Homeless Men Research Articles

Association of Problematic Alcohol Use and Food Insecurity among Homeless Men and Women.

Food insecurity results from unreliable access to affordable and nutritious food. Homeless adults are particularly vulnerable to both food insecurity and problematic alcohol use. The current study examined the link between problematic alcohol use and food insecurity among homeless adults. Participants (N = 528; 62.7% men; Mage = 43.6 ± 12.2) were recruited from homeless-serving agencies in Oklahoma City. Problematic alcohol use was measured using the Alcohol Quantity and Frequency Questionnaire and the Patient Health Questionnaire. The latter used DSM-IV diagnostic criteria to assess probable alcohol use dependence/abuse. Heavy drinking was considered >7 drinks (women) and >14 drinks (men) per week. Food insecurity was measured with the USDA Food Security Scale-Short Form. The link between alcohol problems and food insecurity was examined with logistic regression analyses controlling for sex, age, education, income, and months homeless. Overall, 28.4% of the sample had probable alcohol dependence, 25% were heavy drinkers, and 78.4% were food insecure. Probable alcohol dependence and heavy drinking were correlated at 0.53 (p < 0.001). Results indicated that heavy drinking (OR = 2.12, CI.95 = 1.21, 3.73) and probable alcohol dependence/abuse (OR = 2.72, CI.95 = 1.55, 4.77) were each associated with increased odds of food insecurity. Food insecurity and problematic alcohol use are major issues among homeless populations; this study suggests they are associated. Future research is needed to shed light on potential causal mechanisms and on whether alcohol may take precedence over eating or food purchases.

Unique health needs and characteristics of homeless women in Iowa City, Iowa

<strong>Context:</strong> Homeless individuals have comparatively poorer health, however few gender specific assessments exist. <strong>Purpose:</strong> This cross-sectional survey of homeless individuals assesses gender-specific health needs. <strong>Procedure:</strong> 68 Homeless adults were surveyed at a shelter from March to April, 2015 in Iowa City, IA. Descriptive statistics were computed to compare gender-subgroup responses. <strong>Main Findings:</strong> The study population was predominately male (45, 67.2%), white (37, 54.4%), and averaged 42.35 years old (range 21-74). Males were more likely to be veterans (13, 28.9% vs. 1, 4.5%, p=0.025). Women were more likely to have dependents (9, 47.4% vs. 1, 4%, p=0.001) and access to dental coverage (16, 80% vs. 12, 30.8%, p=0.001). Similar rates of chronic disease, primary care access, and unmet health needs were noted. <strong>Conclusions</strong>: Homeless women and men have unique needs and would benefit from gender-specific health interventions. Resources for child-care may be important for women who are homeless, while dental health care may be particularly beneficial for men.

Risk factors for homelessness: A structural equation approach

This study aims to assess the pathway relationships between adolescent adversities, adult addictive behaviours, divorce, conviction, long-standing unemployment, disability, and homelessness. A structural equation model was estimated using data on n1 = 677 homeless men and n2 = 651 housed men of the same age and educational distribution, living in Warsaw, Poland. Retrospective adolescent adversities were found to be significantly related to the occurrence of adult homelessness (p ≤ .01). This relationship was mainly indirect and largely mediated by addictive behaviours, divorce, conviction, and unemployment. Addiction, divorce, and conviction were the three most frequent events preceding homelessness and were likely to coincide. The first job experience did not differentiate the two groups from each other. However, homeless individuals were more likely to currently prefer self-employment over wage employment. Low perceived importance of family life and preference for self-employment over wage employment were hypothesised to be related to the severity of homelessness.

Causes of homelessness, attempts to improve their situation and hopes for the future – analysis of individual in-depth interviews of homeless men with higher education

Analysis of the causes of homelessness and attempts to change their situation among homeless people with higher education are the purpose of the presented article. Losing home among people with higher education is not a common topic of research and analysis. In society, a homeless person is associated rather with an uneducated person. In order to analyze the reasons, the general situation and actions taken to overcome homelessness, five individual in-depth interviews with homeless men from the Mazovia region were carried out. All respondents completed university studies. Among the respondents, the main causes of homelessness are addictions and conflicts in marriage. The respondents admit that it is difficult for them to improve their situation, especially in terms of raising professional qualifications. They have education, so they mostly wonder what other actions they could take. Completed studies show that leaving homelessness, even with a university degree, is not easy. There is no effective system of help for homeless people in this group of people – they are offered jobs or courses and training definitely not corresponding to their possibilities and education.

