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van Loenen T, Sow J, van den Muijsenbergh M. The collateral damage of the COVID-19 pandemic on homeless people in the Netherlands; a qualitative study on the impact of health and care. Front Med (Lausanne) 2024; 11:1305834. [PMID: 38515983 PMCID: PMC10954826 DOI: 10.3389/fmed.2024.1305834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/21/2024] [Indexed: 03/23/2024] Open
Abstract
Introduction People experiencing homelessness, also in the Netherlands, experience poorer physical and mental health compared to the general population and suffer from unmet health needs that are strongly related to their unfavorable social situation. This makes them especially vulnerable to negative consequences of a public health emergency such as the COVID-19 pandemic. This qualitative study aims to provide insight into the experiences of people experiencing homelessness with the impact of the pandemic on their health and lives. Methods We performed semistructured interviews at 3 different times in the first 2 years of the pandemic including, respectively, 67, 55, and 53 persons. Interviews focused on their experienced mental and physical health, their experiences with the public health measures taken, and the care they received during the pandemic. Results In each round of interviews, the self-reported mental health was lower than before. In the last round approximately half felt mentally unhealthy. Mental health was negatively impacted due to livelihood insecurity, loss of social contact and poor accessibility to social and medical care. Twenty-four hour shelter locations with smaller dormitories had a positive impact on mental health. Conclusion and recommendations Most preventive measures taken during the pandemic negatively impacted the mental health of people experiencing homelessness but some improved their health. We recommend special attention to the effects on mental health when planning measures for pandemic control and we recommend to implement 24-h shelter and smaller dormitories.
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Affiliation(s)
- Tessa van Loenen
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands
- Pharos, Centre of Expertise on Health Disparities, Utrecht, Netherlands
| | - Jeyna Sow
- Pharos, Centre of Expertise on Health Disparities, Utrecht, Netherlands
| | - Maria van den Muijsenbergh
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands
- Pharos, Centre of Expertise on Health Disparities, Utrecht, Netherlands
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Ogbonna O, Bull F, Spinks B, Williams D, Lewis R, Edwards A. Interventions to mitigate the risks of COVID-19 for people experiencing homelessness and their effectiveness: a systematic review. Front Public Health 2024; 11:1286730. [PMID: 38239803 PMCID: PMC10794490 DOI: 10.3389/fpubh.2023.1286730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/29/2023] [Indexed: 01/22/2024] Open
Abstract
Objectives People experiencing homelessness also experience poorer clinical outcomes of COVID-19. Various interventions were implemented for people experiencing homelessness in 2020-2022 in different countries in response to varied national guidance to limit the impact of COVID-19. It is important to understand what was done and the effectiveness of such interventions. This systematic review aims to describe interventions to mitigate the risks of COVID-19 in people experiencing homelessness and their effectiveness. Methods A protocol was developed and registered in PROSPERO. Nine databases were searched for studies on interventions to mitigate the impact of COVID-19 on people experiencing homelessness. Included studies were summarised with narrative synthesis. Results From 8,233 references retrieved from the database searches and handsearching, 15 were included. There was a variety of interventions, including early identification of potential COVID-19 infections, provision of isolation space, healthcare support, and urgent provision of housing regardless of COVID-19 infection. Conclusion The strategies identified were generally found to be effective, feasible, and transferable. This review must be interpreted with caution due to the low volume of eligible studies and the low quality of the evidence available.
