods study of homeless youth.

PubMed

Tucker, Joan S; Sussell, Jesse; Golinelli, Daniela; Zhou, Annie; Kennedy, David P; Wenzel, Suzanne L

2012-12-01

Pregnancy rates are substantially higher among homeless youth than in the general population of youth, yet little is known about homeless adolescents' and young adults' pregnancy-related attitudes and behaviors. Pregnancy-related attitudes and behaviors were examined among two samples of sexually active homeless 13-24-year-olds in Los Angeles County. Data from 37 semistructured interviews conducted in March-April 2011 were analyzed using standard qualitative methods. Data from a structured survey with 277 respondents, conducted between October 2008 and August 2009, were analyzed primarily using regression modeling. More than half of interview respondents held ambivalent attitudes toward pregnancy, and ambivalent youth reported less contraceptive use than others. The interviews identified several potential influences on pregnancy attitudes: barriers associated with homelessness, readiness to settle down, desire to achieve goals, belief that a child would create something positive in life, and family and partners. In the survey, having positive attitudes toward pregnancy was positively associated with duration of homelessness (odds ratio, 1.6), contact with relatives (1.1) and relationship commitment (1.8); it was negatively associated with frequency of drinking (0.9). Relationship commitment was positively associated with nonuse of an effective contraceptive method at last sex (1.5). Effective and accessible pregnancy prevention and family planning programs for homeless youth are needed. Youths' ambivalence toward pregnancy and feelings of relationship commitment warrant attention as possible areas for programs to address. Copyright © 2012 by the Guttmacher Institute.

Understanding Pregnancy-Related Attitudes and Behaviors: A Mixed-Methods Study of Homeless Youth

PubMed Central

Tucker, Joan S.; Sussell, Jesse; Golinelli, Daniela; Zhou, Annie; Kennedy, David P.; Wenzel, Suzanne L.

2012-01-01

CONTEXT Pregnancy rates are substantially higher among homeless youth than in the general population of youth, yet little is known about homeless adolescents’ and young adults’ pregnancy-related attitudes and behaviors. METHODS Pregnancy-related attitudes and behaviors were examined among two samples of sexually active homeless 13–24-year-olds in Los Angeles County. Data from 37 semistructured interviews conducted in March–April 2011 were analyzed using standard qualitative methods. Data from a structured survey with 277 respondents, conducted between October 2008 and August 2009, were analyzed primarily using regression modeling. RESULTS More than half of interview respondents held ambivalent attitudes toward pregnancy, and ambivalent youth reported less contraceptive use than others. The interviews identified several potential influences on pregnancy attitudes: barriers associated with homelessness, readiness to settle down, desire to achieve goals, belief that a child would create something positive in life, and family and partners. In the survey, having positive attitudes toward pregnancy was positively associated with duration of homelessness (odds ratio, 1.6), contact with relatives (1.1) and relationship commitment (1.8); it was negatively associated with frequency of drinking (0.9). Relationship commitment was positively associated with nonuse of an effective contraceptive method at last sex (1.5). CONCLUSIONS Effective and accessible pregnancy prevention and family planning programs for homeless youth are needed. Youths’ ambivalence toward pregnancy and feelings of relationship commitment warrant attention as possible areas for programs to address. PMID:23231333

The Relationship between Literacy and Depression and Anxiety in Homeless Adults

ERIC Educational Resources Information Center

Holland, Mark Edward

2014-01-01

Homelessness is a problem that has correlating social, psychological, and health problems. The pathways that lead to homelessness are plentiful and varied, as are the risk factors that are associated with chronic homelessness. Much of the research that has been completed with homeless individuals has focused on substance use or psychological…

Youth Homelessness: The Impact of Supportive Relationships on Recovery.

PubMed

Gasior, Sara; Forchuk, Cheryl; Regan, Sandra

2018-03-01

Background Homeless youth are the fastest growing sub-group within the homeless population. They face impaired access to health services and are often left unsupported. They lack social and family support or relationships with service providers. Unsupported homeless youth often become homeless adults. Purpose To test a model based on Peplau's Theory of Interpersonal Relations, examining the influence of a network of service providers, perceptions of social supports, and family relations on a homeless youth's perceptions of recovery. Methods This study is a secondary analysis and used a sample (n = 187) of data collected as part of the original Youth Matters in London study. A cross-sectional design was used to analyze the relationship between variables. Participants were interviewed at 6-month intervals over a 2.5-year period. Hierarchical multiple regression analysis was used. Results Network of service providers, perceived social supports, and perceived family relations explained 21.8% of the variance in homeless youth perceptions of recovery. Perceived social support and family relations were significantly, positively correlated to perceptions of recovery. Network of service providers was not significantly correlated to perceptions of recovery. Conclusions The findings suggest that stronger social supports and family relations may contribute to increased perceptions of recovery among homeless youth.

Homeless Housing: HUD's Shelter Programs. Updated.

ERIC Educational Resources Information Center

Vanhorenbeck, Susan M.

This paper briefly discusses new housing programs for the homeless sponsored by the Department of Housing and Urban Development (HUD), the funding provided by the 100th Congress, and two additional HUD programs to aid the homeless. The following four programs are discussed: (1) the Emergency Shelter Program; (2) the Transitional Housing Program,…

The Multi-Dimensional Lives of Children Who Are Homeless

ERIC Educational Resources Information Center

Grineski, Steve

2014-01-01

It is widely reported that children who are homeless are victimized by overwhelming challenges like poverty and ill-advised policy decisions, such as underfunding the McKinney-Vento Homeless Assistance Act. This act is the only federal legislation devoted to this marginalized group. Children who are homeless, however, should not be characterized…

Crossing the Threshhold: Successful Learning Provision for Homeless People.

ERIC Educational Resources Information Center

Cameron, Helen; McKaig, Wendy; Taylor, Sue

This guide tells the story of a successful collaboration between The City Literary Institute and homelessness agencies to create an arts-based learning program for homeless people in central London. It identifies guidelines and good practice to stimulate similar work in other locations with problems of homelessness and rough sleeping. The guide is…

Housing Retention in Single-Site Housing First for Chronically Homeless Individuals With Severe Alcohol Problems

PubMed Central

Malone, Daniel K.; Clifasefi, Seema L.

2013-01-01

Objectives. We studied housing retention and its predictors in the single-site Housing First model. Methods. Participants (n = 111) were chronically homeless people with severe alcohol problems who lived in a single-site Housing First program and participated in a larger nonrandomized controlled trial (2005–2008) conducted in Seattle, Washington. At baseline, participants responded to self-report questionnaires assessing demographic, illness burden, alcohol and other drug use, and psychiatric variables. Housing status was recorded over 2 years. Results. Participants were interested in housing, although a sizable minority did not believe they would be able to maintain abstinence-based housing. Only 23% of participants returned to homelessness during the 2-year follow-up. Commonly cited risk factors—alcohol and other drug use, illness burden, psychiatric symptoms, and homelessness history—did not predict resumed homelessness. Active drinkers were more likely to stay in this housing project than nondrinkers. Conclusions. We found that single-site Housing First programming fills a gap in housing options for chronically homeless people with severe alcohol problems. PMID:24148063

Previous Homelessness as a Risk Factor for Recovery from Serious Mental Illnesses.

PubMed

Castellow, Jennifer; Kloos, Bret; Townley, Greg

2015-08-01

This paper argues that the experience of homelessness is inherently traumatic and thus has the potential to affect the manifestation of mental illness. The experiences related to being homeless might act as specific and unique sources of vulnerability. This study included 424 people diagnosed with serious mental illnesses living in supported housing programs in South Carolina. Three hierarchical regression analyses measuring the impact of homelessness on three types of outcomes revealed the following: (1) ever experiencing homelessness as well as the amount of time spent homeless were related to higher levels of psychiatric distress, (2) ever experiencing homelessness was related to higher levels of reported alcohol use, and (3) total amount of time spent homeless was related to lower perceived recovery from mental illness. These findings suggest that experiencing homelessness might contribute to psychosocial vulnerability to negative mental health outcomes. Future investigations examining this concept of risk and vulnerability as a result of homelessness are in order.

Aging on the Street: Homeless Older Adults in America.

PubMed

Sorrell, Jeanne M

2016-09-01

Older adults are at greater risk for homelessness today than at any time in recent history. Approximately one half of homeless individuals in America are older than 50, which has created serious challenges for how cities, governments, and health care providers care for homeless populations. Systems established in the 1980s to help care for homeless individuals were not designed to address problems of aging. It is critical that nurses and all health professionals have a better understanding of the unique needs and concerns of homeless older adults. Nurses can be an important part of the solution, not only through direct patient care but by advocating for improvements in care for this vulnerable population. [Journal of Psychosocial Nursing and Mental Health Services, 54(9), 25-29.]. Copyright 2016, SLACK Incorporated.

The association of military discharge variables with smoking status among homeless Veterans.

PubMed

Hammett, Patrick; Fu, Steven S; Lando, Harry A; Owen, Greg; Okuyemi, Kolawale S

2015-12-01

There is a dearth of research examining the health correlates of tobacco use within the homeless population, particularly with respect to homeless Veterans. An aim of the present study was to compare homeless Veteran and homeless non-Veteran smokers across a series of socio-demographic and health variables, and to determine whether any of these variables were independently associated with Veteran status. A subsequent aim was to compare the socio-demographic and health profiles of Veteran smokers and Veteran nonsmokers, and to determine whether any of these variables were independently associated with current smoking. Data were obtained from the 2009 Homelessness in Minnesota survey conducted by the Wilder Research Foundation. The final sample included 4750 homeless individuals living throughout Minnesota. The prevalence of smoking was greater among homeless Veterans (74%) than homeless non-Veterans (70%). The prevalence of physical and mental health problems was higher among homeless Veteran smokers than homeless non-Veteran smokers, although these variables were not independently associated with Veteran status after controlling for socio-demographics. Analyses of the homeless Veteran sample indicated that receipt of Veterans' benefits, type of discharge, and alcohol and/or chemical dependence were independently associated with current smoking. Homeless Veteran smokers exhibit heightened rates of physical and mental health problems compared to homeless non-Veteran smokers. Military service and discharge characteristics may contribute to this high smoking prevalence. Future efforts should focus on increasing Veterans' access to and knowledge of Veterans' health resources, and on developing innovative strategies to boost cessation in this population. Copyright © 2015 Elsevier Inc. All rights reserved.

Multilevel Considerations of Family Homelessness and Schooling in the Recession Era

ERIC Educational Resources Information Center

Miller, Peter; Schreiber, James

2012-01-01

This mixed methods investigation of homeless education in a major urban region identified a number of significant developments and dilemmas amid the larger homeless crisis in the United States. We found that the wider community demographics of homelessness have shifted in recent years, resulting in a higher number of homeless families--many of…

Activity patterns of elderly men and women.

PubMed

Sidney, K H; Shephard, R J

1977-01-01

The activity patterns of elderly men and women (greater than 60 years) were examined by diaries, ECG taperecorders, and electro-chemical integrators. Although the subjects thought that they were active relative to others of their age, both activity measurements and initial assessments of fitness indicated an inactive life style. At different periods of the day, the heart rate averaged 70-90 beats per minute, and the physical training threshold was rarely approached. During the week, the women engaged in 90 min. more physical activity than the men. However, at the weekend the men added an average of 100 min. of physical activity, whereas the women carried out 30 min. less physical work. Introduction of a 1-hour physical activity class four times per week increased the average daily energy expenditure by 150-200 kCal, to 2500 kCal in the men and 2200 kCal in the women. The added activity was sufficient to augment aerobic power, to induce favorable changes in body composition and to initiate change in other areas of life style, including a diminished use of the car.

Homeless Children in America: Challenges for the 1990s.

ERIC Educational Resources Information Center

Rafferty, Yvonne

The 1980s brought an unprecedented rise in the number of homeless families with children. That there may be as many as three million homeless persons in the United States, with families representing one-third of this population, indicates that homelessness is a social problem of catastrophic proportions. This paper finds that while Federal…

Unaccompanied, Unidentified and Uncounted: Developing Strategies to Meet the Needs of America's Homeless Youth. Issue Brief on the Education of Unaccompanied Homeless Youth

ERIC Educational Resources Information Center

Appleseed, 2012

2012-01-01

Unaccompanied homeless youth appear to be one of the fastest growing and most vulnerable segments of the larger homeless population, but flawed information-gathering by government entities makes it impossible to be sure. This issue brief examines reasons why the plight of unaccompanied homeless youth is not fully captured through current models of…

Homelessness and Money Mismanagement in Iraq and Afghanistan Veterans

PubMed Central

Sullivan, Connor P.; Wolfe, James; Wagner, Henry Ryan; Beckham, Jean C.

2013-01-01

Objectives. We examined the empirical link between money mismanagement and subsequent homelessness among veterans. Methods. We used a random sample of Iraq and Afghanistan War era veterans from the National Post-Deployment Adjustment Survey in 2009–2011. Results. Veterans were randomly selected from a roster of all US military service members in Operation Iraqi Freedom or Operation Enduring Freedom who were separated from active duty or in the Reserves/National Guard. Veterans (n = 1090) from 50 states and all military branches completed 2 waves of data collection 1 year apart (79% retention rate). Thirty percent reported money mismanagement (e.g., bouncing or forging a check, going over one’s credit limit, falling victim to a money scam in the past year). Multivariate analysis revealed money mismanagement (odds ratio [OR] = 4.09, 95% CI = 1.87, 8.94) was associated with homelessness in the next year, as were arrest history (OR = 2.65, 95% CI = 1.33, 5.29), mental health diagnosis (OR = 2.59, 95% CI = 1.26, 5.33), and income (OR = 0.30, 95% CI = 0.13, 0.71). Conclusions. Money mismanagement, reported by a substantial number of veterans, was related to a higher rate of subsequent homelessness. The findings have implications for policymakers and clinicians, suggesting that financial education programs offered by the US Departments of Defense and Veterans Affairs may be targeted to effectively address veteran homelessness. PMID:24148067

Homelessness, Poverty, and Children's Literacy Development

ERIC Educational Resources Information Center

Walker-Dalhouse, Doris; Risko, Victoria J.

2008-01-01

Over 100 million families worldwide lack permanent housing or income sufficient to meet their basic needs. Some homeless children are able to succeed in school despite the many challenges they face, but others are not. Seventy-five percent of U.S. homeless children perform below grade level in reading, and schools and teachers may not be prepared…

The impact of economic downturns and budget cuts on homelessness claim rates across 323 local authorities in England, 2004–12

PubMed Central

Loopstra, Rachel; Reeves, Aaron; Barr, Ben; Taylor-Robinson, David; McKee, Martin; Stuckler, David

2016-01-01

Background It is unclear why rates of homelessness claims in England have risen since 2010. We used variations in rates across local authorities to test the impact of economic downturns and budget cuts. Methods Using cross-area fixed effects models of data from 323 UK local authorities between 2004 and 2012, we evaluated associations of changes in statutory homelessness rates with economic activity (Gross Value Added per capita), unemployment, and local and central government expenditure. Results Each 10% fall in economic activity was associated with an increase of 0.45 homelessness claims per 1000 households (95% CI: 0.10–0.80). Increasing rates of homelessness were also strongly linked with government reductions in welfare spending. Disaggregating types of welfare expenditure, we found that strongest associations with reduced homelessness claims were spending on social care, housing services, discretionary housing payments and income support for older persons. Conclusions Recession and austerity measures are associated with significant increases in rates of homelessness assistance. These findings likely understate the full burden of homelessness as they only capture those who seek aid. Future research is needed to investigate what is happening to vulnerable groups who may not obtain assistance, including those with mental health problems and rough sleepers. PMID:26364320

HIV seroprevalence among orphaned and homeless youth: no place like home.

PubMed

Hillis, Susan D; Zapata, Lauren; Robbins, Cheryl L; Kissin, Dmitry M; Skipalska, Halyna; Yorick, Roman; Finnerty, Erin; Marchbanks, Polly A; Jamieson, Denise J

2012-01-02

We evaluated the combined influences of orphaned status and homelessness on HIV seroprevalence and risk among street-involved Ukrainian youth in 2008. Systematic, multicity, community-based, cross-sectional assessment. Time-location sampling was used to identify eligible youth aged 15-24 after city-wide mapping of 91 sites where street-involved youth gathered in Odessa, Kiev, and Donetsk. Universal sampling identified 961 youth in 74 randomly selected sites; 97% consented. Youth reporting one or both parents dead were classified as orphaned; those without a stable residence or sleeping outside their residence at least two nights per week were classified as homeless. Trained staff provided HIV counseling and rapid testing via mobile vans. Adjusted odds ratios (AORs) were calculated using logistic regression, accounting for intracluster homogeneity. We found 32% (300 of 929) were both orphaned and homeless; 48% either (but not both) homeless [37% (343 of 929)] or orphaned [11% (104 of 929)]; and [20% (182 of 929)] neither orphaned nor homeless. HIV seroprevalences were 7% for neither orphaned/homeless; 16 and 17%, respectively, for either orphaned/homeless; 28% for both orphaned/homeless (P for trend <0.0001). AORs for HIV infection were 1 for neither; 2.3 and 2.4 for either homeless [95% confidence interval (CI) 1.7-2.9] or orphaned (CI 1.8-3.3); 3.3 for both orphaned/homeless (CI 2.3-4.4). Ever-use of injection drugs increased from 15 to 32 to 48% for those who neither, either, or both orphaned and homeless, respectively (P for trend <0.0001). One of four youths who were both homeless and orphaned was HIV-infected; these youths were significantly more likely to be HIV infected and to report injection drug use than those with adequate housing and living parents.

