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Esser K, Moore C, Hounsell KG, Davis A, Sunderji A, Shulman R, Maguire B, Cohen E, Orkin J. Housing Need Among Children With Medical Complexity: A Cross-Sectional Descriptive Study of Three Populations. Acad Pediatr 2022; 22:900-909. [PMID: 34607051 DOI: 10.1016/j.acap.2021.09.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 09/20/2021] [Accepted: 09/26/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Children with medical complexity (CMC) are hypothesized to have unique housing and accessibility needs due to their medical fragility and medical technology dependency; however, research on prevalence and types of housing need in CMC is limited. The objective was to describe housing need in families of CMC, and to compare housing need across CMC, children with one chronic condition (Type 1 diabetes; CT1D) and healthy children (HC). METHODS This cross-sectional descriptive study assessed housing suitability, adequacy, affordability, stress, stability, and accessibility using survey methodology. Participants were caregivers of CMC, CT1D and HC at a tertiary-care pediatric hospital. The association of housing need outcomes across groups was analyzed using logistic and ordinal logistic regression models, adjusting for income, educational attainment, employment status, community type, immigration status, child age, and number of people in household. RESULTS Four hundred ninety caregivers participated. Caregivers of CMC reported increased risk of housing-related safety concerns (aOR 3.1 [1.3-7.5]), using a common area as a sleeping area (5.6 [2.0-16.8]), reducing spending (4.6 [2.3-9.5]) or borrowing money to afford rent (2.9 [1.2-6.7]), experiencing housing stress (3.3 [1.8-6.0]), and moving or considering moving to access health/community services (15.0 [6.4-37.6]) compared to HC. CONCLUSIONS CMC were more likely to experience multiple indicators of housing need compared to CT1D and HC even after adjusting for sociodemographic factors, suggesting an association between complexity of child health conditions and housing need. Further research and practise should consider screening for and supporting housing need in CMC.
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Affiliation(s)
- Kayla Esser
- Child Health Evaluative Sciences, The Hospital for Sick Children (K Esser, C Moore, KG Hounsell, R Shulman, E Cohen, and J Orkin), Toronto, Canada
| | - Clara Moore
- Child Health Evaluative Sciences, The Hospital for Sick Children (K Esser, C Moore, KG Hounsell, R Shulman, E Cohen, and J Orkin), Toronto, Canada
| | - Kara Grace Hounsell
- Child Health Evaluative Sciences, The Hospital for Sick Children (K Esser, C Moore, KG Hounsell, R Shulman, E Cohen, and J Orkin), Toronto, Canada
| | - Adrienne Davis
- Division of Paediatric Emergency Medicine, The Hospital for Sick Children (A Davis and A Sunderji), Toronto, Canada
| | - Alia Sunderji
- Division of Paediatric Emergency Medicine, The Hospital for Sick Children (A Davis and A Sunderji), Toronto, Canada
| | - Rayzel Shulman
- Child Health Evaluative Sciences, The Hospital for Sick Children (K Esser, C Moore, KG Hounsell, R Shulman, E Cohen, and J Orkin), Toronto, Canada; Division of Endocrinology, The Hospital for Sick Children (R Shulman), Toronto, Canada; Department of Paediatrics, University of Toronto (R Shulman), Toronto, Canada
| | - Bryan Maguire
- Biostatistics, Design and Analysis, Research Institute, The Hospital for Sick Children (B Maguire), Toronto, Canada
| | - Eyal Cohen
- Child Health Evaluative Sciences, The Hospital for Sick Children (K Esser, C Moore, KG Hounsell, R Shulman, E Cohen, and J Orkin), Toronto, Canada; Department of Paediatrics, University of Toronto (R Shulman), Toronto, Canada; Division of Paediatric Medicine, The Hospital for Sick Children (E Cohen and J Orkin), Toronto, Canada; Edwin S.H. Leong Centre for Healthy Children, University of Toronto (E Cohen), Toronto, Canada
| | - Julia Orkin
- Child Health Evaluative Sciences, The Hospital for Sick Children (K Esser, C Moore, KG Hounsell, R Shulman, E Cohen, and J Orkin), Toronto, Canada; Department of Paediatrics, University of Toronto (R Shulman), Toronto, Canada; Division of Paediatric Medicine, The Hospital for Sick Children (E Cohen and J Orkin), Toronto, Canada.
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152
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Nix E, Paulose J, Lakhanpaul M, Factor-Litvak P, Parikh P, Altamirano-Medina H, Bou Karim Y, Manikam L. COVID-19 & informal settlements: is 'Stay Home' safe? UCL Open Environ 2022; 4:e038. [PMID: 37228455 PMCID: PMC10208323 DOI: 10.14324/111.444/ucloe.000038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 06/09/2022] [Indexed: 05/27/2023]
Abstract
The disproportional burden of coronavirus (COVID-19) and vulnerability to containment measures in informal settlements have been recognised; however, the role of poor housing conditions in propagating these remains neglected. Poor housing conditions makes it difficult to effectively implement social distancing measures. With increased time spent in cramped, dark and uncomfortable indoor environments, water and sanitation outside the home, and no outdoor space, higher exposure to existing health hazards and high levels of stress, with women and children being most vulnerable, are anticipated. Through this commentary paper, we reflect on these interconnections and recommend immediate measures and the long-term need for adequate housing for health and well-being.
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Affiliation(s)
- Emily Nix
- UCL Institute for Environmental Design and Engineering, Bartlett School for Energy, Environment and Resources, University College London, London, UK
| | - Jacob Paulose
- UCL Institute for Environmental Design and Engineering, Bartlett School for Energy, Environment and Resources, University College London, London, UK
| | - Monica Lakhanpaul
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK
- Whittington Health NHS Trust, London, UK
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Priti Parikh
- Engineering for International Development Centre, London, UK
- Civil, Environmental and Geomatic Engineering, University College London, London, UK
| | - Hector Altamirano-Medina
- UCL Institute for Environmental Design and Engineering, Bartlett School for Energy, Environment and Resources, University College London, London, UK
| | - Yasmin Bou Karim
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK
- Aceso Global Health Consultants Ltd, 3 Abbey Terrace, London SE2 9EY, UK
| | - Logan Manikam
- Aceso Global Health Consultants Ltd, 3 Abbey Terrace, London SE2 9EY, UK
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153
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Azim FT, Ariza-Vega P, Gardiner PA, Ashe MC. Indoor Built Environment and Older Adults' Activity: A Systematic Review. Can J Aging 2022;:1-18. [PMID: 35848156 DOI: 10.1017/S0714980822000241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Although the physical environment can influence people's activity, there are few knowledge syntheses for indoor environments and older adults' daily life routines. Therefore, we conducted a systematic review of peer-reviewed evidence to inform future research and practice. Inclusion criteria were studies with any research designs, across all years and languages focused on older adults 60 years of age or more, on physical activity/sedentary behaviour and the indoor environment. After searching five databases, two authors completed title/abstract and full-text screening. The last search was on December 19, 2020. We screened 1,367 citations, and included 23 studies situated in private or collective dwellings (e.g., assisted living). We identified physical activity-supportive indoor features across three domains: campus (e.g., amenities, pathways), building (e.g., area, floor level), and fixtures (e.g., elevators, hallways). Knowledge of indoor environmental factors for older adults' engagement in daily activities can guide future research and policy on housing design.
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154
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Gieseke D, Lambertz C, Gauly M. Effects of Housing and Management Factors on Selected Indicators of the Welfare Quality(®) Protocol in Loose-Housed Dairy Cows. Vet Sci 2022; 9. [PMID: 35878370 DOI: 10.3390/vetsci9070353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/04/2022] [Accepted: 07/08/2022] [Indexed: 11/29/2022] Open
Abstract
The objective of this study was to examine the effects of housing and management factors on animal welfare indicators in dairy cows using a benchmarking approach. In total, 63 conventional dairy cattle farms with zero-grazing in Northern Germany were assessed using selected animal welfare indicators (body condition score, integument alterations, lameness, milk somatic cell count, and social behaviour) of the Welfare Quality® protocol. Additionally, housing characteristics such as designs of barns, cubicles, and floors were documented during farm visits and farmers were interviewed concerning their common management routines. Farms were categorized into a high welfare or low welfare group by calculating upper and lower tertiles for each of the animal welfare indicators separately. Both groups were compared regarding housing conditions and management practices using univariable and multivariable logistic regressions. Several associations between housing and management factors and animal welfare indicators were demonstrated in univariable analysis (p < 0.20). Significant effects within multivariable logistic regression analysis were determined for lameness (routine use of foot-baths), milk somatic cell count (milking frequency) and social behaviour (cow-to-stall ratio) (p < 0.05). Comparing farms with higher and lower animal welfare status can provide useful information about effective options to improve animal welfare.
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155
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Phipps M, Dalton L, Maxwell H, Cleary M. More than a house: Women's recovery from homelessness in Australia. Health Soc Care Community 2022; 30:e1427-e1437. [PMID: 34411360 DOI: 10.1111/hsc.13550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 05/22/2021] [Accepted: 08/09/2021] [Indexed: 06/13/2023]
Abstract
Recovery from homelessness for women is often a long, complex and highly individualised journey. This study investigated women's experiences of exiting homelessness and examined the factors that influenced recovery. The qualitative interpretive study involved auto-driven photo elicitation and in-depth interviews with 11 women who had previously been homeless. It took place in Australia between August 2018 and August 2019. Women took photographs that represented their experiences of exiting homelessness to guide discussion during interviews. Data were analysed using thematic analysis. Findings indicate that recovery from homelessness involves more than becoming housed. Recovery from homelessness is the overarching theme being presented, described using five subthemes: Finding the right house, Making a house a home, Connection, Building confidence and Helping others. Housing was only the starting point for recovery from homelessness for women. The women drew on their own self determination to create factors necessary for recovery from the experience of homelessness. We conclude that ongoing support is necessary to empower and assist women recovering from the traumatic experiences of homelessness. Trauma-informed care offers service providers a framework for supporting women who have lived through homelessness. Services can draw on this framework to provide support beyond the point of securing a house and assist women to create a home environment, build confidence in themselves and form connections to their community as they transition out of homelessness.
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Affiliation(s)
- Monique Phipps
- School of Health Sciences, University of Tasmania, Sydney, New South Wales, Australia
| | - Lisa Dalton
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Hazel Maxwell
- School of Health Sciences, University of Tasmania, Sydney, New South Wales, Australia
| | - Michelle Cleary
- School of Nursing, Midwifery & Social Sciences, CQ University, Sydney, New South Wales, Australia
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156
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Carlson AR, Helmers DP, Hawbaker TJ, Mockrin MH, Radeloff VC. The wildland-urban interface in the United States based on 125 million building locations. Ecol Appl 2022; 32:e2597. [PMID: 35340097 DOI: 10.1002/eap.2597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 11/09/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
The wildland-urban interface (WUI) is the focus of many important land management issues, such as wildfire, habitat fragmentation, invasive species, and human-wildlife conflicts. Wildfire is an especially critical issue, because housing growth in the WUI increases wildfire ignitions and the number of homes at risk. Identifying the WUI is important for assessing and mitigating impacts of development on wildlands and for protecting homes from natural hazards, but data on housing development for large areas are often coarse. We created new WUI maps for the conterminous United States based on 125 million individual building locations, offering higher spatial precision compared to existing maps based on U.S. census housing data. Building point locations were based on a building footprint data set from Microsoft. We classified WUI across the conterminous United States at 30-m resolution using a circular neighborhood mapping algorithm with a variable radius to determine thresholds of housing density and vegetation cover. We used our maps to (1) determine the total area of the WUI and number of buildings included, (2) assess the sensitivity of WUI area included and spatial pattern of WUI maps to choice of neighborhood size, (3) assess regional differences between building-based WUI maps and census-based WUI maps, and (4) determine how building location accuracy affected WUI map accuracy. Our building-based WUI maps identified 5.6%-18.8% of the conterminous United States as being in the WUI, with larger neighborhoods increasing WUI area but excluding isolated building clusters. Building-based maps identified more WUI area relative to census-based maps for all but the smallest neighborhoods, particularly in the north-central states, and large differences were attributable to high numbers of non-housing structures in rural areas. Overall WUI classification accuracy was 98.0%. For wildfire risk mapping and for general purposes, WUI maps based on the 500-m neighborhood represent the original Federal Register definition of the WUI; these maps include clusters of buildings in and adjacent to wildlands and exclude remote, isolated buildings. Our approach for mapping the WUI offers flexibility and high spatial detail and can be widely applied to take advantage of the growing availability of high-resolution building footprint data sets and classification methods.
