Comparing Unsheltered and Sheltered Homeless: Demographics, Health Services Use and Predictors of Health Services Use

Petrovich, James C.; Hunt, Joel J.; North, Carol S.; Pollio, David E.; Murphy, Erin

doi:10.1007/s10597-019-00470-0

Cited by 27 publications

(36 citation statements)

References 34 publications

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“…PEH frequently use emergency departments for health care, contributing to overcrowded emergency rooms and significant hospital costs, and experience higher mortality rates than the general population [ 2 – 5 ]. Although there are health care services for PEH in many U.S. cities, these services remain underutilized [ 6 – 9 ]. It is critical that PEH have access to and use community-based, preventive and longitudinal health care services to address their unmet medical and behavioral health needs, supporting their improved quality of life, reduced mortality, and reduced strain on emergency departments.…”

mentioning

confidence: 99%

Unmet health needs and barriers to health care among people experiencing homelessness in San Francisco’s Mission District: a qualitative study

et al. 2022

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Background People experiencing homelessness have unique health needs and barriers to medical and behavioral health care (mental health, substance use disorder, and overall well-being) compared to housed people. It remains unclear why many people experiencing homelessness do not access care when community-based homeless health care resources are available at low or no cost. This qualitative study examined perspectives of people experiencing homelessness and staff members at community-based homeless health and service organizations in San Francisco’s Mission District on unmet medical and behavioral health needs and barriers to accessing care. Methods We conducted 34 interviews between September and November 2020: 23 with people experiencing homelessness and 11 with staff at community-based homeless health and service organizations in the Mission District. Qualitative interviews were transcribed, coded, and analyzed using the Framework Method on NVivo Qualitative Data Analysis Software. Results Both staff and homeless participants reported unmet and common health needs of mental illness, physical injury and disability, food and nutrition insecurity, and substance use disorder. Barriers to care included negative prior health care experiences, competing priorities, and provider turnover. Recommendations for improving services included building more trust with people experiencing homelessness by training clinic staff to treat patients with respect and patience and expanding clinical outreach and health education programs. Conclusions People experiencing homelessness face many different health needs and barriers to care, some of which community-based organizations have the ability to address. These findings can help inform future strategies for homeless health care programs to identify and target the specific unmet health needs and barriers to care of people experiencing homelessness in their communities.

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confidence: 99%

Unmet health needs and barriers to health care among people experiencing homelessness in San Francisco’s Mission District: a qualitative study

et al. 2022

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“…studies have found associations between unsheltered status and substance use, mental health disorders, and criminal justice problems. 12,13,28,36 In addition, unsheltered homelessness disproportionately affects people of color, 12,36 although that was not the case among this sample. This study, which draws on a national sample, helps to illustrate how the complex sociopolitical phenomena of unsheltered homelessness involve a measurable stack of personal-and community-level factors.…”

Section: Discussionmentioning

confidence: 61%

“…11 Many involve local samples. 12,13 This study seeks a statistical portrait of personal and community characteristics associated with unsheltered homelessness among veterans on the basis of a research survey of >5,000 veterans with experiences of homelessness (sheltered and unsheltered), including veterans who obtained housing after being homeless. Although crosssectional data preclude direct causal inference, they may hint at factors contributing to unsheltered status, and descriptive data can direct attention to vulnerabilities that may require help after homelessness ends.…”

mentioning

confidence: 99%

Characteristics Associated With Unsheltered Status Among Veterans

Kertesz

DeRussy

Riggs

et al. 2021

American Journal of Preventive Medicine

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“…Another study compared unsheltered and sheltered homeless adults in terms of their demographics and health service use. Findings indicated that unsheltered participants were less likely to have insurance and more likely to use emergency services and outpatient services than sheltered participants (12). Previous studies focused on this topic have had limitations.…”

Section: Introductionmentioning

confidence: 89%

Unsheltered homeless and unstably housed adults have higher levels of stress and more health risk factors than sheltered homeless adults

Karen¹,

Hébert

Alexander³

et al. 2021

Journal of Social Distress and Homelessness

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Background: In the United States, approximately 568,000 individuals are homeless on a single night. Homelessness can be categorized into three subgroups: sheltered homeless, unsheltered homeless, and unstably housed. Few studies have examined the relations between homelessness subtypes, shelter service utilization, levels of stress experienced, and health risk factors. This study aimed to empirically examine whether shelter status the previous night was related to current stress, recent utilization of shelter-based mental health services, and current health risk factors. Methods: Data were collected at multiple homeless shelters in 2016 in the Oklahoma City area (N=575). All participants completed assessments of demographic characteristics, including age, sex, race, marital status, years of education, and incarceration history and victimization. Multiple linear and logistic regression analyses were conducted to examine relations between homelessness subgroups and outcomes (shelter-based service utilization, health risk factors, and stressors).Results: Results indicated that the sheltered group was younger and more likely to be White than the unsheltered group, had higher levels of education, and reported more lifetime months in jail than the unstably housed group. In addition, unsheltered homeless and unstably housed adults used fewer shelter-based health services, exhibited more health risk factors, experienced greater levels of stress, and had higher levels of food insecurity than sheltered homeless adults.Conclusion: Homeless adults who reside at shelters bene t most from available shelter services. The development of policies and programs targeted toward increasing sheltering options for unsheltered and unstably housed adults is needed.

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Comparing Unsheltered and Sheltered Homeless: Demographics, Health Services Use and Predictors of Health Services Use

Cited by 27 publications

References 34 publications

Unmet health needs and barriers to health care among people experiencing homelessness in San Francisco’s Mission District: a qualitative study

Unmet health needs and barriers to health care among people experiencing homelessness in San Francisco’s Mission District: a qualitative study

Characteristics Associated With Unsheltered Status Among Veterans

Unsheltered homeless and unstably housed adults have higher levels of stress and more health risk factors than sheltered homeless adults

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