Education Rights of Homeless Students: A Guide for Advocates

ERIC Educational Resources Information Center

Education Law Center, 2005

2005-01-01

There is no question that students who are homeless, like all students, are entitled to be educated. A federal law, known as the McKinney-Vento Homeless Assistance Act, requires states to provide homeless children and youth with the same access to free public education as is available to other students. The Act also requires states to eliminate…

The potential impacts of the homeless on public lands

Treesearch

Sidney M. Blumner; Carolyn M. Daugherty

1995-01-01

The multidimensional problem of the homeless population in San Bernardino and nearby counties in California is examined and its impacts on adjacent public lands. The characteristics of the homeless in the area are described, as well as possible implications of this population for public lands use. Issues related to the homeless population are examined, such as...

Diagnoses Treated in Ambulatory Care Among Homeless-Experienced Veterans

PubMed Central

Gabrielian, Sonya; Yuan, Anita H.; Andersen, Ronald M.; Gelberg, Lillian

2016-01-01

Purpose: Little is known about how permanent supported housing influences ambulatory care received by homeless persons. To fill this gap, we compared diagnoses treated in VA Greater Los Angeles (VAGLA) ambulatory care between Veterans who are formerly homeless—now housed/case managed through VA Supported Housing (“VASH Veterans”)—and currently homeless. Methods: We performed secondary database analyses of homeless-experienced Veterans (n = 3631) with VAGLA ambulatory care use from October 1, 2010 to September 30, 2011. We compared diagnoses treated—adjusting for demographics and need characteristics in regression analyses—between VASH Veterans (n = 1904) and currently homeless Veterans (n = 1727). Results: On average, considering 26 studied diagnoses, VASH (vs currently homeless) Veterans received care for more (P < .05) diagnoses (mean = 2.9/1.7). Adjusting for demographics and need characteristics, VASH Veterans were more likely (P < .05) than currently homeless Veterans to receive treatment for diagnoses across categories: chronic physical illness, acute physical illness, mental illness, and substance use disorders. Specifically, VASH Veterans had 2.5, 1.7, 2.1, and 1.8 times greater odds of receiving treatment for at least 2 condition in these categories, respectively. Among participants treated for chronic illnesses, adjusting for predisposing and need characteristics, VASH (vs currently homeless) Veterans were 9%, 8%, and 11% more likely to have 2 or more visits for chronic physical illnesses, mental illnesses, and substance use disorder, respectively. Conclusion: Among homeless-experienced Veterans, permanent supported housing may reduce disparities in the treatment of diagnoses commonly seen in ambulatory care. PMID:27343544

A Sort of Homecoming: Incarceration and the housing security of urban men

PubMed Central

Curtis, Marah A.

2011-01-01

While individuals returning from prison face many barriers to successful re-entry, among the most serious are the challenges they face in securing housing. Housing has long been recognized as a prerequisite for stable employment, access to social services, and other aspects of individual and family functioning. The formerly incarcerated face several administrative and de facto restrictions on their housing options; however, little is known about the unique instabilities that they face. We use a longitudinal survey of urban families to examine housing insecurity among nearly 3,000 urban men, including over 1,000 with incarceration histories. We find that men recently incarcerated face greater housing insecurity, including both serious hardships such as homelessness, and precursors to homelessness such as residential turnover and relying on others for housing expenses. Their increased risk is tied both to diminished annual earnings and other factors, including, potentially, evictions from public housing supported by Federal “one-strike” policies. PMID:21927519

Use of outpatient mental health services by homeless veterans after hurricanes.

PubMed

Brown, Lisa M; Barnett, Scott; Hickling, Edward; Frahm, Kathryn; Campbell, Robert R; Olney, Ronald; Schinka, John A; Casey, Roger

2013-05-01

Little is known about the impact of hurricanes on people who are homeless at the time a disaster occurs. Although researchers have extensively studied the psychosocial consequences of disaster produced homelessness on the general population, efforts focused on understanding how homeless people fare have been limited to a few media reports and the gray literature. In the event of a hurricane, homeless veterans may be at increased risk for negative outcomes because of their cumulative vulnerabilities. Health care statistics consistently document that homeless veterans experience higher rates of medical, emotional, substance abuse, legal, and financial problems compared with the general population. This study used the 2004 to 2006 Veterans Health Administration (VHA) Outpatient Medical Dataset to examine the effects of hurricanes on use of outpatient mental health services by homeless veterans. Homeless veterans residing in hurricane-affected counties were significantly more likely to participate in group psychotherapy (32.4% vs. 13.4%, p < .002), but less likely to participate in individual 30-40-min sessions with medical evaluations (3.5% vs. 17.3%, p < .001). The study findings have implications for homeless programs and the provision of VHA mental health services to homeless veterans postdisaster. PsycINFO Database Record (c) 2013 APA, all rights reserved.

The power of the drug, nature of support, and their impact on homeless youth.

PubMed

Hudson, Angela L; Nyamathi, Adeline; Slagle, Alexandra; Greengold, Barbara; Griffin, Deborah Koniak; Khalilifard, Farinaz; Gedzoff, Danny; Reid, Courtney

2009-10-01

The purpose of this study was to explore homeless youths' perspectives on the power of drugs in their lives, the preferred type of drugs used, barriers to treatment, and strategies to prevent drug initiation and abuse. This was a descriptive, qualitative study using focus groups with a purposeful sample of 24 drug-using homeless youth. The results provided insight into the lives of drug-using homeless youth. The most commonly used drugs were marijuana and alcohol. Reported reasons for drug use were parental drug use, low self-esteem, and harsh living conditions on the streets. Barriers to treatment were pleasurable enjoyment of the drug, physical dependence, and non-empathetic mental health providers. Strategies to prevent initiation and abuse of drugs were creative activities, such as art, sports, and music, and disdain for parental/family drug use and abuse. Comparative research is needed on specific personal factors that cause initiation and deterrence of drugs use/abuse among homeless youth.

The Power of the Drug, Nature of Support, and their Impact on Homeless Youth

PubMed Central

Hudson, Angela L.; Nyamathi, Adeline; Slagle, Alexandra; Greengold, Barbara; Griffin, Deborah Koniak; Khalilifard, Farinaz; Gedzoff, Danny; Reid, Courtney

2010-01-01

The purpose of this study was to explore homeless youths’ perspectives on the power of drugs in their lives, the preferred type of drugs used, barriers to treatment, and strategies to prevent drug initiation and abuse. This was a descriptive, qualitative study using focus groups with a purposeful sample of 24 homeless drug-using youth. The results provided insight into the lives of drug-using homeless youth. Most commonly-used drugs were marijuana and alcohol. Reported reasons for drug use were parental drug use, low self-esteem, and harsh living conditions on the streets. Barriers to treatment were pleasurable enjoyment of the drug, physical dependence, and non-empathetic mental health providers. Strategies to prevent initiation and abuse of drugs were creative activities, such as art, sports, and music, and disdain for parental/family drug use and abuse. Comparative research is needed on specific personal factors that cause initiation and deterrence of drugs use/abuse among homeless youth. PMID:20155605

From homeless to housed: caring for people in transition.

PubMed

Drury, Lin J

2008-01-01

This ethnographic study was conducted to determine what homeless people experience during the transition from street life into community housing. Data were gathered through participant observation at a program designed to secure housing and support services for homeless people upon discharge from a psychiatric hospital. Sixty homeless, mentally ill adults were followed from hospital discharge through their first 2 years in community housing. Homeless people interact with health care providers across a cultural divide produced by vast differences in their lived experiences. This cultural distance limits access to the services that these individuals require to achieve residential stability.

Internet and Social Media Access Among Youth Experiencing Homelessness: Mixed-Methods Study.

PubMed

VonHoltz, Lauren A Houdek; Frasso, Rosemary; Golinkoff, Jesse M; Lozano, Alicia J; Hanlon, Alexandra; Dowshen, Nadia

2018-05-22

homelessness. While experiencing homelessness, participants indicated their behaviors were more goal-oriented and less focused on leisure or entertainment activities. While homeless youth experience changes in the frequency, amount of time, and specific uses of the internet and social media, study participants were able to access the internet regularly. The internet was used to search health-related topics. Given the importance of smartphones in accessing the internet, mobile-optimized websites may be an effective method for reaching this group. ©Lauren A Houdek VonHoltz, Rosemary Frasso, Jesse M Golinkoff, Alicia J Lozano, Alexandra Hanlon, Nadia Dowshen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.05.2018.

Homelessness, Mental Health and Suicidality Among LGBTQ Youth Accessing Crisis Services.

PubMed

Rhoades, Harmony; Rusow, Joshua A; Bond, David; Lanteigne, Amy; Fulginiti, Anthony; Goldbach, Jeremy T

2018-01-10

LGBTQ youth experience increased risks of homelessness, mental health disorder symptoms, and suicidality. Utilizing data from LGBTQ youth contacting a suicide crisis services organization, this study examined: (a) rates of homelessness among crisis services users, (b) the relationship between disclosure of LGBTQ identity to parents and parental rejection and homelessness, and (c) the relationship between homelessness and mental health disorder outcomes and suicidality. A nationwide sample of LGBTQ youth was recruited for a confidential online survey from an LGBTQ-focused crisis services hotline. Overall, nearly one-third of youth contacting the crisis services hotline had experienced lifetime homelessness, and those who had disclosed their LGBTQ identity to parents or experienced parental rejection because of LGBTQ status experienced higher rates of homelessness. Youth with homelessness experiences reported more symptoms of several mental health disorders and higher rates of suicidality. Suggestions for service providers are discussed.

Racial Differences in Cigarette Smoking Among Homeless Youth.

PubMed

Golinelli, Daniela; Tucker, Joan S; Shadel, William G

2016-12-01

Several studies have reported pronounced racial/ethnic differences in smoking behavior among homeless youth. Better understanding the factors underlying racial/ethnic differences in daily smoking among homeless youth may help inform programs to reduce smoking in this population. Data come from a probability sample of homeless youth in Los Angeles County collected between 2008 and 2009. The sample includes 116 African American, 99 Hispanic, and 119 White youth with ages ranging from 13 to 24 years. Chi-square tests were used to test the differences in daily smoking among African American, Hispanic, and White youth. Propensity score and doubly robust methods were used to produce a less biased estimate of the association between daily smoking and race/ethnicity after having removed the effect of potential confounders. The daily smoking rate for White youth was 70.1%, more than 31 percentage points than the rates for either African American or Hispanic youth. Propensity score analysis revealed that the majority of the racial/ethnic differences in smoking rates could be explained by differences in homelessness severity, although background characteristics and comorbidity were relevant as well. As programs are developed to reduce smoking among homeless youth, results suggest that additional outreach may be needed to engage White youth in services. Also, smoking prevention programs may benefit from incorporating a social network-based approach that assists youth in fostering relationships with lower-risk peers, as well as addressing other forms of substance use. Incorporating these elements may help reduce the large racial/ethnic disparities in daily smoking among homeless youth. This report extends the small existing literature on racial/ethnic differences in smoking among homeless youth in two important respects. First, it confirms differences in daily smoking, an important indicator of dependence, across racial/ethnic groups. Second, it seeks to understand the extent

Community care for people who are homeless and mentally ill.

PubMed

Drury, Lin J

2003-05-01

This qualitative longitudinal study documents the experiences of 60 people who are homeless and mentally ill from their state mental hospital discharge through their first two years in community housing. The study explores the personal, cultural, and environmental contexts of life for adults who are homeless and mentally ill and examines the interaction between an individual's needs and community resources. The research identifies forces that perpetuate homelessness and traces the struggles that people who are homeless and mentally ill encounter during the transition from the streets to stable housing. The findings describe a culturally based pattern of mutual avoidance between homeless mentally ill clients and caregivers, which limits delivery of services to the population. Recommendations include development of alternative systems of care delivery, expansion of educational experiences with underserved populations, and increased funding for service or research with people who are homeless and mentally ill.

Engaging the Homeless Paranoid Patient

PubMed Central

Patel, Gayatri

2007-01-01

For people who are disenfranchised from society for other reasons, especially homelessness, a paranoid delusional system can create an additional obstacle in the therapeutic engagement and treatment of such individuals. In this article, we describe a composite case of a homeless woman with paranoid schizophrenia. Through this case example, we will explore various obstacles to treatment and discuss strategies to overcome these hurdles to treatment, initiate a therapeutic alliance, and further facilitate and maintain therapy. PMID:20526407

Homeless Status, Postdischarge Health Care Utilization, and Readmission After Surgery.

PubMed

Titan, Ashley; Graham, Laura; Rosen, Amy; Itani, Kamal; Copeland, Laurel A; Mull, Hillary J; Burns, Edith; Richman, Joshua; Kertesz, Stefan; Wahl, Tyler; Morris, Melanie; Whittle, Jeffery; Telford, Gordon; Wilson, Mark; Hawn, Mary

2018-06-01

Homeless Veterans are vulnerable to poor care transitions, yet little research has examined their risk of readmission following inpatient surgery. This study investigates the predictors of surgical readmission among homeless relative to housed Veteran patients. Inpatient general, vascular, and orthopedic surgeries occurring in the Veterans Health Administration from 2008 to 2014 were identified. Administrative International Classification of Diseases, Ninth Revision, Clinical Modification codes and Veterans Health Administration clinic stops were used to identify homeless patients. Bivariate analyses examined characteristics and predictors of readmission among homeless patients. Multivariate logistic models were used to estimate the association between homeless experience and housed patients with readmission following surgery. Our study included 232,373 surgeries: 43% orthopedic, 39% general, and 18% vascular with 5068 performed on homeless patients. Homeless individuals were younger (56 vs. 64 y, P<0.01), more likely to have a psychiatric comorbidities (51.3% vs. 19.4%, P<0.01) and less likely to have other medical comorbidities such as hypertension (57.1% vs. 70.8%, P<0.01). Homeless individuals were more likely to be readmitted [odds ratio (OR), 1.43; confidence interval (CI), 1.30-1.56; P<0.001]. Discharge destination other than community (OR, 0.57; CI, 0.44-0.74; P<0.001), recent alcohol abuse (OR, 1.45; CI, 1.15-1.84; P<0.01), and elevated American Society Anesthesiologists classification (OR, 1.86; CI, 1.30-2.68; P<0.01) were significant risk factors associated with readmissions within the homeless cohort. Readmissions are higher in homeless individuals discharged to the community after surgery. Judicious use of postoperative nursing or residential rehabilitation programs may be effective in reducing readmission and improving care transitions among these vulnerable Veterans. Relative costs and benefits of alternatives to community discharge merit

[Health and healthcare of homeless persons].

PubMed

Jackson, Yves; Wuillemin, Timothée; Bodenmann, Patrick

2016-10-05

Homelessness is a complex issue linked to poverty and structural conditions. It is increasing in Western countries with younger people and multiple generations being affected. Hard and unstable living conditions and inappropriate access to care predispose people to increase morbidity with poor health outcomes. This article reviews recent evidence about homeless health and strategies to improve health outcomes while harnessing societal benefits.

Predictors of Transience among Homeless Emerging Adults

ERIC Educational Resources Information Center

Ferguson, Kristin M.; Bender, Kimberly; Thompson, Sanna J.

2014-01-01

This study identified predictors of transience among homeless emerging adults in three cities. A total of 601 homeless emerging adults from Los Angeles, Austin, and Denver were recruited using purposive sampling. Ordinary least squares regression results revealed that significant predictors of greater transience include White ethnicity, high…

Homelessness in the Elementary School Classroom: Social and Emotional Consequences

ERIC Educational Resources Information Center

Chow, Kirby A.; Mistry, Rashmita S.; Melchor, Vanessa L.

2015-01-01

This study examined elementary school teachers' experiences working with homeless students. Specifically, we focused on the psychosocial impacts of homelessness on students and their teachers. Qualitative, semi-structured interviews were conducted with 28 teachers who worked at designated public schools for family homeless shelters. A prominent…

New to care: demands on a health system when homeless veterans are enrolled in a medical home model.

PubMed

O'Toole, Thomas P; Bourgault, Claire; Johnson, Erin E; Redihan, Stephen G; Borgia, Matthew; Aiello, Riccardo; Kane, Vincent

2013-12-01

We compared service use among homeless and nonhomeless veterans newly enrolled in a medical home model and identified patterns of use among homeless veterans associated with reductions in emergency department (ED) use. We used case-control matching with a nested cohort analysis to measure 6-month health services use, new diagnoses, and care use patterns in veterans at the Providence, Rhode Island, Veterans Affairs Medical Center from 2008 to 2011. We followed 127 homeless and 106 nonhomeless veterans. Both groups had similar rates of chronic medical and mental health diagnoses; 25.4% of the homeless and 18.1% of the nonhomeless group reported active substance abuse. Homeless veterans used significantly more primary, mental health, substance abuse, and ED care during the first 6 months. Homeless veterans who accessed primary care at higher rates (relative risk ratio [RRR] = 1.46; 95% confidence interval [CI] = 1.11, 1.92) or who used specialty and primary care (RRR = 10.95; 95% CI = 1.58, 75.78) had reduced ED usage. Homeless veterans in transitional housing or doubled-up at baseline (RRR = 3.41; 95% CI = 1.24, 9.42) had similar reductions in ED usage. Homeless adults had substantial health needs when presenting for care. High-intensity primary care and access to specialty care services could reduce ED use.

