Objective: The homeless population experiences inequality in health compared with the general population, which may have widened during the COVID-19 pandemic. However, the impact of being homeless on the outcomes of COVID-19 is uncertain. This systematic review aimed to analyse the impact of experiencing homelessness on the clinical outcomes of COVID-19, including the effects on health inequalities.Methods: A review protocol was developed and registered in PROSPERO (PROSPERO registration 2022 CRD42022304941). Nine databases were searched in November 2022 to identify studies on homeless populations which contained primary research on the following outcomes of COVID-19: incidence, hospitalisation, mortality, long COVID, mental wellbeing, and evidence of inequalities. Included studies were summarised with narrative synthesis.Results: The searches yielded 8,233 initial hits; after screening, 41 studies were included. Overall, evidence showed that those in crowded living settings had a higher risk of COVID-19 infection compared to rough sleepers and the general population. The homeless population had higher rates of hospitalisation and mortality than the general population, lower vaccination rates, and suffered negative mental health impacts.Conclusion: This systematic review shows the homeless population is more susceptible to COVID-19 outcomes. Further research is needed to determine the actual impact of the pandemic on this population, and of interventions to mitigate overall risk, given the low certainty of findings from some of the low-quality evidence available. In addition, further research is required to ascertain the impact of long COVID on those experiencing homelessness, since the present review yielded no studies on this topic.

The DC Metropolitan Area Drug Study (DCMADS) was
conducted in 1991, and included special analyses of homeless and
transient populations and of women delivering live births in the DC
hospitals. DCMADS was undertaken to assess the full extent of the
drug problem in one metropolitan area. The study was comprised of 16
separate studies that focused on different sub-groups, many of which
are typically not included or are underrepresented in household
surveys. The Homeless and Transient Population
study examines the prevalence of illicit drug, alcohol, and tobacco
use among members of the homeless and transient population aged 12 and
older in the Washington, DC, Metropolitan Statistical Area (DC
MSA). The sample frame included respondents from shelters, soup
kitchens and food banks, major cluster encampments, and literally
homeless people. Data from the questionnaires include history of
homelessness, living arrangements and population movement, tobacco,
drug, and alcohol use, consequences of use, treatment history, illegal
behavior and arrest, emergency room treatment and hospital stays,
physical and mental health, pregnancy, insurance, employment and
finances, and demographics. Drug specific data include age at first
use, route of administration, needle use, withdrawal symptoms,
polysubstance use, and perceived risk.This study has 1 Data Set.

BackgroundHomelessness is one of the most disabling and precarious living conditions. The objective of this Delphi consensus study was to identify priority needs and at-risk population subgroups among homeless and vulnerably housed people to guide the development of a more responsive and person-centred clinical practice guideline.MethodsWe used a literature review and expert working group to produce an initial list of needs and at-risk subgroups of homeless and vulnerably housed populations. We then followed a modified Delphi consensus method, asking expert health professionals, using electronic surveys, and persons with lived experience of homelessness, using oral surveys, to prioritize needs and at-risk sub-populations across Canada. Criteria for ranking included potential for impact, extent of inequities and burden of illness. We set ratings of ≥ 60% to determine consensus over three rounds of surveys.FindingsEighty four health professionals and 76 persons with lived experience of homelessness participated from across Canada, achieving an overall 73% response rate. The participants identified priority needs including mental health and addiction care, facilitating access to permanent housing, facilitating access to income support and case management/care coordination. Participants also ranked specific homeless sub-populations in need of additional research including: Indigenous Peoples (First Nations, Métis, and Inuit); youth, women and families; people with acquired brain injury, intellectual or physical disabilities; and refugees and other migrants.InterpretationThe inclusion of the perspectives of both expert health professionals and people with lived experience of homelessness provided validity in identifying real-world needs to guide systematic reviews in four key areas according to priority needs, as well as launch a number of working groups to explore how to adapt interventions for specific at-risk populations, to create evidence-based guidelines.

Review of Economics and Statistics: Forthcoming.

According to a study conducted between 2021 and 2022, 22 percent of people experiencing homelessness in California said that they left their last housing in the United States due to lost or reduced income. A further 12 percent cited high housing costs as the main economic reason for why they left their last housing.

