Homeless Individuals Research Articles

노숙인의 정신적 습관 형성에 영향을 미친 경험

Mental habits could be considered a major determinant not only of physical health behaviors and status but also of mental health. However, there has been limited research on the concept of mental habits in Korea and internationally. As homeless people experience mental health issues more frequently than the general population, early detection and management could be crucial for improving their mental health. Therefore, this study aims to conduct a phenomenological study to discover common experiences of the homeless, focusing on the formation process of mental habits. Through the analysis of in-depth interviews with 12 homeless people, 21 themes, 11 theme clusters, and 6 categories were derived. The results suggested that the mental habits of the homeless were formed through experiences including social disconnection, addiction, unethical behavior, economic difficulties, social exclusion, chronic problematic environments, and intrinsic motivations for life. From childhood to the current homeless status, various experiences have led to complicated interactions affecting the interviewees in multiple ways: a single event could lead to multiple mental habits, or a combination of experiences could develop a single mental habit. Therefore, policies for homeless people should not simply aim to provide shelter but should also aim to end homelessness through supports for sustainable living. This should be built on an understanding of their experiences including life before homelessness, the process of becoming homeless, and their experiences as homeless individuals. Based on this, the researchers' policy recommendations are as follows: First, programs for the homeless should proactively aim to eliminate discrimination. Second, interventions for mental habits should incorporate specific and non-specific interventions. Lastly, interventions for the mental health of homeless people should focus on creating intrinsic motivations.

Social aesthetics and the homeless: Acting on the body and the identity of this extremely marginalized group

This article explores the relevance of the psycho-corporal mediation that interventions based on social aesthetics allow when working with the homeless, particularly regarding the specific nature of their identities and bodies. Based on an ethnographic survey conducted in an experimental shelter for extremely marginalized people (named the “Integration Village”), we detail the health, body, and identity issues related to this type of care. The scientific literature and the social aestheticians we interviewed also indicate that the bodily and psychological dimensions of this type of treatment are closely intertwined. After specifying the modalities for the implementation of social aesthetics sessions in the Village, we focus on the perceptions and expectations of homeless patients toward this potential care approach. Finally, we observe the effects of a social aesthetics-based approach on homeless individuals in order to test the hypothesis that socio-aesthetic care is beneficial to them (at different levels and in different ways), both in terms of their relationship with their bodies and their self-esteem.

Strategi Dinas Sosial Kota Makassar Dalam Upaya Penanganan Anak Jalanan

The aim of this research is to gain an understanding of the strategies employed by the Department of Social Affairs in addressing street children in the city of Makassar, including the supporting and inhibiting factors influencing the implementation of these strategies. The research conducted is qualitative and descriptive in nature, utilizing sociological and communication approaches, with observation and interview techniques. Primary data sources include information obtained through direct observation at the research location and interviews, while secondary data is derived from documentation, mass media, and journals.The research findings indicate that the strategies of the Makassar City Social Affairs Department align with Regional Regulation No. 2 of 2008 related to the guidance of street children, homeless individuals, street musicians, and beggars. The department addresses these social issues through data collection activities and providing guidance. However, there are several obstacles in dealing with street children, such as the absence of facilities or rehabilitation centers in Makassar that can accommodate street children for personal development, aiming to reduce the number of street children in the area.

Type 2 diabetes management in the homeless population: health inequality and the Housing First approach

Homelessness is a significant public health concern, with a substantial homeless population in England. Homeless individuals face unique challenges, including a heightened risk of violence, inadequate nutrition, limited healthcare access and increased prevalence of co-morbidities. Type 2 diabetes (T2DM) is notably more prevalent among homeless individuals compared to the general population, leading to higher rates of diabetes-related emergency department visits and hospitalisations. There is limited research examining diabetes management specifically in homeless populations, and a comprehensive review addressing the barriers and targeted interventions for this vulnerable group is currently lacking. This article aims to explore the health inequalities experienced by homeless individuals in relation to T2DM management, and to evaluate the Housing First approach as a potential intervention. Housing First, which provides immediate access to permanent housing, has demonstrated efficacy in enhancing housing stability and healthcare behaviours among homeless populations. Moreover, the available evidence suggests that Housing First programmes may improve diabetes-related outcomes, including HbA1c testing and medication adherence, and may lead to fewer hospitalisations.

