Look Up

This article highlights the findings of the 1998 humanbecoming inquiry considering tomorrow. The participants in this inquiry were women homeless in Chicago. Children's books, recent TV and newspaper articles focusing on the homeless in Pensacola, Florida, and various other humanbecoming inquiries involving homeless populations emphasize the importance of looking up and paying attention to what is occurring in humanuniverse so as to seize opportunities that present themselves with the emerging now.

Respiratory Syncytial Virus Infection in Homeless Populations, Washington, USA

Homelessness has not previously been identified as a risk factor for respiratory syncytial virus (RSV) infection. We conducted an observational study at an urban safety-net hospital in Washington, USA, during 2012–2017. Hospitalized adults with RSV were more likely to be homeless, and several clinical outcome measures were worse with RSV than with influenza.

Impact of a New York City Supportive Housing Program on Housing Stability and Preventable Health Care among Homeless Families

OBJECTIVE

To assess the impact of a New York City supportive housing program on housing stability and preventable emergency department (ED) visits/hospitalizations among heads of homeless families with mental and physical health conditions or substance use disorders.

DATA SOURCES

Multiple administrative data from New York City and New York State for 966 heads of families eligible for the program during 2007-12.

STUDY DESIGN

We captured housing events and health care service utilization during 2 years prior to the first program eligibility date (baseline) and 2 years postbaseline. We performed sequence analysis to measure housing stability and compared housing stability and preventable ED visits and hospitalizations between program participants (treatment group) and eligible applicants not placed in the program (comparison group) via marginal structural modeling.

DATA COLLECTION/EXTRACTION METHODS

We matched electronically collected data.

PRINCIPAL FINDINGS

Eighty-seven percent of supportive housing tenants experienced housing stability in 2 years postbaseline. Compared with unstably housed heads of families in the comparison group, those in the treatment group were 0.60 times as likely to make preventable ED visits postbaseline (95% CI = 0.38, 0.96).

CONCLUSIONS

Supportive housing placement was associated with improved housing stability and reduced preventable health care visits among homeless families.

Variation in the implementation of California's Full Service Partnerships for persons with serious mental illness

OBJECTIVE

This study examined variation in the implementation of California's Full Service Partnerships (FSPs), which are supported housing programs that do "whatever it takes" to improve outcomes among persons with serious mental illness who are homeless or at risk of homelessness.

DATA SOURCES/SETTING

Ninety-three FSPs in California.

STUDY DESIGN

A mixed methods approach was selected to develop a better understanding of the complexity of the FSP programs. The design structure was a combined explanatory and exploratory sequential design (qual→QUAN→qual) where a qualitative focus group was used to develop a quantitative survey that was followed by qualitative site visits. The survey was used to describe the breadth of variation based on fidelity to the Housing First model, while the site visits were used to provide a depth of information on high- versus low-fidelity programs.

PRINCIPAL FINDINGS

We found substantial variation in implementation among FSPs. Fidelity was particularly low along domains related with housing and service philosophy, indicating that many FSPs implemented a rich array of services but applied housing readiness requirements and did not adhere to consumer choice in housing.

CONCLUSIONS

There remains room for improvement in the recovery-orientation of FSPs. Fortunately, we have identified several processes by which program managers and counties can increase the fidelity of their programs.