Women’s Experiences of Homelessness: A Longitudinal Study

Drawing on the results of a qualitative longitudinal analysis of the experiences of homeless people using an employment related programme in the UK, this article explores the experiences of homeless women. Research focused on women’s trajectories through homelessness remains unusual and this comparatively large study provided an opportunity to look at a group of homeless women over time. The results from 136 in-depth interviews with forty-seven homeless women are reported. The interviews explored their lives prior to becoming homeless, their routes into homelessness and their trajectories through and out of homelessness. The article does not compare experiences across gender, focusing solely on women, because the existing evidence base focuses largely on the experiences of lone homeless men. The goals of the article are twofold, first to add to the existing evidence on women’s experiences of homelessness and second to add to emergent debates on whether gender is associated with differentiated trajectories through homelessness.

Kate WiselDriving in Cars with Homeless Men

With this book, I think, Ungváry serves well the cause of neglected national selfanalysis and the cause of democracy without qualifying epithets. George Gömöri London L. M. Brown Were We Awake Burlington, Vermont. Fomite. 2019. 236 pages. BOOKENDED BY A lyric from Emily Dickinson’s “We dream – it is good we are dreaming,” and from which its title is appropriately borrowed, Were We Awake is author L. M. Brown’s 2019 collection of short stories examining life and loss in rural Ireland. Consisting of tales that seem to exist simultaneously in all times and in no time at all, the effect Brown achieves here is illusory and appositely dreamlike, reading as both nostalgic and jarringly current. Were We Awake capably braids together all the love and lust and loss that round out our lives—those things that make us so tragically and impossibly human. Steeped in death and disillusion, all distinctly Irish, these vignettes are inhabited by fully realized characters living fully realized lives punctuated by a million fully realized losses (of innocence, of ignorance, of marriage, of performance , of identity), which Brown explores adeptly and through a multigenerational lens. Loss scathes and shatters and stays with these characters; it shunts them together and propels them forward, a paradox that suggests the common thread between them, between us, is not life, after all, but death. Brown has produced a collection not about death or bereavement necessarily but, at its core, about human [dis]connection; we are bound and unbound by our ability to love and to grieve and to lose everything. While Brown’s stand-alone stories are shorter and punchier and tidily self-contained , there’s a quiet sort of brilliance in those that return to and build upon their predecessors (“Communion” / ”Flight,” “Confession” / “Anniversaries” / “Games They Played”), for it is in these stories that Brown has married Dickensian sprawl and Dickinsonian sensibility and somehow contained them in twenty or fewer pages. Pair that with perceptive use of metaphor throughout (the sea is a mirror of a relationship on the verge of imploding, or caged birds, the inability to let go of the past) and the sharp imagery only a native could conjure, and you have Were We Awake, an ideological Celtic knot, which, despite intermittently patchy editing, is an effective and thought-provoking collection. This is a quick read worthy of being devoured in one sitting and savored in another. Logan Webb Oklahoma City, Oklahoma Kate Wisel Driving in Cars with Homeless Men Pittsburgh. University of Pittsburgh Press. 2019. 185 pages. IN HER TOUR DE FORCE debut collection , Driving in Cars with Homeless Men, Kate Wisel weaves the stories of four women: Serena, Frankie, Raffa, and Natalya. Her protagonists, adrift yet assured, are fettered to one another by friendship, their ferocious hunger for human connection, their withstanding of abuse and its insidious violence, and their ever-present belief in possibility and redemption. Garbed in black jeans, black hoodies, and black-inked tattoos , they represent Boston’s working class, its disenfranchised, its drug-hazed denizens and misfits. Wisel deftly shifts between points of view and writes with verve, incisive detail, and a poet’s attention to tempo and cadence. Narratively and chronologically, the temporal terrain of these twenty linked stories is perpetually shifting. The reader moves between their childhoods, their present-day lives, and their futures—sometimes in the span of just a few pages. Hers is an unflinching , laser-focused portrayal of violence and how relational violence informs the trajectory of one’s life—your friendships, intimacy , opportunities, and well-being. Serena, her utterances the most pronounced in this chorus of female voices, becomes a victim of domestic and physical abuse at the hands of her boyfriend, Niko. In the story “Trouble,” Niko gives her a puppy (aptly named Trouble) as an apology WORLDLIT.ORG 109 Sonallah Ibrahim Ice Trans. Margaret Litvin. London. Seagull Books. 2019. 303 pages. IN 2016 I CHATTED with Sonallah Ibrahim about his then-new novel, Berlin 69. I asked him: “Did your experience in East Germany and Russia (1969–74) give you a useful perspective on Nasser’s version of socialism?” He replied: “The dream was fantastic, but it remains...