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Affiliation(s)
- Obianuju Ogbonna
- Health and Care Research Evidence Centre, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Francesca Bull
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Bethany Spinks
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Denitza Williams
- Health and Care Research Evidence Centre, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Ruth Lewis
- North Wales Centre for Primary Care Research, School of Medical and Health Sciences, Bangor University, Bangor, United Kingdom
| | - Adrian Edwards
- Health and Care Research Evidence Centre, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
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Ogbonna O, Bull F, Spinks B, Williams D, Lewis R, Edwards A. The Impact of Being Homeless on the Clinical Outcomes of COVID-19: Systematic Review. Int J Public Health 2023; 68:1605893. [PMID: 37780134 PMCID: PMC10540688 DOI: 10.3389/ijph.2023.1605893] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 08/22/2023] [Indexed: 10/03/2023] Open
Abstract
Objective: The homeless population experiences inequality in health compared with the general population, which may have widened during the COVID-19 pandemic. However, the impact of being homeless on the outcomes of COVID-19 is uncertain. This systematic review aimed to analyse the impact of experiencing homelessness on the clinical outcomes of COVID-19, including the effects on health inequalities. Methods: A review protocol was developed and registered in PROSPERO (PROSPERO registration 2022 CRD42022304941). Nine databases were searched in November 2022 to identify studies on homeless populations which contained primary research on the following outcomes of COVID-19: incidence, hospitalisation, mortality, long COVID, mental wellbeing, and evidence of inequalities. Included studies were summarised with narrative synthesis. Results: The searches yielded 8,233 initial hits; after screening, 41 studies were included. Overall, evidence showed that those in crowded living settings had a higher risk of COVID-19 infection compared to rough sleepers and the general population. The homeless population had higher rates of hospitalisation and mortality than the general population, lower vaccination rates, and suffered negative mental health impacts. Conclusion: This systematic review shows the homeless population is more susceptible to COVID-19 outcomes. Further research is needed to determine the actual impact of the pandemic on this population, and of interventions to mitigate overall risk, given the low certainty of findings from some of the low-quality evidence available. In addition, further research is required to ascertain the impact of long COVID on those experiencing homelessness, since the present review yielded no studies on this topic.
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Affiliation(s)
- Obianuju Ogbonna
- Health and Care Research Wales Evidence Centre, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Francesca Bull
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Bethany Spinks
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Denitza Williams
- Health and Care Research Wales Evidence Centre, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Ruth Lewis
- North Wales Centre for Primary Care Research, School of Medical and Health Sciences, Bangor University, Bangor, United Kingdom
| | - Adrian Edwards
- Health and Care Research Wales Evidence Centre, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
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Marquez J, Goodfellow C, Hardoon D, Inchley J, Leyland AH, Qualter P, Simpson SA, Long E. Loneliness in young people: a multilevel exploration of social ecological influences and geographic variation. J Public Health (Oxf) 2023; 45:109-117. [PMID: 34999845 PMCID: PMC10017088 DOI: 10.1093/pubmed/fdab402] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Loneliness is a growing public health concern, yet little is known about loneliness in young people. The current study aimed to identify social ecological factors related to loneliness and examine the extent to which geographic region may account for differences in loneliness. METHODS The data come from a cross-sectional sample of 6503 young people living in the UK. Loneliness was measured using the UCLA 3-item scale. Bivariate analyses were used to test associations between each predictor and loneliness. Multilevel models were used to identify key social ecological factors related to loneliness, and the extent to which loneliness may vary across geographic regions (local authority districts). RESULTS Sociodemographic, social, health and well-being, and community factors were found to be associated with loneliness. Geographic region was associated with 5-8% of the variation in loneliness. The effect of gender, sexual orientation and minority ethnic background on loneliness differed across regions. CONCLUSIONS This is the first study to highlight modifiable social and community factors related to youth loneliness, and individual vulnerabilities, such as poor mental well-being. Results related to geographic differences suggest that local-level initiatives may be most appropriate in tackling loneliness, rather than wider, less contextualized national efforts.