New to Care: Demands on a Health System When Homeless Veterans Are Enrolled in a Medical Home Model

PubMed Central

Bourgault, Claire; Johnson, Erin E.; Redihan, Stephen G.; Borgia, Matthew; Aiello, Riccardo; Kane, Vincent

2013-01-01

Objectives. We compared service use among homeless and nonhomeless veterans newly enrolled in a medical home model and identified patterns of use among homeless veterans associated with reductions in emergency department (ED) use. Methods. We used case–control matching with a nested cohort analysis to measure 6-month health services use, new diagnoses, and care use patterns in veterans at the Providence, Rhode Island, Veterans Affairs Medical Center from 2008 to 2011. Results. We followed 127 homeless and 106 nonhomeless veterans. Both groups had similar rates of chronic medical and mental health diagnoses; 25.4% of the homeless and 18.1% of the nonhomeless group reported active substance abuse. Homeless veterans used significantly more primary, mental health, substance abuse, and ED care during the first 6 months. Homeless veterans who accessed primary care at higher rates (relative risk ratio [RRR] = 1.46; 95% confidence interval [CI] = 1.11, 1.92) or who used specialty and primary care (RRR = 10.95; 95% CI = 1.58, 75.78) had reduced ED usage. Homeless veterans in transitional housing or doubled-up at baseline (RRR = 3.41; 95% CI = 1.24, 9.42) had similar reductions in ED usage. Conclusions. Homeless adults had substantial health needs when presenting for care. High-intensity primary care and access to specialty care services could reduce ED use. PMID:24148042

Voices from the street: exploring the realities of family homelessness.

PubMed

Gültekin, Laura; Brush, Barbara L; Baiardi, Janet M; Kirk, Keri; VanMaldeghem, Kelley

2014-11-01

Homelessness threatens the health and well-being of thousands of families in the United States, yet little is known about their specific needs and how current services address them. To fill this knowledge gap, we explored the experiences of homelessness families in Detroit, Michigan. We targeted homeless mothers and their caseworkers for study to see if the perceptions of needs and services were in alignment. Using focus groups and content analysis, we identified four overarching themes that illustrate homeless mothers' experience with homelessness. We then analyzed data from caseworkers to look specifically for similarities and differences in their perceptions. Key findings included reports of family histories of violence, poverty, social isolation, and a lack of informal support as contributing to homelessness. The differing perspectives of mothers and their caseworkers regarding how best to move forward highlight how current programs and services may not be meeting the needs of this growing and vulnerable cohort. © The Author(s) 2014.

Health Outcomes of Obtaining Housing Among Older Homeless Adults.

PubMed

Brown, Rebecca T; Miao, Yinghui; Mitchell, Susan L; Bharel, Monica; Patel, Mitkumar; Ard, Kevin L; Grande, Laura J; Blazey-Martin, Deborah; Floru, Daniella; Steinman, Michael A

2015-07-01

We determined the impact of obtaining housing on geriatric conditions and acute care utilization among older homeless adults. We conducted a 12-month prospective cohort study of 250 older homeless adults recruited from shelters in Boston, Massachusetts, between January and June 2010. We determined housing status at follow-up, determined number of emergency department visits and hospitalizations over 12 months, and examined 4 measures of geriatric conditions at baseline and 12 months. Using multivariable regression models, we evaluated the association between obtaining housing and our outcomes of interest. At 12-month follow-up, 41% of participants had obtained housing. Compared with participants who remained homeless, those with housing had fewer depressive symptoms. Other measures of health status did not differ by housing status. Participants who obtained housing had a lower rate of acute care use, with an adjusted annualized rate of acute care visits of 2.5 per year among participants who obtained housing and 5.3 per year among participants who remained homeless. Older homeless adults who obtained housing experienced improved depressive symptoms and reduced acute care utilization compared with those who remained homeless.

Health Outcomes of Obtaining Housing Among Older Homeless Adults

PubMed Central

Miao, Yinghui; Mitchell, Susan L.; Bharel, Monica; Patel, Mitkumar; Ard, Kevin L.; Grande, Laura J.; Blazey-Martin, Deborah; Floru, Daniella; Steinman, Michael A.

2015-01-01

Objectives. We determined the impact of obtaining housing on geriatric conditions and acute care utilization among older homeless adults. Methods. We conducted a 12-month prospective cohort study of 250 older homeless adults recruited from shelters in Boston, Massachusetts, between January and June 2010. We determined housing status at follow-up, determined number of emergency department visits and hospitalizations over 12 months, and examined 4 measures of geriatric conditions at baseline and 12 months. Using multivariable regression models, we evaluated the association between obtaining housing and our outcomes of interest. Results. At 12-month follow-up, 41% of participants had obtained housing. Compared with participants who remained homeless, those with housing had fewer depressive symptoms. Other measures of health status did not differ by housing status. Participants who obtained housing had a lower rate of acute care use, with an adjusted annualized rate of acute care visits of 2.5 per year among participants who obtained housing and 5.3 per year among participants who remained homeless. Conclusions. Older homeless adults who obtained housing experienced improved depressive symptoms and reduced acute care utilization compared with those who remained homeless. PMID:25973822

Experiences with and attitudes toward death and dying among homeless persons.

PubMed

Song, John; Ratner, Edward R; Bartels, Dianne M; Alderton, Lucy; Hudson, Brenda; Ahluwalia, Jasjit S

2007-04-01

Homeless persons face many barriers to health care, have few resources, and experience high death rates. They live lives of disenfranchisement and neglect. Few studies have explored their experiences and attitudes toward death and dying. Unfortunately, studies done in other populations may not apply to homeless persons. Exploring these experiences and attitudes may provide insight into life, health care, and end-of-life (EOL) concerns of this population. To explore the experiences and attitudes toward death and dying among homeless persons. Qualitative study utilizing focus groups. Fifty-three homeless persons recruited from homeless service agencies. In-depth interviews, which were audiotaped and transcribed. We present seven themes, some of which are previously unreported. Homeless persons described many significant experiences with death and dying, and many participants suffered losses while very young. These encounters influenced participants' attitudes toward risks and risky behavior: e.g., for some, these experiences provided justification for high-risk behaviors and influenced their behaviors while living on the streets. For others, they may be associated with their homelessness. Finally, these experiences informed their attitudes toward death and dying as well as EOL care; homeless persons believe that care will be poor at the EOL. Findings from this study have implications for addressing social services, health promotion, prevention, and EOL care for homeless persons, as well as for others who are poor and disenfranchised.

Characterizing Stressors and Modifiable Health Risk Factors Among Homeless Smokers: An Exploratory Pilot Study.

PubMed

Kendzor, Darla E; Reitzel, Lorraine R; Businelle, Michael S

2015-10-01

This pilot study was conducted to explore the associations between stressors related to homelessness and modifiable health risk factors (poor diet, insufficient physical activity, and overweight/obesity) and to provide direction for future research. Participants (N = 57) were homeless adults enrolled in a smoking cessation program. Analyses were conducted to characterize the sample as well as the relations between relevant stressors (discrimination, chronic stress, and fear and mistrust) and health risk factors. Inadequate daily consumption of fruits, vegetables, and fiber was common. High-fat diet and insufficient physical activity were also prevalent, and the majority of participants were overweight/obese. Participants commonly endorsed discrimination, fear of victimization, mistrust of others, and several other stressors. Greater endorsement of stressors was associated with a high-fat diet. Results suggest that lifestyle interventions and policy changes may be warranted in homeless shelters to attenuate the potential effects of stressors on high-fat dietary consumption among smokers. © 2015 Society for Public Health Education.

Effect of the Economic Recession on Primary Care Access for the Homeless.

PubMed

White, Brandi M; Jones, Walter J; Moran, William P; Simpson, Kit N

2016-01-01

Primary care access (PCA) for the homeless can prove challenging, especially during periods of economic distress. In the United States, the most recent recession may have presented additional barriers to accessing care. Limited safety-net resources traditionally used by the homeless may have also been used by the non-homeless, resulting in delays in seeking treatment for the homeless. Using hospitalizations for ambulatory care sensitivity (ACS) conditions as a proxy measure for PCA, this study investigated the recession's impact on PCA for the homeless and non-homeless in four states. The State Inpatient Databases were used to identify ACS admissions. Findings from this study indicate the recession was a barrier to PCA for homeless people who were uninsured. Ensuring that economically-disadvantaged populations have the ability to obtain insurance coverage is crucial to facilitating PCA. With targeted outreach efforts, the Affordable Care Act provides an opportunity for expanding coverage to the homeless.

Homelessness, cigarette smoking and desire to quit: results from a US national study.

PubMed

Baggett, Travis P; Lebrun-Harris, Lydie A; Rigotti, Nancy A

2013-11-01

We determined whether or not homelessness is associated with cigarette smoking independent of other socio-economic measures and behavioral health factors, and whether homeless smokers differ from non-homeless smokers in their desire to quit. We analyzed data from 2678 adult respondents to the 2009 Health Center Patient Survey, a nationally representative cross-sectional survey of homeless and non-homeless individuals using US federally funded community health centers. We used multivariable logistic regression to examine the association between homelessness and (i) current cigarette smoking among all adults, and (ii) past-year desire to quit among current smokers, adjusting for demographic, socio-economic and behavioral health characteristics. Adults with any history of homelessness were more likely than never homeless respondents to be current smokers (57 versus 27%, P < 0.001). In multivariable models, a history of homelessness was associated independently with current smoking [adjusted odds ratio (AOR) 2.09; 95% confidence interval (CI) = 1.49-2.93], even after adjusting for age, sex, race, veteran status, insurance, education, employment, income, mental illness and alcohol and drug abuse. Housing status was not associated significantly with past-year desire to stop smoking in unadjusted (P = 0.26) or adjusted (P = 0.60) analyses; 84% of currently homeless, 89% of formerly homeless and 82% of never homeless smokers reported wanting to quit. Among patients of US health centers, a history of homelessness doubles the odds of being a current smoker independent of other socio-economic factors and behavioral health conditions. However, homeless smokers do not differ from non-homeless smokers in their desire to quit and should be offered effective interventions. © 2013 Society for the Study of Addiction.

Men on the Move: A Pilot Program to Increase Physical Activity among African American Men

ERIC Educational Resources Information Center

Griffith, Derek M.; Allen, Julie Ober; Johnson-Lawrence, Vicki; Langford, Aisha

2014-01-01

Despite the important contribution increasing physical activity levels may play in reducing chronic disease morbidity and mortality, there is a paucity of interventions and research indicating how to improve physical activity levels in African American men. "Men on the Move" was a pilot study to increase African American men's levels of…

Working to End Family Homelessness. Annual Report

ERIC Educational Resources Information Center

National Center on Family Homelessness (NJ1), 2012

2012-01-01

The National Center on Family Homelessness is determined to end family homelessness. Sheltering families provides a temporary safe haven. Connecting families to permanent housing, essential services, and critical supports can change their lives forever. Through research the Center learns what families need to rebound from the housing, economic,…

The New Poverty: Homeless Families in America.

ERIC Educational Resources Information Center

Nunez, Ralph da Costa

This book discusses homeless families in the United States and advocates the efforts of residential educational and employment training centers--American Family Inns--which provide comprehensive services education, job training, and parenting and life skills to address the poverty-related conditions that contribute to homelessness. Chapters of the…

Spirituality and Mental Health among Homeless Mothers

ERIC Educational Resources Information Center

Hodge, David R.; Moser, Stephanie E.; Shafer, Michael S.

2012-01-01

Mothers are one of the fastest growing segments of the homeless population in the United States. Although mental health problems often contribute to homelessness, little is known about the factors that affect mothers' mental health. To help identify protective factors, this longitudinal study examined the relationship between spirituality and…

Counting the Homeless: A Previously Incalculable Tuberculosis Risk and Its Social Determinants

PubMed Central

Teeter, Larry D.; Musser, James M.; Graviss, Edward A.

2013-01-01

Tuberculosis (TB) surveillance among the homeless is not supported by the political will necessary for TB elimination. We merged the first stakeholder-accepted enumeration of homeless persons with existing surveillance data to assess TB risk among the homeless in Houston, Texas. The average incidence per 100 000 was 411 among homeless and 9.5 among housed persons. The homeless were more likely than the housed to be US-born, clustered, and in a larger-sized cluster. Multivariate analysis revealed that TB rates among the homeless were driven not by comorbidities but by social determinants. Homeless patients were hospitalized more days than the housed and required more follow-up time. Reporting of TB rates for populations with known health disparities could help reframe TB prevention and better target limited funds. PMID:23488504

Twenty-five years of child and family homelessness: where are we now?

PubMed

Grant, Roy; Gracy, Delaney; Goldsmith, Grifin; Shapiro, Alan; Redlener, Irwin E

2013-12-01

Family homelessness emerged as a major social and public health problem in the United States during the 1980s. We reviewed the literature, including journal articles, news stories, and government reports, that described conditions associated with family homelessness, the scope of the problem, and the health and mental health of homeless children and families. Much of this literature was published during the 1980s and 1990s. This raises questions about its continued applicability for the public health community. We concluded that descriptions of the economic conditions and public policies associated with family homelessness are still relevant; however, the homeless family population has changed over time. Family homelessness has become more prevalent and pervasive among poor and low-income families. We provide public health recommendations for these homeless families.

Homeless Education and Social Capital: An Examination of School and Community Leaders

ERIC Educational Resources Information Center

Miller, Peter M.

2011-01-01

Background/Context: This study contributes to the literature on the schooling of homeless and highly mobile students. Although previous work has detailed the demographics of homelessness, the effects of homelessness on academic progress, and particular legal issues in homeless education, this research focused on how individual and institutional…

What Kind of School Board Member Would Help Homeless Children?

ERIC Educational Resources Information Center

Harrington-Lueker, Donna

1989-01-01

Homelessness is a growing problem in every part of the United States. Federal legislation requires state plans for educating homeless children, but will provide less than $23 per child. Summarizes some of the state plans and suggests steps school boards can take to provide homeless children with public education. (MLF)

Transforming Teacher Constructs of Children and Families Who Are Homeless

ERIC Educational Resources Information Center

Powers-Costello, Beth; Swick, Kevin J.

2011-01-01

The focus of this article is on articulating the importance of teacher development of constructs about homeless children and families and examining factors that influence teachers' perceptions of children and families who are homeless or at high-risk of becoming homeless. The article also explores some strategies to support teachers in…

Educating Homeless Children in the United States.

ERIC Educational Resources Information Center

Yon, Maria

1995-01-01

A survey of 102 urban school districts in large cities indicates that school districts have responded to the requirements of the Stewart B. McKinney Act for the education of homeless children to varying degrees. However, 69 percent of districts described the problem of homeless students as nonexistent or small. (SLD)

Homelessness and Other Risk Factors for HIV Infection in the Current Outbreak Among Injection Drug Users in Athens, Greece

PubMed Central

Sypsa, Vana; Paraskevis, Dimitrios; Malliori, Meni; Nikolopoulos, Georgios K.; Panopoulos, Anastasios; Kantzanou, Maria; Katsoulidou, Antigoni; Psichogiou, Mina; Fotiou, Anastasios; Pharris, Anastasia; Van De Laar, Marita; Wiessing, Lucas; Jarlais, Don Des; Friedman, Samuel R.

2015-01-01

Objectives. We examined HIV prevalence and risk factors among injection drug users (IDUs) in Athens, Greece, during an HIV outbreak. Methods. We used respondent-driven sampling (RDS) to recruit 1404 IDUs to the Aristotle intervention in August to October 2012. We interviewed participants and tested for HIV. We performed bivariate and multivariate analyses. Results. Estimated HIV prevalence was 19.8% (RDS-weighted prevalence = 14.8%). Odds of infection were 2.3 times as high in homeless as in housed IDUs and 2.1 times as high among IDUs who injected at least once per day as among less frequent injectors (both, P < .001). Six percent of men and 23.5% of women reported transactional sex in the past 12 months, and condom use was low. Intercourse with non-IDUs was common (53.2% of men, 25.6% of women). Among IDUs who had been injecting for 2 years or less the estimated incidence rate was 23.4 new HIV cases per 100 person-years at risk. Conclusions. Efforts to reduce HIV transmission should address homelessness as well as scaling up prevention services, such as needle and syringe distribution and other risk reduction interventions. PMID:24524508

Making a home for the homeless in hate crime legislation.

PubMed

Al-Hakim, Mohamad

2015-06-01

Several jurisdictions in the United States (e.g., Florida and Washington) have recently incorporated the status of "homeless" under the protection of hate crime legislation. This was largely promoted by new data and reports by the National Coalition for the Homeless urging added protection for the homeless. The issue of whether the homeless belong under hate crime provisions raises the following question: What criteria must a group meet to be eligible for its inclusion? What similarities do the homeless have with other protected groups? Finally, what implications does the recognition of economic status have on other economic groups, particularity the top wealthy 1%? In this article, I explore some of the issues raised by including the homeless as a protected group. I survey several rationales offered for the selection of protected characteristics. I argue that the rationales currently offered suffer from descriptive inadequacy by either being under- or over-inclusive. I turn instead to the political conception of "disadvantage" for an identity marker that better explains the link between the various protected groups and identities under hate crime legislation. Moreover, the use of disadvantage allows for the inclusion of the homeless without the need for incorporating other socio-economic identities. © The Author(s) 2014.

Chronic kidney disease in homeless persons in Mexico.

