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Addressing the Health Needs of Individuals Experiencing Homelessness

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: 31 August 2024 | Viewed by 7215

Special Issue Editors


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Guest Editor
Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB T6G 1C9, Canada
Interests: homelessness; patients experiencing homelessness; injury control; health advocacy; transformational leadership; media advocacy; safety culture assessment; firefighters wellness
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
The Bizzell Group, LLC and Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
Interests: road safety; injury prevention; health promotion
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Living homeless can set one up for failure in every aspect of life. Not having a place to call home often robs one of life’s opportunities. It becomes almost impossible to treat acute and chronic illnesses such as pneumonia and hypertension, to treat an injury like a badly burned leg, or even to get help for a problem pregnancy. Having a substance misuse disorder further complicates any chance of finding stability in recovery when people have no place to call home. Being burdened by mental health issues further compounds the ability to find a job or a place to stay. If one’s homeless existence is characterized by “addiction to chaos”, then having a place to stay is a first step toward recovery. Homelessness and health are at the opposite ends of the wellness spectrum, and providing adequate health care and reducing homelessness are strategies that can support wellness in a community.

Homelessness is closely connected to declines in physical and mental health. Unhoused individuals often experience high rates of health problems such as HIV and hepatis A infections, alcohol and drug addiction, mental illness, tuberculosis, and other serious conditions. The health problems facing individuals experiencing homelessness result from various factors, including lack of housing, racism and discrimination, barriers to health care, lack of access to adequate food and protection, and limited resources for social services. 

Developing strategies for reducing the multiple health risk factors which predispose populations to homelessness, the acute and long-term health complications of homelessness, and identifying the economic costs to the health care system in managing the health of individuals experiencing homelessness are critical factors in designing and implementing strategies that improve the health of individuals and families experiencing homelessness.

This Special Issue is open to studies related to health and health care of individuals experiencing homelessness. The keywords listed below indicate some of the areas of interest.

Prof. Dr. Louis Hugo Francescutti
Prof. Dr. David Sleet
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • homelessness and prevention
  • homelessness and emergency department use
  • homelessness and clinical care
  • homelessness and long-term health effects
  • homelessness and cost of comprehensive care
  • homelessness and public health systems
  • homelessness and behavioral risk factors
  • homelessness and hunger
  • homelessness and injuries

Published Papers (4 papers)