Our objective is to identify, gather and synthesize studies on the Food and Nutrition Security of the homeless population, through a scoping review.

Welcome to the survey of PHA Engagement with Homeless Households. Department of Housing and Urban Development (HUD) has contracted with Abt Associates and its subsidiary Abt SRBI to conduct this survey. The information collected will allow researchers to explore and document how Public Housing Authorities (PHAs) currently serve homeless households. Our purpose is to establish a baseline level of PHAs’ current engagement in serving homeless households and to better understand the current opportunities provided by PHAs that have an explicit preference for homeless households. Findings of this study will enable HUD to:

--identify the variety of mechanisms that PHAs employ to target homeless households for assistance;
--highlight innovative ways in which PHAs may be engaging with homeless households;highlight the broader set of community partners providing services to homeless people.

Through this study PHAs will learn from each other about different approaches to assisting homeless families. Responses to this survey will be used for research purposes only and will NOT be used for compliance monitoring. If you have questions about the survey please call 1‐866‐626‐9805 or email us at PHASURVEY@srbi.com. If you have questions about the study itself, please contact Ms. Anne Fletcher, Social Science Analyst, Office of Policy Development and Research, HUD at (202) 402‐4347 or Ms. Eliza Kean, the Abt Associates Project Director at (301) 634‐1743.

The DC Metropolitan Area Drug Study (DCMADS) was
conducted in 1991, and included special analyses of homeless and
transient populations and of women delivering live births in the DC
hospitals. DCMADS was undertaken to assess the full extent of the
drug problem in one metropolitan area. The study was comprised of 16
separate studies that focused on different sub-groups, many of which
are typically not included or are under-represented in household
surveys.The DCMADS: Household and Non-household Populations
examines the prevalence of tobacco, alcohol, and drug use among
members of household and non-household populations aged 12 and older
in the District of Columbia Metropolitan Statistical Area (DC
MSA). The study also examines the characteristics of three
drug-abusing sub-groups: crack-cocaine, heroin, and needle users. The
household sample was drawn from the 1991 National Household Survey on
Drug Abuse (NHSDA). The non-household sample was drawn from the
DCMADS Institutionalized and Homeless and Transient Population
Studies. Data include demographics, needle use, needle-sharing, and
use of tobacco, alcohol, cocaine, crack, inhalants, marijuana, hallucinogens, heroin, sedatives, stimulants, psychotherapeutics (non-medical use), tranquilizers, and analgesics.This study has 1 Data Set.

This scoping review seeks to carry out a global mapping of literature on the structural, procesual and outcome elements involved in the improvement of the quality of access to vaccination for people experiencing homelessness

This dataset tracks the updates made on the dataset "Washington DC Metropolitan Area Drug Study Homeless and Transient Population (DC-MADST-1991)" as a repository for previous versions of the data and metadata.

BackgroundHomelessness is a growing public health challenge in the United Kingdom and internationally, with major consequences for physical and mental health. Women represent a particularly vulnerable subgroup of the homeless population, with some evidence suggesting that they suffer worse mental health outcomes than their male counterparts. Interventions aimed at improving the lives of homeless women have the potential to enhance mental health and reduce the burden of mental illness in this population. This review synthesised the evidence on the effectiveness and acceptability of interventions which aim to improve mental health outcomes in homeless women.MethodsFive electronic bibliographic databases: MEDLINE, PsycInfo, CINAHL, ASSIA and EMBASE, were searched. Studies were included if they measured the effectiveness or acceptability of any intervention in improving mental health outcomes in homeless women. Study quality was assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool. A narrative summary of the study findings in relation to the research questions was produced.ResultsThirty-nine studies met inclusion criteria. Overall, there was moderate evidence of the effectiveness of interventions in improving mental health outcomes in homeless women, both immediately post-intervention and at later follow-up. The strongest evidence was for the effectiveness of psychotherapy interventions. There was also evidence that homeless women find interventions aimed at improving mental health outcomes acceptable and helpful.ConclusionsHeterogeneity in intervention and study methodology limits the ability to draw definitive conclusions about the extent to which different categories of intervention improve mental health outcomes in homeless women. Future research should focus on lesser-studied intervention categories, subgroups of homeless women and mental health outcomes. More in-depth qualitative research of factors that enhance or diminish the acceptability of mental health interventions to homeless women is also required.