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Affiliation(s)
- J Marquez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - C Goodfellow
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - D Hardoon
- What Works Centre for Wellbeing, London SW1H 9EA, UK
| | - J Inchley
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - A H Leyland
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - P Qualter
- University of Manchester, Manchester Institute of Education, Manchester M13 9PL, UK
| | - S A Simpson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - E Long
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
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Mejia‐Lancheros C, Alfayumi‐Zeadna S, Lachaud J, O'Campo P, Gogosis E, Da Silva G, Stergiopoulos V, Hwang SW, Thulien N. Differential impacts of COVID-19 and associated responses on the health, social well-being and food security of users of supportive social and health programs during the COVID-19 pandemic: A qualitative study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4332-e4344. [PMID: 35524402 PMCID: PMC9347945 DOI: 10.1111/hsc.13826] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 03/25/2022] [Accepted: 04/22/2022] [Indexed: 06/14/2023]
Abstract
The effects of the coronavirus disease-2019 (COVID-19) pandemic on the lives of underserved populations are underexplored. This study aimed to identify the impacts of the COVID-19 pandemic and associated public health responses on the health and social well-being, and food security of users of Housing First (HF) services in Toronto (Canada) during the first wave of the COVID-19 pandemic. This qualitative descriptive study was conducted from July to October 2020 in a subsample of 20 adults with a history of homelessness and serious mental disorders who were receiving HF services in Toronto. A semi-structured interview guide was used to collect narrative data regarding health and social well-being, food security and access to health, social and preventive services. A thematic analysis framework guided analyses and interpretation of the data. The COVID-19 pandemic and response measures had a variable impact on the health, social well-being and food security of participants. Around 40% of participants were minimally impacted by the COVID-19 pandemic. Conversely, among the remaining participants (impacted group), some experienced onset of new mental health problems (anxiety, stress, paranoia) or exacerbation of pre-existing mental disorders (depression, post-traumatic stress disorder and obsessive-compulsive disorder). They also struggled with isolation and loneliness and had limited leisure activities and access to food goods. The pandemic also contributed to disparities in accessing and receiving healthcare services and treatment continuity for non-COVID-19 health issues for the negatively impacted participants. Overall, most participants were able to adhere to COVID-19 public health measures and get reliable information on COVID-19 preventive measures facilitated by having access to the phone, internet and media devices and services. In conclusion, the COVID-19 pandemic and associated response measures impacted the health, social well-being, leisure and food security of people with experiences of homelessness and mental disorders who use supportive social and housing services in diverse ways.
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Affiliation(s)
- Cilia Mejia‐Lancheros
- MAP Centre for Urban Health SolutionsLi Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health TorontoTorontoOntarioCanada
- Research Group in Nursing Care and Practice, Family Health Nursing and Health Measures; Nursing FacultyUniversidad Nacional de ColombiaBogotáColombia
| | - Samira Alfayumi‐Zeadna
- MAP Centre for Urban Health SolutionsLi Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health TorontoTorontoOntarioCanada
- Center for Women's Health Studies and PromotionBen‐Gurion University of the NegevBeer‐ShevaIsrael
| | - James Lachaud
- MAP Centre for Urban Health SolutionsLi Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health TorontoTorontoOntarioCanada
- Research Group in Nursing Care and Practice, Family Health Nursing and Health Measures; Nursing FacultyUniversidad Nacional de ColombiaBogotáColombia
| | - Patricia O'Campo
- MAP Centre for Urban Health SolutionsLi Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health TorontoTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Evie Gogosis
- MAP Centre for Urban Health SolutionsLi Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health TorontoTorontoOntarioCanada
| | - George Da Silva
- MAP Centre for Urban Health SolutionsLi Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health TorontoTorontoOntarioCanada
| | - Vicky Stergiopoulos
- Centre for Addiction and Mental HealthTorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | - Stephen W. Hwang
- MAP Centre for Urban Health SolutionsLi Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health TorontoTorontoOntarioCanada