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Affiliation(s)
- Amanda R Carlson
- SILVIS Lab, Department of Forest and Wildlife Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - David P Helmers
- SILVIS Lab, Department of Forest and Wildlife Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Todd J Hawbaker
- U.S. Geological Survey, Geosciences and Environmental Change Science Center, Denver, Colorado, USA
| | - Miranda H Mockrin
- Northern Research Station, U.S. Department of Agriculture Forest Service, Baltimore, Maryland, USA
| | - Volker C Radeloff
- SILVIS Lab, Department of Forest and Wildlife Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
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157
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Lens MC. Zoning, Land Use, and the Reproduction of Urban Inequality. Annu Rev Sociol 2022; 48:421-439. [PMID: 38045490 PMCID: PMC10691857 DOI: 10.1146/annurev-soc-030420-122027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Zoning determines what can be built where, and is ubiquitous in the United States. Low-density residential zoning predominates in US cities far more than in other countries, limiting housing opportunities for those who cannot afford large homes. These zoning regulations have racist and classist origins, make housing more expensive, and reinforce segregation patterns. While sociologists study these consequences of zoning, and other causes of unaffordable housing and segregation, they rarely examine zoning itself. This article argues for a sociological research agenda on zoning and land use.
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Affiliation(s)
- Michael C Lens
- Department of Urban Planning and Public Policy, UCLA Luskin School of Public Affairs, University of California, Los Angeles, California, USA
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158
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Gabrielian S, Koosis ER, Cohenmehr J, Hellemann G, Tuepker A, Green MF, Vazzano JK, Young AS. Factors associated with recovery from homelessness among veterans in permanent supportive housing. J Community Psychol 2022; 50:2144-2162. [PMID: 34862803 DOI: 10.1002/jcop.22760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 09/13/2021] [Accepted: 11/15/2021] [Indexed: 06/13/2023]
Abstract
AIMS We sought to identify person- and program-level factors distinguishing permanent supportive housing (PSH) residents with higher versus lower social integration; and higher versus lower instrumental functioning. METHODS Among 60 PSH residents at Los Angeles' VA, surveys and medical records captured person-level factors. Using a median split, we dichotomized participants with higher versus lower social integration; and higher versus lower instrumental functioning. Recursive partitioning (RP) identified variables that best-differentiated these subgroups. Interviews with 26 participants captured their perceptions on social integration and instrumental functioning. RESULTS Using RP, health-related quality of life, psychiatric symptoms and case management frequency best-differentiated the social integration subgroups. Few perceived that PSH affected social integration. RP did not yield a stable model to differentiate the instrumental functioning subgroups; participants perceived that PSH addressed most functional deficits. CONCLUSIONS Services that enhance social integration may benefit PSH residents with poor health; existing services may adequately address instrumental functioning.
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Affiliation(s)
- Sonya Gabrielian
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles, Los Angeles, California, USA
- Department of Psychiatry, VA Greater Los Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Ella R Koosis
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles, Los Angeles, California, USA
| | - Jennifer Cohenmehr
- Department of Psychiatry, VA Greater Los Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Gerhard Hellemann
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Anaïs Tuepker
- VA HSR&D Center to Improve Veteran Involvement in Care, VA Portland Health Care, Portland, Oregon, USA
- Division of General Internal Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Michael F Green
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Jesse K Vazzano
- Care Management and Social Work, VA Western Colorado Health Care System, Grand Junction, Colorado, USA
| | - Alexander S Young
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles, Los Angeles, California, USA
- Department of Psychiatry, VA Greater Los Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
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159
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Chen J, Hao S, Wu Y. Housing and health in vulnerable social groups: an overview and bibliometric analysis. Rev Environ Health 2022; 37:267-279. [PMID: 34049423 DOI: 10.1515/reveh-2020-0167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 05/08/2021] [Indexed: 06/12/2023]
Abstract
Previous studies have confirmed that poor living conditions can lead to a wide range of health problems. However, in the context of the COVID-19 pandemic, vulnerable groups in unstable housing are more susceptible to disease. This study aims to systematically examine the housing and health problems of vulnerable groups using a bibliometric approach to explore how housing causes health problems, types of health illnesses, and coping strategies. It is found that the poor housing mechanism, persistent inequalities, and poor housing environments have a significant impact on the health of vulnerable groups. Therefore, the government must make concerted efforts across all sectors to ensure that the housing and health care needs of vulnerable groups are improved, and that housing security standards and related policies are improved; targeted safety plans are formulated with community as the carrier, taking into account the characteristics of vulnerable groups; and new information technology is widely used to provide medical convenience for vulnerable groups. It is hoped that the research in this paper can arouse social attention to the health of vulnerable groups and improve their health from the perspective of housing, so as to point out the direction for solving the housing health problems of vulnerable groups in the future.
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Affiliation(s)
- Junhua Chen
- Department of Urban and Real Estate Management, Central University of Finance and Economics, Beijing, Beijing, China
| | - Shuya Hao
- Department of Urban and Real Estate Management, Central University of Finance and Economics, Beijing, Beijing, China
| | - Ying Wu
- National Institute of Social Development, Central University of Finance and Economics, No. 5 Jiangguomennei Street, 100732, Beijing, Beijing, China
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160
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Kim C, Teo C, Nielsen A, Chum A. What are the mental health consequences of austerity measures in public housing? A quasi-experimental study. J Epidemiol Community Health 2022; 76:jech-2021-218324. [PMID: 35705363 DOI: 10.1136/jech-2021-218324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 05/26/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND As governments around the world implement austerity measures to reduce national deficits, there is an urgent need to investigate potential health impacts of specific measures to avoid unintended consequences. In 2013, the UK government implemented the underoccupancy penalty (ie, the bedroom tax) to reduce the national housing benefits bill, by cutting social housing subsidies for households deemed to have excess rooms. We investigated the impact of the bedroom tax on self-reported psychological distress. METHODS Using data from the UK Household Longitudinal Study (2010-2014), the sample included those who received housing subsidies, aged 16-60, living in England. Control and treatment groupings were identified on their household composition and housing situation. We used matching methods to create an exchangeable set of observations. Difference-in-differences analysis was performed to examine changes across the prereform and postreform psychological distress of the treatment and control groups, using the 12-item General Health Questionnaire. RESULTS The implementation of the reform was associated with a moderate increase in psychological distress (0.88, 95% CI 0.06 to 1.71) among the treatment group, relative to the control group. However, the announcement was not associated with change in psychological distress (0.53, 95% CI 0.21 to 1.27). CONCLUSION Our study provides evidence that the implementation of housing austerity measures can increase psychological distress among social housing tenants. As the use of austerity measures become more widespread, policy-makers should consider supplementary interventions to ameliorate potential negative health consequences.
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Affiliation(s)
- Chungah Kim
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Celine Teo
- Department of Applied Health Sciences, Brock University, St Catharines, Ontario, Canada
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Ontario, Canada
| | - Andrew Nielsen
- Department of Applied Health Sciences, Brock University, St Catharines, Ontario, Canada
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Ontario, Canada
| | - Antony Chum
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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161
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Uphoff EP, Zamperoni V, Yap J, Simmonds R, Rodgers M, Dawson S, Seymour C, Kousoulis A, Churchill R. Mental health promotion and protection relating to key life events and transitions in adulthood: a rapid systematic review of systematic reviews. J Ment Health 2022:1-14. [PMID: 35658814 DOI: 10.1080/09638237.2022.2069724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 04/04/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND During the decades representing working-age adulthood, most people will experience one or several significant life events or transitions. These may present a challenge to mental health. AIM The primary aim of this rapid systematic review of systematic reviews was to summarise available evidence on the effectiveness of interventions to promote and protect mental health relating to four key life events and transitions: pregnancy and early parenthood, bereavement, unemployment, and housing problems. This review was conducted to inform UK national policy on mental health support. METHODS We searched key databases for systematic reviews of interventions for working-age adults (19 to 64 years old) who had experienced or were at risk of experiencing one of four key life events. Titles and abstracts were screened by two reviewers in duplicate, as were full-text manuscripts of relevant records. We assessed the quality of included reviews and extracted data on the characteristics of each literature review. We prioritised high quality, recent systematic reviews for more detailed data extraction and synthesis. RESULTS The search and screening of 3997 titles/abstracts and 239 full-text papers resulted in 134 relevant studies, 68 of which were included in a narrative synthesis. Evidence was strongest and of the highest quality for interventions to support women during pregnancy and after childbirth. For example, we found benefits of physical activity and psychological therapy for outcomes relating to mental health after birth. There was high quality evidence of positive effects of online bereavement interventions and psychological interventions on symptoms of grief, post-traumatic stress, and depression. Evidence was inconclusive and of lower quality for a range of other bereavement interventions, unemployment support interventions, and housing interventions. CONCLUSIONS Whilst evidence based mental health prevention and promotion is available during pregnancy and early parenthood and for bereavement, it is unclear how best to support adults experiencing job loss, unemployment, and housing problems.
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Affiliation(s)
| | | | - Jade Yap
- Mental Health Foundation, London, UK
| | | | - Mark Rodgers
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Sarah Dawson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | | | - Rachel Churchill
- Centre for Reviews and Dissemination, University of York, York, UK
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162
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Mee G, Tipton E, Oxley JA, Westgarth C. Owner demographic factors are associated with suitable pet rabbit housing provision in the United Kingdom. Vet Rec 2022; 190:e1736. [PMID: 35661365 DOI: 10.1002/vetr.1736] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 03/01/2022] [Accepted: 04/20/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Rabbits are popular pets, but research into their welfare is limited. This study analysed the potential association(s) between the provision of suitable housing and owner demographic factors. METHODS Data from 2017, 2018 and 2019 PDSA Animal Wellbeing (PAW) report surveys gave a sample of 1333 UK rabbit owners. Whether the rabbit housing was adequate or inadequate was ascertained by asking owners to indicate images of hutch and run size or indoor environment type that were similar to their own. The owner demographic factors collected included gender, education, household income and deprivation. Chi-squared tests and binary logistic regression (univariable and multivariable) were used to investigate factors associated with adequate/inadequate housing. RESULTS One-third (31.2%) of rabbits lived in inadequate housing and half were housed alone (51.4%). Male owners were more likely to report providing inadequate housing than females (odds ratio [OR] = 1.795, 95% confidence interval [CI] 1.319-2.441, p < 0.001). Compared to owners over 55 years old, those aged 25-34 years were more likely to house their rabbits inadequately (OR = 2.050, 95% CI 1.286-3.267, p = 0.003). Owners with a household income below average were more likely to report providing inadequate housing compared to those with a household income above average (OR = 1.406, 95% CI 1.025-1.928, p = 0.035). CONCLUSION The findings identify that inadequate rabbit housing is provided by owners of all ages, genders and deprivation levels but highlight some particular owner demographics that could be useful to target if resources are limited.