Introduction: Despite the growing efforts to standardize coding for social determinants of health (SDOH), they are infrequently captured in electronic health records (EHRs). Most SDOH variables are still captured in the unstructured fields (i.e., free-text) of EHRs. In this study we attempt to evaluate a practical text mining approach (i.e., advanced pattern matching techniques) in identifying phrases referring to housing issues, an important SDOH domain affecting value-based healthcare providers, using EHR of a large multispecialty medical group in the New England region, United States. To present how this approach would help the health systems to address the SDOH challenges of their patients we assess the demographic and clinical characteristics of patients with and without housing issues and briefly look into the patterns of healthcare utilization among the study population and for those with and without housing challenges.Methods: We identified five categories of housing issues [i.e., homelessness current (HC), homelessness history (HH), homelessness addressed (HA), housing instability (HI), and building quality (BQ)] and developed several phrases addressing each one through collaboration with SDOH experts, consulting the literature, and reviewing existing coding standards. We developed pattern-matching algorithms (i.e., advanced regular expressions), and then applied them in the selected EHR. We assessed the text mining approach for recall (sensitivity) and precision (positive predictive value) after comparing the identified phrases with manually annotated free-text for different housing issues.Results: The study dataset included EHR structured data for a total of 20,342 patients and 2,564,344 free-text clinical notes. The mean (SD) age in the study population was 75.96 (7.51). Additionally, 58.78% of the cohort were female. BQ and HI were the most frequent housing issues documented in EHR free-text notes and HH was the least frequent one. The regular expression methodology, when compared to manual annotation, had a high level of precision (positive predictive value) at phrase, note, and patient levels (96.36, 95.00, and 94.44%, respectively) across different categories of housing issues, but the recall (sensitivity) rate was relatively low (30.11, 32.20, and 41.46%, respectively).Conclusion: Results of this study can be used to advance the research in this domain, to assess the potential value of EHR's free-text in identifying patients with a high risk of housing issues, to improve patient care and outcomes, and to eventually mitigate socioeconomic disparities across individuals and communities.

A survey of homeless adults in California found that around 30 percent reported suffering from high blood pressure, while 11 percent had diabetes. This statistic shows the percentage of homeless adults in California who reported select chronic health conditions as of 2022.

Objectives: To analyze the views of general practitioners (GPs) about how they can provide care to homeless people (HP) and to explore which measures could influence their views. Design: Mixed-methods design (qualitative –> quantitative (cross-sectional observational) ïƒ qualitative). Qualitative data were collected through semi-structured interviews; quantitative data were collected through questionnaires with closed questions. Quantitative data were analyzed with descriptive statistical analyses on SPPS; a content analysis was applied on qualitative data. Setting: primary care; views of urban GPs working in deprived area in Marseille were explored by questionnaires and/or semi-structured interview. Participants: 19 GPs involved in HP’s healthcare were recruited for phase 1 (qualitative); for phase 2 (quantitative), 150 GPs who provide routine health care (“standard†GPs) were randomized, 144 met the inclusion criteria and 105 responded the questionnaire; for phase 3 (qualitative...

Abstract

This study aims to help address the issue of the appropriate use of statistical data in policy development in Serbia. Faced with enterprise restructuring, high unemployment and high levels of social exclusion, as well as the consequences of internal population displacement, the Government of Serbia (GoS) has recognized and acknowledged the need for fundamental reforms in social policy area and the collection of adequate data of social statistics. Reliable household data are scarce in Serbia, with the result that social policy making is put on a precarious basis. The exceptional circumstances of Serbia have left a legacy of immense complexity, in which social groups have become fractured and excluded. A statistically reliable basis for policy making, particularly in the social sphere, is a priority. Data on poverty and living standards are seen as a part of information system to support decision making by the GoS and its line Ministries. The public is also keenly interested in poverty data. Therefore poverty data are also crucially important for strategic planning bodies within GoS, and for donors in assessing their strategies in support of the Poverty Reduction Strategy (PRS).