- Division of General Internal Medicine, Department of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Naomi Thulien
- MAP Centre for Urban Health SolutionsLi Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health TorontoTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
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Dost K, Heinrich F, Graf W, Brennecke A, Kowalski V, Leider A, Kraus A, van Rüth V, Ondruschka B, Püschel K, König HH, Bertram F, Hajek A. Predictors of Loneliness among Homeless Individuals in Germany during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12718. [PMID: 36232018 PMCID: PMC9566392 DOI: 10.3390/ijerph191912718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE The aim of the study was to identify the frequency of loneliness and to examine the factors associated with loneliness among homeless individuals in Germany during the COVID-19 pandemic. METHODS Data were taken from the 'national survey on the psychiatric and somatic health of homeless individuals during the COVID-19 pandemic'. The data collection took place from 26th July to 17th September 2021 (the analytical sample included n = 491 observations). The well-established UCLA-3 tool was used to quantify loneliness. Independent variables included sex, age, marital status, the existence of children and pets, level of education, country of origin, duration of homelessness, alcohol and drug consumption, mental health concerns and concerns regarding COVID-19 illness. Multiple logistic regressions were used to examine the predictors of loneliness. RESULTS The frequency of loneliness was 41.7% for the total sample. Multiple logistic regression analysis stratified by gender showed that a higher likelihood of loneliness was associated with being born in Germany, being middle aged (40 to 49 years compared to 18 to 29 years), having mental health problems and a short period of homelessness (1 month compared to longer periods) among women. In men, a higher likelihood of loneliness was associated with a higher fear of COVID-19 and a short period of homelessness. CONCLUSIONS Our study revealed a high frequency rate of loneliness among homeless individuals. The study results highlight the associations between some explanatory variables (i.e., the duration of homelessness and mental health problems). Identifying the factors associated with loneliness may help to adequately address the problems of homeless individuals at risk of loneliness. Longitudinal studies are required to confirm our findings.
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Affiliation(s)
- Katharina Dost
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Fabian Heinrich
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Wiebke Graf
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Anna Brennecke
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Veronika Kowalski
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Anna Leider
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Anika Kraus
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Victoria van Rüth
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Benjamin Ondruschka
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Klaus Püschel
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Franziska Bertram
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
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7
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Munté-Pascual A, Redondo-Sama G, De Vicente I, Matulic V. You Are Not Alone: The (In)Visible Homeless and the Role of Social Workers and Related Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10070. [PMID: 36011704 PMCID: PMC9408099 DOI: 10.3390/ijerph191610070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/26/2022] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Abstract
The scientific literature has already shown that health information is a factor that contributes to reduce health disparities, improving the situation of vulnerable groups, such as homeless people. However, less is known about the ways that health information has been spread by social workers and related professionals to homeless people in the first moments of the COVID-19 pandemic. This work analyses some social work actions related to health information addressed to homeless people and to identify its impact during the lockdown in Barcelona. This qualitative study is based on semi-structured interviews with social workers and related professionals involved in developing interventions related to health information with homeless people in Barcelona. The data analysis is based on the communicative methodology to identify exclusionary and transformative dimensions. The results show the improvement in the health information of homeless people during the pandemic through the design and development of actions facilitated and promoted by some social workers and related professionals. The findings demonstrate the role that some social workers and related professionals have played in the improvement of health information of homeless people during the lockdown in Barcelona.