Medical School Civic Engagement During COVID-19: Activating Institutions for Equitable Community Response

The Medical College of Wisconsin (MCW) serves the Milwaukee metro area, one of the most diverse and segregated urban areas in the United States. In the acute crisis phase of the COVID-19 pandemic, MCW’s Civic and Community Engagement (C/CE) efforts were leveraged to address community concerns around four key initiatives: (a) availability of personal protective equipment in community; (b) food and housing issues for homeless individuals; (c) the need for multi-lingual, culturally tailored public health information around infection control through work with artists, influencers, and community health workers; and (d) later, addressing vaccination disparities and fears in an equitable way. These efforts were undertaken in collaboration with the City of Milwaukee Health Department, the Milwaukee County Office of African American Affairs, and other external partners. A multi-actor case study approach examined the intersection of Institutions of Higher Education, government, and community—with a particular emphasis on how Schools of Medicine can serve a unique role in bridging these domains to create a more robust framework for equitable, humanistically informed community crisis response. Implications for future public health disasters, as well as institutional civic engagement in response to pervasive, day-to-day problems around upstream determinants of health are explored.

Canadian Health Care Providers' Perspectives on Working with Older Homeless Adults in Outreach Settings.

Service providers have a unique understanding of older homeless adults' challenges and service needs. However, research on the experiences of health care providers (HCPs) who work with this population is limited. We aimed to gain a better understanding of the experiences (roles, challenges, and rewards) of HCPs who work with older homeless adults (age 50 and over) in outreach settings. We conducted individual semi-structured interviews with 10 HCPs who worked in these roles. Four themes emerged: (a) the client-provider relationship as an essential building block to HCPs' work; (b) progression of care that acknowledges the "whole person"; (c) collaboration as integral to providers' work; and (d) the importance of system navigation. Providers found their work personally and professionally fulfilling but were frustrated by system-level challenges. Findings can be used to identify strategies on how to further support providers in their roles and enhance service provision for older homeless individuals.

Molecular epidemiology and drug sensitivity of Mycobacterium tuberculosis in homeless individuals in the Addis Ababa city, Ethiopia

Although homeless segment of the society could be the hotspots for tuberculosis (TB) transmission, there is little data on TB in homeless individuals in Ethiopia. The objective of this study was to investigate the molecular epidemiology and drug sensitivity of Mycobacterium tuberculosis (M. tuberculosis) isolated from homeless individuals in Addis Ababa, Ethiopia. The study was conducted on 59 M. tuberculosis isolates, which were recovered by the clinical screening of 5600 homeless individuals and bacteriological examination of 641 individuals with symptoms of pulmonary tuberculosis (PTB). Region of difference-9 (RD9) based polymerase-chain reaction (PCR), Spoligotyping and 24-loci Mycobacterial Interspersed Repetitive Unit-Variable Number Tandem Repeat (MIRU-VNTR) typing were used for genotyping of the isolates. In addition, drug sensitivity test was performed on the isolates using BD Bactec Mycobacterial Growth Inhibition Tube (MGIT) 960. Fifty-eight of the 59 isolates were positive by spoligotyping and spoligotyping International type (SIT) 53, SIT 37, and SIT 149 were the dominant spoligotypes; each consisting of 19%, 15.5%, and10.3% of the isolates, respectively. The majority of the isolates (89.7%) were members of the Euro-American (EA) major lineage. MIRU-VNTR identified Ethiopia_3, Delhi/CAS, Ethiopia_2, TUR, X-type, Ethiopia_H37Rv-like strain, Haarlem and Latin-American Mediterranean (LAM) sub lineages. The proportion of clustering was 77.6% (45/58) in spoligotyping while it was 39.7% (23/58) in 24-loci MIRU-VNTR typing. Furthermore, the proportion of clustering was significantly lowered to 10.3% (6/58) when a combination of spoligotyping and 24-loci MIRU-VNTRplus was used. The recent transmission index (RTI) recorded by spoligotyping, 24-loci MIRU-VNTR typing, and a combination of the two genotyping methods were 58.6%, 27.6% and 5.2%, respectively. Young age and living in groups were significantly associated with strain clustering (P < 0.05). The drug sensitivity test (DST) result showed 8.9% (4/58) of the isolates were resistant to one or more first line ant-TB drugs; but multidrug resistant isolate was not detected. Clustering and RTI could suggest the transmission of TB in the homeless individuals, which could suggest a similar pattern of transmission between homeless individuals and the general population. Hence, the TB control program should consider homeless individuals during the implementation of TB control program.

