Health status, diseases and vaccinations of the homeless in the city of Palermo, Italy.

Abstract

In Italy, as in the rest of the world, the number of homeless people is increasing considerably. Many of them suffer from chronic conditions, mental health problems and addiction to alcohol, drugs or smoking, and need complex medical care. Their health status is often exacerbated by greater difficulty in accessing primary care. The aim of the present study was to assess health conditions of homeless people living in Palermo, Southern Italy, and to find ways to limit the spread of common infectious diseases that can be prevented by vaccination. A self-administered questionnaire was distributed. The questionnaire was structured into two parts including an introduction with socio-demographic information, and a second part investigating health status, chronic diseases and vaccinations. A multivariable logistic regression model was used and adjusted Odds Ratios (aOR) are presented. The sample consisted of 52 homeless, 35 (67.3%) of whom were male and the most represented age class (55.8%) was < 50 years of age. The average age of the sample was 49.6 years (SD ± 15.2) and 88.5% were born in Italy. A multivariable logistic regression model based on 52 observations was used. The analysis showed that the female gender was significantly associated with: not performing regular physical activity (aOR 4.14, 95% C.I. 1.20 - 14.32, p = 0.025), suffering from chronic diseases (aOR 3.52, 95% C.I. 1.02 - 12.11, p = 0.046) and taking medicines (aOR 3.95, 95% C.I. 1.14 - 13.64, p = 0.030). This particularly fragile population is exposed to diseases that are largely preventable or curable through a wider and more early access to care by local health facilities with a subsequent reduction in the worsening of clinical outcomes and related social costs.