PubMed

Garcia-Garcia, Guillermo; Gutiérrez-Padilla, Alfonso J; Renoirte-Lopez, Karina; Mendoza-Garcia, Martha; Oseguera-Vizcaino, Ma C; Perez-Gomez, Hector R; Marquez-Amezcua, J Mario; Tonelli, Marcello

2013-05-01

Little is known about the prevalence of chronic kidney disease (CKD) among the homeless in Mexico. The role of substance abuse, alcoholism, and homelessness in CKD has not been properly evaluated. We screened 260 homeless individuals in the state of Jalisco, Mexico, for the presence of CKD and its risk factors, and compared their characteristics with those from a separate cohort of poor Jalisco residents and with a survey of the general Mexican population. CKD was more prevalent among the homeless than among the poor Jalisco population (22% vs. 15.8%, P =0.0001); 16.5% had stage 3, 4.3% stage 4, and 1.2% stage 5. All were unaware of having CKD. Only 5.8% knew they had diabetes, but 19% had fasting blood sugar >126 mg/dl; 3.5% knew they were hypertensive but 31% had systolic blood pressure ⩾140 mm Hg or diastolic blood pressure ⩾90 mm Hg. Alcoholism was less common than in the poor Jalisco population (23.5% vs. 32.3%, P =0.002), but tobacco smoking (34.6% vs. 21.5%, P =0.0001) and substance abuse (18% vs. 1.1%, P =0.0001) were more prevalent among the homeless. Likewise, chronic viral infections such as HIV (4.5% vs. 0.3%, P =0.0001) and HCV (7.7% vs. 1.4%, P =0.0001) were also significantly higher among the homeless than in the general population. In conclusion, CKD and its risk factors are highly prevalent among the homeless individuals in Jalisco, Mexico. Lack of awareness of having diabetes and hypertension is highly common, as is substance abuse. Programs aiming to prevent CKD and its risk factors in Mexico should specifically target this high-risk population.

Foot Conditions among Homeless Persons: A Systematic Review

PubMed Central

To, Matthew J.; Brothers, Thomas D.; Van Zoost, Colin

2016-01-01

Introduction Foot problems are common among homeless persons, but are often overlooked. The objectives of this systematic review are to summarize what is known about foot conditions and associated interventions among homeless persons. Methods A literature search was conducted on MEDLINE (1966–2016), EMBASE (1947–2016), and CINAHL (1982–2016) and complemented by manual searches of reference lists. Articles that described foot conditions in homeless persons or associated interventions were included. Data were independently extracted on: general study characteristics; participants; foot assessment methods; foot conditions and associated interventions; study findings; quality score assessed using the Downs and Black checklist. Results Of 333 articles screened, 17 articles met criteria and were included in the study. Prevalence of any foot problem ranged from 9% to 65% across study populations. Common foot-related concerns were corns and calluses, nail pathologies, and infections. Foot pathologies related to chronic diseases such as diabetes were identified. Compared to housed individuals across studies, homeless individuals were more likely to have foot problems including tinea pedis, foot pain, functional limitations with walking, and improperly-fitting shoes. Discussion Foot conditions were highly prevalent among homeless individuals with up to two thirds reporting a foot health concern, approximately one quarter of individuals visiting a health professional, and one fifth of individuals requiring further follow-up due to the severity of their condition. Homeless individuals often had inadequate foot hygiene practices and improperly-fitting shoes. These findings have service provision and public health implications, highlighting the need for evidence-based interventions to improve foot health in this population. An effective interventional approach could include optimization of foot hygiene and footwear, provision of comprehensive medical treatment, and

Effective interventions for homeless youth: a systematic review.

PubMed

Altena, Astrid M; Brilleslijper-Kater, Sonja N; Wolf, Judith L M

2010-06-01

To date, there has not been clear evidence regarding interventions that are effective in addressing the specific needs of homeless youth. A systematic and comprehensive international review on effective interventions for homeless youth is presented. This study seeks to provide an accurate and complete picture of effective interventions for homeless youth by collecting, summarizing, categorizing, and evaluating quantitative studies (i.e., those that have assessed treatment outcomes). EVIDENCE ACQUISTION: The following databases were searched in 2008: PsycINFO, ERIC, MEDLINE, and Cochrane were searched from 1985 through 2008 using specific key words: interventions and programs, with homeless youth (s), homeless adolescents, street youth (s), runaways and throwaways. In addition, references of key articles were searched by hand. Eleven studies met pre-established inclusion criteria. To determine study quality, a set of operational parameters was formulated to rate each study as either good, fair, or poor. There is no compelling evidence that specific interventions are effective for homeless youth, owing to moderate study quality and the small number of intervention studies. Conclusions that can be drawn from the studies are limited by the heterogeneity of interventions, participants, methods, and outcome measures. Many interventions focused on reduction of substance abuse, whereas other important outcomes, such as quality of life, have received little attention. No study received a quality rating of good, and four studies were rated as fair. Most convincing, but still marginal, were results of interventions based on cognitive-behavioral approaches, which revealed some positive results on psychological measures. More methodologically sound research is needed to determine what specific interventions are beneficial for subgroups of homeless youth. Implications for future research are discussed. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All

"They're homeless in a home": Retaining homeless-experienced consumers in supported housing.

PubMed

Gabrielian, Sonya; Hamilton, Alison B; Alexandrino, Adrian; Hellemann, Gerhard; Young, Alexander S

2017-05-01

Permanent, community-based housing with supportive services ("supported housing") has numerous favorable outcomes for homeless-experienced consumers. Little is known, however, about consumers who attain but subsequently lose their supported housing. Using mixed methods, we compared persons who retained their supported housing for at least 1 year ("stayers") with those who lost their supported housing within 1 year of move-in ("exiters"). Among persons housed through the VA Supported Housing (VASH) program at the VA Greater Los Angeles between 2011 and 2012, we queried VA homeless registry data to identify stayers (n = 1,558) and exiters (n = 85). We reviewed the medical records of 85 randomly selected stayers and all 85 exiters to compare demographics, homelessness chronicity, era of service, income, presence or absence of a serious mental illness, and health service utilization. From this subsample, we purposively selected 20 stayers and 20 exiters for semistructured, qualitative interviews, and more detailed medical record review. We also performed qualitative interviews and focus groups with VASH staff/leadership (n = 15). Recursive partitioning identified quantitative variables that best-differentiated stayers from exiters. Thematic analyses were performed on qualitative data. Interrelated factors were associated with exiting supported housing: chronic homelessness; low intrinsic motivation; unmet needs for mental health care, substance abuse treatment, and independent living skills; poor primary care engagement; frequent emergency department use; and recent mental health hospitalizations. These findings suggest the value of clinical interventions that address these factors-for example, motivational interviewing or social skills training-adapted to the setting and context of supported housing. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Experiences With and Attitudes Toward Death and Dying Among Homeless Persons

PubMed Central

Ratner, Edward R; Bartels, Dianne M.; Alderton, Lucy; Hudson, Brenda; Ahluwalia, Jasjit S.

2007-01-01

Background Homeless persons face many barriers to health care, have few resources, and experience high death rates. They live lives of disenfranchisement and neglect. Few studies have explored their experiences and attitudes toward death and dying. Unfortunately, studies done in other populations may not apply to homeless persons. Exploring these experiences and attitudes may provide insight into life, health care, and end-of-life (EOL) concerns of this population. Objective To explore the experiences and attitudes toward death and dying among homeless persons. Design Qualitative study utilizing focus groups. Participants Fifty-three homeless persons recruited from homeless service agencies. Measurements In-depth interviews, which were audiotaped and transcribed. Results We present seven themes, some of which are previously unreported. Homeless persons described many significant experiences with death and dying, and many participants suffered losses while very young. These encounters influenced participants’ attitudes toward risks and risky behavior: e.g., for some, these experiences provided justification for high-risk behaviors and influenced their behaviors while living on the streets. For others, they may be associated with their homelessness. Finally, these experiences informed their attitudes toward death and dying as well as EOL care; homeless persons believe that care will be poor at the EOL. Conclusions Findings from this study have implications for addressing social services, health promotion, prevention, and EOL care for homeless persons, as well as for others who are poor and disenfranchised. PMID:17372788

Statins and physical activity in older men: the osteoporotic fractures in men study.

PubMed

Lee, David S H; Markwardt, Sheila; Goeres, Leah; Lee, Christine G; Eckstrom, Elizabeth; Williams, Craig; Fu, Rongwei; Orwoll, Eric; Cawthon, Peggy M; Stefanick, Marcia L; Mackey, Dawn; Bauer, Douglas C; Nielson, Carrie M

2014-08-01

Muscle pain, fatigue, and weakness are common adverse effects of statin medications and may decrease physical activity in older men. To determine whether statin use is associated with physical activity, longitudinally and cross-sectionally. Men participating in the Osteoporotic Fractures in Men Study (N = 5994), a multicenter prospective cohort study of community-living men 65 years and older, enrolled between March 2000 and April 2002. Follow-up was conducted through 2009. Statin use as determined by an inventory of medications (taken within the last 30 days). In cross-sectional analyses (n = 4137), statin use categories were users and nonusers. In longitudinal analyses (n = 3039), categories were prevalent users (baseline use and throughout the study), new users (initiated use during the study), and nonusers (never used). Self-reported physical activity at baseline and 2 follow-up visits using the Physical Activity Scale for the Elderly (PASE). At the third visit, an accelerometer measured metabolic equivalents (METs [kilocalories per kilogram per hour]) and minutes of moderate activity (METs ≥3.0), vigorous activity (METs ≥6.0), and sedentary behavior (METs ≤1.5). At baseline, 989 men (24%) were users and 3148 (76%) were nonusers. The adjusted difference in baseline PASE between users and nonusers was -5.8 points (95% CI, -10.9 to -0.7 points). A total of 3039 men met the inclusion criteria for longitudinal analysis: 727 (24%) prevalent users, 845 (28%) new users, and 1467 (48%) nonusers. PASE score declined by a mean (95% CI) of 2.5 (2.0 to 3.0) points per year for nonusers and 2.8 (2.1 to 3.5) points per year for prevalent users, a nonstatistical difference (0.3 [-0.5 to 1.0] points). For new users, annual PASE score declined at a faster rate than nonusers (difference of 0.9 [95% CI, 0.1 to 1.7] points). A total of 3071 men had adequate accelerometry data, 1542 (50%) were statin users. Statin users expended less METs (0.03 [95% CI, 0.02-0.04] METs less

Homelessness among a nationally representative sample of US veterans: prevalence, service utilization, and correlates.

PubMed

Tsai, Jack; Link, Bruce; Rosenheck, Robert A; Pietrzak, Robert H

2016-06-01

To examine the prevalence of lifetime homelessness among veterans and use of Veterans Affairs (VA) homeless services, as well as their association with sociodemographic and clinical characteristics. A nationally representative sample of 1533 US veterans was surveyed July-August 2015. Among all veterans, 8.5 % reported any lifetime homelessness in their adult life, but only 17.2 % of those reported using VA homeless services. Prevalence of homelessness and VA homeless service use did not significantly differ by gender. Being low income, aged 35-44, and having poor mental and physical health were each independently associated with lifetime homelessness. Veterans who were White or lived in rural areas were significantly less likely to have used VA homeless services. Homelessness remains a substantial problem across different generations of veterans. The low reported uptake of VA homeless services suggests there are barriers to care in this population, especially for veterans who live in rural areas. Governmental resources dedicated to veteran homelessness should be supported, and obtaining accurate prevalence estimates are important to tracking progress over time.

Perceptions about Homeless Elders and Community Responsibility

ERIC Educational Resources Information Center

Kane, Michael N.; Green, Diane; Jacobs, Robin

2013-01-01

Human service students were surveyed ("N" = 207) to determine their perceptions about homeless elders and communal responsibility for their well-being. Using a backward regression analysis, a final model ("F" = 15.617, "df" = 7, "p" < 0.001) for Perceptions about Homeless Persons and Community…

Interaction of duration of homelessness and gender on adolescent sexual health indicators.

PubMed

Rew, Lynn; Grady, Matthew; Whittaker, Tiffany A; Bowman, Katherine

2008-01-01

The purpose of this analysis was to determine the effects of duration of homelessness and gender on personal and social resources, cognitive-perceptual factors, and sexual health behaviors among homeless youth. Cross-sectional analysis of data collected at baseline from 461 homeless adolescents who participated in a sexual health intervention study was done. Data were collected via laptop computers from homeless adolescents (mean age=19.52+1.91 years) in both comparison and intervention groups before the initiation of the intervention. Significant interaction effects were found for personal and social resources F (4, 426)=2.83, p<.05. Male participants who had been homeless<6 months had significantly higher scores on social connectedness than did male participants who were homeless>1 year. Univariate analysis of variance (ANOVA) indicated that both boys and girls who had been homeless>1 year had greater AIDS knowledge, F (1, 441)=7.91, p<.01, reported significantly more sexual risk-taking behaviors, F (1, 396)=9.93, p<.05, and engaged in fewer safe-sex behaviors, F (1, 396)=12.05, p<.05, than did those who had been homeless<6 months. Univariate ANOVA indicated that female participants had significantly lower levels of perceived health status, F (1, 429)=12.08, p<.01, significantly greater sexual self-care behaviors, F (1, 396)=16.29, p<.01, and significantly higher levels of assertive communication F (1, 396)=4.03, p<.05 than did male participants, regardless of duration of homelessness. The duration of homelessness and gender has both direct and interaction effects on cognitive-perceptual and behavioral outcomes associated with sexual health. Nurses and other healthcare providers working with homeless youth recognize the need to develop brief interventions that address health-risk behaviors. Findings from this study indicate that gender-specific interventions should be provided to youth soon after they become homeless.

Caring for homeless persons with serious mental illness in general hospitals.

PubMed

Bauer, Leah K; Baggett, Travis P; Stern, Theodore A; O'Connell, Jim J; Shtasel, Derri

2013-01-01

The care of homeless persons with serious mental illness remains a common and challenging problem in general hospital settings. This article aims to review data on homelessness and its psychiatric comorbidities, and to expand the skills of providers who encounter homeless individuals in general hospital settings. Literature review reveals patient, provider, and systems factors that contribute to suboptimal health outcomes in homeless individuals. Diagnostic rigor, integrated medical and psychiatric care, trauma-informed interventions, special considerations in capacity evaluations, and health care reform initiatives can improve the treatment of homeless persons with serious mental illness. Copyright © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

The Prevalence and Needs of Homeless Undergraduates at a Large, Urban University

ERIC Educational Resources Information Center

Carlson, Corissa

2017-01-01

Empirical research has been limited with respect to homelessness among college undergraduates. Research on educational outcomes has been limited to K-12th grade, but what is known points to worse outcomes for people who are homeless. The National Coalition for the Homeless (2014) reported that 75% of homeless or runaway teenagers drop out of…

The Teacher Attitudes toward Homeless Students Scale: Development and Validation

ERIC Educational Resources Information Center

Brown, Jessica J.

2012-01-01

Recent estimates suggest there are roughly 1.6 million homeless children and this number is growing (National Center on Family Homelessness, 2011). This trend is particularly worrisome given that homeless children face a number of obstacles within society and education, not the least of which is negative teacher attitudes (Swick, 2000; U.S.…

For Youth, by Youth: A Third Student-Run Homeless Shelter

ERIC Educational Resources Information Center

Seider, Scott C.

2016-01-01

This past winter, the third student-run homeless shelter in the United States came into being. Two recent Harvard graduates, Sam Greenberg and Sarah Rosenkrantz, who had volunteered at the Harvard Square Homeless Shelter as college students, saw a need within the Boston and Cambridge communities for a homeless shelter serving young adults. Drawing…

Universal health insurance and health care access for homeless persons.

PubMed

Hwang, Stephen W; Ueng, Joanna J M; Chiu, Shirley; Kiss, Alex; Tolomiczenko, George; Cowan, Laura; Levinson, Wendy; Redelmeier, Donald A

2010-08-01

We examined the extent of unmet needs and barriers to accessing health care among homeless people within a universal health insurance system. We randomly selected a representative sample of 1169 homeless individuals at shelters and meal programs in Toronto, Ontario. We determined the prevalence of self-reported unmet needs for health care in the past 12 months and used regression analyses to identify factors associated with unmet needs. Unmet health care needs were reported by 17% of participants. Compared with Toronto's general population, unmet needs were significantly more common among homeless individuals, particularly among homeless women with dependent children. Factors independently associated with a greater likelihood of unmet needs were younger age, having been a victim of physical assault in the past 12 months, and lower mental and physical health scores on the 12-Item Short Form Health Survey. Within a system of universal health insurance, homeless people still encounter barriers to obtaining health care. Strategies to reduce nonfinancial barriers faced by homeless women with children, younger adults, and recent victims of physical assault should be explored.

Universal Health Insurance and Health Care Access for Homeless Persons

PubMed Central

Ueng, Joanna J. M.; Chiu, Shirley; Kiss, Alex; Tolomiczenko, George; Cowan, Laura; Levinson, Wendy; Redelmeier, Donald A.

2010-01-01

Objectives. We examined the extent of unmet needs and barriers to accessing health care among homeless people within a universal health insurance system. Methods. We randomly selected a representative sample of 1169 homeless individuals at shelters and meal programs in Toronto, Ontario. We determined the prevalence of self-reported unmet needs for health care in the past 12 months and used regression analyses to identify factors associated with unmet needs. Results. Unmet health care needs were reported by 17% of participants. Compared with Toronto's general population, unmet needs were significantly more common among homeless individuals, particularly among homeless women with dependent children. Factors independently associated with a greater likelihood of unmet needs were younger age, having been a victim of physical assault in the past 12 months, and lower mental and physical health scores on the 12-Item Short Form Health Survey. Conclusions. Within a system of universal health insurance, homeless people still encounter barriers to obtaining health care. Strategies to reduce nonfinancial barriers faced by homeless women with children, younger adults, and recent victims of physical assault should be explored. PMID:20558789

Job Training for the Homeless Demonstration Program: U.S. Department of Labor--Employment and Training Administration. Final Evaluation Report.

ERIC Educational Resources Information Center

Elgin Community Coll., IL.

This report evaluates the Fox Valley Consortium for Job Training and Placement of the Homeless which involves five educational, social service, and community organizations in activities to facilitate the educational development and financial independence of homeless participants. The consortium consists of: the Community Crisis Center (area…

The Disadvantage of Homelessness in Children's Schooling.