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Affiliation(s)
- Ariadna Munté-Pascual
- Social Work Training and Research Section, Faculty of Education, University of Barcelona, 08035 Barcelona, Spain
| | | | - Irene De Vicente
- Social Work Training and Research Section, Faculty of Education, University of Barcelona, 08035 Barcelona, Spain
| | - Virginia Matulic
- Social Work Training and Research Section, Faculty of Education, University of Barcelona, 08035 Barcelona, Spain
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8
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Rodriguez NM, Martinez RG, Ziolkowski R, Tolliver C, Young H, Ruiz Y. "COVID knocked me straight into the dirt": perspectives from people experiencing homelessness on the impacts of the COVID-19 pandemic. BMC Public Health 2022; 22:1327. [PMID: 35820879 PMCID: PMC9275174 DOI: 10.1186/s12889-022-13748-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/06/2022] [Indexed: 11/18/2022] Open
Abstract
Background People experiencing homelessness are uniquely susceptible and disproportionately affected by the impacts of the COVID-19 pandemic. Understanding context-specific challenges, responses, and perspectives of people experiencing homelessness is essential to improving pandemic response and mitigating the long-term consequences of the pandemic on this vulnerable population. Methods As part of an ongoing community-based participatory research study in partnership with a homeless service organization in Indiana, semi-structured interviews were conducted with a total of 34 individuals experiencing homelessness between January and July 2021. Guided by the NIMHD Health Disparities Research Framework, which builds on the socio-ecological model, data was thematically coded using Nvivo12 qualitative coding software and themes were organized by levels of influence (individual, interpersonal, community, societal) and domains of influence (biological, behavioral, physical/built environment, sociocultural environment, health care system). Results Narratives revealed numerous and compounding factors affecting COVID-19 risks and health outcomes among people experiencing homelessness across all levels and domains of influence. At the individual level, people experiencing homelessness face unique challenges that heightened their susceptibility to COVID-19, including pre-existing physical and mental health conditions, substance use and behavioral health risks, socioeconomic precarity, and low health literacy and COVID-related knowledge. At the interpersonal level, poor communication between people experiencing homelessness and service providers led to limited understanding of and poor compliance with COVID safety measures. At the community level, closures and service disruptions restricted access to usual spaces and resources to meet basic needs. At a policy level, people experiencing homelessness were disregarded in ways that made pandemic relief resources largely inaccessible to them. Conclusions Our findings reveal important and mitigable issues with ongoing pandemic response efforts in homeless populations through direct, first-hand accounts of their experiences during COVID-19. These insights offer opportunities for multilevel interventions to improve outreach, communication, and impact mitigation strategies for people experiencing homelessness. This study highlights the importance of centering the voices of vulnerable communities to inform future pandemic response for homeless and other underserved and marginalized populations.
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Affiliation(s)
- Natalia M Rodriguez
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA. .,Regenstrief Center for Healthcare Engineering, Purdue University, West Lafayette, IN, USA.
| | - Rebecca G Martinez
- Department of Anthropology, College of Liberal Arts, Purdue University, West Lafayette, Indiana, USA
| | - Rebecca Ziolkowski
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
| | - Cealia Tolliver
- Department of Pharmacy Practice, College of Pharmacy, Purdue University, West Lafayette, Indiana, USA
| | - Hope Young
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
| | - Yumary Ruiz
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
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9
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Nouri M, Ostadtaghizadeh A, Sari AA. COVID-19 in Homelessness: A Worldwide Scoping Review on Vulnerabilities, Risks, and Risk Management. SOCIAL WORK IN PUBLIC HEALTH 2022; 37:303-318. [PMID: 34963409 DOI: 10.1080/19371918.2021.2011525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Homeless individuals are at greater risk of death due to social inequalities during Covid-19 pandemic. Strategies taken for general population to prevent the spread of Covid-19, such as social distance, staying at home, and observing personal hygiene are not possible for this group of people. This is a scoping review on articles published and other credible resources published analyze studies done on homeless people during the COVID-19 pandemic. In this scoping review, for the first time, we studied published articles on the situation of the homeless during the Covid-19 epidemic and by extracting and categorizing vulnerabilities, risks, as well as risk management plans, Finally we presented, useful guidance for organizations providing health and social services during the spread of diseases.