Lost in the cityscape: Exploring urban homelessness, its societal imprints and policy suggestions

This concise exposition illuminates the societal ramifications of urban homelessness by delving into the subjective experiences of homeless individuals as elucidated through an all-encompassing investigation carried out in Siliguri, India. Employing the qualitative approach based on Constructivist Grounded Theory (CGT), we tried to capture the lived experiences of people experiencing homelessness. The findings divulge a multifaceted tapestry of socio-psychological factors situated at the core of the homelessness predicament, encompassing marginalization, maladaptive behaviors, vulnerability within specific demographics, and the unfulfilled entitlement to urban living. The study underscores the pressing necessity for social reappraisal, specialized support services, and policy interventions to address the extreme marginalization and isolation experienced by this vulnerable cohort. It accentuates the significance of economical housing alternatives, community-oriented shelters, accessible programs for addressing drug abuse and mental health disorders, measures promoting economic empowerment, and provision of identification cards enabling democratic rights and governmental program access. The study advocates for a comprehensive approach driven by communal collaboration to combat homelessness while ensuring inclusive and sustainable urban environments wherein every individual is entitled to their "right to the city."

The Pet Paradox: Uncovering the Role of Animal Companions During the Serious Health Events of People Experiencing Homelessness

ABSTRACT Despite the prevalence of animal companions in the lives of homeless individuals and the established benefits and complications offered by animals during serious illness and end-of-life (EOL), little is known about the experiences of homeless people who have animal companions and chronic illness. Two subsamples from a larger study – longitudinal medical documentation of homeless palliative-care patients who discussed animal companionship during their care (n = 11) and interviews with cross-sector service providers (n = 3) who spoke to the role of animals in care – were analyzed using an interpretive description approach. Results showcased three major themes: (1) healing benefits to animal companionship during concurrent homelessness and serious illness; (2) choosing animal companionship over formal housing and health services; (3) when animal companionship’s consequences outweigh the benefits. These findings provide practical implications for clinical assessment, programing, and service expansion for persons with animal companions and future translational science to benefit animal companion owners experiencing serious illnesses while homeless.

Association between religiosity/spirituality and substance use among homeless individuals.

Alcohol and illicit drug use are prevalent among homeless people. Religiosity and spirituality (RS) have been widely associated with lower consumption of substances. However, evidence of this relationship among homeless people is still scarce. To evaluate the associations between RS and alcohol and illicit drug consumption among homeless people in a large Brazilian urban center. This cross-sectional study was carried out in São Paulo city, Brazil. Aspects such as spirituality (FACIT-Sp12), religiosity (DUREL), spiritual-religious coping (Brief-RCOPE), and self-report questions concerning the current substance use (alcohol and illicit substances) were evaluated. Adjusted logistic regression models were used to assess the impact of RS beliefs on alcohol and illicit drug consumption. A total of 456 homeless people were included, of an average age of 44.5 (SD = 12.6) years. More than half of the participants consumed alcohol (55.7%) weekly and 34.2% used illicit drugs weekly. Adjusted logistic regression models identified that aspects of RS were associated with lower likelihood factors for alcohol and illicit drug use; conversely, negative spiritual religious coping (SRC) strategies were associated with a higher likelihood to use both. The prevalence of alcohol and illicit drug use among participants was high. RS and positive SRC were important protective factors for lower consumption of these substances. Conversely, negative SRC strategies were associated with risk factors.