'I just hope they take it seriously': homeless men talk about their health care.

Objective Men who experience homelessness in Australia often have complex health and social issues, including the trimorbidity of concurrent mental illness, substance use disorders and physical health conditions. These men tend to have poor health outcomes, and present challenges to healthcare systems. To improve system responsiveness and patient outcomes, the perspectives of marginalised groups need to be understood. Methods Five focus groups were conducted with 20 men in a homeless men's hostel, exploring their experiences of seeking and receiving health care, and views about improving these. An inductive thematic analysis was undertaken. Results Several participants expressed gratitude for care provided for life-threatening physical illness and trauma. However, negative experiences of health system responses were more frequently reported. Four emerging themes all made securing effective 'tickets of entry' to health care more difficult: dismissive care, care fragmentation, inconsistent medical management of pain and inadequate acknowledgement of psychological distress. Conclusions Improvements are needed in care integration and the de-escalation of potentially confrontational interactions. Effective, safe and compassionate system responses to presentations of psychological distress and pain should be collaboratively developed. Some current responses may entrench stigma, further traumatising vulnerable patients. What is known about the topic? Men who experience homelessness have poor health outcomes and present challenges to healthcare systems. What does this paper add? This paper describes healthcare experiences and insights of men who are experiencing homelessness in Australia. These men reported experiencing dismissive care, care fragmentation, inconsistent, inadequate and/or unsafe prescribing for pain and inconsistent and/or ineffective responses to psychological distress. What are the implications for practitioners? Changes are needed in health system responses, informed by the experiences and insights of marginalised people, to break cycles of trauma and exclusion.

Lives that Are Dealt

Lives that Are Dealt Alex Eaker (bio) Driving in Cars with Homeless MenKate Wisel University of Pittsburgh Press www.upittpress.org/books/9780822945680/ 185Pages; Cloth, $23.00 Nostalgia mutates into malt liquor and Boston’s back roads in Kate Wisel’s debut collection, Driving in Cars With Homeless Men. This linked collection of stories is delicately tied together by Serena, Frankie, Raffa, and Nat, all women whose lives collapse onto each other like a bridged deck of playing cards. The primary focus of this collection is the relationship these women find themselves in with men — abusive men in varying degrees, some plainly violent, some emotionally, some gentle but not healing to the extent the protagonists need, their scar tissues fissuring around the corners of each page. Set in both the early 2000s and contemporary Boston, the four women are lower-middle class workers, students, daughters, lovers, addicts, survivors, and criminals at times — their true natures impossible to grasp like a sly fish in the shallows, their stories eager to sound simultaneously farfetched and undeniable. In the story “Mick’s Street,” Raffa’s husband kicks her out of the house, forcing her to break into their summer home on the Cape where she does heroin with a squatter. In “Stage Four,” Frankie moves in with a conman named Villy who convinces her to use up the last of her student loans to pay for rent and his need to shop at a fancy grocery store where he steals blocks of butter and toilet paper. These stories are esoteric and familiar all at once, Wisel’s lens sharpened in on what’s interesting about her world. Bleeding on the page are these women’s stories, their survival perched tenuously on the tip of Wisel’s pen, which fills the bindings with stark honesty and razor-sharp detail. One way she aptly defines her characters are through the things that make up their world — a mish-mash of the benignly childish and the R-rated: Sesame Street toothbrushes, Colt 45 wrappers, crushed Altoids, India ink tattoos, “gang-rape” collars, a Bruce Lee poster over a teenager’s bed, the stories are filled with gems that bring authenticity to each character and each setting. These women may be malt-liquor drinking, spitting-inside-of-mini-malls, wearing black to a wedding chaos, but their child artifacts, so delicately placed on each page, remind the reader these are coming of age stories, that for now these are only just girls. Despite the sense of hopelessness evoked through the collection, vital to its ability to bring about catharsis is the agency endowed onto Serena, Frankie, Raffa, and Nat: choices to abuse — to be abused — by substance, by love, by loss, by having but not doing. Each story hones in on the conflict between circumstance and intervention (or lack-there-of). Wisel cares about the lives each one of us are dealt, fair and unfair advantages, and how this can shape who we become later on: who our parents are, what part of the city do we live in, how many student loans did we have to take out? As the collection passes, the protagonists steadily age into women who carry with them the grievances of their adolescents. Despite the walls closing in on them, there is still the sense these women have power and control, which is vital to the reader meeting them at eye level. By the end of “When I Call, You Answer,” the few words, “I quit” free Serena from an emotionally abusive boss. In the collection’s final story, “Run For Your Life,” Raffa chases down a bike thief on foot with the exertion that despite the thief’s speed, she has purpose, making her infinitely more dangerous than him. Wisel illustrates how courage and cowardice are not black and white, but [End Page 25] traits which can be exerted simultaneously. These women have weakness, but are strong. They get hit, but in the same instance they can hit back. When they are defeated there is always the sense they will survive, and ultimately this collection is about just that: matters of life and death. Wisel is...

