The mental and physical health of the homeless

Bertram, Franziska; Hajek, André; Dost, Katharina; Graf, Wiebke; Brennecke, Anna; Kowalski, Veronika; Rüth, Victoria van; König, Hans‐Helmut; Wulff, Birgit; Ondruschka, Benjamin; Püschel, Klaus; Heinrich, Fabian

doi:10.3238/arztebl.m2022.0357

Cited by 5 publications

(16 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The major share of mental health burden can be attributed to alcohol dependency and substance use disorders, further anxiety disorders, affective disorders, drug dependence, and major depression (5). Similar results were described in the Germanbased National Survey on Psychiatric and Somatic Health of Homeless Individuals (6). Homelessness is not only associated with a higher prevalence of somatic and mental illness, but also with higher mortality rates.…”

Section: Introductionsupporting

confidence: 62%

See 1 more Smart Citation

Determinants of COVID-19 vaccine acceptance and access among people experiencing homelessness in Germany: A qualitative interview study

Grune

Savelsberg

Kobus

et al. 2023

Front. Public Health

View full text Add to dashboard Cite

IntroductionPeople experiencing homelessness face lower life expectancy, higher prevalence of somatic and mental diseases and a more difficult access to healthcare compared to people in secure living. During the COVID-19 pandemic transmission rates were higher among people experiencing homelessness and preventive public health measures were not properly adapted to the specific needs of people experiencing homelessness. Thus, goal of our study was understanding the determinants of acceptability and access of the COVID-19 vaccine.Materials and methodsWe conducted a qualitative interview study with twenty guideline interviews with adult people currently experiencing homelessness in Berlin, Germany (August 2021 – April 2022). Participants were approached in a purposive sampling strategy. The interviews were analyzed with qualitative content analysis according to Mayring.ResultsAcceptance and attitude toward the COVID-19 vaccine is influenced by confidence in the vaccine as well as in the political and healthcare system, the individual COVID-19 risk perception and sense of collective responsibility. Overall, the acceptance of the vaccine was high among our participants. Facilities offering low threshold COVID-19 vaccines for people experiencing homelessness were perceived as helpful. Language barriers and the need for identity documents were major barriers to access the COVID 19 vaccine.DiscussionPeople experiencing homelessness are a marginalized and vulnerable group often underrepresented in the public and scientific discourse. During the COVID-19 pandemic, preventive public health measures, including the COVID-19 vaccine, failed to consider specific needs of people experiencing homelessness. Multidimensional strategy to enhance inclusive healthcare are needed to improve access and to reduce discrimination and stigmatization.

show abstract

Section: Introductionsupporting

confidence: 62%

“…At the same time, PEH face major barriers when seeking health care (6,8). A qualitative study from Spain identified administrative, personal, and medical-professional barriers for PEH, demonstrating inequities in accessing healthcare.…”

Section: Introductionmentioning

confidence: 99%

Determinants of COVID-19 vaccine acceptance and access among people experiencing homelessness in Germany: A qualitative interview study

Grune

Savelsberg

Kobus

et al. 2023

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…In our sample, no homeless individual reported recent release from institutions (category 6) ( 44 ). A more detailed description can be found in Bertram et al ( 45 ).…”

Section: Methodsmentioning

confidence: 99%

Immunity against measles, mumps, rubella, and varicella among homeless individuals in Germany — A nationwide multi-center cross-sectional study

Graf,

Bertram,

Dost

et al. 2024

Front. Public Health

Self Cite

View full text Add to dashboard Cite

IntroductionHomeless individuals suffer a high burden of vaccine-preventable infectious diseases. Moreover, they are particularly susceptible to adverse infection outcomes with limited access to the health care system. Data on the seroprevalence of measles, mumps, rubella, and varicella within this cohort are missing.MethodsThe seroprevalence of measles, mumps, rubella, and varicella was determined within the homeless population in Germany. Predictors of lacking immune protection were determined using multivariable logistic regression analysis.ResultsHomeless individuals in Germany (n = 611) showed a seroprevalence of 88.5% (95% CI: 85.8–91.0) for measles, 83.8% (95% CI: 80.6–86.6) for mumps, 86.1% (95% CI: 83.1–88.7) for rubella, and 95.7% (95% CI 93.8–97.2) for varicella. Measles seroprevalences declined from individuals born in 1965 to individuals born in 1993, with seroprevalences not compatible with a 95% threshold in individuals born after 1980. For mumps, seroprevalences declined from individuals born in 1950 to individuals born in 1984. Here, seroprevalences were not compatible with a 92% threshold for individuals born after 1975. Seronegativity for measles, mumps and rubella was associated with age but not with gender or country of origin.DiscussionHerd immunity for measles and mumps is not achieved in this homeless cohort, while there was sufficient immune protection for rubella and varicella. Declining immune protection rates in younger individuals warrant immunization campaigns also targeting marginalized groups such as homeless individuals. Given that herd immunity thresholds are not reached for individuals born after 1980 for measles, and after 1975 for mumps, vaccination campaigns should prioritize individuals within these age groups.