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Affiliation(s)
- Mohsen Nouri
- Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences(TUMS), Tehran, Iran
| | - Abbas Ostadtaghizadeh
- Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences(TUMS), Tehran, Iran
| | - Ali Akbari Sari
- Department of Health Management and EconomicsSchool of Public Health, Tehran University of Medical Sciences (Tums), Tehran, Iran
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10
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Corey J, Lyons J, O’Carroll A, Stafford R, Ivers JH. A Scoping Review of the Health Impact of the COVID-19 Pandemic on Persons Experiencing Homelessness in North America and Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063219. [PMID: 35328907 PMCID: PMC8954292 DOI: 10.3390/ijerph19063219] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 02/04/2023]
Abstract
Persons experiencing homelessness (PEH) are at heightened risk for infection, morbidity, and mortality from COVID-19. However, health consequences of the pandemic extend far beyond those directly caused by the virus. This scoping review aimed to explore the impacts of the COVID-19 pandemic on the health and well-being of PEH in North America and Europe. A systematic search of academic and grey literature was conducted in September 2021. To be included, studies had to include primary data related to the impact of the pandemic on health or well-being of PEH and be written in English. All potentially relevant references were independently screened by two reviewers, and minor conflicts were settled with input of a third reviewer. A total of 96 articles met criteria for inclusion. Data extraction was completed for all included studies, and findings synthesised and presented thematically. Numerous health impacts of the pandemic on PEH were identified, including SARS-CoV-2 infection, morbidity, mortality, and hospitalisation, fear of infection, access to housing, hygiene, PPE, food, as well as mental health, substance use, other health-related outcomes and treatment services. Gaps in the literature relating to persons using alcohol, access to mental health support, and violence were also identified. Implications for future research are discussed.
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Affiliation(s)
- Julia Corey
- Department of Public Health & Primary Care, School of Medicine, Trinity College Dublin, D24H74 Dublin, Ireland; (J.C.); (J.L.)
| | - James Lyons
- Department of Public Health & Primary Care, School of Medicine, Trinity College Dublin, D24H74 Dublin, Ireland; (J.C.); (J.L.)
| | | | - Richie Stafford
- HSE Community Healthcare Organisation Dublin North City & County, D09C8P5 Dublin, Ireland;
| | - Jo-Hanna Ivers
- Department of Public Health & Primary Care, School of Medicine, Trinity College Dublin, D24H74 Dublin, Ireland; (J.C.); (J.L.)
- Correspondence:
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11
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Bertram F, Hajek A, Dost K, Graf W, Brennecke A, Kowalski V, Rüth VV, König HH, Wulff B, Ondruschka B, Püschel K, Heinrich F. The Mental and Physical Health of the Homeless. DEUTSCHES ARZTEBLATT INTERNATIONAL 2022; 119:861-868. [PMID: 36382585 PMCID: PMC9989961 DOI: 10.3238/arztebl.m2022.0357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 04/10/2022] [Accepted: 10/10/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The health status of homeless individuals in Germany has been described incompletely. Mental and somatic illnesses seem to contribute to the high mortality in this cohort. METHODS In this national, multicenter, cross-sectional study, data were collected on the health of 651 homeless individuals in the metropolitan regions of Hamburg, Frankfurt, Leipzig, and Munich metropolitan regions. The lifetime prevalences of physician-diagnosed mental and somatic illnesses were determined with interviewbased questionnaires. Furthermore, clinical and laboratory examinations were carried out. Multivariable regressions were performed to identify determinants of health status and access to care. RESULTS High prevalences of both mental and somatic illnesses were confirmed. Particularly, cardiovascular and metabolic diseases were highly prevalent. Evidence for possible unrecognized arterial hypertension and possible unrecognized hypercholesterolemia was found in 27.5% and 15.6% of homeless individuals, respec - tively. 23.1% of study participants reported having received a diagnosis of a mental illness. Evidence for a possible unrecognized mental illness was found in 69.7%. A history of immigration from another country to Germany was found to be an important determinant of the summed scores for mental, somatic, and possible unrecognized illness. Homeless individuals of non-German origin were more likely to be living without shelter (p = 0.03) and to lack health insurance (p < 0.001). CONCLUSION High prevalence rates for mental and somatic illnesses and limited access to mainstream medical care were found. Homeless individuals appear to receive inadequate care for mental illness. Healthcare programs for homeless individuals in Germany should pay particular attention to homeless migrants.
