Patients’ Perspectives on Elements of Stable Housing and Threats to Housing Stability

2020 ◽  
pp. 000-000
Author(s):  
Ann Elizabeth Montgomery ◽  
Thomas H. Byrne ◽  
Meagan C. Cusack ◽  
Manik Chhabra ◽  
Anneliese E. Sorrentino ◽  
...  
Keyword(s):  
Housing Stability ◽  
Stable Housing

scholarly journals Housing Stability and Hepatitis C Infection for Young Adults Who Inject Drugs: Examining the Relationship of Consistent and Intermittent Housing Status on HCV Infection Risk

2020 ◽  
Vol 97 (6) ◽  
pp. 831-844
Author(s):  
Meghan D. Morris ◽  
Irene H. Yen ◽  
Steve Shiboski ◽  
Jennifer L. Evans ◽  
Kimberly Page
Keyword(s):  
Hepatitis C ◽  
Cox Regression ◽  
Infection Risk ◽  
Hcv Infection ◽  
Hepatitis C Infection ◽  
Housing Status ◽  
Housing Stability ◽  
Stable Housing ◽  
Independent Association ◽  
The Relationship

AbstractHousing status affects drug using behaviors, but less is known about the relationship between housing patterns and hepatitis C virus (HCV) infection. HCV-negative young people who inject drugs (PWID) were enrolled into a prospective cohort (2003–2019) with quarterly study visits. We used Cox regression to estimate the independent association of recent housing status (housed vs. unhoused, housing stability, and housing trajectory) on HCV incidence. Among 712 participants, 245 incident HCV infections occurred over 963.8 person-years (py) (cumulative incidence 24.4/100 py). An inverse relationship between time housed and HCV incidence was observed (always unhoused 45.0/100 py, 95% confidence interval (CI) 37.1, 54.5; variably housed 18.0/100 py, 95% CI 15.0, 21.3; and always housed 7.0/100 py, 95% CI 3.0, 17.3). In Cox regression models controlling for confounders, those unhoused versus housed at baseline had a 1.9-fold increased infection risk (95% CI 1.4, 2.6). Those always unhoused versus always housed had a 1.5 times greater risk of HCV (95% CI 1.0, 2.3), and those spending a portion of time in stable housing a lower risk (adjusted relative hazard 0.05, 95% CI 0.3, 0.9) with a similar trend for those being housed for less time. Young adult PWID experiencing both recent and chronic states of being unhoused are at elevated risk for HCV infection. Importantly for this group of PWID, our findings indicate that some frequency of residential housing significantly reduces HCV infection risk.

Brief Note: Exploratory Examination of How Race and Criminal Record Relate to Housing Instability Among Domestic Violence Survivors

2021 ◽  
pp. 088626052110426
Author(s):  
Jasmine Engleton ◽  
Cris M. Sullivan ◽  
Noora Hamdan
Keyword(s):  
Domestic Violence ◽  
Racial Differences ◽  
The United States ◽  
Housing Instability ◽  
Criminal Record ◽  
Major Barrier ◽  
Housing Stability ◽  
Stable Housing ◽  
Domestic Violence Survivors ◽  
Latina Survivors

Housing instability is a critical concern in the United States, and domestic violence (DV) survivors are a group at high risk for experiencing housing instability or of becoming unhoused. Prior research has also identified having a criminal record (CR) as being a major barrier to obtaining stable housing, and this is truer for Black and Latinx people compared to their White counterparts. No study has examined whether comparable trends exist among survivors of DV, a group also at elevated risk of having a CR, sometimes related to their experience of abuse. The current exploratory study included 305 unhoused or unstably housed female DV survivors who had sought out DV support services. Multivariate regressions explored if survivor race and CR were separately linked to greater housing instability. CR was then explored as a potential moderator in the relation between race and housing instability. Results revealed that DV survivors with a CR faced greater housing instability than those without a CR, Black and Latina survivors experienced greater housing stability than did White survivors, and CR did not moderate the relation between race and housing instability. The racial differences were unexpected and are discussed in light of methodological limitations. This is the first study to date to explore the role of CR possession on housing instability for DV survivors.

Patterns and effects of social integration on housing stability, mental health and substance use outcomes among participants in a randomized controlled Housing First trial

2020 ◽  
Vol 265 ◽  
pp. 113481
Author(s):  
Maritt Kirst ◽  
Rebecca Friesdorf ◽  
Martha Ta ◽  
Alexandra Amiri ◽  
Stephen W. Hwang ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Social Integration ◽  
Housing First ◽  
Housing Stability ◽  
Randomized Controlled

Returning Citizens and Point of Entry: Is There a Match?