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Affiliation(s)
- Grace Mee
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, UK
| | - Emma Tipton
- Veterinary Department, People's Dispensary for Sick Animals (PDSA), Telford, UK
| | - James A Oxley
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, UK
| | - Carri Westgarth
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, UK
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163
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Brown P, Newton D, Armitage R, Monchuk L, Robson B. Locked down: Ontological security and the experience of COVID-19 while living in poor-quality housing. J Community Psychol 2022:10.1002/jcop.22883. [PMID: 35611443 PMCID: PMC9347395 DOI: 10.1002/jcop.22883] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 03/17/2022] [Accepted: 05/14/2022] [Indexed: 06/15/2023]
Abstract
The aim of the paper is to illustrate how the housing system in the United Kingdom (UK) has contributed to creating vulnerabilities during the COVID-19 pandemic. Drawing on the concept of ontological security we look at how living with housing insecurity whilst enduring poor housing conditions has impacted the lives of those living in households. The paper draws on semi-structured interviews with 50 residents and 8 housing professionals. The findings outline the grinding impact of the pandemic on the ontological security of residents and the coping strategies adopted by a wider range of households who are now increasingly vulnerable. A number of people went into lockdown in vulnerable situations, experiencing deep inequalities and living in poorly maintained homes. This has weakened the ontological security experienced by many households. These represent significant failings of the housing system and housing policy impacting on the health and wellbeing of a wider cohort of people creating additional vulnerabilities.
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Affiliation(s)
- Philip Brown
- School of Human and Health SciencesUniversity of HuddersfieldHuddersfieldUK
| | - Dillon Newton
- School of Human and Health SciencesUniversity of HuddersfieldHuddersfieldUK
| | - Rachel Armitage
- School of Human and Health SciencesUniversity of HuddersfieldHuddersfieldUK
| | - Leanne Monchuk
- School of Human and Health SciencesUniversity of HuddersfieldHuddersfieldUK
| | - Brian Robson
- Policy & Public AffairsNorthern Housing ConsortiumSunderlandUK
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164
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Abstract
Millions of families in the United States are economically vulnerable: one shock can lead to hardship. We use data from the Fragile Families and Child Wellbeing Study to examine the association between acute healthcare utilization - emergency room visits or hospitalizations - and subsequent housing hardships, such as being evicted for financial reasons. Further, we explore whether this association differs by who in the family utilized the care and whether perceived social support protects against hardship when these experiences occur. Using lagged dependent variable regression models, we find that families that visited the emergency room or were hospitalized, regardless if it was a child or parent with this experience, were five percentage points more likely to experience any housing hardship than families that did not use acute care. Among families in which a child utilized acute care, perceived social support buffered the impact of using acute care. That perceived social support is associated with a lower likelihood of housing hardship among families that experienced acute care utilization for a child, but not parent, suggests that social support may be able to offset the challenges arising from children's, but not adults', use of acute care. In the face of economic precarity, informal safety nets may be insufficient to reduce the impact of acute care utilization on housing hardships.
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Affiliation(s)
- Sarah Gold
- Bendheim-Thoman Center for Research on Child Wellbeing, School of Public and International Affairs, Princeton University, Princeton, NJ 08544
| | - Brandon Wagner
- Department of Sociology, Anthropology, and Social Work, Texas Tech University, 63 Holden Hall, Lubbock, TX 79409
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165
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Chiaramonte D, Clements KA, López‐Zerón G, Ayeni OO, Farero AM, Ma W, Sullivan CM. Examining contextual influences on the service needs of homeless and unstably housed domestic violence survivors. J Community Psychol 2022; 50:1831-1853. [PMID: 34146356 PMCID: PMC8684560 DOI: 10.1002/jcop.22637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 05/09/2021] [Accepted: 05/11/2021] [Indexed: 06/12/2023]
Abstract
Domestic violence (DV) is a leading cause of homelessness for women, yet many DV agencies are just beginning to focus on helping clients stabilize their housing situations. The purpose of this study was to better understand the contexts and service needs of unstably housed and homeless DV survivors, to promote more efficient and successful service matching from DV agencies. We examined whether DV survivors could be grouped by particular features, histories, and contextual factors, and how these group differences impacted what they needed from DV agencies. The sample included 406 homeless and unstably housed DV survivors who had recently sought DV services. Latent class analysis supported the identification of four distinct classes: (1) highest disadvantages service seeker, (2) moderate disadvantages-criminal legal system service seeker, (3) moderate disadvantages service seeker, and (4) lower disadvantages service seeker. Additionally, we were able to profile each class, and test the types of services survivors in each class needed from agencies.
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Affiliation(s)
- Danielle Chiaramonte
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | | | | | | | - Adam M. Farero
- Psychology DepartmentMichigan State UniversityEast LansingMichiganUSA
| | - Wenjuan Ma
- Center for Statistical Training and ConsultationMichigan State UniversityEast LansingMichiganUSA
| | - Cris M. Sullivan
- Psychology DepartmentMichigan State UniversityEast LansingMichiganUSA
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166
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Ramiller A. Displacement through development? Property turnover and eviction risk in Seattle. Urban Stud 2022; 59:1148-1166. [PMID: 35602657 PMCID: PMC9122234 DOI: 10.1177/00420980211004214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Eviction is a powerful form of displacement that perpetuates and amplifies socioeconomic and racial inequalities through the rental housing market. Examining the relationship between evictions and property turnover through Neil Smith's theories of gentrification and uneven geographical development, this article considers the argument that eviction provides a mechanism for property owners to facilitate displacement prior to property redevelopment and neighborhood change. Models of property-level turnover in the city of Seattle reveal that evictions are more likely to occur at properties that are sold in the same year, properties where planned demolition or remodeling activity is imminent, and buildings that were recently constructed. Increased likelihood of eviction is also associated with a greater volume of remodeling and demolition permit applications filed in the surrounding neighborhood, suggesting that evictions may be more likely to occur at the early stages of development-driven neighborhood change. These findings highlight the multifaceted relationship between evictions and property turnover and illustrate the value of administrative microdata for displacement research.
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Affiliation(s)
- Alex Ramiller
- Department of City and Regional Planning, University of California - Berkeley, 230 Wurster Hall #1820, Berkeley, CA, USA 94720
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167
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Knight KR, Weiser J, Handley MA, Olsen P, Weeks J, Kushel M. Temporary stays with housed family and friends among older adults experiencing homelessness: Qualitative findings from the HOPE HOME study. Qual Soc Work 2022; 21:542-558. [PMID: 35706979 PMCID: PMC9197090 DOI: 10.1177/14733250211012745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND The proportion of adults age 50 and older experiencing homelessness is growing. People at risk for homelessness may stay with family and friends to prevent homelessness. Moving in with housed family and friends is a strategy used to exit homelessness. Little is known about these stays with family and friends. This study examined the motivations for and challenges of older adults experiencing homelessness staying with or moving in with family or friends. METHODS We purposively sampled 46 participants from the HOPE HOME study, a cohort of 350 community-recruited adults experiencing homelessness age ≥50 in Oakland, CA. Inclusion criteria included having stayed with housed family/friends for ≥1 nights in the prior 6 months. We sampled 19 family/friends who had hosted participants experiencing homelessness. We conducted separate, semi-structured interviews, summarized, memoed and coded data consistent using a grounded theory approach. RESULTS Older adults experiencing homelessness reported primarily temporary stays. Motivations for stays on the part of participants included a need for environmental, physical, and emotional respite from homelessness. Both individuals experiencing homelessness and hosts cited the mutual benefits of stays. Barriers to stays included feelings of shame, concerns about burdening the hosts, and interpersonal conflicts between older adults experiencing homelessness and host participants. CONCLUSIONS There are potential opportunities and concerns surrounding temporary stays between older adults experiencing homelessness and their family or friends. Policy solutions should support the potential mutual benefits of temporary stays, while addressing interpersonal barriers to strengthen kinship and friendship networks and mediate the negative impacts of homelessness.
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Affiliation(s)
- Kelly R Knight
- Department of Humanities and Social Sciences, University of California, San Francisco, CA, USA
| | - Jeremy Weiser
- School of Medicine, University of California, San Francisco, CA, USA
| | - Margaret A Handley
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Pamela Olsen
- UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - John Weeks
- UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Margot Kushel
- UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
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168
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Pixley CL, Henry FA, DeYoung SE, Settembrino MR. The role of homelessness community based organizations during COVID-19. J Community Psychol 2022; 50:1816-1830. [PMID: 34033680 PMCID: PMC8242750 DOI: 10.1002/jcop.22609] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 05/07/2021] [Accepted: 05/08/2021] [Indexed: 05/12/2023]
Abstract
People experiencing homelessness are vulnerable to disasters and hazards and are at risk for contracting COVID-19. In this study, we gathered data from 10 community-based organizations (CBO's) in the United States that work to provide services for people experiencing homelessness. The combined CBO's span across rural, urban, and a mixture of both settings. We identified three needs that the CBO's indicated to be urgent: (1) the increased need for basic services among guests/clients, (2) new organizational challenges for the CBO's, and (3) issues related to emergency management and disasters. Among these urgent needs, respondents also indicated the need for emotional support for staff and volunteers experiencing burnout during the COVID-19 response. They also expressed some unique aspects of new care delivery systems, such as clients' willingness to engage in rehabilitation programs because of noncongregate sheltering options corresponding with those support services.
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Affiliation(s)
- Cotina Lane Pixley
- Disaster Science & Management ProgramUniversity of DelawareNewarkDelawareUSA
| | - Felicia A. Henry
- Department of Sociology & Criminal JusticeUniversity of DelawareNewarkDelawareUSA
| | - Sarah E. DeYoung
- Department of Sociology & Criminal JusticeUniversity of DelawareNewarkDelawareUSA
| | - Marc R. Settembrino
- Department of Sociology & Criminal JusticeSoutheastern Louisiana UniversityHammondLouisianaUSA
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169
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Tate A, Edwards K, Holmes N, Buffer S, Fusfeld Z, Baronet W, Frasso R. 'Even a smile helps': Exploring the interactions between people experiencing homelessness and passersby in public spaces. Int J Soc Psychiatry 2022; 68:525-532. [PMID: 33499726 DOI: 10.1177/0020764021989385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Many people experiencing homelessness dwell, panhandle, or congregate in public spaces where they frequently cross paths with others. In these spaces, they can be recipients of acts of kindness or emotional and physical insult, but there is little research on the quality, nature, or value of interactions between people living on the street and those who pass them by. AIM This study explored the lived experiences of unhoused people who panhandle and their interactions with passersby in Philadelphia, Pennsylvania. METHODS Forty semi-structured interviews were conducted with participants who were approached while panhandling and asked to describe their experiences asking for help in public and accessing homelessness services, as well as what they wished to share with passersby. Interviews were coded and analyzed using a directed content analysis approach. RESULTS Participants described being ignored and subjected to violence, leading them to crave meaningful interaction with passersby. They also described experiences of receiving kindness and support while panhandling. Many shared personal histories of tragedy and called for greater empathy and compassion from passersby, as well as society as a whole, for people experiencing homelessness. CONCLUSION Participants' experiences were consistent with loneliness, as characterized in the literature as distress at lack of social connection, and were also notable for the verbal and physical violence endured in public spaces. Social isolation and trauma are detrimental to mental health in this vulnerable group, so interventions to support this population should provide opportunities for consistent, supportive social connections and focus on providing low-barrier, stable housing.
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Affiliation(s)
- Alyssa Tate
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Kaéla Edwards
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA
| | - Nichole Holmes
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA
| | - Steven Buffer
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA
| | - Zachary Fusfeld
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA
| | - Willie Baronet
- Meadows School of the Arts, Southern Methodist University, University Park, TX, USA
| | - Rosemary Frasso
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA
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170
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Abstract
This study is the first trans-inclusive exploration of the relation between running away from home, health, and access to healthcare and supportive figures as a function of gender among adolescents. Secondary data analysis of the 2013 BC Adolescent Health Survey found that trans adolescents were 4.25 times as likely as males, and 3.0 times as likely as females, to have run away. Logistic regressions indicated that runaway adolescents of all genders had greater odds of reporting poor or fair overall health (OR: 2.9) and mental health (OR: 4.5), and of foregoing needed physical (OR: 4.8) and mental health care (OR: 4.5) compared to adolescents who had not run away. The relation between running away and health was exacerbated among trans adolescents. Trans and female youth were also less likely than males to report receiving helpful support. Findings highlight the importance of offering trans-affirming services and care to mitigate harms associated with running away from home.