Film Documents History of Deinstitutionalization and Its Impact on Today’s SMI Population

Film Documents History of Deinstitutionalization and Its Impact on Today’s SMI Population

Alcohol Use Among Homeless Men in Tehran, Iran: Risk and Protective Factors

Background: Alcohol use is one of the most complicated health problems. The understanding of risk and protective factors contributing to alcohol use could help deal with this problem more efficiently. Objectives: The present study examined the risk and protective factors for alcohol use among homeless men living in Tehran, Iran. Methods: This cross-sectional study was conducted from September to November 2015. A total of 193 homeless men were recruited using convenience sampling from Khavaran Shelter, the largest shelter for homeless people, in the south of Tehran. Data were analyzed using a logistic regression model to examine if using alcohol is associated with potential risk and protective factors. Conducting logistic regression, adjusted odds ratio (aOR) point estimate and 95% confidence interval (CI 95%) as the effect measures were reported. All tests were run using SPSS version 21. Results: The prevalence rates of recent (past 7 days)‏ and past-year alcohol use were 14.5% (95% CI: 9.50, 19.50) and 43.52% (95% CI: 36.50, 50.50), respectively. Hosmer-Lemeshow test (χ2 (4) = 10.37, P = 0.17) indicated the goodness of fit of the model to the data. The results of the fitted logistic regression model explained that social support (OR = 0.63, CI 95%: 0.36-1.08) and being a local resident (OR = 0.32, CI 95%: 0.17 - 0.61) were the protective factors while the level of relationship with peer network (OR = 2.08, CI 95%: 1.19 - 3.63) and having a history of arrest (OR = 3.16, CI 95%: 1.34 - 7.46) were risk factors of alcohol use among Iranian homeless men during the last year. The predictors entered into the regression model could explain between 13% and 17.5% of the variance of the outcome (alcohol use). Conclusions: This study contributes to the existing literature by examining risk and protective factors among a high-risk population. Our findings can be used in designing and implementing interventions that are more effective for the homeless group living in a non-Western context.

Urban masculinity, contested spaces, and classed subcultures: young homeless men navigating downtown Ottawa, Canada

This article seeks to address the lacuna in many academic and non-academic accounts of male homeless youth, which consistently overlook and thus fail to theorize the degree to which young homeless men’s experiences are shaped by gendered and classed youth subcultures. The theoretical contribution that this article seeks to make is to bring together culturally-infused analyses with a geographic focus on space and masculinity, in order to expand the repertoire of conceptual tools with which to understand young men’s experiences of homelessness in urban spaces. It does so through an empirical investigation of urban spatial navigations of young homeless and precariously housed men in Ottawa, Canada. Mobilizing the concept of territoriality, as developed by Phil Cohen of the Birmingham Centre for Contemporary Cultural Studies, alongside the Bourdieusian concept of classification struggles, the article ultimately seeks to demonstrate that there is an internal logic of practice to young men’s navigations of urban space under conditions of extreme inequality, one that seeks to reconcile the deep contradictions of neoliberalism. Simultaneously, such logics may also serve to reinscribe and reinforce their marginal positions in the city, by exposing them to extreme violence by rival urban groups, and leaving them more vulnerable to expanded criminalization by the state.

