N. Hipple, S. Shaefer, Robert F. Hipple, A. Ballew
{"title":"Can we prevent deaths of homeless persons? Police led public health approach to prevent homeless deaths","authors":"N. Hipple, S. Shaefer, Robert F. Hipple, A. Ballew","doi":"10.1080/10530789.2016.1240950","DOIUrl":"https://doi.org/10.1080/10530789.2016.1240950","url":null,"abstract":"Abstract Research on homeless populations demonstrates that homelessness in itself is an independent risk factor for death. However, there is a dearth of detailed data on homeless decedents and the situations surrounding their deaths. This lack of knowledge, a desire to understand how and why homeless individuals were dying, and a sentinel event death led the Indianapolis Metropolitan Police Department Homelessness and Panhandling Unit to partner with a local researcher and begin conducting homeless death reviews. The approach is modeled after the evidence-based, public health approach of the Fetal and Infant Mortality Review process (FIMR). The FIMR model is a systematic approach to understanding system gaps and obtaining insights into the factors that resulted in homelessness and ultimately death. This article reports on the process to develop this unique multi-agency, police-led review of homeless deaths in Indianapolis, Indiana and resulting recommendations for action to decrease these deaths.","PeriodicalId":45390,"journal":{"name":"Journal of Social Distress and the Homeless","volume":"90 1","pages":"78 - 85"},"PeriodicalIF":1.4,"publicationDate":"2016-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10530789.2016.1240950","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60195150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Doran, N. Kunzler, T. Mijanovich, Samantha Lang, Ada L. Rubin, P. Testa, D. Shelley
{"title":"Homelessness and other social determinants of health among emergency department patients","authors":"K. Doran, N. Kunzler, T. Mijanovich, Samantha Lang, Ada L. Rubin, P. Testa, D. Shelley","doi":"10.1080/10530789.2016.1237699","DOIUrl":"https://doi.org/10.1080/10530789.2016.1237699","url":null,"abstract":"Abstract Emergency departments (EDs) are often called the ‘safety net’ of the U.S. health care system. Little is known, however, about the social determinants of health (SDOH) – including rates and types of homelessness – of ED patients. This study sought to quantify the presence of housing instability, homelessness, and other selected SDOH in ED patients. We conducted a cross-sectional survey of a random sample of 625 patients presenting to an urban ED. 13.8% of patients were currently living in a homeless shelter or on the streets. Further, 25.4% of patients reported concern about becoming homeless in the next 2 months and 9.1% had been evicted in the past year. 42.0% of patients reported difficulty meeting essential expenses and 35.9% were worried about running out of food. In conclusion, we found high rates of homelessness and other social needs in ED patients. Addressing patients’ SDOH will become increasingly important under new healthcare payment models.","PeriodicalId":45390,"journal":{"name":"Journal of Social Distress and the Homeless","volume":"25 1","pages":"71 - 77"},"PeriodicalIF":1.4,"publicationDate":"2016-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10530789.2016.1237699","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60195078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heidi Gilroy, J. Mcfarlane, John Maddoux, Cris M. Sullivan
{"title":"Homelessness, housing instability, intimate partner violence, mental health, and functioning: A multi-year cohort study of IPV survivors and their children","authors":"Heidi Gilroy, J. Mcfarlane, John Maddoux, Cris M. Sullivan","doi":"10.1080/10530789.2016.1245258","DOIUrl":"https://doi.org/10.1080/10530789.2016.1245258","url":null,"abstract":"Abstract Homelessness and housing instability frequently accompany intimate partner violence and can negatively impact health and functioning. When children are exposed to homelessness or housing instability their ability to develop and function is compromised. The purpose of this study is to examine the differential impact of homelessness and unstable housing on health and functioning of women and their children over a 2-year period. Two hundred and seventy-seven mothers reporting intimate partner violence (stalking, physical, or sexual violence by an intimate partner) were asked about housing stability, abuse, risk for murder, mental health, employment/wages, and their child's functioning over a 2-year period. Outcomes of mothers reporting homelessness and unstable housing were compared to mothers reporting stable housing. Over one-third (36%) of the mothers reported at least one episode of unstable housing over the 2-year period and 11% reported homelessness. Measures of maternal mental health and child functioning were worse for both unstably housed and homeless women, compared to stably housed women, with a higher risk for sexual abuse and risk for murder for homeless women. New models of rapid rehousing are needed that address not only the housing problems of women who have experienced intimate partner violence but also the mental health and safety issues that the women and their children face.","PeriodicalId":45390,"journal":{"name":"Journal of Social Distress and the Homeless","volume":"25 1","pages":"86 - 94"},"PeriodicalIF":1.4,"publicationDate":"2016-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10530789.2016.1245258","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60195330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Oudshoorn, C. Ward-Griffin, H. Berman, C. Forchuk, B. Poland