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15 pages, 852 KiB  
Article
Death Is a Possibility for Those without Shelter”: A Thematic Analysis of News Coverage on Homelessness and the 2021 Heat Dome in Canada
by Emily J. Tetzlaff, Farah Mourad, Nicholas Goulet, Melissa Gorman, Rachel Siblock, Sean A. Kidd, Mariya Bezgrebelna and Glen P. Kenny
Int. J. Environ. Res. Public Health 2024, 21(4), 405; https://doi.org/10.3390/ijerph21040405 - 27 Mar 2024
Viewed by 1175
Abstract
Among the most vulnerable to the health-harming effects of heat are people experiencing homelessness. However, during the 2021 Heat Dome, the deadliest extreme heat event (EHE) recorded in Canada to date, people experiencing homelessness represented the smallest proportion of decedents (n = 3, [...] Read more.
Among the most vulnerable to the health-harming effects of heat are people experiencing homelessness. However, during the 2021 Heat Dome, the deadliest extreme heat event (EHE) recorded in Canada to date, people experiencing homelessness represented the smallest proportion of decedents (n = 3, 0.5%)—despite the impacted region (British Columbia) having some of the highest rates of homelessness in the country. Thus, we sought to explore the 2021 Heat Dome as a media-based case study to identify potential actions or targeted strategies that were initiated by community support agencies, individuals and groups, and communicated in the news during this EHE that may have aided in the protection of this group or helped minimize the mortality impacts. Using media articles collated for a more extensive investigation into the effects of the 2021 Heat Dome (n = 2909), we identified a subset which included content on people experiencing homelessness in Canada (n = 274, 9%). These articles were thematically analysed using NVivo. Three main themes were identified: (i) public warnings issued during the 2021 Heat Dome directly addressed people experiencing homelessness, (ii) community support services explicitly targeting this population were activated during the heat event, and (iii) challenges and barriers faced by people experiencing homelessness during extreme heat were communicated. These findings suggest that mass-media messaging and dedicated on-the-ground initiatives led by various organizations explicitly initiated to support individuals experiencing homelessness during the 2021 Heat Dome may have assisted in limiting the harmful impacts of the heat on this community. Full article
(This article belongs to the Special Issue Addressing the Health Needs of Individuals Experiencing Homelessness)
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0 pages, 860 KiB  
Communication
Bridge Healing: A Pilot Project of a New Model to Prevent Repeat “Social Admit” Visits to the Emergency Department and Help Break the Cycle of Homelessness in Canada
by Matthew Robrigado, Igor Zorić, David A. Sleet and Louis Hugo Francescutti
Int. J. Environ. Res. Public Health 2023, 20(19), 6845; https://doi.org/10.3390/ijerph20196845 - 27 Sep 2023
Cited by 1 | Viewed by 1668 | Correction
Abstract
Homelessness continues to be a pervasive public health problem throughout Canada. Hospital Emergency Departments (EDs) and inpatient wards have become a source of temporary care and shelter for homeless patients. Upon leaving the hospital, homeless patients are not more equipped than before to [...] Read more.
Homelessness continues to be a pervasive public health problem throughout Canada. Hospital Emergency Departments (EDs) and inpatient wards have become a source of temporary care and shelter for homeless patients. Upon leaving the hospital, homeless patients are not more equipped than before to find permanent housing. The Bridge Healing program in Edmonton, Alberta, has emerged as a novel approach to addressing homelessness by providing transitional housing for those relying on repeated visits to the ED. This paper describes the three essential components to the Bridge Healing model: partnership between the ED and a Housing First community organization; facility design based on The Eden Alternative™ principles; and grassroots community funding. This paper, in conjunction with the current pilot project of the Bridge Healing facilities, serves as a proof of concept for the model and can inform transitional housing approaches in other communities. Full article
(This article belongs to the Special Issue Addressing the Health Needs of Individuals Experiencing Homelessness)
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13 pages, 665 KiB  
Article
Provider Perspectives on Sleep as a Determinant of Health and Housing Outcomes among Veterans Experiencing Homelessness: An Exploratory, Social-Ecological Study
by Elizabeth M. Moore, Lillian Gelberg, Michael Soh, Cathy Alessi and Roya Ijadi-Maghsoodi
Int. J. Environ. Res. Public Health 2023, 20(9), 5739; https://doi.org/10.3390/ijerph20095739 - 08 May 2023
Cited by 3 | Viewed by 2086
Abstract
Sleep problems are common among United States (U.S.) veterans and are associated with poor health, mental health, and functioning. Yet, little is known about insufficient sleep and factors contributing to sleep disparities among veterans experiencing homelessness. We conducted semi-structured interviews to better understand [...] Read more.
Sleep problems are common among United States (U.S.) veterans and are associated with poor health, mental health, and functioning. Yet, little is known about insufficient sleep and factors contributing to sleep disparities among veterans experiencing homelessness. We conducted semi-structured interviews to better understand the clinical, environmental, and structural factors contributing to insufficient sleep among veterans and to improve care for this population. Interviews were conducted with 13 providers caring for veterans experiencing homelessness, including physicians, psychologists, nurses, social workers, and peer support specialists. Providers worked at a West Coast VA institution serving a large population of veterans experiencing homelessness. Interviews were analyzed for themes pertaining to sleep using the social-ecological model as a framework. On an individual level, factors influencing sleep included psychiatric disorders and use of substances. On an interpersonal level, factors included safety concerns while sleeping. On an environmental level, factors included noise and proximity to others as barriers to sleep. On the organizational level, logistical issues scheduling sleep clinic appointments and lack of transportation to attend sleep clinic appointments were identified as treatment barriers. These findings can inform future research studying the impact of sleep on health and housing outcomes and interventions addressing sleep among veterans experiencing homelessness. Full article
(This article belongs to the Special Issue Addressing the Health Needs of Individuals Experiencing Homelessness)
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11 pages, 317 KiB  
Commentary
A Novel Framework to Address the Complexities of Housing Insecurity and Its Associated Health Outcomes and Inequities: “Give, Partner, Invest”
by Sonika Bhatnagar, John Lovelace, Ray Prushnok, Justin Kanter, Joan Eichner, Dan LaVallee and James Schuster
Int. J. Environ. Res. Public Health 2023, 20(14), 6349; https://doi.org/10.3390/ijerph20146349 - 12 Jul 2023
Viewed by 1428
Abstract
The association between housing insecurity and reduced access to healthcare, diminished mental and physical health, and increased mortality is well-known. This association, along with structural racism, social inequities, and lack of economic opportunities, continues to widen the gap in health outcomes and other [...] Read more.
The association between housing insecurity and reduced access to healthcare, diminished mental and physical health, and increased mortality is well-known. This association, along with structural racism, social inequities, and lack of economic opportunities, continues to widen the gap in health outcomes and other disparities between those in higher and lower socio-economic strata in the United States and throughout the advanced economies of the world. System-wide infrastructure failures at municipal, state, and federal government levels have inadequately addressed the difficulty with housing affordability and stability and its associated impact on health outcomes and inequities. Healthcare systems are uniquely poised to help fill this gap and engage with proposed solutions. Strategies that incorporate multiple investment pathways and emphasize community-based partnerships and innovation have the potential for broad public health impacts. In this manuscript, we describe a novel framework, “Give, Partner, Invest,” which was created and utilized by the University of Pittsburgh Medical Center (UPMC) Insurance Services Division (ISD) as part of the Integrated Delivery and Finance System to demonstrate the financial, policy, partnership, and workforce levers that could make substantive investments in affordable housing and community-based interventions to improve the health and well-being of our communities. Further, we address housing policy limitations and infrastructure challenges and offer potential solutions. Full article
(This article belongs to the Special Issue Addressing the Health Needs of Individuals Experiencing Homelessness)
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