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Affiliation(s)
- Franziska Bertram
- Institute of Forensic Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Health Economics and Health Services Research, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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12
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Nyamathi AM, Gelberg L, Lee D, Arce N, Patten-Jones A, Yadav K, Goodwine M, Alikhani M, Yao M, Chang AH, Salem BE. Perceptions of Homeless Adults and Their Providers on Coping With the Impact of COVID-19 Pandemic on Mental Health, Substance Use, and Harm Reduction Services. Glob Qual Nurs Res 2022; 9:23333936221108712. [PMID: 35912133 PMCID: PMC9335488 DOI: 10.1177/23333936221108712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 06/03/2022] [Accepted: 06/06/2022] [Indexed: 11/17/2022] Open
Abstract
Adults experiencing homelessness experience a disproportionate burden of health disparities which has further exacerbated mental health, substance use, and coping during the COVID-19 pandemic. As limited data is available to understand the experience of adults experiencing homelessness and their health during this time, the purpose of this study was to explore how COVID-19 may have impacted their mental health, substance use, and ways of coping in this population. Using community-based participatory research, a community advisory board was established and remote individual interviews with 21 adults experiencing homelessness and 10 providers were conducted in Skid Row, Los Angeles. Using a qualitative, data analytic approach, the following major themes emerged: (1) Negative Impact of COVID-19 on Mental Health; (2) Negative Impact of COVID-19 on Limitation of Harm Reduction Services; and (3) Coping Strategies Utilized During the COVID-19 Pandemic. More research is needed to understand the impact of this pandemic on underserved communities.
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Affiliation(s)
| | - Lillian Gelberg
- David Geffen School of Medicine at University of California, Los Angeles, California, USA
| | - Darlene Lee
- University of California, Irvine, California, USA
| | | | | | - Kartik Yadav
- University of California, Irvine, California, USA
| | | | | | - Maritas Yao
- University of California, Los Angeles, California, USA
| | - Alicia H Chang
- Los Angeles County Department of Public Health, California, USA
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13
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Scarlett H, Davisse-Paturet C, Longchamps C, Aarbaoui TE, Allaire C, Colleville AC, Convence-Arulthas M, Crouzet L, Ducarroz S, Melchior M. Depression during the COVID-19 pandemic amongst residents of homeless shelters in France. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 6:100243. [PMID: 34632442 PMCID: PMC8487751 DOI: 10.1016/j.jadr.2021.100243] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/14/2021] [Accepted: 09/24/2021] [Indexed: 12/28/2022] Open
Abstract
Background Accumulating evidence suggests that the COVID-19 pandemic has negatively affected global mental health and well-being. However, the impact amongst homeless persons has not been fully evaluated. The ECHO study reports factors associated with depression amongst the homeless population living in shelters in France during the spring of 2020. Methods Interview data were collected from 527 participants living in temporary and/or emergency accommodation following France's first lockdown (02/05/20 – 07/06/20), in the metropolitan regions of Paris (74%), Lyon (19%) and Strasbourg (7%). Interviews were conducted in French, English, or with interpreters (33% of participants, ∼20 languages). Presence of depression was ascertained using the Patient Health Questionnaire (PHQ-9). Results Amongst ECHO study participants, 30% had symptoms of moderate to severe depression (PHQ-9 ≥ 10). Multivariate analysis revealed depression to be associated with being female (aOR: 2.15; CI: 1.26–3.69), single (aOR: 1.60; CI: 1.01–2.52), chronically ill (aOR: 2.32; CI: 1.43: 3.78), facing food insecurity (aOR: 2.12; CI: 1.40–3.22) and participants’ region of origin. Persons born African and Eastern Mediterranean regions showed higher levels of depression (30–33% of participants) than those migrating from other European countries (14%). Reduced rates of depression were observed amongst participants aged 30–49 (aOR: 0.60; CI: 0.38–0.95) and over 50 (aOR: 0.28; CI: 0.13–0.64), compared to 18–29-year-olds. Limitations These data are cross-sectional, only providing information on a given moment in time. Conclusions Our results indicate high levels of depression amongst homeless persons during the COVID-19 pandemic. Predicted future instability and economic repercussions could particularly impact the mental health of this vulnerable group.