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Affiliation(s)
- Max Ferguson
- MAP Centre for Urban Health Solutions, St Michael's Hospital, London, UK
| | - Maya Peled
- McCreary Centre Society, Vancouver, Canada
| | - Elizabeth M Saewyc
- McCreary Centre Society, Vancouver, Canada
- School of Nursing, University of British Columbia, Vancouver, Canada
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171
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Kim B, Petrakis BA, McInnes DK, Gifford AL, Sliwinski SK, Smelson DA. Applying after action review to examine residential treatment programs' responses to COVID-19. Int J Health Plann Manage 2022; 37:2461-2467. [PMID: 35419883 PMCID: PMC9087400 DOI: 10.1002/hpm.3475] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/12/2022] [Accepted: 03/27/2022] [Indexed: 11/15/2022] Open
Abstract
Resurgences of COVID‐19 cases are a grave public health concern. Hence, there is an urgent need for health care systems to rapidly and systematically learn from their responses to earlier waves of COVID‐19. To meet this need, this article delineates how we adapted the World Health Organization's After Action Review (AAR) framework to use within our health care system of the United States Department of Veterans Affairs. An AAR is a structured, methodical evaluation of actions taken in response to an event (e.g., recent waves of COVID‐19). It delivers an actionable report regarding (i) what was expected, (ii) what actually happened, (iii) what went well, and (iv) what could have been done differently, and thus what changes are needed for future situations. We share as an example our examination of Mental Health Residential Rehabilitation and Treatment Programs in Massachusetts (a COVID‐19 hotspot). Our work can be further adapted, beyond residential treatment, as a consistent framework for reviewing COVID‐19 responses across multiple health care programs. This will identify both standardized and tailored preparations that the programs can make for future waves of the pandemic. Given the expected resurgences of COVID‐19 cases, the time to apply AAR is now. For health care programs around the world to better respond to future waves of the pandemic, there is an urgent need for them to rapidly and systematically learn from their responses to earlier waves of COVID‐19. This article delineates an adaptation of the World Health Organization’s After Action Review (AAR) framework, applied to examining residential treatment programs’ responses to COVID‐19. Even beyond residential treatment programs, the outlined AAR can be further adapted as a consistent approach for reviewing COVID‐19 responses across multiple health care programs, bringing to light key commonalities and heterogeneities among programs that operate in widely varying contexts.
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Affiliation(s)
- Bo Kim
- VA Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Beth Ann Petrakis
- VA Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, Massachusetts, USA
| | - D Keith McInnes
- VA Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, Massachusetts, USA.,Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Allen L Gifford
- VA Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts, USA.,Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Samantha K Sliwinski
- VA Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - David A Smelson
- VA Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, Massachusetts, USA.,Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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172
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Ide-Okochi A, Samiso T, Kanamori Y, He M, Sakaguchi M, Fujimura K. Depression, Insomnia, and Probable Post-Traumatic Stress Disorder among Survivors of the 2016 Kumamoto Earthquake and Related Factors during the Recovery Period Amidst the COVID-19 Pandemic. Int J Environ Res Public Health 2022; 19:ijerph19074403. [PMID: 35410082 PMCID: PMC8998281 DOI: 10.3390/ijerph19074403] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/25/2022] [Accepted: 04/04/2022] [Indexed: 11/28/2022]
Abstract
The aftereffects of the severe 2016 Kumamoto earthquake were complicated by the COVID-19 pandemic. This study aimed to identify mental health problems and related factors among survivors five years after the earthquake and clarify its long-term effects. A cross-sectional survey was conducted in 2020 among 19,212 survivors affected by the earthquake who moved from temporary to permanent housing. We analysed 8966 respondents (5135 women, 3831 men; mean age 62.25 ± 17.29 years). Logistic regression analysis was conducted to examine associations between mental health problems and socioeconomic factors. Prevalence rates of psychological distress, insomnia, and probable post-traumatic stress disorder were 11.9%, 35.2%, and 4.1%, respectively. Female gender (OR = 1.33, 95% CI = 1.13–1.57; OR = 1.21, 95% CI = 1.08–1.34; OR = 1.81, 95% CI = 1.41–2.32), public housing (OR = 2.14, 95% CI = 1.63–2.83; OR = 1.54, 95% CI = 1.26–1.88; OR = 2.41, 95% CI = 1.62–3.58), loneliness (OR = 9.08, 95% CI = 7.71–10.70; OR = 5.55, 95% CI = 4.90–6.30; OR = 3.52, 95% CI = 2.77–4.49), COVID-19-induced activity reduction (OR = 1.41, 95% CI = 1.19–1.66; OR = 1.86, 95% CI = 1.68–2.07; OR = 1.80, 95% CI = 1.40–2.31), and COVID-19-induced income reduction (OR = 1.33, 95% CI = 1.12–1.57; OR = 1.43, 95% CI = 1.28–1.59; OR = 1.92, 95% CI = 1.51–2.43) were significantly associated with mental health problems. These results suggest that gender, current housing, loneliness, and COVID-19 affected the survivors’ mental health during recovery.
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Affiliation(s)
- Ayako Ide-Okochi
- Graduate School of Health Sciences, Kumamoto University, Kumamoto City 862-0976, Japan; (Y.K.); (M.H.); (M.S.)
- Correspondence: ; Tel.: +81-96-373-5518
| | - Tomonori Samiso
- Health and Welfare Policy Division, Health and Welfare Bureau, Kumamoto City 860-0808, Japan;
| | - Yumie Kanamori
- Graduate School of Health Sciences, Kumamoto University, Kumamoto City 862-0976, Japan; (Y.K.); (M.H.); (M.S.)
| | - Mu He
- Graduate School of Health Sciences, Kumamoto University, Kumamoto City 862-0976, Japan; (Y.K.); (M.H.); (M.S.)
| | - Mika Sakaguchi
- Graduate School of Health Sciences, Kumamoto University, Kumamoto City 862-0976, Japan; (Y.K.); (M.H.); (M.S.)
| | - Kazumi Fujimura
- Department of Community Health Systems Nursing, Ehime University Graduate School of Medicine, Toon City 791-0295, Japan;
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173
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Pilla D, Park-Taylor J. "Halfway Independent": Experiences of formerly homeless adults living in permanent supportive housing. J Community Psychol 2022; 50:1411-1429. [PMID: 34561888 DOI: 10.1002/jcop.22724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/05/2021] [Accepted: 09/23/2021] [Indexed: 06/13/2023]
Abstract
Permanent supportive housing (PSH), which combines affordable public housing with social services, has become the dominant model in the United States for providing housing to formerly homeless people. PSH has been effective in reducing re-entry to homelessness, yet has shown limited evidence of improving formerly homeless individuals' mental health and quality of life. This study aimed to understand the lived experiences of formerly homeless adults' adjustment to tenancy in PSH, with a focus on how living in PSH has affected their meaningful activity and social engagement. Based on a phenomenological approach, a thematic analysis was conducted using semi-structured interviews with 17 individuals living in three PSH buildings in New York City. Results suggested that PSH was beneficial in fulfilling formerly homeless individual's basic needs and facilitating lifestyle improvements, yet many were dissatisfied with their living conditions and lacked meaningful activity, social integration, and community belongingness. These issues were found to develop in large part as a result of formerly homeless individuals' disharmonious relationships within the social context of PSH, consisting of staff members, other residents, and people in the surrounding community. The effects of the COVID-19 pandemic and implications for PSH social services are discussed.
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Affiliation(s)
- David Pilla
- Division of Psychological and Educational Services, Department of Counseling Psychology, Graduate School of Education, Fordham University, New York City, New York, USA
| | - Jennie Park-Taylor
- Division of Psychological and Educational Services, Department of Counseling Psychology, Graduate School of Education, Fordham University, New York City, New York, USA
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174
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Grove LR, Berkowitz SA, Cuddeback G, Pink GH, Stearns SC, Domino ME. Permanent Supportive Housing Tenure Among a Heterogeneous Population of Adults with Disabilities. Popul Health Manag 2022; 25:227-234. [PMID: 35442795 PMCID: PMC9206488 DOI: 10.1089/pop.2021.0348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
People with disabilities can face substantial barriers to living stably in community settings. Evidence shows that permanent supportive housing (PSH), which combines subsidized housing with individualized support services, can improve housing stability among subpopulations of people with disabilities, including those with behavioral health conditions. PSH has also been shown to improve some health outcomes among people with severe mental illness or substance use disorder, but effects varied by participants' program tenure. This study assessed retention in a PSH program serving a broad population of adults with disabilities and identified factors associated with program tenure. Administrative data from 2093 individuals who began participating in a North Carolina PSH program between 2015 and 2018 were analyzed. Participants' unadjusted probability of remaining in a PSH placement at specific time points was estimated, with censoring due to death or the end of the study period (July 2020). Using Cox regression, program tenure was modeled as a function of participant and PSH placement location characteristics. Participants had a 71% probability of remaining in PSH after 2 years. Older age, female gender, and non-Hispanic Black race/ethnicity were associated with lower hazard of PSH departure. Having a severe mental illness diagnosis was associated with greater departure hazard. Level of socioeconomic deprivation and rurality of the PSH placement ZIP code were not associated with departure hazard. PSH programs may be able to successfully retain a heterogeneous population of adults with disabilities, although tenure may vary by participant demographic and clinical characteristics.
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Affiliation(s)
- Lexie R. Grove
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Seth A. Berkowitz
- Division of General Medicine and Clinical Epidemiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Gary Cuddeback
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - George H. Pink
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sally Clark Stearns
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Marisa Elena Domino
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Cecil G. Sheps Center for Health Services Research, UNC-CH, Chapel Hill, NC, USA
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175
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Rutland T. Nowhere land: The evicted space of Black tenants' rights in Montreal. Environ Plan D 2022; 40:208-226. [PMID: 35422559 PMCID: PMC8998151 DOI: 10.1177/02637758211041120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Property relations in 1980s Montreal were a venue of struggle and change. In this period, a well-organized tenants' movement and the election of progressive governments spawned a series of legal and policy changes that strengthened tenants' rights in the city. During the same period, however, an emerging police, government and media discourse cast Black communities as criminal 'ghettos', and a variety of mechanisms, including new policies meant to protect tenants' rights, were used to evict criminalized Black tenants. Guided by recent work on property and Black geographies, respectively, this article examines how racial subjects are constituted in struggles over tenants' rights. The racial limits of tenants' rights in Montreal, it argues, are traceable to the socio-spatial relations of slavery and the intensifying criminalization of Black life in the 1980s, each of which nullified Black spatial belonging in the city. The tenant, the article concludes, is never just a tenant, but also a racial subject - a subject formed at the edges of blackness. In a terrain forged by slavery and its afterlives, the possibility of expansive tenants' rights presupposes a right systemically denied in advance for Black people in the Americas: the right to exist here in the first place.
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Affiliation(s)
- Ted Rutland
- Ted Rutland, Department of Geography, Planning, and Environment, Concordia University, 1455 de Maisonneuve Blvd. W, H-1255, Montreal, QC H3G 1M8, Canada.
