Predictors of Overnight and Emergency Treatment among Homeless Adults

Abstract

High usage of emergency treatment and hospitalization has been reported among homeless individuals. Hence, this study aimed to identify the sociodemographic predictors associated with overnight and emergency hospital treatment among a sample of homeless adults. Participants were recruited from a shelter in Dallas, Texas (N = 354; Mage = 43.7 ± 11.7) and were predominantly uninsured, low-income men from various racial groups. The outcome variables were: (a) stayed overnight for treatment in a hospital; and (b) treated in a hospital emergency room. In logistic regression models, sex emerged as the only predictor of overnight treatment in a hospital (OR = 2.68, 95% CI = 1.61–4.47), and treatment in an emergency room (OR = 2.21, 95% CI = 1.34–3.65), such that women were more likely than men to be treated overnight and use emergency care. Targeted interventions and policies are needed to address homeless women’s primary care needs and reduce costlier treatment.

Perceived Social Support Attenuates the Association between Stress and Health-Related Quality of Life among Adults Experiencing Homelessness

“…Individuals experiencing homelessness are known to experience many stressors [10][11][12][13][14][15][16][17][18], limited social support [57], and poor HRQoL [21,22] relative to domiciled groups, ulti-mately increasing their susceptibility to premature morbidity and mortality [3][4][5][6][7][8][9]. Results of this cross-sectional study among adults experiencing homelessness suggest that social support moderates the association between stress and three of four components of HRQoL (poor physical health days, poor mental health days, and limited activity days due to poor mental or physical health) in models that included several prominent sociodemographic and diagnostic variables.…”

“…2 of 14 and have high rates of behavioral health issues that are associated with increased risks of premature morbidity and mortality [3][4][5][6][7][8][9]. Notable stress-inducing factors related to homelessness include exposure to violence [10]; food insecurity [11]; fear and mistrust [12]; lack of access to preventive medicine, engendering high use of emergency services [13]; criminal justice involvement [14]; poor sleep [15,16]; and discrimination [17], among others [11,18]. In fact, adults experiencing homelessness are known to endure various physical illnesses and chronic conditions that tend not to arise in the domiciled population until about 5-20 years later [19].…”

Mental Illness and Youth-Onset Homelessness: A Retrospective Study among Adults Experiencing Homelessness

“…Inclusion criteria were: aged 18 or over, English-speaking, at least a 7th grade English literacy level as indicated by a score of >4 on the Rapid Estimate of Adult Literacy in Medicine-Short Form [ 39 ], and receiving services and/or shelter at the targeted agencies. Overall, 470 participants were screened in Study 1 and 648 were screened in Study 2, from which 76 (Study 1) and 38 (Study 2) individuals were ineligible for participation (for more information, see [ 37 , 40 ] and [ 38 , 41 ]). Overall, 394 (Study 1) and 610 (Study 2) participants enrolled.…”

Guest Support for Outdoor Smoke-Free Policies within a Homeless Shelter

“…Smoking is socially and culturally accepted among the community of adults experiencing homelessness [ 3 ]; this contributes to unsuccessful quit attempts [ 4 ]. Moreover, the various and voluminous stressors encountered by individuals experiencing homelessness can also negatively impact their tobacco use and perceived ability to successfully quit, including food insufficiency [ 5 ], unmet medical or surgical care [ 6 ], perceived discrimination [ 7 ], victimization, exposure to violence [ 8 ], and high rates of behavioral health problems and comorbid substance use [ 9 ]. Furthermore, high rates of smoking amongst this vulnerable group have been associated with exceedingly high rates of chronic tobacco-related diseases such as cancers, cardiovascular diseases, and heart disease, as well as premature mortality [ 10 , 11 ].…”