ERIC Educational Resources Information Center

Shaver, Debra M.; Dornbusch, Sanford M.

This paper presents findings of a study that investigated the extent to which homeless children in the United States receive the "free and appropriate education" to which they are entitled. Data were collected through several surveys conducted in two San Francisco Bay Area counties: (1) surveys of parents in homeless shelters with 313…

Providing Lifelines for Our Nation's Homeless Youth

ERIC Educational Resources Information Center

Duffield, Barbara

2013-01-01

This article discusses educational challenges for homeless children and explains how districts can and must meet their needs. According to the U.S. Department of Education Federal Data Collection, 1,065,794 homeless children and youth were enrolled in public schools for the school year 2010-2011, the highest number on record. After listing…

Homelessness, Cigarette Smoking, and Desire to Quit: Results from a U.S. National Study

PubMed Central

Baggett, Travis P.; Lebrun-Harris, Lydie A.; Rigotti, Nancy A.

2013-01-01

Aims We determined whether homelessness is associated with cigarette smoking independent of other socioeconomic measures and behavioral health factors, and whether homeless smokers differ from non-homeless smokers in their desire to quit. Design, Setting, and Participants We analyzed data from 2,678 adult respondents to the 2009 Health Center Patient Survey, a nationally representative cross-sectional survey of homeless and non-homeless individuals using U.S. federally-funded community health centers. Measurements We used multivariable logistic regression to examine the association between homelessness and (1) current cigarette smoking among all adults, and (2) past-year desire to quit among current smokers, adjusting for demographic, socioeconomic, and behavioral health characteristics. Findings Adults with any history of homelessness were more likely than never homeless respondents to be current smokers (57% vs. 27%, p<0.001). In multivariable models, a history of homelessness was independently associated with current smoking (AOR 2.09; 95% CI 1.49-2.93), even after adjusting for age, sex, race, veteran status, insurance, education, employment, income, mental illness, and alcohol and drug abuse. Housing status was not significantly associated with past-year desire to stop smoking in unadjusted (p=0.26) or adjusted (p=0.60) analyses; 84% of currently homeless, 89% of formerly homeless, and 82% of never homeless smokers reported wanting to quit. Conclusions Among patients of U.S. health centers, a history of homelessness doubles the odds of being a current smoker independent of other socioeconomic factors and behavioral health conditions. However, homeless smokers do not differ from non-homeless smokers in their desire to quit and should be offered effective interventions. PMID:23834157

Rural Homelessness in Northwest Ohio: Reasons, Patterns, Statistics, and Trends.

ERIC Educational Resources Information Center

Podlin, Georgette A.

Rural homelessness in America is difficult to define, to count, and to see. This article reports the findings of a 1993 county-wide study of rural homelessness. During a one year survey, 118 homeless households were interviewed. Of those surveyed, 25.8 percent were male adults, 30.9 percent were female adults, and 43.2 percent were children.…

Depression Symptoms Among Homeless Smokers: Effect of Motivational Interviewing.

PubMed

Robinson, Cendrine D; Rogers, Charles R; Okuyemi, Kolawole S

2016-08-23

Tobacco use is higher among homeless individuals than the general population. Homeless individuals are also more likely to have symptoms of depression. Depression symptoms may add to the burden of homelessness by increasing psychological distress and serve as a barrier to quitting smoking. The primary goal of this study is to assess the impact of depression symptoms on psychological distress in homeless smokers. The effect of depression symptoms on abstinence and the effect of Motivational Interviewing (MI) on cessation among smokers is also explored. Homeless smokers (N = 430) enrolled in a smoking cessation study were randomized to Motivational Interviewing (MI) or standard care (SC). Participants received nicotine replacement therapy and were followed for 26 weeks. Participants were categorized into a depression symptoms (DS) group or control group using the Patient Health Questionnaire-9. Between group differences of perceived stress, hopelessness, confidence, craving and abstinence were assessed at weeks 8 and 26. The interaction between depression symptoms (levels: DS and control) and the intervention (levels: MI and SC) was also assessed. Homeless smokers in the DS group reported higher levels of hopelessness, perceived stress, and craving. There was no effect of DS status on abstinence at week 8 or week 26. There was no significant interaction between depression symptoms (DS vs. Control) and the intervention (MI vs. SC). Despite reporting greater psychological distress, homeless smokers with depression symptoms in this sample had abstinence levels similar to the control group. Future research should explore protective factors among depressed smokers.

A Population-Based Inquiry of Homeless Episode Characteristics and Early Educational Well-Being.

PubMed

Fantuzzo, John; Leboeuf, Whitney; Brumley, Benjamin; Perlman, Staci

2013-06-01

Child homelessness and educational well-being is an area of national research that requires more precise investigation to address mixed findings. The aim of this study was to extend the investigation of the relations between homelessness and educational well-being by determining if timing and frequency of homeless episodes are differentially associated with children's academic and classroom engagement outcomes. This investigation used a comprehensive research model to study the effects of these homeless episode characteristics within a large urban student cohort. Additionally, this study accounted for co-occurring early risk factors. Findings indicated that having a first homeless episode in early childhood was associated with non-proficiency in mathematics and academic engagement problems. Also more frequent homeless episodes were related to truancy in third grade. These results stress the importance of early intervention for homeless children and underscore the need to further understand the variation in young children's homeless experiences.

A national evaluation of homeless and nonhomeless veterans' experiences with primary care.

PubMed

Jones, Audrey L; Hausmann, Leslie R M; Haas, Gretchen L; Mor, Maria K; Cashy, John P; Schaefer, James H; Gordon, Adam J

2017-05-01

Persons who are homeless, particularly those with mental health and/or substance use disorders (MHSUDs), often do not access or receive continuous primary care services. In addition, negative experiences with primary care might contribute to homeless persons' avoidance and early termination of MHSUD treatment. The patient-centered medical home (PCMH) model aims to address care fragmentation and improve patient experiences. How homeless persons with MHSUDs experience care within PCMHs is unknown. This study compared the primary care experiences of homeless and nonhomeless veterans with MHSUDs receiving care in the Veterans Health Administration's medical home environment, called Patient Aligned Care Teams. The sample included VHA outpatients who responded to the national 2013 PCMH-Survey of Health Care Experiences of Patients (PCMH-SHEP) and had a past-year MSHUD diagnosis. Veterans with evidence of homelessness (henceforth "homeless") were identified through VHA administrative records. PCMH-SHEP survey respondents included 67,666 veterans with MHSUDs (9.2% homeless). Compared with their nonhomeless counterparts, homeless veterans were younger, more likely to be non-Hispanic Black and nonmarried, had less education, and were more likely to live in urban areas. Homeless veterans had elevated rates of most MHSUDs assessed, indicating significant co-occurrence. After controlling for these differences, homeless veterans reported more negative and fewer positive experiences with communication; more negative provider ratings; and more negative experiences with comprehensiveness, care coordination, medication decision-making, and self-management support than nonhomeless veterans. Homeless persons with MHSUDs may need specific services that mitigate negative care experiences and encourage their continuation in longitudinal primary care services. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

CHOICES. A Resource for Literacy Providers and Homeless Families.

ERIC Educational Resources Information Center

Koehler, Gwen; And Others

CHOICES, a literacy program for homeless families, piloted a program at the Women's Emergency Shelter in Champaign, Illinois and later expanded its services to A Woman's Place, a domestic violence shelter, in Urbana, Illinois. The CHOICES program offered weekly language activities for the children and gave mothers information about developing…

Substance dependency among homeless American Indians.

PubMed

Lobo, Susan; Vaughan, Margaret Mortensen

2003-01-01

Extensive qualitative research in the San Francisco Bay Area in California and in Tucson, Arizona, indicates strong associations between substance abuse and homelessness among American Indians. This article takes a comparative approach to describe and analyze precipitating factors and survival patterns of those who are both homeless and who suffer from substance dependency. Possible precipitating factors presented through case studies consider the complex interaction of childhood fostering or adoption into non-Native families, different types of involuntary institutionalization during youth, and the personal impact of accident, trauma and loss. Coping strategies and keys to survival are examined, including the role of the extended family and close friendships, American Indian and mainstream organizations that offer formal and informal services, the existence of anchor or key households, the helping relationships and sobriety groups among homeless individuals, spirituality, and cultural resiliency.

Mortality among the homeless: Causes and meteorological relationships.

PubMed

Romaszko, Jerzy; Cymes, Iwona; Dragańska, Ewa; Kuchta, Robert; Glińska-Lewczuk, Katarzyna

2017-01-01

The homeless constitute a subpopulation particularly exposed to atmospheric conditions, which, in the temperate climate zone, can result in both cold and heat stress leading to the increased mortality hazard. Environmental conditions have become a significant independent risk factor for mortality from specific causes, including circulatory or respiratory diseases. It is known that this group is particularly prone to some addictions, has a shorter life span, its members often die of different causes than those of the general population and may be especially vulnerable to the influence of weather conditions. The retrospective analysis is based on data concerning 615 homeless people, out of which 176 died in the analyzed period (2010-2016). Data for the study was collected in the city of Olsztyn, located in north-east Poland, temperate climatic zone of transitional type. To characterize weather conditions, meteorological data including daily minimum and maximum temperatures and the Universal Thermal Climate Index (UTCI) were used. The average life span of a homeless person was shorter by about 17.5 years than that recorded for the general population. The average age at death of a homeless male was 56.27 years old (SD 10.38), and 52.00 years old (SD 9.85) of a homeless female. The most frequent causes of death were circulatory system diseases (33.80%). A large number of deaths were attributable to smoking (47.18%), whereas a small number was caused by infectious diseases, while a relatively large proportion of deaths were due to tuberculosis (2.15%). Most deaths occurred in the conditions of cold stress (of different intensity). Deaths caused by hypothermia were thirteen-fold more frequently recorded among the homeless than for the general population. A relative risk of death for a homeless person even in moderate cold stress conditions is higher (RR = 1.84) than in thermoneutral conditions. Our results indicate excessive mortality among the homeless as well as the

Helping Homeless Families Overcome Barriers to Successful Functioning

ERIC Educational Resources Information Center

Swick, Kevin J.

2005-01-01

The author articulates key stressors in the lives of families who are homeless. These stresses often combine with barriers such as lack of job opportunities and/or insensitive professionals. Strategies for helping homeless families overcome these barriers and related issues are presented.

Preliminary Findings on Rural Homelessness in Ohio.

ERIC Educational Resources Information Center

First, Richard J.; And Others

This report is designed to present preliminary findings from the first comprehensive study of rural homelessness in the United States. The study was conducted during the first 6 months of 1990, and data were collected from interviews with 921 homeless adults in 21 randomly selected rural counties in Ohio. The sample counties represent 26% of the…

Housing as an intervention on hospital use: access among chronically homeless persons with disabilities.

PubMed

Parker, David

2010-12-01

A study examining demographics and hospital utilization for chronically homeless persons with disabilities was conducted at pre-housing enrollment and at 6 months post-housing. Of the 20 participants, 70% (n = 14) were Black American and 30% (n = 6) were White; 100% (n = 20) were non-Hispanic; 90% (n = 18) were men; 40% (n = 8) were veterans; Median years since last permanent housing and total homelessness were 7 and 10.5 respectively. The following increases were observed: employment (0 to 1); income (20%, n = 4 to 35%, n = 7); primary care (25%, n = 5 to 95%, n = 19); and mental health service use (25%, n = 5 to 60%, n = 12). Known disabilities included HIV (15%, n = 3); hepatitis C (45%, n = 9); mental illness (60%, n = 12) and substance abuse (80%, n = 16) with 45% (n = 9) dually diagnosed. Over the course of the study, Emergency department visits and inpatient hospitalization use decreased. While these differences were not statistically significant (p = 0.14 and p = 0.31, respectively), they translate to an estimated $250,208 savings.

Correlates of energy intake and body mass index among homeless children in Minnesota.

PubMed

Richards, Rickelle; Smith, Chery; Eggett, Dennis L

2013-06-01

This study evaluated environmental, personal, and behavioral correlates of BMI-for-age percentiles, dietary intake (kilocalories, carbohydrates, protein, fat, and Food Guide Pyramid food groups), and physical activity variables among homeless children. A 74-item survey, using social cognitive theory as the theoretical framework, height, weight, and one 24-hour recall were collected from homeless children aged 9-13 (n=159) at two shelters in Minneapolis, MN. Principal component analysis was performed on the subsections of the survey. Independent t-tests, Fisher exact tests, and chi-squared statistics evaluated sociodemographic and BMI percentile variables. Nonparametric tests evaluated dietary data. Stepwise regression models evaluated correlates of BMI percentiles, physical activity, and dietary intake variables. Approximately 45% were overweight or obese (≥85(th) percentile). Dietary data represented intake on a given day, with children consuming a median 1.2 servings from the fruits and vegetables food group, 17.3 servings from the fats and sweets food group (one serving=grams in 1 Tbsp. fat/1 tsp. sugar), and the percent of calories from fat varying significantly between shelter 1 (S1) versus shelter 2 (S2) boys (37.1% vs. 31.7%, p<0.001). Factors identified from survey items and sociodemographic variables accounted for between 6% and 14% of the variance in energy intake and other dietary and physical activity variables (p range, 0.008 to <0.001). Parental role modeling of eating behaviors and getting enough food were associated with less favorable food choices among homeless children. Policy interventions and program initiatives in the homeless environment could promote healthier food choices among children.

Are Homeless Women with Children Accessing Available Resources: If Not, Why?

ERIC Educational Resources Information Center

Chaney, Denise M.

2017-01-01

This qualitative Interpretative Phenomenological Analysis (IPA) study explored the subjectivity of the phenomenon of homelessness among women with children. The study examined the perceived critical incidents homeless women with children ascribe to their homelessness alongside the perceptions held regarding the accessibility of available resources…

Problem Behaviors of Homeless Youth: A Social Capital Perspective

PubMed Central

Bantchevska, Denitza; Bartle-Haring, Suzanne; Dashora, Pushpanjali; Glebova, Tatiana; Slesnick, Natasha

2008-01-01

Homeless youth are one of the most marginalized groups in our society. Many researchers identify much higher levels of various problem behaviors among these youth compared to their non-homeless peers. The current study examined the utility of social capital in predicting problem behaviors among homeless youth. Overall, the theoretically derived social capital variable significantly predicted substance use frequency, sexual risk behavior, depression, delinquent behavior as well as number of days homeless. Thus, social capital was useful in understanding and predicting the current life situation among these youth and may be worthy of further study. Findings suggest that meaningful change should utilize interventions that go beyond the individual and are geared towards modifying the social context of individuals’ lives. PMID:18787647

Personal Network Correlates of Alcohol, Cigarette, and Marijuana Use Among Homeless Youth

PubMed Central

Wenzel, Suzanne L.; Tucker, Joan S.; Golinelli, Daniela; Green, Harold D.; Zhou, Annie

2013-01-01

Background Youth who are homeless and on their own are among the most marginalized individuals in the United States and face multiple risks, including use of substances. This study investigates how the use of alcohol, cigarettes, and marijuana among homeless youth may be influenced by characteristics of their social networks. Methods Homeless youth aged 13–24 were randomly sampled from 41 service and street sites in Los Angeles County (N = 419). Predictors of substance use were examined using linear regression analysis (for average number of drinks and average number of cigarettes per day) and negative binomal regression analysis (for frequency of past month marijuana use). Results Youth with more substance users in their networks reported greater alcohol, cigarette, and marijuana consumption regardless of whether these network members provided tangible or emotional support. Marijuana use was more frequent for youth who met more network members through homeless settings, but less frequent among those who met more network members through treatment or AA/NA. Greater alcohol use occurred among youth who met more network members through substance use-related activities. Youth having more adults in positions of responsibility in their networks consumed less alcohol, and those with more school attendees in their networks consumed less alcohol and cigarettes. Conclusions Findings highlight the importance of social context in understanding substance use among homeless youth. Results also support the relevance of network-based interventions to change social context for substance using youth, in terms of both enhancing pro-social influences and reducing exposure to substance use. PMID:20656423

Personal network correlates of alcohol, cigarette, and marijuana use among homeless youth.

PubMed

Wenzel, Suzanne L; Tucker, Joan S; Golinelli, Daniela; Green, Harold D; Zhou, Annie

2010-11-01

Youth who are homeless and on their own are among the most marginalized individuals in the United States and face multiple risks, including use of substances. This study investigates how the use of alcohol, cigarettes, and marijuana among homeless youth may be influenced by characteristics of their social networks. Homeless youth aged 13-24 were randomly sampled from 41 service and street sites in Los Angeles County (N=419). Predictors of substance use were examined using linear regression analysis (for average number of drinks and average number of cigarettes per day) and negative binomial regression analysis (for frequency of past month marijuana use). Youth with more substance users in their networks reported greater alcohol, cigarette, and marijuana consumption regardless of whether these network members provided tangible or emotional support. Marijuana use was more frequent for youth who met more network members through homeless settings, but less frequent among those who met more network members through treatment or AA/NA. Greater alcohol use occurred among youth who met more network members through substance use-related activities. Youth having more adults in positions of responsibility in their networks consumed less alcohol, and those with more school attendees in their networks consumed less alcohol and cigarettes. Findings highlight the importance of social context in understanding substance use among homeless youth. Results also support the relevance of network-based interventions to change social context for substance-using youth, in terms of both enhancing pro-social influences and reducing exposure to substance use. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Lesbian, gay, and bisexual homeless youth: an eight-city public health perspective.