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176
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Ingram E, Gomes M, Hogarth S, McDonald HI, Osborn D, Sheringham J. Household Tenure and Its Associations with Multiple Long-Term Conditions amongst Working-Age Adults in East London: A Cross-Sectional Analysis Using Linked Primary Care and Local Government Records. Int J Environ Res Public Health 2022; 19:ijerph19074155. [PMID: 35409849 PMCID: PMC8998986 DOI: 10.3390/ijerph19074155] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 02/05/2023]
Abstract
Multiple long-term conditions (MLTCs) are influenced in extent and nature by social determinants of health. Few studies have explored associations between household tenure and different definitions of MLTCs. This study aimed to examine associations between household tenure and MLTCs amongst working-age adults (16 to 64 years old, inclusive). This cross-sectional study used the 2019−2020 wave of an innovative dataset that links administrative data across health and local government for residents of a deprived borough in East London. Three definitions of MLTCs were operationalised based on a list of 38 conditions. Multilevel logistic regression models were built for each outcome and adjusted for a range of health and sociodemographic factors. Compared to working-age owner-occupiers, odds of basic MLTCs were 36% higher for social housing tenants and 19% lower for private renters (OR 1.36; 95% CI 1.30−1.42; p < 0.001 and OR 0.81, 95% CI 0.77−0.84, p < 0.001, respectively). Results were consistent across different definitions of MLTCs, although associations were stronger for social housing tenants with physical-mental MLTCs. This study finds strong evidence that household tenure is associated with MLTCs, emphasising the importance of understanding household-level determinants of health. Resources to prevent and tackle MLTCs among working-age adults could be differentially targeted by tenure type.
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Affiliation(s)
- Elizabeth Ingram
- Department of Applied Health Research, University College London, London WC1E 7HB, UK; (M.G.); (J.S.)
- Correspondence:
| | - Manuel Gomes
- Department of Applied Health Research, University College London, London WC1E 7HB, UK; (M.G.); (J.S.)
| | - Sue Hogarth
- London Boroughs of Camden and Islington, London N1 1XR, UK;
| | - Helen I. McDonald
- London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
| | - David Osborn
- Division of Psychiatry, University College London, London W1T 7BN, UK;
- Camden and Islington NHS Foundation Trust, London NW1 0PE, UK
| | - Jessica Sheringham
- Department of Applied Health Research, University College London, London WC1E 7HB, UK; (M.G.); (J.S.)
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177
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Sharpe RA, Wyatt KM, Williams AJ. Do the Determinants of Mental Wellbeing Vary by Housing Tenure Status? Secondary Analysis of a 2017 Cross-Sectional Residents Survey in Cornwall, South West England. Int J Environ Res Public Health 2022; 19:3816. [PMID: 35409496 DOI: 10.3390/ijerph19073816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/18/2022] [Accepted: 03/20/2022] [Indexed: 11/27/2022]
Abstract
Housing is a social determinant of health, comprising multiple interrelated attributes; the current study was developed to examine whether differences in mental wellbeing across housing tenure types might relate to individual, living, or neighbourhood circumstances. To achieve this aim, an exploratory cross-sectional analysis was conducted using secondary data from a county-wide resident survey undertaken by Cornwall Council in 2017. The survey included questions about individual, living, or neighbourhood circumstances, as well as mental wellbeing (Short Warwick-Edinburgh Mental Wellbeing Scale). A random sample of 30,152 households in Cornwall were sent the survey, from whom 11,247 valid responses were received (38% response), but only 4085 (13.5%) provided complete data for this study. Stratified stepwise models were estimated to generate hypotheses about inequalities in mental wellbeing related to housing tenure. Health, life satisfaction, and social connectedness were found to be universal determinants of mental wellbeing, whereas issues related to living circumstances (quality of housing, fuel poverty) were only found to be related to wellbeing among residents of privately owned and rented properties. Sense of safety and belonging (neighbourhood circumstances) were also found to be related to wellbeing, which together suggests that whole system place-based home and people/community-centred approaches are needed to reduce inequalities.
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178
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Nathan K, Robertson O, Atatoa Carr P, Howden-Chapman P, Pierse N. Residential mobility and potentially avoidable hospitalisations in a population-based cohort of New Zealand children. J Epidemiol Community Health 2022; 76:606-612. [PMID: 35292510 DOI: 10.1136/jech-2021-218509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 02/05/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Residential moves are common in early childhood and associations have been found between residential mobility and adverse child health and well-being outcomes. Although there are studies on potentially avoidable hospitalisations (PAH) in children, few have examined PAH in relation to residential mobility. Our aim, therefore, was to investigate residential mobility and PAH in a population-based cohort of New Zealand children. METHODS Using a retrospective cohort design, we analysed data from the Integrated Data Infrastructure for a cohort of 314 283 children born since the start of 2004, who had at least one residential address recorded by 2 years of age. Residential mobility was derived from address data and PAH were determined from hospital discharge data. RESULTS Half of the cohort children (52%) experienced at least one residential move by 2 years of age, and 22% experienced two or more moves. Fifteen per cent of the cohort experienced one or more PAH between 2 and 4 years of age. A linear association between residential mobility and PAH was found (relative risk (RR)=1.18, CI 1.17 to 1.19) and this remained robust when adjusting for several covariates. Sensitivity analyses for ambulatory care sensitive hospitalisations (ACSH) and PAH attributable to the housing/physical environment (PAH-HE) produced results very similar to those for PAH (ACSH: adjusted RR (aRR)=1.10, CI 1.09 to 1.11; PAH-HE: aRR=1.11, CI 1.10 to 1.12). CONCLUSION This study found a linear association between higher residential mobility and an increased likelihood of PAH in young children. Avenues for further investigation are suggested.
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Affiliation(s)
- Kim Nathan
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Oliver Robertson
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Polly Atatoa Carr
- Te Ngira: Institute for Population Research, University of Waikato, Hamilton, New Zealand
| | | | - Nevil Pierse
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
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179
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Davies LE, Brittain K, Wilkinson H, Lewis S, Robinson L, Kingston A. Describing transitions in residential status over 10 years in the very old: results from the Newcastle 85+ Study. Age Ageing 2022; 51:6554094. [PMID: 35348585 PMCID: PMC8963161 DOI: 10.1093/ageing/afac056] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background the very old (aged ≥ 85) are the fastest growing subpopulation of many developed countries but little is known about how their place of residence changes over time. We investigated transitions in residential status in an inception cohort of 85-year-olds over 10 years. Methods data were drawn from the Newcastle 85+ Study, a population-based longitudinal study of individuals aged 85 in 2006 (i.e. born in 1921) and permanently registered with a Newcastle or North Tyneside general practice (n = 849). Results 76.3% lived in standard (non-supported) housing at baseline (age = 85) and few moved into a care home. The majority either remained in standard housing or died over the study period. A significant number who lived in standard housing had dependency and frailty at baseline. Discussion given the undersupply of care homes, and preference of older people to remain in their own homes as they age, the questions posed by this analysis are how to survive to 85 and remain in standard housing until the age of 85? And how, and by whom, are such a group being supported to remain at home? We need qualitative research to explore the informal-formal care networks of the very old.
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Affiliation(s)
- Laurie E Davies
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Katie Brittain
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Heather Wilkinson
- Advanced Care Research Centre (ACRC), University of Edinburgh, Edinburgh, EH16 4UX, UK
| | - Sue Lewis
- Advanced Care Research Centre (ACRC), University of Edinburgh, Edinburgh, EH16 4UX, UK
| | - Louise Robinson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Andrew Kingston
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
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180
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Frederick T, Vitopoulos N, Leon S, Kidd S. Subjective housing stability in the transition away from homelessness. J Community Psychol 2022; 50:1083-1101. [PMID: 34520067 DOI: 10.1002/jcop.22702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 07/29/2021] [Accepted: 08/19/2021] [Indexed: 06/13/2023]
Abstract
Housing stability is a complex concept to measure. One set of factors under consideration are those based on a personal or subjective sense of stability. We explore the variables associated with subjective stability and explore how subjective stability relates to housing stability across time. We use data from longitudinal, mixed methods research with 85 young people exiting homelessness. We find that subjective stability is a meaningful construct that can be validated through qualitative and quantitative data. The construct is primarily linked to indicators of environmental and social wellbeing. Subjective stability is also one of the only variables with a significant relationship to T2 housing stability. Qualitative analysis is used to explore these relationships in more detail. We conclude that subjective stability can provide holistic insight into the complex life circumstances influencing housing stability. However, this strength introduces complexity in that subjective stability appears to be developed in comparison with past experiences, as well as feelings of forward momentum on goals beyond housing.
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Affiliation(s)
- Tyler Frederick
- Faculty of Social Science and Humanities, Ontario Tech University, Oshawa, Ontario, Canada
| | - Nina Vitopoulos
- Psychology, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Scott Leon
- Wellesley Institute, Toronto, Ontario, Canada
| | - Sean Kidd
- Psychiatry, University of Toronto, Toronto, Ontario, Canada
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181
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Robb K, Diaz Amigo N, Marcoux A, McAteer M, de Jong J. Using Integrated City Data and Machine Learning to Identify and Intervene Early on Housing-Related Public Health Problems. J Public Health Manag Pract 2022; 28:E497-E505. [PMID: 33729188 PMCID: PMC8781224 DOI: 10.1097/phh.0000000000001343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Housing is more than a physical structure-it has a profound impact on health. Enforcing housing codes is a primary strategy for breaking the link between poor housing and poor health. OBJECTIVE The objective of this study was to determine whether machine learning algorithms can identify properties with housing code violations at a higher rate than inspector-informed prioritization. We also show how city data can be used to describe the prevalence and location of housing-related health risks, which can inform public health policy and programs. SETTING This study took place in Chelsea, Massachusetts, a demographically diverse, densely populated, low-income city near Boston. DESIGN Using data from 1611 proactively inspected properties, representative of the city's housing stock, we developed machine learning models to predict the probability that a given property would have (1) any housing code violation, (2) a set of high-risk health violations, and (3) a specific violation with a high risk to health and safety (overcrowding). We generated predicted probabilities of each outcome for all residential properties in the city (N = 5989). RESULTS Housing code violations were present in 54% of inspected properties, 85% of which were classified as high-risk health violations. We predict that if the city were to use integrated city data and machine learning to identify at-risk properties, it could achieve a 1.8-fold increase in the number of inspections that identify code violations as compared with current practices. CONCLUSION Given the strong connection between housing and health, reducing public health risk at more properties-without the need for additional inspection resources-represents an opportunity for significant public health gains. Integrated city data and machine learning can be used to describe the prevalence and location of housing-related health problems and make housing code enforcement more efficient, effective, and equitable in responding to public health threats.
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Affiliation(s)
- Katharine Robb
- Ash Center for Democratic Governance and Innovation, Harvard Kennedy School, Cambridge, Massachusetts (Drs Robb and de Jong, Mr Diaz Amigo, and Ms Marcoux); and Chelsea City Hall, Chelsea, Massachusetts (Mr McAteer)
| | - Nicolas Diaz Amigo
- Ash Center for Democratic Governance and Innovation, Harvard Kennedy School, Cambridge, Massachusetts (Drs Robb and de Jong, Mr Diaz Amigo, and Ms Marcoux); and Chelsea City Hall, Chelsea, Massachusetts (Mr McAteer)
| | - Ashley Marcoux
- Ash Center for Democratic Governance and Innovation, Harvard Kennedy School, Cambridge, Massachusetts (Drs Robb and de Jong, Mr Diaz Amigo, and Ms Marcoux); and Chelsea City Hall, Chelsea, Massachusetts (Mr McAteer)
| | - Mike McAteer
- Ash Center for Democratic Governance and Innovation, Harvard Kennedy School, Cambridge, Massachusetts (Drs Robb and de Jong, Mr Diaz Amigo, and Ms Marcoux); and Chelsea City Hall, Chelsea, Massachusetts (Mr McAteer)
| | - Jorrit de Jong
- Ash Center for Democratic Governance and Innovation, Harvard Kennedy School, Cambridge, Massachusetts (Drs Robb and de Jong, Mr Diaz Amigo, and Ms Marcoux); and Chelsea City Hall, Chelsea, Massachusetts (Mr McAteer)
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182
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Chen KL, Chen K, Holaday LW, Lopez L. Assessing Concordance Across Nonprofit Hospitals' Public Reporting on Housing as a Community Health Need in the Era of the Affordable Care Act. J Public Health Manag Pract 2022; 28:E615-E618. [PMID: 33938486 PMCID: PMC9994632 DOI: 10.1097/phh.0000000000001357] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Although the Affordable Care Act requires nonprofit hospital organizations to report how they identify and invest in community health needs, the utility of mandated reporting documents for tracking investments in the social determinants of health has been questioned. Using public reporting documents and focusing on housing as a social determinant of health, we describe how nonprofit hospital organizations in 5 communities with the highest rates of homelessness document needs and investments related to housing on their Community Health Needs Assessments, Implementation Strategies, and Schedule H (990H) tax forms. Of 47 organizations, 55% identified housing as a health need, 36% described housing-related implementation strategies, and 26% reported relevant 990H spending. Overall concordance among identified needs, strategies, and spending was low, with only 15% of organizations addressing housing across all 3 documents. Regulatory reform could help promote accountability and transparency in organizations' efforts to address housing and other health-related social needs.