Effectiveness of Cognitive Enhancement Therapy on Vocational abilities and Cognitive Functioning of Inmates residing at destitute home of Punjab: A Quasi Experimental study

Background: Homelessness in India is a growing issue, one that will require multilateral cooperation from various sources to over come. There are approximately 1.8 million homeless individuals living in India. Institutionalized people are disadvantaged from vocational skills and have higher psychological issues. So, Cognitive Enhancement Therapy to inmates of destitute home is to be provided to enhance their cognitive functioning and vocational abilities. Aim: To assess the efficacy of Cognitive Enhancement Therapy on vocational abilities and cognitive functioning in inmates residing at destitute home. Material and methods: A Quasi Experimental (Pretest- Posttest control group design) was used for the study. Purposive sampling method was used to select destitute home, 40 females were selected using simple random sampling technique and subjects were allocated in Experimental and Control group who fulfilled the inclusion criteria. Mini Mental Status examination and Vocational Ability Assessment Scale were used to determine cognitive functioning and vocational abilities. The sessions were delivered among experimental group in 15 consecutive days whereas no intervention was given to control group. Results: Cognitive Enhancement Therapy was found to be effective in terms of improvements of cognitive functioning as the obtained “t” value is 2.54(p= 0.01) and vocational abilities but not statistically significant (p&gt;0.01). Conclusion: The study concluded that Cognitive Enhancement Therapy is useful strategy to improve cognitive functioning and vocational abilities.

Cardiovascular disease screening in homeless individuals-a feasibility study

Abstract Background The risk and burden of cardiovascular disease (CVD) are higher in homeless than in housed individuals, yet population-level CVD screening largely excludes homeless individuals. Purpose (i)To investigate feasibility of dedicated mobile CVD screening for homeless individuals; and (ii)To estimate prevalence of risk factors and burden of CVD Methods With patients, health professionals and researchers, we co-developed and implemented a 15-minute CVD assessment for homeless individuals as an add-on service to the Find&amp;Treat service (a peer-led, multi-disciplinary outreach team across London) during scheduled, routine visits to homeless hostels. We included a questionnaire (demographic, past medical history and symptom data) as well as clinical assessment (blood pressure, ABPI, cholesterol, HDL, HDL ratio, glucose, HbA1c and mobile ECG to detect atrial fibrillation, AF). Results Among 656 individuals screened in 75 routine visits between May 2019 and January 2023, we recruited 524 (79.9%) individuals. Mean age was 47 (SD 13.1) years (range 18-87). Male gender (79%) and white ethnicity (55%) were more common. Current or previous smoking (79%), previous CVD (stroke, myocardial infarction, or peripheral arterial disease) (15%) and family history of heart attack in a 1st degree relative&amp;lt;60 years (27%) were common. Although only 2% reported previously diagnosed hypercholesterolaemia, 24% of screened individuals had total cholesterol&amp;gt;5.0 mmol/L. Prevalence of AF was high, particularly among those aged 18-30 (7/57, 12.3%). Asian and British Asian individuals had highest prevalence of raised HbA1C levels (&amp;gt;6%) (8/33, 24.2%), compared to black and black British (22/120, 18.3%) and white (15/283, 5.3%) individuals. Among individuals aged 25 – 84 with no previous CVD, one third had a 10-year QRISK score of ≥10% (120/362, 33.1%), consistent across different ethnic groups: white (75/233, 32.2%), black (24/77, 31.2%) and Asian (6/17, 35.3%). Conclusions A simple, pragmatic CVD assessment for homeless individuals was feasible and acceptable, and identified gaps in diagnosis and prevention. There is a high burden of CVD risk factors and CVD amongst homeless individuals, which could be addressed by integration of CVD screening into existing inclusion health outreach frameworks.