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Affiliation(s)
- Honor Scarlett
- Équipe de Recherche en Épidémiologie Sociale, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP,Sorbonne Université, INSERM, Paris F75012, France
| | - Camille Davisse-Paturet
- Équipe de Recherche en Épidémiologie Sociale, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP,Sorbonne Université, INSERM, Paris F75012, France
| | - Cécile Longchamps
- Équipe de Recherche en Épidémiologie Sociale, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP,Sorbonne Université, INSERM, Paris F75012, France
| | - Tarik El Aarbaoui
- Équipe de Recherche en Épidémiologie Sociale, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP,Sorbonne Université, INSERM, Paris F75012, France
| | - Cécile Allaire
- French National Public Health Agency, Santé Publique France, Saint-Maurice F94415, France
| | - Anne-Claire Colleville
- French National Public Health Agency, Santé Publique France, Saint-Maurice F94415, France
| | - Mary Convence-Arulthas
- Équipe de Recherche en Épidémiologie Sociale, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP,Sorbonne Université, INSERM, Paris F75012, France
| | - Lisa Crouzet
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, France
| | - Simon Ducarroz
- Équipe de Recherche en Épidémiologie Sociale, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP,Sorbonne Université, INSERM, Paris F75012, France.,Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, France
| | - Maria Melchior
- Équipe de Recherche en Épidémiologie Sociale, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP,Sorbonne Université, INSERM, Paris F75012, France.,CNRS, Institut Convergences Migration, Aubervilliers, France
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14
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Hajek A, König HH. Do lonely and socially isolated individuals think they die earlier? The link between loneliness, social isolation and expectations of longevity based on a nationally representative sample. Psychogeriatrics 2021; 21:571-576. [PMID: 33966322 DOI: 10.1111/psyg.12707] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 04/03/2021] [Accepted: 04/18/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Loneliness and social isolation both have been linked to morbidity and mortality. However, there is a lack of studies investigating whether these factors are associated with expectations of longevity. Therefore, we aimed to clarify this association. METHODS Cross-sectional data were taken from a nationally representative sample of middle-aged and older individuals (analytical sample, n = 4857). Well-established scales were used to measure loneliness and social isolation. Equally to other large cohort studies, expectations of longevity were assessed using the question 'What age do you think you will live to?' It was adjusted for various socioeconomic and health-related factors. RESULTS After adjusting for various socioeconomic and health-related covariates, multiple linear regressions showed that both loneliness (total sample: β = -0.97, P < 0.001; men: β = -1.04, P < 0.001; women: β = -0.97, P < 0.01) and social isolation (total sample: β = -0.93, P < 0.001; men: β = -0.86, P < 0.001; women: β = -0.91, P < 0.01) were associated with lower expectations of longevity in the total sample and stratified by gender. Furthermore, lower expectations of longevity were consistently associated with younger age (β = 0.32, P < 0.001), being retired (β = -2.39, P < 0.001), not being employed (β = -1.97, P < 0.001), worse self-rated health (β = -1.31, P < 0.001), and a higher number of chronic illnesses (β = -0.38, P < 0.001) in the total sample, and in both genders. CONCLUSIONS Even after adjusting for various covariates, findings still indicate an association between both loneliness and social isolation and markedly lower expectations of longevity. Future studies based on longitudinal data are required to gain further insights.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Centre for Health Economics, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Centre for Health Economics, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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