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Affiliation(s)
- Katherine L Chen
- National Clinician Scholars Program, University of California, Los Angeles, California (Dr K. L. Chen); Division of General Internal Medicine, Cedars Sinai Medical Center, Los Angeles, California (Dr K. L. Chen); Office of Ambulatory Care, New York City Health + Hospitals, New York City, New York (Drs K. Chen and Lopez); Division of General Internal Medicine and Clinical Innovation (Dr K. Chen) and Department of Population Health (Dr Lopez), New York University School of Medicine, New York City, New York; VA HSR&D Center for the Study of Healthcare Innovation, Implementation, & Policy, West Haven, Connecticut (Dr Holaday); and National Clinician Scholars Program, Yale University, New Haven, Connecticut (Dr Holaday)
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183
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Chatindiara K, Marais L, Cloete J. Housing and Child Health in South Africa: The Value of Longitudinal Research. Int J Environ Res Public Health 2022; 19:2497. [PMID: 35270189 DOI: 10.3390/ijerph19052497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 02/01/2022] [Accepted: 02/10/2022] [Indexed: 02/01/2023]
Abstract
Research investigating the link between housing and health often produces mixed results. It does not always prove that good housing improves health. The results suggest a complex set of factors play a role, and the findings are sometimes contradictory. Two ways of addressing these concerns are longitudinal research, where the relationship between housing and health is measured in the short and medium terms, and a focus on children. We use the children’s housing and health data from the five waves of the National Income and Distribution Survey (NIDS) survey in South Africa, 2008 to 2017. We investigate the effect that continued living in informal housing over the five waves has had on these children’s health. Our results show a statistically significant relationship between prolonged residence in poor housing and poor health outcomes for some health indicators. The results call for a closer understanding of health issues in housing policy in South Africa.
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184
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Cyrus E, Johnson SA, Perez-Gilbe HR, Wuyke G, Fajardo FJ, Garba NA, Deviéux J, Jimenez D, Garcia S, Holder CL. Engagement in Care and Housing Instability Influence HIV Screening Among Transgender Individuals in South Florida. Transgend Health 2022; 7:52-60. [PMID: 35224190 PMCID: PMC8867217 DOI: 10.1089/trgh.2020.0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: HIV screening is a critical step in the HIV care continuum to lowering incidence and achieving viral load suppression among at-risk populations. Few studies assess factors associated with HIV screening among transgender individuals living in the southeast region of the United States. This study was conducted to determine factors that influence HIV screening among transgender individuals in South Florida. Methods: During Fall 2016, 68 participants were recruited to complete a questionnaire as part of a pilot pre-exposure prophylaxis study. Correlations were examined between sociodemographic factors, HIV risk, and access to and engagement in care. Significant correlations were entered into one logistic regression model to estimate predictors of HIV screening and knowledge of HIV status. Results: Almost half (48.5%) of the respondents were Latinx, 38.2% Black, 10.3% non-Latinx White, and 3% other. Seventy-eight percent reported access and routine engagement in care within the past year, 25% had not screened for HIV in the past year, and of those who knew their status, 16.7% reported living with HIV. Regression analysis revealed that participants with routine engagement in care were twice as likely to screen for HIV (p=0.02). Unstable housing was associated with no HIV screening in the past year (p=0.05). Conclusion: Stable housing is linked to engagement in routine care that can increase the likelihood of an at-risk transgender individual screening for HIV. Further research is needed to develop interventions to improve engagement in care among transgender individuals who do not have adequate housing or access to care.
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Affiliation(s)
- Elena Cyrus
- Department of Population Health Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA.,*Address correspondence to: Elena Cyrus, PhD, MPH, Department of Population Health Sciences, College of Medicine, University of Central Florida, 6850 Lake Nona Boulevard, Orlando, FL 32827, USA,
| | - Shaina A. Johnson
- Robert Stempel College of Public Health and Social Work, Department of Health Promotion and Disease Prevention, Florida International University, Miami, Florida, USA
| | - Hector R. Perez-Gilbe
- Health Sciences UCI Libraries, University of California-Irvine, Irvine, California, USA
| | - Gabriella Wuyke
- Robert Stempel College of Public Health and Social Work, Department of Health Promotion and Disease Prevention, Florida International University, Miami, Florida, USA
| | - Francisco J. Fajardo
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
| | - Nana Aisha Garba
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
| | - Jessy Deviéux
- Robert Stempel College of Public Health and Social Work, Department of Health Promotion and Disease Prevention, Florida International University, Miami, Florida, USA
| | - Daniel Jimenez
- Robert Stempel College of Public Health and Social Work, School of Social Work, Florida International University, Miami, Florida, USA
| | - Stephanie Garcia
- Integrated Biostatistics and Data Management Center, Florida International University, Miami, Florida, USA
| | - Cheryl L. Holder
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
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185
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O'Connell B, Sloop A, Intagliata N, Quinn M. They Built My Soul: A Qualitative Analysis of the Impacts of Home Repairs in Rural Tennessee. J Appalach Health 2022; 4:9-19. [PMID: 35769505 PMCID: PMC9200454 DOI: 10.13023/jah.0401.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Housing is an important social determinant of health and substandard housing is linked to physical, mental, and social health problems. PURPOSE The purpose of the study was to qualitatively assess the impacts of repairs to substandard housing in rural East Tennessee through twenty-eight interviews. METHODS Zoom was utilized for recording phone interviews in January-February 2021 and NVivo software was used for thematic analysis in May-July 2021. RESULTS Themes that emerged included environmental risk reduction, impacts on physical health, impacts on mental health, impacts on financial well-being, and willingness to receive future assistance from service organizations. IMPLICATIONS Further research is recommended to quantify impacts including effects on utilization of health care and community services, school and work attendance, and mental health impacts.
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Affiliation(s)
- Bethseda O'Connell
- Department of Community and Behavioral Health, East Tennessee State University
| | | | | | - Megan Quinn
- Department of Biostatistics and Epidemiology, East Tennessee State University
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186
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Bushman G, Mehdipanah R. Housing and health inequities during COVID-19: findings from the national Household Pulse Survey. J Epidemiol Community Health 2022; 76:121-127. [PMID: 34226259 PMCID: PMC8260303 DOI: 10.1136/jech-2021-216764] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/26/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND COVID-19 has exploited the inequities within the US housing system. Examining the association between housing and health during the pandemic is imperative to reducing health inequities and improving population health. METHODS We analysed 957 714 responses from the Household Pulse Survey Study, collected between April and July 2020. Using survey-weighted multivariable regression analyses, we assessed the relationships between housing tenure and health, both on average and over time, as well as how these relationships were moderated by COVID-19-related hardships including job loss, food insecurity and inability to afford housing-related costs. We controlled for a variety of potential socioeconomic and demographic confounding factors. RESULTS We found that housing tenure was significantly associated with both self-rated health and mental distress. Compared with homeowners without mortgage debt, homeowners with mortgage debt reported worse self-rated health (β=-0.13; 95% CI -0.15 to -0.12, p<0.001) and greater mental distress (β=0.50; 95% CI 0.44 to 0.55, p<0.001). Renters also reported worse self-rated health (β=-0.18; 95% CI -0.20 to -0.16, p<0.001) and greater mental distress (β=0.76; 95% CI 0.69 to 0.83, p<0.001) than homeowners without mortgage debt. Across all tenure groups, self-rated health decreased (β=-0.007; 95% CI -0.011 to -0.004, p<0.001) and mental distress increased (β=0.05; 95% CI 0.05 to 0.06, p<0.001) over this period. Additionally, time and COVID-19-related hardships compounded differences in health status between homeowners and renters. CONCLUSIONS These results add to a limited body of evidence suggesting that, during this period, housing instability and COVID-19-related hardships have contributed to an increase in health inequities in the USA.
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Affiliation(s)
- Gregory Bushman
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Roshanak Mehdipanah
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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187
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Austin AE, Durrance CP, Runyan CW, Runyan DK, Martin SL, Mercer J, Shanahan ME. Affordable housing through the low-income housing tax credit program and intimate partner violence-related homicide. Prev Med 2022; 155:106950. [PMID: 34974073 DOI: 10.1016/j.ypmed.2021.106950] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 11/18/2021] [Accepted: 12/27/2021] [Indexed: 11/24/2022]
Abstract
The most severe outcome of intimate partner violence (IPV) is IPV-related homicide. Access to affordable housing may both facilitate exit from abusive relationships and reduce financial stress in intimate relationships, potentially preventing IPV-related homicide. We examined the association of the availability of rental housing through the Low-Income Housing Tax Credit (LIHTC) program, a federal program providing tax incentives to support the development of affordable housing, with IPV-related homicide and assessed whether this association differed by eviction rates at the state-level. We used 2005-2016 National Violent Death Reporting System, LIHTC Property, and Eviction Lab data for 13 states and compared the rate of IPV-related homicide in state-years with ≥30 to state-years with <30 LIHTC units per 100,000 population, overall and stratified by eviction rates. We conducted analyses in fall 2020. Adjusting for potential state-level confounders, the rate of IPV-related homicide in state-years with ≥30 LIHTC units per 100,000 population was lower than in state-years with <30 LIHTC units per 100,000 population (RR = 0.89, 95% CI 0.81, 0.98). The reduction in the rate of IPV-related homicide was slightly larger in state-years with higher eviction rates (≥3500 evictions per 100,000 renter population; RR = 0.83, 95% CI 0.74, 0.93) compared to state-years with lower eviction rates (<3500 evictions per 100,000 renter population; RR = 0.91, 95% CI 0.81, 1.03). Overall, at the state-level, increased availability of affordable housing through the LIHTC program was associated with lower rates of IPV-related homicide. Increasing the availability of affordable housing may be one tool for preventing IPV-related homicide.
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Affiliation(s)
- Anna E Austin
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America.
| | - Christine Piette Durrance
- La Follette School of Public Affairs, University of Wisconsin, Madison, WI, United States of America
| | - Carol W Runyan
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, United States of America; Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States of America
| | - Desmond K Runyan
- Department of Pediatrics and Kempe Center, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Sandra L Martin
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Jeremy Mercer
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Meghan E Shanahan
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
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188
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Rosenwohl-Mack A, Smith D, Greene M, Skultety K, Deutsch M, Dubbin L, Flatt JD. Building H.O.U.S.E (Healthy Outcomes Using a Supportive Environment): Exploring the Role of Affordable and Inclusive Housing for LGBTQIA+ Older Adults. Int J Environ Res Public Health 2022; 19:1699. [PMID: 35162722 DOI: 10.3390/ijerph19031699] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/08/2022] [Accepted: 01/28/2022] [Indexed: 11/21/2022]
Abstract
Little is known about how permanent, inclusive, affordable, and supportive long-term housing may affect the health of low-income lesbian, gay, bisexual, transgender, queer, intersex, asexual and/or another identity (LGBTQIA+) older adults. Focus group interviews were conducted with 21 older adults to explore the lived experiences and potential health benefits of living in a new LGBTQIA+-welcoming senior housing. Participants reported that moving into the housing was associated with benefits for health and well-being, especially for psychological health. Community, social support, and in-house services were particularly important. However, the combined nature of LGBTQIA+-welcoming and older adult only housing evoked mixed feelings. Appropriate and accessible housing solutions are essential for LGBTQIA+ older adults and may help address health disparities for these populations.