Evidence for Bartonella quintana in Lice Collected from the Clothes of Ethiopian Homeless Individuals.

Human lice, Pediculus humanus, can transmit various pathogens, including Bartonella quintana, Borrelia recurrentis, and Rickettsia prowazekii. Xenosurveillance is an epidemiological approach to assessing human infection risks performed by screening vectors of infectious disease agents. In the proof-of-principle study reported herein, the DNA of 23 human lice was collected from the clothes of 30 homeless Ethiopian individuals. These samples were assessed using 16S rRNA gene-specific pan-eubacterial PCR for screening, followed by Bartonella genus 16S-23S internal transcribed spacer (ITS) sequence-specific PCR, Bartonella genus gltA gene-specific PCR, and 16S rRNA gene PCR with specificity for relapsing-fever-associated Borrelia spp. with subsequent sequencing of the amplicons. In one sample, the pan-eubacterial 16S rRNA gene-specific screening PCR, the Bartonella genus 16S-23S ITS sequence-specific PCR, and the Bartonella genus gltA gene-specific PCR allowed for the sequencing of B. quintana-specific amplicons. In two additional samples, Bartonella genus gltA gene-specific PCR also provided sequences showing 100% sequence identity with B. quintana. In total, 3/23 (13.0%) of the assessed lice were found to be positive for B. quintana. Correlating clinical data were not available; however, the assessment confirmed the presence of B. quintana in the local louse population and thus an associated infection pressure. Larger-sized cross-sectional studies seem advisable to more reliably quantify the infection risk of lice-infested local individuals. The need for prevention by providing opportunities to maintain standard hygiene for Ethiopian homeless individuals is stressed by the reported findings, especially in light of the ongoing migration of refugees.

The impact of having a free community eye clinic located inside a homeless shelter: a retrospective analysis of patient demographics

Worsening vision is a life-altering process that affects individuals in many aspects of daily life. While worsening vision can be caused by normal physiological processes that occur with age, there can be underlying systemic or ocular diseases that may be the root cause. Routine eye exams can screen for disease as well determine the degree of vision correction required to attain acceptable vision. Access to an eye exam ordinarily requires vision insurance and one must consider the added expense of glasses if they are recommended. While this can be a life-improving visit for many, there are several socioeconomic barriers that discourage homeless and low-income individuals from being able to access this service. The lack of resources to access regular eye exams and the resulting inadequate eye care may lead to underdiagnosis of serious ocular pathology. The Kansas City Free Eye Clinic is located inside a homeless shelter and, therefore, provides a convenient location for homeless and low-income individuals to receive comprehensive eye exams as well as prescription glasses at no cost. In this paper, we discuss the unique setup and demographics of this student-run eye clinic and the ways in which it has served the Kansas City population and how its integration into a homeless shelter could serve as a role model for free community eye clinics.

SARS-CoV-2 incidence, seroprevalence, and COVID-19 vaccination coverage in the homeless population: a systematic review and meta-analysis.