Geographic coverage

National

Analysis unit

Households

Kind of data

Sample survey data [ssd]

Sampling procedure

The population for LSMS consists of Republic of Serbia residents, excluding Kosovo and Metohija . The sampling frame for the LSMS was based on the Enumeration District (ED) delineated for the 2002 Serbia Census, excluding those with less than 20 households. It is estimated that the households in the excluded EDs only represent about 1 percent of the population of Serbia. The sampling frame also excludes the population living in group quarters, institutions and temporary housing units, as well as the homeless population: these groups also represent less than 1 percent of the population, so the sampling frame should cover at least 98 percent of the Serbian population. Stratification was done in the same way as for the previous LSMSs. Enumeration District were stratified according to: (1) Region in 6 strata (Vojvodina, Belgrade, West Serbia, Sumadija and Pomoravlj e, East Serbia and South East Serbia) (2) Type of settlement (urban and other)

The allocation of EDs according to region and type of settlement was propoI1ionai to the number of occupied dwellings, adjusted to provide sufficient precision of estimates at the regional level. To provide optimal sample sizes in each region we decided that the minimum number of allocated EDs to each stratum should be 60. The result of this procedure was a slight deviation from strictly proportional allocation. The sample size for LSMS 2007 was 71 40 households from 510 selected EDs. Within each ED 14 occupied dwellings were selected. From each selected occupied dwelling one household was selected (using a Kish Grid). The sample size was determined according with the aim of achieving 5,000 household interviews with an expected non-response rate of around 30%. The final response rate was 78%, producing a sample size of 5,557 households.

Sampling deviation

The overall estimated total number of households from the 2007 LSMS based on the final weights is about 10 percent lower than the corresponding figure from the 2002 Census frame. The difference is larger for the rural strata (12.1 percent) than the urban strata (8.7 percent). These differences probably include an actual decline in the number of households in some strata and may also reflect the quality of the updating of the listing of occupied dwelling units in sample EDs.

Mode of data collection

Face-to-face [f2f]

Response rate

Response rate was 78 percent

In this study, a monitor was established to track infections among the homeless population during the first year of the COVID-19 pandemic in 8 street doctor practices in the Netherlands. Additionally, the impact of the pandemic on the lives of homeless individuals was documented through interviews with homeless individuals, healthcare and shelter professionals, as well as municipal/health department officials. The collected data has been summarized in 9 small reports in Dutch. English versions can be requested at the authors. Factsheet 1: More information about the study setup. Factsheet 2: Key results from the investigation into the implementation of municipal policies during the first two years of the pandemic. Factsheet 3: Key results regarding the impact of COVID-19 according to homeless individuals in the first year of the pandemic. Factsheet 4: Key results regarding the impact of COVID-19 according to healthcare and shelter staff in the first year of the pandemic. Factsheet 5: Outcomes of the COVID-19 monitor among homeless individuals in the first year of the pandemic. Factsheet 6: Key results of the impact of COVID-19 experienced by homeless individuals in the second year of the pandemic. Factsheet 7: Key results of the impact of COVID-19 on homeless individuals as experienced by healthcare and shelter staff in the second year of the pandemic. Factsheet 8: New initiatives for homeless individuals during COVID-19; inspiration and good examples. Factsheet 9: Insight into effective elements of a vaccination strategy for homeless individuals.

Autism is recognised as a disability in the United Kingdom (UK), whereby autistic people have social, communication, behaviour and sensory differences that can have substantial and ongoing effects on their daily lives (American Psychiatric Association, 2013; World Health Organization, 2023). Our world, however, is generally shaped by the wants and needs of people without disabilities who are in the majority, which can limit opportunities for autistic people to lead flourishing lives (Pellicano et al., 2022).