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189
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Ijadi-Maghsoodi R, Moore EM, Feller S, Cohenmehr J, Ryan GW, Kataoka S, Gelberg L. Beyond housing: Understanding community integration among homeless-experienced veteran families in the United States. Health Soc Care Community 2022; 30:e493-e503. [PMID: 33340381 PMCID: PMC9601248 DOI: 10.1111/hsc.13233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 09/22/2020] [Accepted: 09/30/2020] [Indexed: 05/02/2023]
Abstract
Community integration is important to address among homeless-experienced individuals. Little is known about helping veteran families (families with a parent who is a veteran) integrate into the community after homelessness. We sought to understand the experiences of community integration among homeless-experienced veteran families. We used a two-stage, community-partnered approach. First, we analysed 16 interviews with homeless-experienced veteran parents (parents who served in the military; n = 9) living in permanent housing and providers of homeless services (n = 7), conducted from February to September 2016, for themes of community integration. Second, we developed a workgroup of nine homeless-experienced veteran parents living in a permanent housing facility, who met four times from December 2016 to July 2017 to further understand community integration. We audio-recorded, transcribed and analysed the interviews and workgroups for community integration themes. For the analysis, we developed community integration categories based on interactions outside of the household and built a codebook describing each topic. We used the codebook to code the individual interviews and parent workgroup sessions after concluding that the workgroup and interview topics were consistent. Findings were shared with the workgroup. We describe our findings across three stages of community integration: (a) first housed, (b) adjusting to housing and the community, and (c) housing maintenance and community integration. We found that parents tended to isolate after transitioning into permanent housing. After this, families encountered new challenges and were guarded about losing housing. One facilitator to community integration was connecting through children to other parents and community institutions (e.g. schools). Although parents felt safe around other veterans, many felt judged by non-veterans. Parents and providers reported a need for resources and advocacy after obtaining housing. We share implications for improving community integration among homeless-experienced veteran families, including providing resources after obtaining housing, involving schools in facilitating social connections, and combating stigma.
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Affiliation(s)
- Roya Ijadi-Maghsoodi
- UCLA Division of Population Behavioral Health, Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- VA Health Service Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Elizabeth M. Moore
- VA Health Service Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- National Clinician Scholars Program, Division of General Internal Medicine and Health Services Research at UCLA, Los Angeles, CA, USA
| | - Sophie Feller
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Jennifer Cohenmehr
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Gery W. Ryan
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Sheryl Kataoka
- UCLA Division of Population Behavioral Health, Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Center for Health Services and Society, Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
| | - Lillian Gelberg
- VA Health Service Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Office of Healthcare Transformation and Innovation, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
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190
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Onapa H, Sharpley CF, Bitsika V, McMillan ME, MacLure K, Smith L, Agnew LL. The physical and mental health effects of housing homeless people: A systematic review. Health Soc Care Community 2022; 30:448-468. [PMID: 34423491 DOI: 10.1111/hsc.13486] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/26/2021] [Accepted: 06/07/2021] [Indexed: 05/25/2023]
Abstract
Housing is a significant determinant of health and is widely accepted as a key solution to address some of the health disparities that exist among the homeless. It is estimated that 150 million people worldwide are homeless, and approximately 1.8 billion lack adequate housing. However, understanding of how housing has a positive impact on the health of the homeless remains unclear and underdeveloped. This systematic review investigates intervention studies that report on the physical and mental health effects of housing homeless persons. A search of PubMed, PsycINFO, EBSCOHost-Academic Search Complete and the Cochrane Library was conducted for peer-reviewed articles published in English from 1999 to 2020 that had a combination of at least one housing intervention and health outcome, with a homeless sample. Three previous reviews and 24 studies were included for analysis. Most of the studies (n = 20) encompassed permanent supportive housing interventions that emphasised placing homeless people with mental illness directly into affordable housing with access to support services. The primary health outcomes reported were general physical and mental health, well-being, and quality of life. Despite inconsistent findings and significant issues identified in the reviewed literature, housing (in the short term) improves some aspects of health in homeless populations with human immunodeficiency virus, anxiety and depression.
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Affiliation(s)
- Hebaat Onapa
- Brain-Behaviour Research Group, School of Science and Technology, University of New England, Armidale, NSW, Australia
| | - Christopher F Sharpley
- Brain-Behaviour Research Group, School of Science and Technology, University of New England, Armidale, NSW, Australia
| | - Vicki Bitsika
- Brain-Behaviour Research Group, School of Science and Technology, University of New England, Armidale, NSW, Australia
| | - Mary E McMillan
- Brain-Behaviour Research Group, School of Science and Technology, University of New England, Armidale, NSW, Australia
| | | | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Linda L Agnew
- Brain-Behaviour Research Group, School of Science and Technology, University of New England, Armidale, NSW, Australia
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191
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Ecarnot F, Sanchez S, Berrut G, Suissa V, Guérin S, Letty A. Defining Your "Life Territory": The Meaning of Place and Home for Community Dwellers and Nursing Home Residents-A Qualitative Study in Four European Countries. Int J Environ Res Public Health 2022; 19:517. [PMID: 35010777 DOI: 10.3390/ijerph19010517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/31/2021] [Accepted: 01/02/2022] [Indexed: 11/27/2022]
Abstract
The meaning of place and home for community dwellers and nursing home residents remains unclear. We explored the relationship between older people and their “life territory”, to propose a working definition of this concept, which could be used to orient policy decisions. Individual, semi-structured interviews were performed with older people, nursing home staff, and representatives of local institutions/elected officials in four European countries (France, Belgium, Germany, Italy). Interviews were transcribed and analysed using thematic analysis. In total, 54 interviews were performed. Five main themes emerged: (i) working definition of “your life territory” (a multidimensional concept covering individual and collective aspects); (ii) importance of the built environment (e.g., public transport, sidewalks, benches, access ramps); (iii) interactions between nursing homes and the outside community (specifically the need to maintain interactions with the local community); (iv) a sense of integration (dependent on social contacts, seniority in the area, perceived self-utility); and (v) the use of new technologies (to promote integration, social contacts and access to culture). This study found that the “life territory” of older people is a multidimensional concept, centred around five main domains, which together contribute to integrating older people into the fibre of their community.
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192
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Douglas S, Hayashi K, Richardson L, DeBeck K, Kerr T. Social-Structural Predictors of Fentanyl Exposure among Street Involved Youth. Subst Use Misuse 2022; 57:21-26. [PMID: 34738494 PMCID: PMC8884258 DOI: 10.1080/10826084.2021.1975746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
ObjectiveThe emergence of synthetic fentanyl has been a main contributor to North America's rising overdose death rates. While increasing attention has been given to drug-related harm among youth, little is known about how social-structural conditions influence their risk of fentanyl exposure. Therefore, we evaluated potential relationships between social-structural conditions and fentanyl exposure among youth who use illicit drugs in Vancouver, BC. Methods: Data were derived from the At-Risk Youth Study (ARYS), a prospective cohort study. The ARYS cohort involves street-involved youth, who use illicit substances in Vancouver, Canada. A multivariable logic regression analysis model was used to identify social factors associated with recent fentanyl exposure as determined through urine drug screening. Results: Overall, 423 participants were included in this analysis, with 380 (38.23%) testing positive for recent fentanyl exposure. In a multivariable relative risk analysis, living in Vancouver's Downtown Eastside in the last six months (RR = 1.16, 95% CI: 1.03-1.32) and daily heroin injection drug use (RR = 1.31, 95% CI: 1.15 - 1.50) were positively associated with fentanyl exposure. As a secondary measure, we found that within the encounters who denied using fentanyl (92.25% of total encounters), 321 (35.05%) still tested positive. Conclusions: We found that youth residing in Vancouver's Downtown Eastside was positively associated with being exposed to fentanyl. Our findings highlight the need to support youth in finding secure housing outside of Vancouver's drug use epicenter to reduce fentanyl exposure.
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Affiliation(s)
- Sarah Douglas
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kanna Hayashi
- British Columbia Centre on Substance Use, St. Paul's Hospital Chair in Substance Use Research, Vancouver, British Columbia, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Lindsey Richardson
- British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada.,Department of Sociology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kora DeBeck
- British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada.,School of Public Policy, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Thomas Kerr
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada
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193
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Wong MS, Clair K, Stigers PJ, Montgomery AE, Kern RS, Gabrielian S. Housing outcomes among homeless-experienced veterans engaged in vocational services. Am J Orthopsychiatry 2022; 92:741-747. [PMID: 36548074 PMCID: PMC10103901 DOI: 10.1037/ort0000650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Though unemployment and homelessness are closely intertwined, vocational services are rarely prioritized for homeless-experienced individuals engaging in housing services. Our goal was to examine associations between vocational service use and housing outcomes among homeless-experienced Veterans engaged in permanent supportive housing. We obtained data from Veterans Health Administration (VHA) medical record and homelessness registry data for homeless-experienced Veterans engaged in U.S. Department of Veterans Affairs (VA) Greater Los Angeles' permanent supportive housing program from October 2016 to September 2017 (n = 1,200). We used multivariate logistic regression to examine whether vocational service use was associated with housing attainment and/or premature permanent supportive housing exits. We found that Veterans in permanent supportive housing who used vocational services were more likely to attain housing (OR = 2.52, p < .001) than their peers who did not use these services. There were no between-group differences in the odds of premature exits from the permanent supportive housing program (OR = 1.92, p = .425). Our study suggests that, among homeless-experienced Veterans engaged in permanent supportive housing programs, those who use vocational services potentially may be more likely to attain housing. However, future research can better elucidate the pathways underlying vocational service use and housing outcomes for individuals in permanent supportive housing programs. Greater integration of vocational services and permanent supportive housing programs, and encouragement of vocational service use may enhance housing outcomes among permanent supportive housing participants. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Michelle S Wong
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System
| | - Kimberly Clair
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System
| | - Peter J Stigers
- Vocational Rehabilitation Services, VA Greater Los Angeles Healthcare System
| | | | - Robert S Kern
- VA Rehabilitation R&D Center on Enhancing of Community Integration for Homeless Veterans, VA Greater Los Angeles Healthcare System
| | - Sonya Gabrielian
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System
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194
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Abstract
Would increasing allowable housing densities in expensive cities generate more housing construction and make housing more affordable? In a provocative article, Andrés Rodríguez-Pose and Michael Storper survey the evidence and answer no. Restrictions on housing density, they contend, do not substantially influence housing production or price. They further argue that allowing more density in growing metropolitan areas would only improve housing outcomes for the affluent, and most likely harm the poor. We take issue with both of these contentions. While uncertainties remain in the study of housing prices and land use regulation, neither theory nor evidence warrant dispensing with zoning reform, or concluding that it could only be regressive. Viewed in full, the evidence suggests that increasing allowable housing densities is an important part of housing affordability in expensive regions.