SARS-CoV-2 infection and COVID-19 vaccination of homeless people are a serious public health concern during COVID-19 pandemic. We aimed to systematically assess SARS-CoV-2 incidence, seroprevalence, and COVID-19 vaccination coverage in homeless people, which are important to inform resource allocation and policy adjustment for the prevention and control of COVID-19. We searched PubMed, Web of Science, and the World Health Organization COVID-19 database for the studies of SARS-CoV-2 incidence, seroprevalence, and COVID-19 vaccination coverage in the homeless population. Subgroup analyses were conducted to pool SARS-CoV-2 incidence and seroprevalence in sheltered homeless, unsheltered homeless, and mixed population, respectively. Potential sources of heterogeneity in the estimates were explored by meta-regression analysis. Forty-nine eligible studies with a total of 75,402 homeless individuals and 5,000 shelter staff were included in the meta-analysis. The pooled incidence of SARS-CoV-2 infection was 10% (95% CI: 7 to 12%) in the homeless population and 8% (5 to 12%) for shelter staff. In addition, the overall estimated SARS-CoV-2 specific seroprevalence was 19% (8 to 33%) for homeless populations and 22% (3 to 52%) for shelter staff, respectively. Moreover, for the homeless subjects, the pooled incidence was 10% (4 to 23%) for asymptomatic SARS-CoV-2 infections, 6% (1 to 12%) for symptomatic SARS-CoV-2 infections, 3% (1 to 4%) for hospitalization for COVID-19, and 1% (0 to 2%) for severe COVID-19 cases, respectively while no COVID-19-related death was reported. Furthermore, the data derived from 12 included studies involving 225,448 homeless individuals revealed that the pooled proportion of one dose COVID-19 vaccination was 41% (35 to 47%), which was significantly lower than those in the general population. Our study results indicate that the homeless people remain highly susceptible to SARS-CoV-2 infection, but COVID-19 vaccination coverage was lower than the general population, underscoring the need for prioritizing vaccine deployment and implementing enhanced preventive measures targeting this vulnerable group.

Hepatitis E Prevalence in Vulnerable Populations in Goiânia, Central Brazil.

A transversal study was conducted among 472 vulnerable individuals (recyclable waste pickers, immigrants and refugees, homeless individuals, as well as lesbian, gay, bisexual, and transexual individuals) in Goiânia City, the capital of the State of Goiás, Brazil, to investigate the prevalence of hepatitis E virus (HEV) infection. A total of 459 (97.2%) serum samples were tested for anti-HEV IgG and IgM antibodies using fully automated chemiluminescence immunoassays (Liaison® Murex Anti-HEV IgG and IgM assays, DiaSorin, Saluggia, Italy). Positive samples were tested for the presence of HEV RNA by a real-time polymerase chain reaction. A seroprevalence of 0.87% (95% confidence interval [CI]: 0.34-2.22) was found for anti-HEV IgG. Furthermore, anti-HEV IgM was detected in only one individual (0.22%; 95% CI: 0.04-1.22), who was also negative for HEV RNA. These findings revealed that HEV infection is infrequent in vulnerable individuals in Central Brazil, with low seroprevalence of past and recent HEV infections.

Prevalence and distribution of Lewy pathology in a homeless population.

The homeless population experience significant inequalities in health, and there is an increasing appreciation of the potential of lifestyle factors in the development of neurodegenerative diseases, including Parkinson's disease. We performed a study on the prevalence and distribution of pathological alpha-synuclein deposition throughout the central and peripheral nervous systems in a homeless population. Forty-four homeless individuals consecutively available for autopsy were recruited. Immunohistochemistry was performed using 5G4 antibody recognizing disease-associated forms of alpha-synuclein, complemented by phospho-synuclein antibody on autopsy tissues collected from 18 regions of the brain and spinal cord, as well as the right and left olfactory bulb, the cauda equina, the extramedullary portion of the vagus nerve, and 27 sites of peripheral organs. The study cohort consisted of 38 males and 6 females, median age 58 years (range 32-67). Lewy-related pathology was present in the brains of three male cases. One showed Braak stage 2 (60 years old), and two stage 4 (56 and 59 years old). One of the Braak stage 4 cases had Lewy-related pathology in the spinal cord, the cauda equina, and the extramedullary portion of the vagus nerve. Examination of 27 sites of peripheral organs found that all three cases with Lewy-related pathology present in the brain were devoid of peripheral organ alpha-synuclein pathology. Multiple system-type alpha-synuclein pathology was not found. Our study, representing a snapshot of the homeless population that came to autopsy, suggests that alpha-synuclein pathology is prevalent in the homeless supporting further study of this vulnerable population.