Despite the potential lack of fit between our world and the needs and preferences of individual autistic people, few studies in the field of autism research have focused on person-environment fit and how this lack of fit can impact on their wellbeing (Mandy, 2022). Various UK advocacy and charitable organisations have published resources and launched campaigns and schemes in public settings such as supermarkets, cinemas and museums to improve accessibility for autistic people, including in the form of quiet times and autism-friendly spaces (Ambitious about Autism, n.d.; Dimensions, n.d.; Lightley, 2019; National Autistic Society, n.d.). While this is encouraging, remarkably little is known about how autistic people feel about their private spaces, namely, their home – a place where people spend a significant portion of their lives.

In this scoping review, we seek to characterise all research literature published on the homes and homelessness of autistic adults and to identify their reported living situations, needs and preferences. (See attached protocol for more detailed background.)

Abstract copyright UK Data Service and data collection copyright owner.

A comparative study of the causes of new episodes of homelessness among people aged 50 or more years was undertaken in Boston, Massachusetts (USA), Melbourne, Australia, and four English cities. The aims were to make a substantial contribution to the predominantly American debate on the causes of homelessness, and to make practice recommendations for the improvement of prevention.

The study had several objectives. It aimed to collect information about the antecedents, triggers and risk factors for becoming homeless in later life and about the national and local policy and service contexts. Furthermore, the researchers aimed to analyse and interpret the findings with reference to an integrated model of the causes of homelessness that represented structural and policy factors, including housing, health and social service organisation and delivery factors, and personal circumstances, events, problems and dysfunctions. The aim was to do this collaboratively, by drawing on the project partners' experience and knowledge. Finally, it was hoped to develop recommendations for housing, primary health care and social welfare organisations for the prevention of homelessness. This was to be done by identifying the common sequences and interactions of events that precede homelessness and their markers (or 'early warning' indicators) and by holding workshops in England with practitioners and their representative organisations on new ways of working.

By the study of contrasting welfare and philanthropic regimes in a relatively homogeneous category of homeless incidence (i.e. recent cases among late middle-aged and older people), it was hoped that valuable insights into the relative contributions of the policy, service and personal factors would be obtained. The study focused on older people who had recently become homeless, purposely to gather detailed and reliable information about the prior and contextual circumstances. To have included people who had been homeless for several years would have reduced the quality of the data because of 'recall' problems.

Users should note that data from the Australian sample for the study are not included in this dataset.
Main Topics:

The data file includes information about the English respondents and those from Boston. It was compiled in two stages. The first stage involved each project partner entering the pre-coded responses into the file. All partners then identified themes and created codes for the open-ended responses, and the resulting variables were added. Data quality-control procedures included blind checks of the data coding and keying.

The first 200 variables pertain to information collected from the respondents. They comprise descriptive variables of the circumstances prior to homelessness, including housing tenure during the three years prior to the survey, previous homelessness, employment history, income, health and addiction problems, and contacts with family, friends and formal services. The respondents were asked to rate whether specific factors were implicated in becoming homeless, and where appropriate, a following open-ended question sought elaboration.

The remaining variables comprise information collected from the respondents' 'key workers' about their understanding of the events and states that led to their clients becoming homeless.

Priority populations ranking.

Homelessness continues to be a major social and clinical problem. The homeless population has a higher burden of disease that includes psychiatric disorders. In addition, they have a lower use of ambulatory health services and a higher use of acute care. Few investigations analyze the use of services of this population group in the long term. We analyzed the risk of psychiatric readmission of homeless individuals through survival analysis. All admissions to a mental health hospitalization unit in the city of Malaga, Spain, from 1999 to 2005, have been analyzed. Three analyses were carried out: two intermediate analyses at 30 days and 1 year after starting follow-up; and one final analysis at 10 years. In all cases, the event was readmission to the hospitalization unit. The adjusted Hazard Ratio at 30 days, 1-year, and 10-year follow-ups were 1.387 (p = 0.027), 1.015 (p = 0.890), and 0.826 (p = 0.043), respectively. We have found an increased risk of readmission for the homeless population at 30 days and a decreased risk of readmission at 10 years. We hypothesize that this lower risk of long-term readmission may be due to the high mobility of the homeless population, its low degree of adherence to long-term mental health services, and its high mortality rate. We suggest that time-critical intervention programs in the short term could decrease the high rate of early readmission of the homeless population, and long-term interventions could link them with services and avoid its dispersion and abandonment.