PubMed

Van Leeuwen, James M; Boyle, Susan; Salomonsen-Sautel, Stacy; Baker, D Nico; Garcia, J T; Hoffman, Allison; Hopfer, Christian J

2006-01-01

This article reports on results of a one-day public health survey conducted in six states by homeless youth providers to measure and compare risk factors between lesbian, gay, and bisexual (LGB) homeless youth and non-LGB homeless youth. This article intends to inform the child welfare field on existing gaps in services and areas where more training and technical support is necessary in providing services to homeless LGB youth. The findings point to substantial differences within the homeless youth sample and demonstrate that in addition to the public health risks young people face merely by being homeless, the risks are exacerbated for those who self-identify as lesbian, gay, or bisexual. The article informs child welfare providers and policymakers about the substantial vulnerability of LGB youth beyond that of non-LGB homeless youth and the need to fund programming, training, technical assistance and further research to specifically respond to the complex needs of this population.

The worlds of homeless white and African American youth in San Francisco, California: a cultural epidemiological comparison.

PubMed

Hickler, Benjamin; Auerswald, Colette L

2009-03-01

Research to date has given little attention to differences in the experience of youth homelessness by ethnicity. This article provides a comparative descriptive analysis of the effect of differences and similarities in paths to homelessness, self-perception, and survival strategies on health behaviors and consequent health outcomes of African American and white homeless youth in San Francisco, USA. We conducted participant observation and ethnographic interviews with 54 youth primarily recruited from street venues. Hypotheses generated from the ethnographic data were validated in between-group analyses using concurrent epidemiological data collected from a sample of 205 youth. Our samples of unstably housed African American and white youth, though sharing common histories of family dysfunction, differed in both the ethnographic accounts and epidemiological analyses in their experiences of family, access to housing, street survival strategies, self-presentation, health behaviors and service utilization. Our sample of white youth generally identified with the term "homeless," engaged in survival activities associated with such a label, and accessed the services intended to address the needs of homeless youth. In contrast, our sample of African American youth generally did not perceive themselves as "homeless," a stigmatized term, and were thus less likely to utilize, or be accessed by, relevant services.

Comparing homeless persons' care experiences in tailored versus nontailored primary care programs.

PubMed

Kertesz, Stefan G; Holt, Cheryl L; Steward, Jocelyn L; Jones, Richard N; Roth, David L; Stringfellow, Erin; Gordon, Adam J; Kim, Theresa W; Austin, Erika L; Henry, Stephen Randal; Kay Johnson, N; Shanette Granstaff, U; O'Connell, James J; Golden, Joya F; Young, Alexander S; Davis, Lori L; Pollio, David E

2013-12-01

We compared homeless patients' experiences of care in health care organizations that differed in their degree of primary care design service tailoring. We surveyed homeless-experienced patients (either recently or currently homeless) at 3 Veterans Affairs (VA) mainstream primary care settings in Pennsylvania and Alabama, a homeless-tailored VA clinic in California, and a highly tailored non-VA Health Care for the Homeless Program in Massachusetts (January 2011-March 2012). We developed a survey, the "Primary Care Quality-Homeless Survey," to reflect the concerns and aspirations of homeless patients. Mean scores at the tailored non-VA site were superior to those from the 3 mainstream VA sites (P < .001). Adjusting for patient characteristics, these differences remained significant for subscales assessing the patient-clinician relationship (P < .001) and perceptions of cooperation among providers (P = .004). There were 1.5- to 3-fold increased odds of an unfavorable experience in the domains of the patient-clinician relationship, cooperation, and access or coordination for the mainstream VA sites compared with the tailored non-VA site; the tailored VA site attained intermediate results. Tailored primary care service design was associated with a superior service experience for patients who experienced homelessness.

Temporary Housing for the Homeless: A Pre-Engineering Design Project

ERIC Educational Resources Information Center

Schreuders, Paul D.; Salmon, Scott D.; Stewardson, Gary A.

2008-01-01

It has been reported by the National Law Center on Homelessness and Poverty that in 2004, over 3.5 million Americans were homeless. While many homeless live in temperate climates, many others live in locations where it can get very cold in the winter. Without adequate shelter, this can become very hazardous to the health and well-being of these…

Methamphetamine Use among Homeless Former Foster Youth: The Mediating Role of Social Networks

PubMed Central

Yoshioka-Maxwell, Amanda; Rice, Eric; Rhoades, Harmony; Winetrobe, Hailey

2015-01-01

Objectives Social network analysis can provide added causal insight into otherwise confusing epidemiologic findings in public health research. Although foster care and homelessness are risk factors for methamphetamine use, current research has failed to explicate why homeless youth with foster care experience engage in methamphetamine use at higher rates than other homeless young adults. This study examined the mediating effect of network engagement and time spent homeless on the relationship between foster care experience and recent methamphetamine use among homeless youth in Los Angeles. Methods Egocentric network data from a cross-sectional community-based sample (n = 652) of homeless youth aged 13–25 were collected from drop-in centers in Los Angeles. Questions addressed foster care experience, time spent homeless, methamphetamine use, and perceived drug use in social networks. Path analysis was performed in SAS to examine mediation. Results Controlling for all other variables, results of path analysis regarding recent methamphetamine use indicated a direct effect between foster care experience and recent methamphetamine use (B = .269, t = 2.73, p < .01). However, this direct effect became statistically nonsignificant when time spent homeless and network methamphetamine use were added to the model, and indirect paths from time spent homeless and network methamphetamine use became statistically significant. Conclusions Foster care experience influenced recent methamphetamine use indirectly through time spent homeless and methamphetamine use by network members. Efforts to reduce methamphetamine use should focus on securing stable housing and addressing network interactions among homeless former foster youth. PMID:26146647

Personality disorders and treatment drop out in the homeless

PubMed Central

Salavera, Carlos; Tricás, José M; Lucha, Orosia

2013-01-01

The homeless drop out of treatment relatively frequently. Also, prevalence rates of personality disorders are much higher in the homeless group than in the general population. We hypothesize that when both variables coexist — homelessness and personality disorders — the possibility of treatment drop out grows. The aim of this study was to analyze the hypotheses, that is, to study how the existence of personality disorders affects the evolution of and permanence in treatment. One sample of homeless people in a therapeutic community (N = 89) was studied. The structured clinical interview for the diagnostic and statistical manual of mental disorders (DSM-IV-TR) was administered and participants were asked to complete the Millon Clinical Multiaxial Inventory-II (MCMI-II). Cluster B personality disorders (antisocial, borderline, and narcissistic) avoided permanence in the treatment process while cluster C disorders, as dependent, favored adhesion to the treatment and improved the prognosis. Knowledge of these personality characteristics should be used to advocate for better services to support homeless people and prevent their dropping out before completing treatment. PMID:23569378

Adults Experiencing Homelessness in the US–Mexico Border Region: A Photovoice Project

PubMed Central

Moya, Eva Margarita; Chavez-Baray, Silvia M.; Loweree, Jacqueline; Mattera, Brian; Martinez, Nahomi

2017-01-01

Homelessness is a social, economic, and political crisis in the United States. In particular, the US–Mexico Border region has seen a surge of homelessness, specifically among veterans, women victims of intimate partner violence, and immigrants. In 2014, 12 persons in El Paso, TX, with experience of being homeless used the photovoice methodology to participate in a project titled, “The Voices and Images of the Residents of the Opportunity Center for the Homeless: A Visual Project on the Identity and Challenges Homeless Adults Face on the Border Region.” The project was led by faculty from the Department of Social Work and facilitated by graduate students from the Departments of Social Work, Sociology, and Anthropology at the University of Texas at El Paso. In partnership with the Opportunity Center for the Homeless, a community-based organization, a gallery of photographs with respective narratives was produced along with a video documentary. The participants identified four themes: broken systems, invisibility, opportunities and what works, and growth and determination. These themes represent participants’ life experiences with homelessness and their aspirations. In addition to the photo gallery, participants supported the development of a Call to Action asking the community, policy, and decision makers to commit to changing the current social, economic, and political conditions affecting individuals experiencing homelessness. The gallery, Call to Action, and overall participant experiences with photovoice were shared during local, regional, and national conferences and events, including three State of the Homeless Conferences led by the Opportunity Center for the Homeless in partnership with the university. PMID:28580355

Characteristics of traumatic brain injuries sustained among veterans seeking homeless services.

PubMed

Barnes, Sean M; Russell, Leah M; Hostetter, Trisha A; Forster, Jeri E; Devore, Maria D; Brenner, Lisa A

2015-02-01

This hypothesis-generating research describes the characteristics of traumatic brain injuries (TBIs) sustained among 229 Veterans seeking homeless services. Nearly all participants (83%) had sustained at least one TBI prior to their first episode of homelessness. Among participants with a TBI, assaults, transportation-related accidents, and falls were the most common causes of these injuries. Thirty percent of individuals sustained injuries with severity levels that would be expected to be associated with ongoing TBI-related deficits. Forty-three percent of the Veterans sustained at least one brain injury following their first episode of homelessness. Median lifetime number of TBIs was three. The severity of TBIs was similar among Veterans who sustained injuries before or after their first incident of homelessness. Findings suggest that future research should directly examine the potential bi-directional relationship between TBI and homelessness, as well as the impact of TBI-related deficits on Veterans' ability to benefit from homeless services and/or maintain stable housing.

Does Race Matter in Addressing Homelessness? A Review of the Literature

PubMed Central

Jones, Marian Moser

2017-01-01

Since the 1980s, black persons have been overrepresented in the United States homeless population. Given that morbidity and mortality is elevated among both the black population and the homeless population in comparison to the general U.S. population, this overrepresentation has important implications for health policy. However, the racial demographics of homelessness have received little attention from policymakers. This article reviews published social and behavioral science literature that addresses the relationship between race and contemporary homelessness in the United States. This literature points to substantial differences between racial subgroups of the U.S. homeless population in vulnerabilities, health risks, behaviors, and service outcomes. Such observed differences suggest that policies and programs to prevent and end homelessness must explicitly consider race as a factor in order to be of maximum effectiveness. The limited scope of these findings also suggests that more research is needed to better understand these differences and their implications. PMID:29576910

Youth Homelessness and Vulnerability: How Does Couch Surfing Fit?

PubMed

Curry, Susanna R; Morton, Matthew; Matjasko, Jennifer L; Dworsky, Amy; Samuels, Gina M; Schlueter, David

2017-09-01

Youth homelessness is a problem characterized by high levels of vulnerability. The extent to which couch surfing - moving from one temporary housing arrangement to another - is part of youth homelessness is not well understood. Chapin Hall's Voices of Youth Count, a national research initiative, involves a multicomponent approach to studying youth homelessness. This study reports emerging findings regarding couch surfing and homelessness primarily from a national survey of 13,113 adults with youth ages 13-25 in their households or who are themselves ages 18-25. Findings suggest that couch surfing is relatively common, particularly among the older age group. Among households with 13- to 17-year-olds and 18- to 25-year-olds, 4.0% and 20.5%, respectively, reported that any of them had couch surfed in the last 12 months. There are notable social, economic, and educational differences, on average, between youth reporting homelessness and those reporting only couch surfing. However, most youth who report experiencing homelessness also report couch surfing, and these youth who experience both circumstances present high levels of socioeconomic vulnerability. Couch surfing encompasses a range of experiences, some of which likely include need for services. Interviews currently in the field, and expanded analysis of data, will contribute more nuanced policy insights. © Society for Community Research and Action 2017.

The Association Between Familial Homelessness, Aggression, and Victimization Among Children.

PubMed

Jetelina, Katelyn K; Reingle Gonzalez, Jennifer M; Cuccaro, Paula M; Peskin, Melissa F; Elliott, Marc N; Coker, Tumaini R; Mrug, Sylvie; Davies, Susan L; Schuster, Mark A

2016-12-01

The purpose of this study was to evaluate the relationship between the number of periods children were exposed to familial homelessness and childhood aggression and victimization. Survey data were obtained from 4,297 fifth-grade children and their caregivers in three U.S. cities. Children and primary caregivers were surveyed longitudinally in 7th and 10th grades. Family homelessness, measured at each wave as unstable housing, was self-reported by the caregiver. Children were categorized into four mutually exclusive groups: victim only, aggressor only, victim-aggressor, and neither victim nor aggressor at each time point using validated measures. Multinomial, multilevel mixed models were used to evaluate the relationship among periods of homelessness and longitudinal victimization, aggression, and victim aggression compared to children who were nonvictims and nonaggressors. Results suggest that children who experienced family homelessness were more likely than domiciled children to report aggression and victim aggression but not victimization only. Multivariate analyses suggested that even brief periods of homelessness were positively associated with aggression and victim aggression (relative to neither) compared to children who were never homeless. Furthermore, childhood victimization and victim aggression significantly decreased from 5th grade to 10th grade while aggression significantly increased in 10th grade. Children who experienced family homelessness for brief periods of time were significantly more likely to be a victim-aggressor or aggressor compared to those who were never homeless. Prevention efforts should target housing security and other important factors that may reduce children's likelihood of aggression and associated victimization. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Diagnostic patterns in hospital use by an urban homeless population.

PubMed Central

Morris, W; Crystal, S

1989-01-01

Because patterns of disease and health care system usage by the homeless constitute a neglected area of research in the medical literature, we undertook a retrospective analysis of inpatient records on medically indigent adults, controlling for housing status, to add to the growing body of research in the area of homeless health care. Data on all 4,243 indigent patients admitted over 2 fiscal years (1985 and 1986) under the county medical services program of San Diego County, California, revealed 5.3% (226) to be homeless. The commonest major diagnostic category among the homeless discharges was "diseases and disorders of the skin, subcutaneous tissue, and breast," constituting 21.2% as compared with only 8.7% of the discharge diagnoses for housed indigent persons. Within this major diagnostic category, the predominant diagnosis-related group was cellulitis, accounting for 12.8% of diagnoses in the homeless and only 4.0% of discharge diagnoses in other medically indigent persons. A homeless housing status was also correlated with a higher percentage of discharges with the major diagnostic category of "substance use and substance-induced organic mental disorders" but was negatively correlated with that of "diseases and disorders of the circulatory system." PMID:2588589

Who is Supporting Homeless Youth? Predictors of Support in Personal Networks

PubMed Central

de la Haye, Kayla; Green, Harold D.; Kennedy, David P.; Zhou, Annie; Golinelli, Daniela; Wenzel, Suzanne L.; Tucker, Joan S.

2012-01-01

Homeless youth lack the traditional support networks of their housed peers, which increases their risk for poor health outcomes. Using a multilevel dyadic analytic approach, this study identified characteristics of social contacts, relationships, and social networks associated with the provision of tangible and emotional support to homeless youth (N = 419, M age = 20.09, SD = 2.80). Support providers were likely to be family members, sex-partners, or non-street based contacts. The provision of support was also associated with contacts’ employment and homelessness status, frequency of contact, shared risk behaviors, and the number of network members that were homeless and employed. The results provide insights into how homeless youth could be assisted to develop more supportive social networks. PMID:23204810

Characteristics of sheltered homeless families.

PubMed Central

Bassuk, E L; Rubin, L; Lauriat, A S

1986-01-01

To describe the characteristics of homeless families, we interviewed 80 homeless mothers and 151 children living in 14 family shelters in Massachusetts (two-thirds of the shelters in the state). Ninety-four per cent of the families were headed by women, 91 per cent were on AFDC (aid to families with dependent children), with twice as many as the state average having been on AFDC for at least two years; most had long histories of residential instability. Although 60 per cent had completed high school, only a third had worked for longer than one month. One-third of the mothers reported having been abused during their childhood, and two-thirds had experienced a major family disruption. At the time of the interview, almost two-thirds either lacked or had minimal supportive relationships and one-fourth of these named their child as the major support. Eighteen mothers were involved with the Department of Social Services because of probable child abuse or neglect. Seventy-one per cent of the mothers had personality disorders. In contrast to many adult homeless individuals, however, deinstitutionalized persons or those suffering from psychoses were not overrepresented. About 50 percent of the homeless children were found to have developmental lags, anxiety, depression, and learning difficulties, and about half required further psychiatric evaluation. Two-thirds described housing and social welfare agencies as not helpful. Given the many serious problems of the mothers and the difficulties already manifested by their children, comprehensive psychosocial and economic interventions must be made to interrupt a cycle of extreme instability and family breakdown. PMID:3740332

Experience of primary care among homeless individuals with mental health conditions.

PubMed

Chrystal, Joya G; Glover, Dawn L; Young, Alexander S; Whelan, Fiona; Austin, Erika L; Johnson, Nancy K; Pollio, David E; Holt, Cheryl L; Stringfellow, Erin; Gordon, Adam J; Kim, Theresa A; Daigle, Shanette G; Steward, Jocelyn L; Kertesz, Stefan G

2015-01-01

The delivery of primary care to homeless individuals with mental health conditions presents unique challenges. To inform healthcare improvement, we studied predictors of favorable primary care experience among homeless persons with mental health conditions treated at sites that varied in degree of homeless-specific service tailoring. This was a multi-site, survey-based comparison of primary care experiences at three mainstream primary care clinics of the Veterans Administration (VA), one homeless-tailored VA clinic, and one tailored non-VA healthcare program. Persons who accessed primary care service two or more times from July 2008 through June 2010 (N = 366) were randomly sampled. Predictor variables included patient and organization characteristics suggested by the patient perception model developed by Sofaer and Firminger (2005), with an emphasis on mental health. The primary care experience was assessed with the Primary Care Quality-Homeless (PCQ-H) questionnaire, a validated survey instrument. Multiple regression identified predictors of positive experiences (i.e. higher PCQ-H total score). Significant predictors of a positive experience included a site offering tailored service design, perceived choice among providers, and currently domiciled status. There was an interaction effect between site and severe psychiatric symptoms. For persons with severe psychiatric symptoms, a homeless-tailored service design was significantly associated with a more favorable primary care experience. For persons without severe psychiatric symptoms, this difference was not significant. This study supports the importance of tailored healthcare delivery designed for homeless persons' needs, with such services potentially holding special relevance for persons with mental health conditions. To improve patient experience among the homeless, organizations may want to deliver services that are tailored to homelessness and offer a choice of providers.