show abstract

“…178.000 von ihnen kommen regelmäßig in Notunterkünften der Kommunen unter, etwa 37.400 Menschen leben dauerhaft auf der Straße [ 2 , 4 ]. Etwa 40 % der wohnungslosen Menschen nutzen Versorgungssysteme nicht, weil sie es als zu gefährlich erachten oder dort mit zu vielen anderen Personen untergebracht seien [ 2 , 5 ]. Dies führt dazu, dass die Ergebnisse aus Studien mit wohnungslosen Menschen selten generalisierbar sind, da nur bestimmte Gruppen innerhalb dieser Kohorte erreicht werden können.…”

Section: Hohes Risiko Für Eine Sars-cov‑2-infektion Durch Umwelt- Und...unclassified

“…Im Rahmen der NAPSHI-Studie gaben 46 % der Studienteilnehmenden eine abgeschlossene Schulbildung an, 67 % waren ledig. Im Median waren die Befragten 18 Monate ohne festen Wohnsitz [ 2 , 5 ].…”

Section: Hohes Risiko Für Eine Sars-cov‑2-infektion Durch Umwelt- Und...unclassified

Health of homeless individuals during the COVID-19 pandemic

Rüth

Hajek

Heinrich

et al. 2023

Bundesgesundheitsbl

Self Cite

View full text Add to dashboard Cite

ZusammenfassungDie Lebenssituation und die Gesundheit wohnungsloser Menschen unterscheiden sich in vielerlei Hinsicht von denen der Allgemeinbevölkerung. Die Vermutung liegt nahe, dass es sich bei wohnungslosen Menschen um eine besonders vulnerable Personengruppe während der Coronavirus-Disease-2019(COVID-19)-Pandemie handelt. In dieser narrativen Übersichtsarbeit soll die aktuelle Literatur zur Gesundheit und Versorgung von wohnungslosen Menschen während der COVID-19-Pandemie zusammengefasst werden. Recherchiert wurde zwischen Dezember 2022 und Februar 2023. Neben der aktuellen nationalen und internationalen Literatur sollen insbesondere die Ergebnisse des „National survey on psychiatric and somatic health of homeless individuals“ (NAPSHI-Studie) synoptisch dargestellt werden; diese untersucht psychische und somatische Erkrankungen sowie die Versorgung wohnungsloser Menschen in Deutschland.Wohnungslose Menschen sind häufig psychisch und somatisch erkrankt und haben einen eingeschränkten Zugang zum medizinischen Regelsystem. Versorgungseinrichtungen mit Gruppenräumen und Schlafsälen stellen ein Risiko für ein Ausbruchsgeschehen in der COVID-19-Pandemie dar. Wie vermutet, zeigten sich im Verlauf der Pandemie bei wohnungslosen Menschen häufiger als in der Allgemeinbevölkerung Hinweise für Severe Acute Respiratory Syndrome Coronavirus Type 2(SARS-CoV‑2)-Infektionen, viele davon schienen allerdings asymptomatisch zu verlaufen. Eine hohe Rate an unwissentlich infizierten wohnungslosen Menschen könnte zur Verbreitung der Viruserkrankung beigetragen haben. Trotzdem war ein unkontrolliertes COVID-19-Ausbruchsgeschehen, vor dem einige Wissenschaftler:innen zu Beginn der Pandemie warnten, nicht zu beobachten.

show abstract

The mental and physical health of the homeless

Cited by 5 publications

References 34 publications

Determinants of COVID-19 vaccine acceptance and access among people experiencing homelessness in Germany: A qualitative interview study

Determinants of COVID-19 vaccine acceptance and access among people experiencing homelessness in Germany: A qualitative interview study

Immunity against measles, mumps, rubella, and varicella among homeless individuals in Germany — A nationwide multi-center cross-sectional study

Health of homeless individuals during the COVID-19 pandemic

Contact Info

Product

Resources

About