2021 ◽  
pp. 104438942095643
Author(s):  
Sondra J. Fogel ◽  
Kim M. Lersch ◽  
Daniel Ringhoff ◽  
Jessica M. Grosholz
Keyword(s):  
Behavioral Health ◽  
Neighborhood Effects ◽  
Small Body ◽  
Criminal Activity ◽  
Local Communities ◽  
High Poverty ◽  
Point Of Entry ◽  
Stable Housing ◽  
Basic Services ◽  
Returning Citizens

The period after incarceration and the influence of neighborhood effects are gaining interest among scholars as a small body of evidence is illustrating the difficulties returning citizens have obtaining basic services and needs, employment, stable housing, and other social and behavioral health supports in the areas where they are being released. Transitional planning efforts to ensure that returning citizens are prepared to engage in society and have necessary supports are often made. However, returning citizens may be in local communities that do not offer needed supports, such as in areas of high poverty and criminal activity, and low employment options. Findings from this study suggest that more attention is needed to where returning citizens are released following their period of incarceration.

Housing Matters, Services Might: Findings from the High Needs Families Program Evaluation

2021 ◽  
Vol 693 (1) ◽  
pp. 209-229
Author(s):  
Debra J. Rog ◽  
Kathryn A. Henderson ◽  
Clara A. Wagner ◽  
Emily L. Abbruzzi
Keyword(s):  
Support Services ◽  
Justice System ◽  
Subsidized Housing ◽  
Supportive Housing ◽  
Intensive Case Management ◽  
Access To Services ◽  
Supportive Services ◽  
Housing Stability ◽  
The Past ◽  
Permanent Supportive Housing

Permanent supportive housing for families experiencing homelessness—typically, subsidized housing that is not time limited and provides access to a range of support services—has substantially increased over the past 10 years, despite an absence of rigorous evidence of its effectiveness. We examine the benefits of subsidized housing with supportive services compared to subsidized housing alone. Our findings suggest that supportive housing offers more opportunities for access to services and benefits than subsidized housing alone, but it may not be beneficial to families’ housing stability or to family members’ employment or involvement with the criminal justice system. We argue that housing that is coupled with intensive case management, that is service rich, and that provides and adheres to harm reduction principles may help to strengthen supportive housing’s effectiveness.

Health Needs of Homeless Children

PEDIATRICS ◽  
1988 ◽  
Vol 82 (6) ◽  
pp. 938-940
Author(s):  
Keyword(s):  
Affordable Housing ◽  
Homeless Persons ◽  
Homeless Population ◽  
Homeless Children ◽  
Welfare Programs ◽  
Stable Housing ◽  
The Us ◽  
Community Ties ◽  
Societal Problems ◽  
Families With Children

Families with children represent more than one third of the homeless population nationally and more than 50% of the homeless population in many cities. Lack of a permanent dwelling deprives children of the most basic necessities for proper growth and development. Homeless children have unique risks that compromise their health status. Pediatricians are encouraged to be aware of this growing population of children and include them in their service and advocacy efforts. BACKGROUND A homeless person is defined by the National Governors Association as "an undomiciled person who is unable to secure permanent and stable housing without special assistance." The US General Accounting Office defines homeless individuals as those persons who lack resources and community ties necessary to provide for their own adequate shelter. Estimates of the number of people who lacked access to conventional dwelling or residence in 1987 range from 350,000 to more than 3 million.1 Although there is disagreement concerning the exact number of homeless persons, there is consensus that the numbers are large and continuing to increase.2 The average increase from 1986 to 1987 in the number of people needing shelter was 20%, and one quarter of this need could not be met with existing emergency shelters. (US Conference of Mayors, unpublished data, December 1987). Several societal problems contribute to the increasing rate of homelessness among American families, including lack of affordable housing; decrease in availability of rent subsidies; unemployment, especially among those who have held only marginal jobs; personal crises such as divorce and domestic violence; cutbacks in public welfare programs; substance abuse; and deinstitutionalization of the mentally ill.

Cost-effectiveness of assertive community treatment for homeless persons with severe mental illness

1999 ◽  
Vol 174 (4) ◽  
pp. 346-352 ◽  
Author(s):  
Anthony F. Lehman ◽  
Lisa Dixon ◽  
Jeffrey S. Hoch ◽  
Bruce Deforge ◽  
Eimer Kernan ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Cost Effectiveness ◽  
Severe Mental Illness ◽  
Usual Care ◽  
Assertive Community Treatment ◽  
Cost Effective ◽  
Homeless Persons ◽  
Community Treatment ◽  
Stable Housing