Experience of Primary Care among Homeless Individuals with Mental Health Conditions

PubMed Central

Chrystal, Joya G.; Glover, Dawn L.; Young, Alexander S.; Whelan, Fiona; Austin, Erika L.; Johnson, Nancy K.; Pollio, David E.; Holt, Cheryl L.; Stringfellow, Erin; Gordon, Adam J.; Kim, Theresa A.; Daigle, Shanette G.; Steward, Jocelyn L.; Kertesz, Stefan G

2015-01-01

The delivery of primary care to homeless individuals with mental health conditions presents unique challenges. To inform healthcare improvement, we studied predictors of favorable primary care experience among homeless persons with mental health conditions treated at sites that varied in degree of homeless-specific service tailoring. This was a multi-site, survey-based comparison of primary care experiences at three mainstream primary care clinics of the Veterans Administration (VA), one homeless-tailored VA clinic, and one tailored non-VA healthcare program. Persons who accessed primary care service two or more times from July 2008 through June 2010 (N = 366) were randomly sampled. Predictor variables included patient and organization characteristics suggested by the patient perception model developed by Sofaer and Firminger (2005), with an emphasis on mental health. The primary care experience was assessed with the Primary Care Quality-Homeless (PCQ-H) questionnaire, a validated survey instrument. Multiple regression identified predictors of positive experiences (i.e. higher PCQ-H total score). Significant predictors of a positive experience included a site offering tailored service design, perceived choice among providers, and currently domiciled status. There was an interaction effect between site and severe psychiatric symptoms. For persons with severe psychiatric symptoms, a homeless-tailored service design was significantly associated with a more favorable primary care experience. For persons without severe psychiatric symptoms, this difference was not significant. This study supports the importance of tailored healthcare delivery designed for homeless persons’ needs, with such services potentially holding special relevance for persons with mental health conditions. To improve patient experience among the homeless, organizations may want to deliver services that are tailored to homelessness and offer a choice of providers. PMID:25659142

The Reading Connection: Literacy Development and Homeless Children.

ERIC Educational Resources Information Center

Hanning, Eileen

1996-01-01

Describes a model of intervention that is designed to support and encourage literacy development among children whose families are or recently have been homeless. The article then places this model within a global context, discussing the broader implications of providing literacy support services for homeless families. (GR)

Correlates of service utilization among homeless youth.

PubMed

Tyler, Kimberly A; Akinyemi, Sarah L; Kort-Butler, Lisa A

2012-07-01

Though few studies exist on service utilization among homeless youth in the U.S., services are important because without them, many of these young people may resort to delinquent strategies in order to meet their daily survival needs. The current study examines frequency and correlates of service utilization (i.e., shelters, food programs, street outreach, counseling, STI and HIV testing) among a sample of 249 homeless youth ages 14 to 21. Multivariate analysis revealed significant differences in service usage by sex, age, and sexual orientation. Experiencing family physical and/or sexual abuse, being kicked out of the family home, spending more nights per week sleeping on the street, and having ever stayed in a group home facility were significant correlates of homeless youths' service usage.

Arizona Head Start for Homeless Children and Families Project. 1995-96 Evaluation Report.

ERIC Educational Resources Information Center

Mulholland, Lori

Homeless families with children constitute the fastest growing segment of the United States homeless population. This study evaluated Year 2 of the Arizona Head Start for Homeless Children and Families Project, designed to meet educational and social needs of homeless children and families, and to assist Head Start agencies in developing effective…

Arizona Head Start for Homeless Children and Families Project. 1994-95 Evaluation Report.

ERIC Educational Resources Information Center

Mulholland, Lori; Greene, Andrea

Homeless families with children comprise the fastest growing segment of the United States homeless population. This study evaluated Year 1 of the Arizona Head Start for Homeless Children and Families Project, designed to meet educational and social needs of homeless children and families, and to assist Head Start agencies in developing effective…

The Mental and Physical Health of Homeless Youth: A Literature Review

ERIC Educational Resources Information Center

Edidin, Jennifer P.; Ganim, Zoe; Hunter, Scott J.; Karnik, Niranjan S.

2012-01-01

Youth homelessness is a growing concern in the United States. Despite difficulties studying this population due to inconsistent definitions of what it means to be a youth and homeless, the current body of research indicates that abuse, family breakdown, and disruptive family relationships are common contributing factors to youth homelessness.…

Developmental Status and Social-Emotional Functioning of Young Children Experiencing Homelessness

ERIC Educational Resources Information Center

Haskett, Mary E.; Armstrong, Jenna Montgomery; Tisdale, Jennifer

2016-01-01

The developmental status and social-emotional functioning of young children who are homeless has received inadequate attention in spite of high rates of homelessness among families with young children and the potentially negative impact of homelessness and associated stressors on children's well-being. The aim of this study was to gain…

Homelessness as a public mental health and social problem: New knowledge and solutions.

PubMed

Tsai, Jack; O'Toole, Thomas; Kearney, Lisa K

2017-05-01

Homelessness is a major public health problem that has received considerable attention from clinicians, researchers, administrators, and policymakers in recent years. In 2016, 550,000 individuals were homeless in the United States (U.S. Department of Housing and Urban Development, 2016) with 4.2% of individuals in the United States experiencing homelessness for over 1 month sometime in their lives and 1.5% experiencing homelessness in the last year (Tsai, 2017). Homelessness remains a recalcitrant problem and a ripe area for study, particularly in addressing needs of individuals at high risk for homelessness and those from understudied populations. New and innovative measurement approaches, interventions, and study methodologies are presented in this special issue to shed light on how psychology can help benefit and improve homeless services. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria.

PubMed

Peterson, Rachel; Gundlapalli, Adi V; Metraux, Stephen; Carter, Marjorie E; Palmer, Miland; Redd, Andrew; Samore, Matthew H; Fargo, Jamison D

2015-01-01

Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations.

Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria

PubMed Central

Peterson, Rachel; Gundlapalli, Adi V.; Metraux, Stephen; Carter, Marjorie E.; Palmer, Miland; Redd, Andrew; Samore, Matthew H.; Fargo, Jamison D.

2015-01-01

Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations. PMID:26172386

College Access and Success for Students Experiencing Homelessness: A Toolkit for Educators and Service Providers

ERIC Educational Resources Information Center

Dukes, Christina

2013-01-01

This toolkit serves as a comprehensive resource on the issue of higher education access and success for homeless students, including information on understanding homeless students, assisting homeless students in choosing a school, helping homeless students pay for application-related expenses, assisting homeless students in finding financial aid…

Serving Homeless Children and Families in Head Start.

ERIC Educational Resources Information Center

Koblinsky, Sally A.; Anderson, Elaine A.

1993-01-01

Describes the plight of homeless families in the United States, examining the special role that Head Start programs can play in homeless families' lives. Suggests that Head Start programs need to address staff training, family recruitment, health services, transportation, flexible scheduling, home-based options, attendance, parent education,…

Homeless Families in Rural and Non-Urban Communities.

ERIC Educational Resources Information Center

Rife, John C.; And Others

1992-01-01

Interviews with 247 homeless families (including 480 children) in 21 rural Ohio counties found that over two-thirds were headed by young single females. The most frequently cited reasons for homelessness were family conflict or dissolution and economic factors. Implications for service provision and policy development are discussed. (LP)

Homeless Children: Meeting the Educational Challenges. ERIC Digest.

ERIC Educational Resources Information Center

Goins, Brad; Cesarone, Bernard

Difficulties faced by homeless children include depression, low self-esteem, lack of sleep and nutrition, and feelings of shame and embarrassment. Challenges faced by schools in providing education to homeless children include: (1) keeping children in one school despite frequent family moves; (2) ensuring that children's health records are…

Educating Homeless Children: Issues and Answers. Fastback 313.

ERIC Educational Resources Information Center

Stronge, James H.; Tenhouse, Cheri

This publication summarizes issues relating to the education of homeless children and youth and reviews programs that are effective in the delivery of educational services to this population. The report is comprised of five sections. The first section, "Introduction," surveys factors contributing to homelessness and indicates the special…

Characteristics of Individuals With Mental Illness in Tokyo Homeless Shelters.

PubMed

Okamura, Tsuyoshi; Takeshima, Tadashi; Tachimori, Hisateru; Takiwaki, Ken; Matoba, Yuki; Awata, Shuichi

2015-12-01

Japan has the largest number of psychiatric beds in the world and has been in the process of deinstitutionalization since 2004. The majority of psychiatric inpatients are elderly long-term patients, who are at risk of homelessness after they are discharged. There is little information about homeless people with mental illnesses in Japan, and the aim of this study was to describe characteristics of people with a mental illness in homeless shelters in Tokyo. A face-to-face survey was conducted from December 2012 to March 2013 by the staff of a nonprofit organization (NPO) that helps socially isolated persons. Of the 1,056 people who received help during the study period, 684 completed the survey. Eighteen percent of the 684 survey participants had a mental illness. Of the 210 individuals who lived in shelters, one-third had a mental illness. The mean age of shelter users with mental illness was 64.9; they tended to be referred from hospitals, and their mental well-being was poorer than other NPO service users in the study. Among the service users with mental illness, those living in shelters were older than those living in the community and more likely to have a history of trouble with alcohol, poor family relationships, and impaired instrumental activities of daily living. Unmet mental health needs were noted among discharged hospital patients living in Tokyo homeless shelters. An integrated and community-based support system with more effective health care delivery, including critical time interventions, is needed.

Comparing Homeless Persons’ Care Experiences in Tailored Versus Nontailored Primary Care Programs

PubMed Central

Holt, Cheryl L.; Steward, Jocelyn L.; Jones, Richard N.; Roth, David L.; Stringfellow, Erin; Gordon, Adam J.; Kim, Theresa W.; Austin, Erika L.; Henry, Stephen Randal; Kay Johnson, N.; Shanette Granstaff, U.; O’Connell, James J.; Golden, Joya F.; Young, Alexander S.; Davis, Lori L.; Pollio, David E.

2013-01-01

Objectives. We compared homeless patients’ experiences of care in health care organizations that differed in their degree of primary care design service tailoring. Methods. We surveyed homeless-experienced patients (either recently or currently homeless) at 3 Veterans Affairs (VA) mainstream primary care settings in Pennsylvania and Alabama, a homeless-tailored VA clinic in California, and a highly tailored non-VA Health Care for the Homeless Program in Massachusetts (January 2011-March 2012). We developed a survey, the “Primary Care Quality-Homeless Survey," to reflect the concerns and aspirations of homeless patients. Results. Mean scores at the tailored non-VA site were superior to those from the 3 mainstream VA sites (P < .001). Adjusting for patient characteristics, these differences remained significant for subscales assessing the patient–clinician relationship (P < .001) and perceptions of cooperation among providers (P = .004). There were 1.5- to 3-fold increased odds of an unfavorable experience in the domains of the patient–clinician relationship, cooperation, and access or coordination for the mainstream VA sites compared with the tailored non-VA site; the tailored VA site attained intermediate results. Conclusions. Tailored primary care service design was associated with a superior service experience for patients who experienced homelessness. PMID:24148052

An Exploratory Factor Analysis of Coping Styles and Relationship to Depression Among a Sample of Homeless Youth.

PubMed

Brown, Samantha M; Begun, Stephanie; Bender, Kimberly; Ferguson, Kristin M; Thompson, Sanna J

2015-10-01

The extent to which measures of coping adequately capture the ways that homeless youth cope with challenges, and the influence these coping styles have on mental health outcomes, is largely absent from the literature. This study tests the factor structure of the Coping Scale using Exploratory Factor Analysis (EFA) and then investigates the relationship between coping styles and depression using hierarchical logistic regression with data from 201 homeless youth. Results of the EFA indicate a 3-factor structure of coping, which includes active, avoidant, and social coping styles. Results of the hierarchical logistic regression show that homeless youth who engage in greater avoidant coping are at increased risk of meeting criteria for major depressive disorder. Findings provide insight into the utility of a preliminary tool for assessing homeless youths' coping styles. Such assessment may identify malleable risk factors that could be addressed by service providers to help prevent mental health problems.

Making a Place for Nona: Meeting the Needs of Homeless Children.

ERIC Educational Resources Information Center

Boxill, Nancy A.

1994-01-01

Discusses the dilemmas that homeless children face and what day-care center staff can do to help meet the needs of such children, including providing consistency in homeless children's lives; providing basic necessities such as food, sleep, and privacy and showing a willingness to develop a normal relationship with homeless children. (MDM)

Using Evidence-Based Programs to Support Children and Families Experiencing Homelessness

ERIC Educational Resources Information Center

Siebel, Nancy L.; Bassuk, Ellen; Medeiros, Debra

2012-01-01

This article was originally published (November 2011) as a brief created on behalf of the Strengthening At Risk and Homeless Young Mothers and Children Coordinating Center, which is a partnership of The National Center on Family Homelessness, National Alliance to End Family Homelessness, and ZERO TO THREE. The article offers a definition of…

Prevalence and Correlates of Youth Homelessness in the United States

PubMed Central

Morton, Matthew H.; Dworsky, Amy; Matjasko, Jennifer L.; Curry, Susanna R.; Schlueter, David; Chávez, Raúl; Farrell, Anne F.

2018-01-01

Purpose Unaccompanied youth homelessness is a serious concern. Response, however, has been constrained by the absence of credible data on the size and characteristics of the population and reliable means to track youth homelessness over time. We sought to address these gaps. Methods Using a nationally representative phone-based survey (N = 26,161), we solicited household and individual reports on different types of youth homelessness. We collected household reports on adolescents aged 13–17 and young adults aged 18–25, as well as self-reports from young adults aged 18–25. Follow-up interviews with a subsample (n = 150) provided additional information on youth experiences and enabled adjustment for inclusion errors. Results Over a 12-month period, approximately 3.0% of households with 13- to 17-year-olds reported explicit youth homelessness (including running away or being asked to leave) and 1.3% reported experiences that solely involved couch surfing, resulting in an overall 4.3% household prevalence of any homelessness, broadly defined. For 18- to 25-year-olds, household prevalence estimates were 5.9% for explicitly reported homelessness, 6.6% for couch surfing only, and 12.5% overall. The 12-month population prevalence estimates, available only for 18- to 25-year-olds, were 5.2%, 4.5%, and 9.7%, respectively. Incidence rates were about half as high as prevalence rates. Prevalence rates were similar across rural and nonrural counties. Higher risk of homelessness was observed among young parents; black, Hispanic, and lesbian, gay, bisexual, or transgender (LGBT) youth; and those who did not complete high school. Conclusions The prevalence and incidence of youth homelessness reveal a significant need for prevention and youth-centric systems and services, as well as strategies to address disproportionate risks of certain subpopulations. PMID:29153445

Prevalence and Correlates of Youth Homelessness in the United States.

PubMed

Morton, Matthew H; Dworsky, Amy; Matjasko, Jennifer L; Curry, Susanna R; Schlueter, David; Chávez, Raúl; Farrell, Anne F

2018-01-01

Unaccompanied youth homelessness is a serious concern. Response, however, has been constrained by the absence of credible data on the size and characteristics of the population and reliable means to track youth homelessness over time. We sought to address these gaps. Using a nationally representative phone-based survey (N = 26,161), we solicited household and individual reports on different types of youth homelessness. We collected household reports on adolescents aged 13-17 and young adults aged 18-25, as well as self-reports from young adults aged 18-25. Follow-up interviews with a subsample (n = 150) provided additional information on youth experiences and enabled adjustment for inclusion errors. Over a 12-month period, approximately 3.0% of households with 13- to 17-year-olds reported explicit youth homelessness (including running away or being asked to leave) and 1.3% reported experiences that solely involved couch surfing, resulting in an overall 4.3% household prevalence of any homelessness, broadly defined. For 18- to 25-year-olds, household prevalence estimates were 5.9% for explicitly reported homelessness, 6.6% for couch surfing only, and 12.5% overall. The 12-month population prevalence estimates, available only for 18- to 25-year-olds, were 5.2%, 4.5%, and 9.7%, respectively. Incidence rates were about half as high as prevalence rates. Prevalence rates were similar across rural and nonrural counties. Higher risk of homelessness was observed among young parents; black, Hispanic, and lesbian, gay, bisexual, or transgender (LGBT) youth; and those who did not complete high school. The prevalence and incidence of youth homelessness reveal a significant need for prevention and youth-centric systems and services, as well as strategies to address disproportionate risks of certain subpopulations. Copyright © 2017 The Society for Adolescent Health and Medicine. All rights reserved.

Resilience, loneliness, and psychological distress among homeless youth.

PubMed

Perron, Jeff L; Cleverley, Kristin; Kidd, Sean A

2014-08-01

Extant quantitative research on loneliness among homeless youth has grouped loneliness with other elements of psychological distress. The current study seeks to determine if loneliness has a different relationship with resilience than does psychological distress among street youth. Using data from 47 participants, linear regression was conducted. Results indicate that homeless youth experiencing higher psychological distress reported lower resilience scores. However, levels of resilience are not significantly associated with feelings of loneliness when psychological distress was accounted for. This study has implications for how researchers and clinicians conceptualize and address feelings of loneliness among homeless youth. Copyright © 2014 Elsevier Inc. All rights reserved.