{"title":"Relationships in healthcare and homelessness: Exploring solidarity","authors":"A. Oudshoorn, C. Ward-Griffin, H. Berman, C. Forchuk, B. Poland","doi":"10.1080/10530789.2016.1254862","DOIUrl":"https://doi.org/10.1080/10530789.2016.1254862","url":null,"abstract":"Abstract Background: People experiencing homelessness have some of the highest morbidity rates and lowest age of mortality in Canada yet face many barriers to care, in particular the attitudes of healthcare providers. Objectives: In this critical ethnographic study, power within client–provider relationships in health care with people experiencing homelessness is explored. Methods: Multiple qualitative methods of document analysis, participant observation, interviews, and focus groups were used with both clients and providers in a community clinic for people experiencing homelessness. Data analysis involved individual and team thematic analysis, guided by Lather's (2007, Getting lost: Feminist efforts towards a double(d) science. Albany, NY: SUNY Press) criteria for validity. Results: Caregiving relationships involve a negotiation of power based on the many differences of social location between clients and providers. Both clinic policies and personal practices influence the ways power is asserted, taken, or shared. Conclusions: In discussing the implications for addressing power relations in caregiving relationships, it is highlighted that most work in this area has focused on educating health professionals to assist them to relate in more appropriate ways. More needs to be done to actively address the power differentials inherent in caregiving with people experiencing homelessness, for which the concept of ‘solidarity’ is presented as offering some promise.","PeriodicalId":45390,"journal":{"name":"Journal of Social Distress and the Homeless","volume":"25 1","pages":"102 - 95"},"PeriodicalIF":1.4,"publicationDate":"2016-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10530789.2016.1254862","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60195384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevalence and correlates of diabetes mellitus among homeless veterans nationally in the Veterans Health Administration","authors":"T. Iheanacho, R. Rosenheck","doi":"10.1080/10530789.2016.1169722","DOIUrl":"https://doi.org/10.1080/10530789.2016.1169722","url":null,"abstract":"Abstract Background: Homeless people are at high risk for many chronic medical conditions although their risk of diabetes has not been well studied. Current epidemiological studies of diabetes prevalence among homeless adults have been based mostly on self-report data not supported by clinical assessments. Objectives: To determine the prevalence and risk factors for diabetes mellitus (DM) among homeless veterans in the Veteran Health Administration (VHA). Methods: The sample included 3 464 364 veterans with documented body mass indexes (BMI), 137 720 (4%) of whom had been homeless. Logistic regression models were used to determine the odds of having DM among homeless veterans compared to non-homeless veterans. Bivariate and multi-variate analyses were then used to identify potential risk factors for DM among homeless veterans. Results: The prevalence of DM in homeless veterans was 19%. Homeless veterans with DM, compared to those without it were older, more likely to have a BMI > 40 and more likely to have DM-related co-morbidities. Conclusions: There is a high prevalence of DM among homeless veterans in the VHA compared to previous reports for homeless adults (8%). Tailored approaches to improve access to DM screening, prevention, and treatment could benefit homeless veterans.","PeriodicalId":45390,"journal":{"name":"Journal of Social Distress and the Homeless","volume":"25 1","pages":"53 - 59"},"PeriodicalIF":1.4,"publicationDate":"2016-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10530789.2016.1169722","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60194976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Stress on the streets: Validation of a measurement","authors":"L. Rew, T. Powell, S. Thompson","doi":"10.1080/10530789.2015.1116837","DOIUrl":"https://doi.org/10.1080/10530789.2015.1116837","url":null,"abstract":"Abstract Background: Homeless and street-dependent youths experience myriad stressors, but to date there has been no published measure of this phenomenon. Objective: This study was designed to describe the process of developing and testing a measure of stress experienced on the streets suitable for use with this population. Methods: Classical measurement theory was used to develop and evaluate relevance and validity of items in the scale. Results: The total scale content validity index was .95 and the Cronbach’s alpha was .92 in a combined sample of homeless youths (n = 90) and university students (n = 94). The mean scores of the two subsamples were statistically significantly different (t(166) = 4.22, P < .001), supporting construct validity. Factor analysis, using Principal Component Analysis, of data collected from the homeless youths yielded five subscales congruent with content in initial item construction. The subscales were: (1) safety on the streets, (2) housing stability, (3) interpersonal relationships, (4) immediate security and (5) stress about future. Conclusions: The final scale has 27 items suitable for future research with this population.","PeriodicalId":45390,"journal":{"name":"Journal of Social Distress and the Homeless","volume":"25 1","pages":"11 - 18"},"PeriodicalIF":1.4,"publicationDate":"2016-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10530789.2015.1116837","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60194984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Conducting public health photovoice projects with those who are homeless: A review of the literature","authors":"Christopher M. Seitz, R. Strack","doi":"10.1080/10530789.2015.1135565","DOIUrl":"https://doi.org/10.1080/10530789.2015.1135565","url":null,"abstract":"Abstract ‘Photovoice’ is a photographic method that is