BackgroundHomelessness is a major public health problem among persons with severe mental illness (SMI). Cost-effective programmes that address this problem are needed.AimsTo evaluate the cost-effectiveness of an assertive community treatment (ACT) programme for these persons in Baltimore, Maryland.MethodsA total of 152 homeless persons with SMI were randomly allocated to either ACT or usual services. Direct treatment costs and effectiveness, represented by days of stable housing, were assessed.ResultsCompared with usual care, ACT costs were significantly lower for mental health in-patient days and mental health emergency room care, and significantly higher for mental health out-patient visits and treatment for substance misuse. ACT patients spent 31% more days in stable housing than those receiving usual care. ACT and usual services incurred $242 and $415 respectively in direct treatment costs per day of stable housing, an efficiency ratio of 0. 58 in favour of ACT. Patterns of care and costs varied according to race.ConclusionACT provides a cost-effective approach to reducing homelessness among persons with severe and persistent mental illnesses.

Building a Home: Everyday Placemaking in a Toxic Neighborhood

2019 ◽  
Vol 62 (5) ◽  
pp. 709-727
Author(s):  
Maricarmen Hernandez
Keyword(s):  
Land Tenure ◽  
Petrochemical Industry ◽  
Informal Settlement ◽  
Toxic Exposure ◽  
Scarce Resources ◽  
Housing Stability ◽  
Ethnographic Fieldwork ◽  
Petrochemical Complex ◽  
Extended Exposure

Why do residents of a contaminated area actively organize to formalize their land tenure and continually invest scarce resources in the fortification of their homes, despite their high-risk locations? Existing research documents the collective struggles of residents of contaminated communities to leave toxic areas or to confront polluting industries. Drawing from long-term ethnographic fieldwork in an informal settlement located next to a highly polluting petrochemical complex in Esmeraldas, Ecuador, this article presents the case of a marginalized community that is not only well-aware of its toxic exposure but also actively organizing and investing time and resources to ensure its permanence in the area. This article shows that the strenuous circumstances under which families moved into the neighborhood after multiple displacements, their continued struggle to remain there along with their longing for housing stability have contributed to their extended exposure to the poisonous toxic externalities of the neighboring petrochemical industry.

scholarly journals General practice patients starting treatment for substance use problems: observations from two data sources across levels of care

2020 ◽  
Author(s):  
Nicole Boffin ◽  
Jerome Antoine ◽  
Luk Van Baelen ◽  
Sarah Moreels ◽  
Kris Doggen
Keyword(s):  
General Practice ◽  
Substance Use ◽  
Data Sources ◽  
Treatment Episode ◽  
Specialist Care ◽  
Levels Of Care ◽  
Substance Use Problems ◽  
Stable Housing ◽  
Treatment Demand ◽  
Specialist Treatment

Abstract BackgroundIn Belgium, the incidence of treatment episodes for substance use problems is monitored by the Network of Sentinel General Practices (SGP) and by the Treatment Demand Indicator (TDI) surveillance at higher, specialist care levels. Using both data sources, we examine 1) how patients starting specialist treatment for substance use problems on referral by their GP compare to those that were referred by non-GP caregivers; 2) how patients starting GP treatment for substance use problems without receiving specialist treatment concurrently compare to those who do.MethodsThe same European protocol with common variables was used by both surveillances. Data from 2016 and 2017 were examined using 95% confidence intervals and multivariate regression.ResultsAccording to TDI-data (n=16,543), determinants of being referred by a GP (versus by a non-GP caregiver) for specialist treatment were age ≥ median (OR 1.25; 95% CI 1.13-1.38), education ≥ secondary level (OR 1.27; 95% CI 1.15-1.41), recent employment (OR 1.71; 1.56-1.88), stable housing (3.62; 95% CI 3.08-4.26), first treatment episode (OR 1.72; 95% CI 1.57-1.87), recent daily primary substance use (OR 1.46; 95% CI 1.33-1.59) and mono substance use (OR 1.23; 95% CI 1.04-1.48). Type of substance use was a significant determinant with higher odds of using pharmaceuticals (and alcohol) (OR 1.24; 95% CI 1.04-1.48), and lower odds of using cannabis only/primarily (OR 0.73; 95% CI 0.62-0.86), with reference to street drugs minus cannabis only/primarily. According to SGP data (n=314), determinants of starting GP treatment without concurrent specialist treatment were recent employment (OR 2.58; 95% CI 1.36-4.91), first treatment episode (OR 2.78; 95% CI 1.39-5.55) and living in the Brussels or Walloon region (OR 1.97; 95% CI 1.06-3.66).ConclusionsThis study adds knowledge about the general practice population treated for substance use problems and the consistency of data from the surveillances. Both studies show a relatively favourable profile of general practice patients with substance use problems.

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