75 FR 29366 - ``Homeless Veterans' Reintegration Program (HVRP) National Technical Assistance Center...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-25

... ``Homeless Veterans' Reintegration Program (HVRP) National Technical Assistance Center Cooperative Agreement...). Section 2021 authorizes programs to expedite the reintegration of homeless Veterans into the labor force... Technical Assistance Center (NTAC) for the Homeless Veterans' Reintegration Program (HVRP) to include the...

How You Can Help Students Who Are Homeless

ERIC Educational Resources Information Center

Curriculum Review, 2009

2009-01-01

Many schools are struggling with high numbers of homeless students. Some research has suggested that homeless students are often experiencing exhaustion, hunger, stress, abuse and insecurity, making socialization and learning more difficult for them than it is for their peers. This paper discusses three easy ways school professionals can help and…

Visible Voices: Literacy Identity and the Invisible Homeless

ERIC Educational Resources Information Center

Juchniewicz, Melissa M.

2012-01-01

Despite calls for increased awareness of and sensitivity to diverse students and their in- and out-of-school literacies, the "invisible homeless"--those who often decline to self-identify--receive inadequate scholarly attention. They are often individuals who fear the stigma associated with homelessness as they navigate workplace, academic, and…

Veterans and Homelessness

DTIC Science & Technology

2009-06-26

was due, in part, to the decriminalization of actions such as public drunkenness, loitering, and vagrancy.2 Homelessness occurs among families with...51 The first category consisted of nine factors: year of birth, belonging to a racial or ethnic minority, childhood poverty, parental mental

Characterizing Concurrent Tobacco Product Use Among Homeless Cigarette Smokers.

PubMed

Kish, Daniel H; Reitzel, Lorraine R; Kendzor, Darla E; Okamoto, Hiroe; Businelle, Michael S

2015-09-01

Cigarette smoking prevalence rates are high among homeless adults (>70%); however, little is known about concurrent tobacco or other nicotine product use (i.e., concurrent use [CU]) in this population. CU may impact smoking quit rates and confer greater risk of health problems within this vulnerable population. This study characterized CU in a sample of homeless smokers and compared cigarette-only smokers (C-OS) to concurrent users (CUs) on participant characteristics and factors known to be associated with smoking cessation. Participants were 178 adult conventional cigarette smokers from a homeless shelter in Dallas, TX. Sociodemographic characteristics, number of homelessness episodes, tobacco dependence, and items characterizing use of several tobacco/nicotine products over the last 30 days including use frequency, reasons for use, and perceived health risks were described. Sociodemographic characteristics, number of homelessness episodes, tobacco dependence, stress, readiness to quit (RTQ) smoking, and number of smoking quit attempts in the last year were compared between the C-OS and CUs groups using t tests and chi-square tests. CU was prevalent (n = 91; 51.1%), and 49.5% of CUs reported the use of ≥2 products in addition to conventional cigarettes. Compared with C-OS, CUs were younger and had more homelessness episodes, higher expired breath carbon monoxide levels, and higher stress (ps < .05). Groups did not differ on sex, race, other dependence indicators, RTQ, or previous quit attempts. CU is common among homeless smokers. CUs and C-OS did not differ in their RTQ smoking, though greater stress among the CUs may represent a hurdle for cessation. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Development and validation of an instrument to assess imminent risk of homelessness among veterans.

PubMed

Montgomery, Ann Elizabeth; Fargo, Jamison D; Kane, Vincent; Culhane, Dennis P

2014-01-01

Veterans are overrepresented within the homeless population compared with their non-veteran counterparts, particularly when controlling for poverty. The U.S. Department of Veterans Affairs (VA) aims to prevent new episodes of homelessness by targeting households at greatest risk; however, there are no instruments that systematically assess veterans' risk of homelessness. We developed and tested a brief screening instrument to identify imminent risk of homelessness among veterans accessing VA health care. The study team developed initial assessment items, conducted cognitive interviews with veterans experiencing homelessness, refined pilot items based on veterans' and experts' feedback and results of psychometric analyses, and assigned weights to items in the final instrument to indicate a measure of homelessness risk. One-third of veterans who responded to the field instrument reported imminent risk of homelessness (i.e., housing instability in the previous 90 days or expected in the next 90 days). The reliability coefficient for the instrument was 0.85, indicating good internal consistency. Veterans who had a recent change in income, had unpaid housing expenses, were living temporarily with family and friends, needed help to get or keep housing, and had poor rental and credit histories were more likely to report a risk of homelessness than those who did not. This study provides the field with an instrument to identify individuals and households at risk of or experiencing homelessness, which is necessary to prevent and end homelessness. In addition, it supports VA's investment in homelessness prevention and rapid rehousing services for veterans who are experiencing or are at risk for homelessness.

Bartonella quintana Bacteremia among Homeless People.

PubMed

Foucault, C; Barrau, K; Brouqui, P; Raoult, D

2002-09-15

Bartonella quintana infections have recently reemerged, predominantly among the homeless populations in cities in both Europe and the United States. B. quintana can cause trench fever, endocarditis, and chronic bacteremia; the human body louse is the only known vector. Homeless people who presented to the emergency departments of University Hospital in Marseilles, France, were studied, as were those who had been admitted to other medical facilities in the city since 1 January 1997. Samples of blood and body lice were collected for culture for B. quintana and for serological testing. Bartonella bacteremia was associated with sweats, evidence of louse infestation, serological tests that were positive for B. quintana, and high titers of B. quintana antibody. Bacteremia was also associated with being homeless for <3 years. Asymptomatic, prolonged bacteremia (duration, up to 78 weeks) and intermittent bacteremia were found to occur. Data obtained regarding antibiotic regimens showed that treatment with gentamicin and doxycycline was effective in preventing relapses of bacteremia.

77 FR 44653 - Continuum of Care Homeless Assistance Grant Application-Technical Submission

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-30

... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5603-N-50] Continuum of Care Homeless... obtain more detailed technical information not contained in the original Continuum of Care Homeless...: Continuum of Care Homeless Assistance Grant Application--Technical Submission. OMB Approval Number: 2506...

Ten Cities, 1997-1998: A Snapshot of Family Homelessness across America.

ERIC Educational Resources Information Center

Homes for the Homeless, Inc., New York, NY.

In 1997, the Institute for Children and Poverty of Homes for the Homeless joined with more than 58 organizations from 10 cities across the country to develop a national snapshot of family homelessness in the United States. Nearly 800 families were surveyed. This report presents the results of this research. The typical homeless family in the…

Educational Rights of Homeless Children and Youth: Legal and Community Advocacy

ERIC Educational Resources Information Center

de Bradley, Ann Aviles

2008-01-01

Many homeless children and youth have difficulty in school due to their loss of stable housing, and lack of consistent contact with family and friends. When a child becomes homeless, schools are federally mandated to identify these students and provide the same access to a free and appropriate education as their non-homeless counterparts. Within a…

The Community College and the Homeless: A Model for the Nation. Job Training for the Homeless Demonstration Program Final Evaluation Report.

ERIC Educational Resources Information Center

Moehrlin, Cynthia D.

Established in 1981, the Alternatives Program at Elgin Community College (ECC) has provided services for displaced homemakers, single parents, welfare recipients, and homeless women, laying the groundwork for the 1988 formation of the Fox Valley Consortium for Job Training and Placement of the Homeless. Using federal funding, the Consortium offers…

Increased risk for substance use and health-related problems among homeless veterans.

PubMed

Dunne, Eugene M; Burrell, Larry E; Diggins, Allyson D; Whitehead, Nicole Ennis; Latimer, William W

2015-10-01

The first aim of this study was to compare self-reported causes of homelessness between veterans and nonveterans. A second aim examined whether homeless male veterans were more likely than homeless male nonveterans to experience current problems with addictions, mental health, and physical health. Additionally, a third aim was to compare frequency of emergency room visits and treatment needs between the two groups. Secondary data analyses compared male homeless veterans and nonveterans (N = 353) enrolled in the Alachua County Point in Time study in central Florida. Participants completed a questionnaire on demographics and health variables. Additional questions included recent emergency room visits and medical or other needs not being met. Veterans reported higher rates of substance use and mental health problems as a primary cause of homelessness when compared to nonveterans. Homeless veterans were more likely than nonveterans to report current problems with addictions (OR = 6.29, 95% CI: 3.43-11.53, p < .001), mental health problems (OR = 4.12, 95% CI: 2.28-7.42, p < .001), and physical problems (OR = 1.83, 95% CI: 1.08-3.67, p < .01). Finally, over half of homeless veterans (53.1%) reported an ER visit in the past year compared to only 40.9% of nonveterans (OR = 1.73, 95% CI: 1.07-2.80, p < .05). Veterans may be more likely to become homeless due to addiction and mental health and over half of homeless veterans are presenting to hospital emergency rooms. Given the greater utilization among homeless veterans, emergency rooms may serve as a prime opportunity to provide brief treatment and referrals for needed services. © American Academy of Addiction Psychiatry.

The Invisible Crisis: Connecting Schools with Homeless Families

ERIC Educational Resources Information Center

Shields, Carolyn M.; Warke, Amy

2010-01-01

Children and youth represent a growing proportion of the homeless population. Using the lens of transformative leadership, this multifamily case study explores the realities of homeless children, the challenges their families face, and the role of school leaders in ensuring that they receive a quality education. It recommends that leaders (1)…

Contextualizing the Impacts of Homelessness on Academic Growth

ERIC Educational Resources Information Center

Pavlakis, Alexandra E.; Goff, Peter; Miller, Peter M.

2017-01-01

Background/Context: Students experiencing homelessness are also often living in poverty and may share many of the same characteristics and experiences with children in low-income housing. Scholars aim to understand the impacts of homelessness above and beyond the effects of poverty, but studies are mixed. Contextual factors--such as the localized…

Feasibility and Acceptability of a Colocated Homeless-Tailored Primary Care Clinic and Emergency Department.

PubMed

Gabrielian, Sonya; Chen, Jennifer C; Minhaj, Beena P; Manchanda, Rishi; Altman, Lisa; Koosis, Ella; Gelberg, Lillian

2017-10-01

Homeless adults have low primary care engagement and high emergency department (ED) utilization. Homeless-tailored, patient-centered medical homes (PCMH) decrease this population's acute care use. We studied the feasibility (focused on patient recruitment) and acceptability (conceptualized as clinicians' attitudes/beliefs) of a pilot initiative to colocate a homeless-tailored PCMH with an ED. After ED triage, low-acuity patients appropriate for outpatient care were screened for homelessness; homeless patients chose between a colocated PCMH or ED visit. To study feasibility, we captured (from May to September 2012) the number of patients screened for homelessness, positive screens, unique patients seen, and primary care visits. We focused on acceptability to ED clinicians (physicians, nurses, social workers); we sent a 32-item survey to ED clinicians (n = 57) who worked during clinic hours. Questions derived from an instrument measuring clinician attitudes toward homeless persons; acceptability of homelessness screening and the clinic itself were also explored. Over the 5 months of interest, 281 patients were screened; 172 (61.2%) screened positive for homelessness; 112 (65.1%) of these positive screens were seen over 215 visits. Acceptability data were obtained from 56% (n = 32) of surveyed clinicians. Attitudes toward homeless patients were similar to prior studies of primary care physicians. Most (54.6%) clinicians agreed with the homelessness screening procedures. Nearly all (90.3%) clinicians supported expansion of the homeless-tailored clinic; a minority (42.0%) agreed that ED colocation worked well. Our data suggest the feasibility of recruiting patients to a homeless-tailored primary care clinic colocated with the ED; however, the clinic's acceptability was mixed. Future quality improvement work should focus on tailoring the clinic to increase its acceptability among ED clinicians, while assessing its impact on health, housing, and costs.

Feasibility and Acceptability of a Colocated Homeless-Tailored Primary Care Clinic and Emergency Department

PubMed Central

Gabrielian, Sonya; Chen, Jennifer C.; Minhaj, Beena P.; Manchanda, Rishi; Altman, Lisa; Koosis, Ella; Gelberg, Lillian

2017-01-01

Objectives: Homeless adults have low primary care engagement and high emergency department (ED) utilization. Homeless-tailored, patient-centered medical homes (PCMH) decrease this population’s acute care use. We studied the feasibility (focused on patient recruitment) and acceptability (conceptualized as clinicians’ attitudes/beliefs) of a pilot initiative to colocate a homeless-tailored PCMH with an ED. After ED triage, low-acuity patients appropriate for outpatient care were screened for homelessness; homeless patients chose between a colocated PCMH or ED visit. Methods: To study feasibility, we captured (from May to September 2012) the number of patients screened for homelessness, positive screens, unique patients seen, and primary care visits. We focused on acceptability to ED clinicians (physicians, nurses, social workers); we sent a 32-item survey to ED clinicians (n = 57) who worked during clinic hours. Questions derived from an instrument measuring clinician attitudes toward homeless persons; acceptability of homelessness screening and the clinic itself were also explored. Results: Over the 5 months of interest, 281 patients were screened; 172 (61.2%) screened positive for homelessness; 112 (65.1%) of these positive screens were seen over 215 visits. Acceptability data were obtained from 56% (n = 32) of surveyed clinicians. Attitudes toward homeless patients were similar to prior studies of primary care physicians. Most (54.6%) clinicians agreed with the homelessness screening procedures. Nearly all (90.3%) clinicians supported expansion of the homeless-tailored clinic; a minority (42.0%) agreed that ED colocation worked well. Conclusion: Our data suggest the feasibility of recruiting patients to a homeless-tailored primary care clinic colocated with the ED; however, the clinic’s acceptability was mixed. Future quality improvement work should focus on tailoring the clinic to increase its acceptability among ED clinicians, while assessing its impact on

Homeless and in Need of Special Education. Exceptional Children at Risk: CEC Mini-Library.

ERIC Educational Resources Information Center

Heflin, L. Juane; Rudy, Kathryn

This booklet examines the plight of homeless families who have children who need special educational services. It explores the magnitude of homelessness among families, provides empirical descriptions of homeless populations, and identifies factors contributing to the rising incidence of homelessness in the United States. Specific effects of…

'Growing Old' in Shelters and 'On the Street': Experiences of Older Homeless People.

PubMed

Grenier, Amanda; Sussman, Tamara; Barken, Rachel; Bourgeois-Guérin, Valerie; Rothwell, David

2016-01-01

Homelessness among older people in Canada is both a growing concern, and an emerging field of study. This article reports thematic results of qualitative interviews with 40 people aged 46 to 75, carried out as part of a mixed-methods study of older people who are homeless in Montreal, Quebec, Canada. Our participants included people with histories of homelessness (n = 14) and persons new to homelessness in later life (n = 26). Interviews focused on experiences at the intersections of aging and homelessness including social relationships, the challenges of living on the streets and in shelters in later life, and the future. This article outlines the 5 main themes that capture the experience of homelessness for our participants: age exacerbates worries; exclusion and isolation; managing significant challenges; shifting needs and realities; and resilience, strength, and hope. Together, these findings underscore the need for specific programs geared to the unique needs of older people who are homeless.

Longitudinal Predictors of Homelessness: Findings from the National Longitudinal Survey of Youth-97

PubMed Central

Sznajder-Murray, Brittany; Jang, Joy Bohyun; Slesnick, Natasha; Snyder, Anastasia

2016-01-01

Homeless youth represent a vulnerable and understudied population. Little research has prospectively identified factors that may place youth at risk for experiencing homelessness. The current study utilizes data from the National Longitudinal Survey of Youth-97 (NLSY-97) to examine predictors of experiencing homelessness as a young adult (before age 25). The NLSY-97 includes a nationally representative sample of 8,984 youth. Data were first collected from these youth when they were between the ages of 12 to 18 years. The current study examined whether individual and family risk factors reported during adolescence predict homelessness by the age of 25. The findings showed that multiple runaway episodes, non-traditional family structure, lower educational attainment, and parental work limitations due to health increased the risk of homelessness. A permissive parenting style and being Hispanic protected against homelessness. This study offers unique insight into risk and protective factors for youth homelessness, and has important clinical implications. PMID:27774034

Exploring Protective factors among homeless youth: the role of natural mentors.

PubMed

Dang, Michelle T; Conger, Katherine J; Breslau, Joshua; Miller, Elizabeth

2014-08-01

This study explored the presence and characteristics of natural mentors among 197 homeless youth and the association between natural mentoring relationships and youth functioning. Few studies have explored protective factors in the lives of homeless youth and how these may buffer against poor health outcomes. Relationships with natural mentors have been shown to have protective effects on adolescent functioning among the general adolescent population, and, thus, warrant further investigation with homeless youth. Results from this study revealed that 73.6% of homeless youth have natural mentoring relationships, split between kin and non-kin relationships. Having a natural mentor was associated with higher satisfaction with social support and fewer risky sexual behaviors. Findings suggest that natural mentors may play a protective role in the lives of homeless youth and should be considered an important source of social support that may enhance youth resilience.

The mental and physical health of homeless youth: a literature review.

PubMed

Edidin, Jennifer P; Ganim, Zoe; Hunter, Scott J; Karnik, Niranjan S

2012-06-01

Youth homelessness is a growing concern in the United States. Despite difficulties studying this population due to inconsistent definitions of what it means to be a youth and homeless, the current body of research indicates that abuse, family breakdown, and disruptive family relationships are common contributing factors to youth homelessness. Moreover, the experience of homelessness appears to have numerous adverse implications and to affect neurocognitive development and academics, as well as mental and physical health. Substance use, sexually transmitted infections, and psychiatric disorders are particularly prevalent in this population. Whereas some of these problems may be short-lived, the chronic stress and deprivation associated with homelessness may have long-term effects on development and functioning. Further, difficulties accessing adequate and developmentally-appropriate health care contribute to more serious health concerns. Suggestions for future research and interventions are discussed.

Upstream Disaster Management to Support People Experiencing Homelessness.

PubMed