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195
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Ishimaru T, Mine Y, Odgerel CO, Miyake F, Kubo T, Ikaga T, Fujino Y. Prospective cohort study of bedroom heating and risk of common cold in children. Pediatr Int 2022; 64:e14755. [PMID: 33899990 DOI: 10.1111/ped.14755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/23/2021] [Accepted: 04/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND In countries with mild winter climates and inadequate heating, the relationship between housing conditions and health outcomes in winter have not been well studied. The purpose of the present study was to evaluate the relationship between heater type and temperature factors in the bedroom and incidence of the common cold among children in Japan. METHODS In this prospective cohort study, we distributed baseline questionnaires and temperature loggers in December 2019 and administered follow-up questionnaires in March 2020. We recruited children under the age of 15 years. We performed Poisson regression analysis and logistic regression analysis. RESULTS Of 297 participants, air conditioners were the most prevalent (n = 105, 35%), followed by gas or kerosene heaters (n = 50, 17%), and floor heaters (n = 31, 10%). Air-conditioners were associated with higher incidence of all events related to the common cold, especially having a fever (adjusted incidence rate ratio (aIRR) = 1.84, 95% confidence interval (CI): 1.41-2.40). Gas or kerosene and floor heaters showed a lower incidence rate of some events related to the common cold, such as school or nursery school absence (aIRR = 0.55, 95% CI: 0.37-0.82 and aIRR = 0.39, 95% CI: 0.23-0.67, respectively). Bedroom temperature did not show a positive association, but children who always felt cold showed a higher incidence of some events related to the common cold. CONCLUSIONS Our findings imply that the heating approach and modal thermal comfort, such as location of heating appliances, humidity, airflow, and radiant heat, may be more important for the onset of common cold in children than bedroom temperature itself.
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Affiliation(s)
- Tomohiro Ishimaru
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yuko Mine
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Chimed-Ochir Odgerel
- Department of Public Health and Health Policy, Hiroshima University, Hiroshima, Japan
| | - Fuyu Miyake
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Tatsuhiko Kubo
- Department of Public Health and Health Policy, Hiroshima University, Hiroshima, Japan
| | - Toshiharu Ikaga
- Department of System Design Engineering, Faculty of Science and Technology, Keio University, Yokohama, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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196
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Högler W, Tischlinger K, Fraser WD, Tang JCY, Uday S. Influence of maternal socioeconomic deprivation and living environment on newborn bloodspot 25-hydroxyvitamin D levels. Front Endocrinol (Lausanne) 2022; 13:978580. [PMID: 37091212 PMCID: PMC10116494 DOI: 10.3389/fendo.2022.978580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 10/24/2022] [Indexed: 04/25/2023] Open
Abstract
Objectives Vitamin D deficiency in neonates can have life-threatening consequences, hence the knowledge of risk factors is essential. This study aimed to explore the effect of maternal socioeconomic status (SES) on newborn 25-hydroxyvitamin D (25OHD) concentrations. Design Over two 1-week periods (winter and summer of 2019), 3000 newborn heel prick dried blood spots (DBS) and additional data of newborns, from a regional newborn screening laboratory (52° N) in the West Midlands, UK, were gathered. Post code was replaced with lower layer super output area (LSOA). Index of Multiple Deprivation (IMD) quintiles for the corresponding LSOA was used to assess SES [quintile one (Q1): most deprived 20%, quintile five (Q5): least deprived 20%]. Each of the seven domains of deprivation were examined (income, employment, education, health, barriers to housing and services, crime and living environment). 25OHD was measured on 6mm sub-punch from DBS using quantitative liquid chromatography tandem mass spectrometry and equivalent plasma values were derived. Results In total 2999 (1500 summer-born, 1499 winter-born) newborn DBS (1580 males) were analysed. Summer-born newborns had significantly higher 25OHD (IQR) concentrations [49.2 (34.3; 64.8) nmol/l] than winter-born newborns [29.1 (19.8; 40.6) nmol/l, p<0.001].25OHD levels varied significantly between the different IMD quintiles in the whole (p<0.001) and summer-born cohort (p<0.001), but not in the winter-born cohort (p=0.26), whereby Q1 had the lowest 25OHD concentrations. Among the domains of deprivation, living environment had a significant influence on 25OHD levels (β=0.07, p=0.002). In this subdomain, 25OHD levels varied significantly between quintiles in the whole (p<0.001) and summer-born cohort (mean 25OHD Q1 46.45 nmol/l, Q5 54.54 nmol/l; p<0.001) but not in the winter-born cohort (mean 25OHD Q1 31.57 nmol/l, Q5 31.72 nmol/l; p=0.16). In a regression model, living environment was still significant (p=0.018), albeit less than season of birth and ethnicity. Conclusion Among the seven domains of deprivation, maternal living environment had the greatest effect on newborn 25OHD levels. Whilst improved living environment positively influenced vitamin D status in the summer-born babies, winter-born had low 25OHD levels irrespective of the environment. Strategies such as enhanced supplementation and food fortification with vitamin D should be considered to overcome the non-modifiable main risk factors for vitamin D deficiency.
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Affiliation(s)
- Wolfgang Högler
- Department of Paediatrics and Adolescent Medicine, Johannes Kepler University Linz, Linz, Austria
- Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
- *Correspondence: Wolfgang Högler,
| | - Katharina Tischlinger
- Department of Paediatrics and Adolescent Medicine, Johannes Kepler University Linz, Linz, Austria
| | - William D. Fraser
- Department of Medicine, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
- Departments of Diabetes and Endocrinology and Clinical Biochemistry, Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | - Jonathan C. Y. Tang
- Department of Medicine, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
- Clinical Biochemistry, Departments of Laboratory Medicine, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, United Kingdom
| | - Suma Uday
- Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
- Department of Endocrinology and Diabetes, Birmingham Women’s and Children’s Hospital, Birmingham, United Kingdom
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197
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Mehdipanah R, Martin J, Eisenberg AK, Schulz AJ, Morgenstern LB, Langa KM. Housing status, mortgage debt and financial burden as barriers to health among older adults in the U.S. Hous Soc 2022; 49:58-72. [PMID: 35280971 PMCID: PMC8916742 DOI: 10.1080/08882746.2021.1881373] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We examine relations between housing status, mortgage, financial burden, and healthy aging among older U.S. adults. We combine cross-sectional data from 2012 to 2014 Health and Retirement Study cohorts. Using regression models, we examined associations between owners and renters, mortgage and non-mortgage holders, financial strain, and difficulty paying bills, and poor self-rated health (SRH), heart condition (HC) and hospitalization (past two years). We find that compared to owners, renters had greater likelihood of poor SRH and hospitalization. Regardless of tenure, financial strain was associated with greater likelihood of poor SRH, HC and hospitalization, while difficulty paying bills was associated with poor SRH and HC. Mortgage holders had lower likelihood of poor SRH. Accounting for mortgage status, financial strain was associated with greater likelihood of poor SRH, HC and hospitalization, while difficulty paying bills was associated with poor SRH and HC. Associations between tenure or mortgage status and health were not modified by either financial burden factors. We conclude that there need to be more robust and inclusive programs that assist older populations with housing could improve self-rated health, with particular attention to renters, mortgage holders and those experiencing financial burden.
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Affiliation(s)
- Roshanak Mehdipanah
- Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Jaclyn Martin
- Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Alexa K. Eisenberg
- Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Amy J. Schulz
- Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Lewis B. Morgenstern
- Stroke Program, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Kenneth M. Langa
- Division of General Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, United States,Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, United States,Institute for Social Research, University of Michigan, Ann Arbor, MI, United States,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States
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198
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Michener J, SoRelle M. Politics, power, and precarity: how tenant organizations transform local political life. Int Groups Adv 2022; 11:209-236. [PMCID: PMC8853154 DOI: 10.1057/s41309-021-00148-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/13/2021] [Indexed: 10/04/2023]
Abstract
As the coronavirus pandemic exacerbated housing precarity, tenant organizations grew in numbers and salience. But membership-based tenant organizations predated the pandemic and will persist beyond it. There are (at least) hundreds of them in localities across the country. Many aim to advance sweeping change. In doing so, they face formidable tasks: politically organizing in race-class subjugated communities, working in opposition to powerful actors (corporate landlords, property managers, etc.), and navigating complex and sometimes hostile local political institutions (city councils, mayors, rent boards, etc.). How do these organizations build power and effect change in the face of such obstacles? Drawing on a rich body of original qualitative evidence (participant observation and in-depth interviews), this paper explores the politics of local tenant organizations. We assess the origins of such organizations, how they are structured, and how they pursue political change. In doing so, we offer a rich descriptive account of phenomena that have largely escaped the attention of political scientists. We find that tenant organizations can cultivate radically different ways of conceptualizing political economy, carve out a distinctive political focus on race-class subjugated communities, and create critical opportunities for otherwise marginalized actors to develop and exercise political power.
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Affiliation(s)
- Jamila Michener
- Department of Government and Brooks School of Public Policy, Cornell University, 123 Central Ave, Ithaca, NY 14850 USA
| | - Mallory SoRelle
- Sanford School of Public Policy, Duke University, 210 Sanford Building, Durham, NC 27708 USA
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199
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Pro G, Liebert M, Remiker M, Sabo S, Montgomery BEE, Zaller N. Homeless Opioid Treatment Clients Transitioning to Dependent and Independent Housing: Differential Outcomes by Race/Ethnicity. Subst Use Misuse 2022; 57:867-875. [PMID: 35232321 DOI: 10.1080/10826084.2022.2046097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Purpose: Homeless opioid treatment clients who transition into housing generally demonstrate better outcomes, but housing environments vary widely and may not benefit racial/ethnic minority populations equally. We sought to identify how race/ethnicity moderates the association between positive opioid treatment response and moving into dependent or independent living environments. Methods: We used the Treatment Episode Dataset-Discharges (2018-2019) to identify outpatient treatment clients who were homeless at admission and indicated heroin or other opioids as their primary drug of choice (n = 20,021). We defined positive treatment response as a reduction in opioid use between admission and discharge. We used multivariable logistic regression to model treatment response. We included an interaction between housing at discharge (remained homeless [reference], dependent living, or independent living) and race/ethnicity, and adjusted for relevant confounders. Results: Transitioning from homeless to dependent living was positively associated with treatment response among White (aOR = 3.57, 95% CI = 3.15-4.06), Hispanic (aOR = 2.11, 95% CI = 1.55-2.86), and Black clients (aOR = 1.79, 95% CI = 1.41-2.27), but no association was observed for homeless American Indian/Alaska Native clients. Transitioning from homeless to independent living was strongly associated with treatment response among all groups with the strongest association observed among White clients (aOR = 4.70, 95% CI = 4.26-5.19). Conclusions: Interventions aimed at improving OUD treatment outcomes among homeless clients should identify individual and structural factors that support moving into fully housed and independent living environments. Dependent living offers needed support during crises, but should be temporary and priority should be placed on independent, permanent, and autonomous living environments.
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Affiliation(s)
- George Pro
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Melissa Liebert
- Department of Anthropology, Northern Arizona University, Flagstaff, Arizona, USA
| | - Mark Remiker
- Center for Health Equity Research, Northern Arizona University, Flagstaff, Arizona, USA
| | - Samantha Sabo
- Center for Health Equity Research, Northern Arizona University, Flagstaff, Arizona, USA
| | - Brooke E E Montgomery
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Nickolas Zaller
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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Abstract
INTRODUCTION This paper explores how the built environment impacts upon health and well-being and suggests that there are opportunities for more integrated working between professionals and citizens to create healthier, happier places. SOURCES OF DATA Policy and practice guidance is presented from the urban planning and design fields. Evidence and data are presented from a range of disciplines on housing, green infrastructure and mental well-being. AREAS OF AGREEMENT There is an overwhelming agreement around the principles and rationale of incorporating health in planning and design processes. AREAS OF CONTROVERSY These principles are not always implemented in practice. Challenges also exist around how different disciplines create and use evidence. GROWING POINTS More innovative ways of working which incorporates health, public health, planners, designers and citizens, which responds to the needs of communities, should be tested. AREAS TIMELY FOR DEVELOPING RESEARCH Health and public health professionals can contribute to the evidence base using objective measures to assess the impact of the built environment on mental health and well-being.
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Affiliation(s)
- Rachel Turnbull
- AHSN NENC, Biomedical Research Building, The Campus for Ageing and Vitality, Nuns' Moor Road, Newcastle upon Tyne NE4 5PL, UK
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