Lower limb ulcers in people experiencing homelessness

The homelessness crisis in Poland poses a serious challenge to the state, with the number of homeless individuals exceeding 30,000 in 2019. In this paper we highlight one of the most common surgical issue of people experiencing homelessness – venous leg ulcers – and present current treatment guidelines. Homeless individuals, particularly exposed to inadequate living conditions, poor hygiene, and circulatory disorders, are at high risk of developing them. Venous ulcers are chronic wounds with prolonged and complex healing processes.They arise due to venous hypertension associated with chronic venous insufficiency and thrombosis. Often, specialized treatment is necessary, which is a challenge for homeless individuals due to difficulties in accessing regular care.The treatment of venous leg ulcers involves a multi-stage process. The gold standard for managing venous leg ulcers is compression therapy, which reduces edema and venous reflux. The TIME strategy outlines the approach to chronic wound management, emphasizing the importance of initial wound cleansing (surgically, enzymatically, or larvotherapy), infection prevention, maintaining proper moisture and wound edge preparation. This requires the use of suitable antiseptics, dressings, and wound hygiene.People experiencing homelessness face specific issues that necessitate a holistic approach, which includes health education, nutrition, and rehabilitation.

Drug-related deaths among housed and homeless individuals in the UK and the USA: comparative retrospective cohort study.

The UK and USA currently report their highest number of drug-related deaths since records began, with higher rates among individuals experiencing homelessness. Given that overdose prevention in homeless populations may require unique strategies, we evaluated whether substances implicated in death differed between (a) housed decedents and those experiencing homelessness and (b) between US and UK homeless populations. We conducted an internationally comparative retrospective cohort study utilising multilevel multinomial regression modelling of coronial/medical examiner-verified drug-related deaths from 1 January 2012 to 31 December 2021. UK data were available for England, Wales and Northern Ireland; US data were collated from eight county jurisdictions. Data were available on decedent age, sex, ethnicity, housing status and substances implicated in death. Homeless individuals accounted for 16.3% of US decedents versus 3.4% in the UK. Opioids were implicated in 66.3 and 50.4% of all studied drug-related deaths in the UK and the USA respectively. UK homeless decedents had a significantly increased risk of having only opioids implicated in death compared with only non-opioids implicated (relative risk ratio RRR = 1.87, 95% CI 1.76-1.98, P < 0.001); conversely, US homeless decedents had a significantly decreased risk (RRR = 0.37, 95% CI 0.29-0.48, P < 0.001). Methamphetamine was implicated in two-thirds (66.7%) of deaths among US homeless decedents compared with 0.4% in the UK. Both the rate and type of drug-related deaths differ significantly between homeless and housed populations in the UK and USA. The two countries also differ in drugs implicated in death. Targeted programmes for country-specific implicated drug profiles appear warranted.

Homelessness in Sierra Leone: An Overview of Social Work Intervention in Helping Homeless Population

The article looks at the key causes of the rise in homelessness as well as Social Work intervention strategies in helping homeless people in Freetown. In many nations, homelessness has been a long-standing social issue. How to help homeless individuals live independently is a dilemma encountered by those who work and volunteer in homeless shelters. The study looked at problems with homelessness among children, teens, adults, the elderly, women, and veterans over the previous years in this brief study. According to the findings, family circumstances, housing, unemployment, and mental illness are the main causes of homelessness. Initial instances of these issues result in homelessness, which in turn makes them worse. Effective community interventions and policies are needed to prevent and reduce homelessness, including drug rehabilitation facilities job support, and affordable housing.