Urban Homelessness and Poverty During Economic Prosperity and Welfare Reform: Changes in Self-Reported Comorbidities, Insurance, and Sources for Usual Care, 1995-1997

O’Toole, Thomas; Gibbon, Jeanette L.; Seltzer, Deborah L.; Hanusa, Barbara H.; Fine, Michael J.

doi:10.1093/jurban/79.2.200

Cited by 22 publications

(16 citation statements)

References 13 publications

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“…Both measures highlight weak economies that may be more vulnerable to changes in health care access. (24, 25) Race/ethnicity. We considered racial and ethnic minorities using standard Census Bureau measures: non-Hispanic African American, Hispanic, and other non-Hispanic, non-black populations.…”

Section: Study Data and Methodsmentioning

confidence: 99%

Rising Closures Of Hospital Trauma Centers Disproportionately Burden Vulnerable Populations

2011

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Closures of trauma centers have accelerated since 2001. These closures may be disproportionately affecting disadvantaged communities. We evaluate how driving time between ZIP codes and nearest trauma centers changed nationwide from 2001–2007. During this period, 24% of the population experienced increased driving times to the nearest trauma center. Communities with disproportionately high numbers of African Americans, uninsured, people living in poverty and in rural areas were more likely to experience deteriorating access than other communities. Remaining trauma centers serving these communities should be allocated funding, and efforts to coordinate trauma care at the regional level should account for access disparities.

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Section: Study Data and Methodsmentioning

confidence: 99%

Rising Closures Of Hospital Trauma Centers Disproportionately Burden Vulnerable Populations

2011

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“…O'Toole et al [12] studied the influence of economic prosperity and welfare reform on the condition of homeless people in Pittsburgh, USA. They were not able to benefit from economic growth and showed more medical and mental health comorbidity, required more long-term medication and more frequently had no health insurance.…”

Section: Homeless Individuals In the Societymentioning

confidence: 99%

Homelessness and mental illness

Salkow

Fichter

2003

Current Opinion in Psychiatry

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Purpose of reviewThe purpose of this review is to summarize findings of the literature on homelessness and mental illness published in 2002. Recent findingsResearchers focused on different topics concerning homelessness including physical and mental illness (e.g. schizophrenia, substance abuse and psychiatric comorbidity), risk factors, treatment and services. Although there are several methodological problems in homelessness research, many studies still use convenience samples, which may not be representative of the population of homeless individuals in a certain area. Summary It is encouraging that many researchers are interested in the special needs of homeless people, who are very impaired in many areas. It is important to take into account the complex factors that prevent them from being engaged in treatment. Methodologically sound investigations are needed to assess homeless people's needs and existing treatment facilities need improvements and probably reorganization in order to successfully meet these needs.

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“…23 More recently, it has been reported that, even in times of economic prosperity and welfare reform, 940% of one cohort of homeless adults lacked health insurance. 24 All of these barriers have the potential for having a negative impact on HBV vaccine coverage for the children and adolescents living in these families.…”

Section: Discussionmentioning

confidence: 99%

Positive Impact of a Shelter-based Hepatitis B Vaccine Program in Homeless Baltimore Children and Adolescents

et al. 2008

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Homeless youth are at increased risk for hepatitis B virus (HBV) infection and HBV vaccine coverage is poor in this group. The purpose of our study was to determine if a shelter-based HBV vaccine program in children and adolescents 2-18 years of age with a randomized controlled trial using a culturally appropriate HBV video could increase HBV vaccine coverage rates. Subjects were randomized to an 8 min HBV video or a control, smoking prevention video. Before exposure to the videos, HBV knowledge, and demographics were assessed in caregivers and adolescents. HBV vaccine no. 1 was offered to all subjects who did not produce a vaccine record; subsequently, an accurate HBV vaccine history was obtained from medical providers. Subjects were asked to return 1 and 3 months after visit 1, HBV vaccine was offered to all with incomplete coverage, and HBV knowledge was reassessed. There were 328 children and adolescents cared for by 170 caregivers enrolled in the study. One hundred and four had incomplete HBV vaccine coverage. Data are reported for all family units with at least one subject needing vaccine. There were 53 children and adolescents randomized to the HBV video vs. 51 to the smoking video. HBV knowledge scores of caregivers improved at Visit no. 2 vs. no. 1 in the HBV video group (p=0.01) but not in the smoking group (p=0.82). Similar results were observed for adolescents in the HBV video group (p=0.05) but not in the smoking group (p=0.40). Exposure to the HBV video vs the smoking video had a significant effect on return rates for vaccine at Visit no. 2 (59 vs. 31%; p=0.05) but not at Visit no. 3 (47 vs. 18%, p=0.06). The shelterbased vaccine program was very effective in increasing HBV coverage rates in the entire group of 328 children and adolescents enrolled in the study, from 68% coverage at baseline to 85% at the conclusion of the study. We conclude that shelter-based HBV vaccine programs can be highly effective in increasing vaccine coverage rates in older children and adolescents. A brief exposure to a culturally appropriate HBV video improves HBV knowledge and may improve return rates for vaccine.

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Urban Homelessness and Poverty During Economic Prosperity and Welfare Reform: Changes in Self-Reported Comorbidities, Insurance, and Sources for Usual Care, 1995-1997

Abstract: care (78.3% in 1997 vs. 80.2% in 1995, P = .55)

Cited by 22 publications

References 13 publications

Rising Closures Of Hospital Trauma Centers Disproportionately Burden Vulnerable Populations

Rising Closures Of Hospital Trauma Centers Disproportionately Burden Vulnerable Populations

Homelessness and mental illness

Positive Impact of a Shelter-based Hepatitis B Vaccine Program in Homeless Baltimore Children and Adolescents

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