Prevalence and impact of eye disease in an urban homeless and marginally housed population

Jiang, Shangjun; Mikhail, Mirriam; Slomovic, Jackie; Pereira, Austin; Lebovic, Gerald; Noel, Christopher W.; Lichter, Myrna

doi:10.1016/j.jcjo.2019.07.006

Cited by 14 publications

(22 citation statements)

References 12 publications

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“…), which ensured there were no duplicate participants, using a modified data collection sheet that had been used in previous studies looking at other health needs in homeless populations (Appendix 1, available at www.cmajopen.ca/content/8/1/E199/ suppl/DC1). [2][3][4] Demographic characteristics were collected for each participant. To facilitate comparisons with the general Canadian and US populations, some questions in the survey (sections II and III) were identical to those posed in national household surveys (US National Health and Nutrition Examination Survey 1999-2004 [https://www.cdc.gov/nchs/nhanes/] and Canadian Health Measures Survey 2012-2013 25 ).…”

Section: Surveymentioning

confidence: 99%

Hearing loss and hearing needs in an adult homeless population: a prospective cross-sectional study

Noel

Mok

et al. 2020

cmajo

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H omelessness is an important risk factor for poor health outcomes and represents a growing public health concern. About a quarter of a million Canadians experience homelessness in any given year. 1 The link between homelessness and health has been previously established, and it is well known that the homeless population is at increased risk for a variety of medical comorbidities including cardiovascular disease, diabetes, hypertension, vision loss and chronic obstructive pulmonary disease. 2-9 There is also emerging evidence suggesting that the onset of chronic diseases in homeless people may be accelerated. Brown and colleagues 10 observed that the self-reported rate of geriatric syndromes was higher in a homeless cohort than in a general US population that was, on average, more than 20 years older. Despite the growing body of knowledge surrounding homelessness and health, the relation between chronic homelessness and hearing status remains unknown. Although various national health surveys have shown a strong association between low socioeconomic status and hearing loss, 11-14 those studies were geared toward people in

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Section: Surveymentioning

confidence: 99%

Hearing loss and hearing needs in an adult homeless population: a prospective cross-sectional study

Noel

Mok

et al. 2020

cmajo

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“…For example, one study reported that individuals with a lower income and fewer educational milestones have greater odds of being diagnosed with an ocular pathology. 5 Additionally, this population is reported to access specialized eye care services at a much lower rate than the general population. 5 Negative interactions that homeless individuals have with the healthcare system could be a factor contributing to the lower rate of health care access and higher rate of visual impairment.…”

Section: Introductionmentioning

confidence: 95%

“…5 Additionally, this population is reported to access specialized eye care services at a much lower rate than the general population. 5 Negative interactions that homeless individuals have with the healthcare system could be a factor contributing to the lower rate of health care access and higher rate of visual impairment. For example, experiences of stigmatization, shaming and a feeling of being unwelcome when accessing health care services have been reported.…”

Section: Introductionmentioning

confidence: 95%

“…2,3 With regards to ocular health, recent studies have reported that homeless individuals are four times more likely to experience visual impairment than the general population. 4,5 The literature on this topic is limited, however the reasons for this appear to be multi-factorial. For example, one study reported that individuals with a lower income and fewer educational milestones have greater odds of being diagnosed with an ocular pathology.…”

Section: Introductionmentioning

confidence: 99%

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The Attitudes of Canadian Ophthalmology Residents and Pre-Clerkship Medical Students at an Ontario Medical School Towards Homeless Individuals: A Cross-Sectional Study

Sayal

Popović

Mustafa

et al. 2020

Ophthalmic Epidemiology

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Purpose: This cross-sectional study assessed the attitudes of Canadian ophthalmology residents (PGY1-5) and pre-clerkship medical students (year 1 and 2) at the University of Toronto towards individuals experiencing homelessness. Methods: Residents and students were invited to complete the Health Professionals' Attitudes Towards the Homeless Inventory (HPATHI) tool to assess attitudes, interests and confidence in working with the homeless population on a 5-point Likert scale. Comparisons were made between residents and pre-clerkship learners and between junior and senior residents using the Fisher exact test and Mann-Whitney U test. Results: Responses were received from 114 of 220 ophthalmology residents (52%) and 315 of 534 (59%) pre-clerkship medical students. Ophthalmology residents had significantly more negative overall attitudes (pre-clerk median = 4.4, resident median = 4.1, both still indicating positive attitudes) and interests (pre-clerk median = 4.0, resident median = 3.3, residents with more neutral interests) towards working with the homeless population compared to pre-clerkship medical students. Using both statistical methods, beliefs were significantly more negative in 7 of 9 'Attitude' items, 5 of 5 'Interest' items and 1 of 4 'Confidence' items. Ophthalmology residents were only more positive in 1 of 4 of the 'Confidence' items. Attitudes were similar across PGY1-5 training years, except PGY4 and PGY5 residents were more negative than PGY1-3 residents on 1 of 5 'Interest' items. Conclusions: Ophthalmology residents have an at least neutral perception of individuals experiencing homelessness, while medical students have a more positive opinion. Studies exploring optimal ways to advocate for this population are needed for Canada's eye-care trainees.

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“…1 The prevalence of cataracts was 10.4% in Toronto's homeless shelters, and cataracts accounted for 50% of the visual impairment seen among the inner-city homeless patients in Vancouver. 2,3 There are several barriers to accessing ocular care and outpatient surgical care, such as perceived discrimination, lack of medical insurance coverage, transportation limitations, and competing priorities for subsistence needs. 2,4 Further, many ophthalmologists struggle to provide equitable care because of challenges with follow-up, which tends to be lower in the homeless and marginally housed population.…”

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confidence: 99%

Cataract surgery in homeless patients: challenges encountered and strategies for providing care

Hanna

Chan

Lichter

2022

Canadian Journal of Ophthalmology

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Prevalence and impact of eye disease in an urban homeless and marginally housed population

Cited by 14 publications

References 12 publications

Hearing loss and hearing needs in an adult homeless population: a prospective cross-sectional study

Hearing loss and hearing needs in an adult homeless population: a prospective cross-sectional study

The Attitudes of Canadian Ophthalmology Residents and Pre-Clerkship Medical Students at an Ontario Medical School Towards Homeless Individuals: A Cross-Sectional Study

Cataract surgery in homeless patients: challenges encountered and strategies for providing care

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