used for several purposes (e.g. storytelling, building awareness, enhancing personal discovery), including conducting community-based participatory research (CBPR). Since its creation, photovoice has been used as a method for implementing health-related CBPR projects with people experiencing homelessness. As such, this article presents an overview of seven peer-reviewed publications regarding photovoice projects that were conducted with participants who are homeless. The goal of the review is to provide health professionals with a practical summary of the lessons learned from each photovoice project's methods and findings. Based on the literature, the review's major suggestion is that health professionals should plan and implement future projects according to the fundamental aspects of photovoice (e.g. empowerment of participants to document their community, facilitation of group discussions of photos, concerted efforts to reach policymakers).","PeriodicalId":45390,"journal":{"name":"Journal of Social Distress and the Homeless","volume":"25 1","pages":"33 - 40"},"PeriodicalIF":1.4,"publicationDate":"2016-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10530789.2015.1135565","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60194774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Exploring the nutritional vulnerability of homeless men in a Canadian urban setting","authors":"C. D'andreamatteo, J. Slater","doi":"10.1080/10530789.2015.1116839","DOIUrl":"https://doi.org/10.1080/10530789.2015.1116839","url":null,"abstract":"Abstract Homelessness, Aboriginal ethnicity, and nutritional vulnerability are key determinants of health. Substance abuse further compounds health risk. This study explored the nutritional vulnerability of homeless men, some of who were solvent-users, to assess nutrition-related chronic disease risk factors. Anthropometric data were used to calculate disease risk using body mass index. Diet was assessed using a 24-hr food recall and data were compared to Canada’s Food Guide recommendations. A significant proportion of participants had low intakes of vegetables and fruit and milk and alternatives. More than half of the participants met the intake recommendations for grain servings and meat and alternatives. Solvent-using participants consumed significantly higher intakes of vegetables and fruit, grain products, and other foods and beverages, than non-solvent using men. More than half of the participants were classified as overweight or obese. Healthy food consumption was influenced by lack of stable housing, reliance on charitable food, and substance abuse.","PeriodicalId":45390,"journal":{"name":"Journal of Social Distress and the Homeless","volume":"25 1","pages":"26 - 32"},"PeriodicalIF":1.4,"publicationDate":"2016-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10530789.2015.1116839","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60194757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Carpenter-Song, Joelle C Ferron, Sara Kobylenski
{"title":"Social exclusion and survival for families facing homelessness in rural New England","authors":"E. Carpenter-Song, Joelle C Ferron, Sara Kobylenski","doi":"10.1080/10530789.2016.1138603","DOIUrl":"https://doi.org/10.1080/10530789.2016.1138603","url":null,"abstract":"Abstract Homelessness in rural communities remains largely hidden. This article draws on ethnographic data to examine the hidden lives of families facing homelessness and its aftermath in rural New England. Our findings highlight how lived experiences of extreme poverty are shaped by the cultural values in this rural setting. We argue that social exclusion is a defining feature of the lived experience of homelessness in this setting in which individualism and self-sufficiency are core cultural values. While certain practice and policy strategies may apply broadly to impoverished families (e.g. affordable housing, service coordination, vocational support), we propose that efforts to support families should be grounded in, and tailored to, the specific setting and cultural values of rural communities.","PeriodicalId":45390,"journal":{"name":"Journal of Social Distress and the Homeless","volume":"25 1","pages":"41 - 52"},"PeriodicalIF":1.4,"publicationDate":"2016-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10530789.2016.1138603","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60194841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Negotiating the service system: Professionals and patients talk about healthcare for the homeless in a Midwestern City in the U.S.","authors":"J. Davis-berman","doi":"10.1080/10530789.2015.1116838","DOIUrl":"https://doi.org/10.1080/10530789.2015.1116838","url":null,"abstract":"Abstract This article presents and discusses themes generated from in-depth interviews with 10 key informants and four homeless adults in a medium-sized city in the Midwest, United States. The purpose of the interviews was to gain an understanding of the healthcare system that was in place for the homeless, both from the perspective of professionals and consumers alike. Key informants represented the major medical and social service agencies involved in the provision of healthcare services for the homeless in this city. Based on these interviews, the following themes were generated and are presented here for analysis and discussion: Lack of Services, Need for Medicaid, Coordination of Care, Lack of End-of-Life Care, and Suggestions for Change. Practice implications are presented.","PeriodicalId":45390,"journal":{"name":"Journal of Social Distress and the Homeless","volume":"6 1","pages":"19 - 25"},"PeriodicalIF":1.4,"publicationDate":"2016-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10530789.2015.1116838","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60195117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}