Complaint-Oriented Policing: Regulating Homelessness in Public Space

Over the past 30 years, cities across the United States have adopted quality-of-life ordinances aimed at policing social marginality. Scholars have documented zero-tolerance policing and emerging tactics of therapeutic policing in these efforts, but little attention has been paid to 911 calls and forms of third-party policing in governing public space and the poor. Drawing on an analysis of 3.9 million 911 and 311 call records and participant observation alongside police officers, social workers, and homeless men and women residing on the streets of San Francisco, this article elaborates a model of “complaint-oriented policing” to explain additional causes and consequences of policing visible poverty. Situating the police within a broader bureaucratic field of poverty governance, I demonstrate how policing aimed at the poor can be initiated by callers, organizations, and government agencies, and how police officers manage these complaints in collaboration and conflict with health, welfare, and sanitation agencies. Expanding the conception of the criminalization of poverty, which is often centered on incarceration or arrest, the study reveals previously unforeseen consequences of move-along orders, citations, and threats that dispossess the poor of property, create barriers to services and jobs, and increase vulnerability to violence and crime.

Gender differences among Indigenous Canadians experiencing homelessness and mental illness

BackgroundIndigenous people are over represented among homeless populations worldwide and the prevalence of Indigenous homelessness appears to be increasing in Canadian cities. Violence against Indigenous women in Canada has been widely publicized but has not informed the planning of housing interventions. Despite historical policies leading to disenfranchisement of Indigenous rights in gender-specific ways, little is known about contemporary differences in need between homeless Indigenous men and women. This study investigated mental health, substance use and service use among Indigenous people who met criteria for homelessness and mental illness, and hypothesized that, compared to men, women would have significantly higher rates of trauma, suicidality, substance dependence, and experiences of violence.MethodsThis study was conducted using baseline (pre-randomization) data from a multi-site trial. Inclusion in the current analyses was restricted to participants who self-reported Indigenous ethnicity, and combined eligible participants from Vancouver, BC and Winnipeg, MB. Logistic regression analyses were used to model the independent associations between gender and outcome variables.ResultsIn multivariable regression models among Indigenous participants (n = 439), female gender was predictive of meeting criteria for PTSD, multiple mental disorders, current high suicidality and current substance dependence. Female gender was also significantly associated with reported physical (AOR: 1.52, 95% CI = 1.10–2.23) and sexual (AOR: 6.31, 95% CI = 2.78–14.31) violence.ConclusionsOur analyses of Indigenous men and women who are homeless illustrate the distinct legacy of colonization on the experiences of Indigenous women. Our findings are consistent with the widely documented violence against Indigenous women in Canada. Housing policies and services are urgently needed that take Indigenous historical contexts, trauma and gender into account.Trial registrationThis trial has been registered with the International Standard Randomized Control Trial Number Register and assigned ISRCTN42520374; ISRCTN57595077; ISRCTN66721740.

Promoting Oral Health through Manager Training and Dental Referral at a Student-Run Homeless Shelter Clinic

Background: There is a need for oral health awareness among future clinicians and for dental services for homeless men. This quality improvement project aimed to: 1) improve oral health knowledge among physician assistant (PA), medical, and undergraduate student clinic managers; 2) determine the oral health needs of homeless men; and 3) establish a dental referral program for patients at a student-run free clinic.Methods: The project was conducted at a student-run free clinic embedded in a men’s homeless shelter in Dallas, Texas. Student managers underwent a training program that included a PowerPoint presentation and practice oral exams. Pre- and post-tests were used to assess their knowledge of different oral health topics. Patients of the clinic were surveyed for dental concerns at intake, and oral exams and referrals to a student-run dental clinic were done if indicated.Results: Student clinic managers (N=16) demonstrated improved knowledge on the recognition and treatment of some but not all dental conditions. Of the patients surveyed (N=13), most reported a history of dental caries (77%), had loose or missing teeth (62%), and brushed their teeth &lt;2 times per day (69%). Although 65% of patients were referred to the dental clinic, only 9% went to their appointment.Conclusions: The manager training provided additional information and experience for clinic managers around oral health. The increased awareness made it easier for clinic managers to refer appropriate patients to the dental clinic. The newly implemented referral service provided a resource for the clinic to send patients that warrant higher level of dental care.

Frail paths home: former long-term homeless women and men narrate their experiences and meanings of home

ABSTRACT The article focuses on how former long-term homeless people narrate their experiences of housing and home during their life course. The data consist of 11 narrative interviews on housing history. The secondary data consist of six go-along interviews in places chosen by the interviewees. After being homeless for a long time, the interviewees had permanent apartments in a supported housing unit’s community. My interest was in how a long-term homeless person makes an apartment a home after having a fractured housing history or no home at all during their life. I analysed the data by focusing on the narrative episodes related to housing, home, neighbourhoods and living in the housing unit. The crucial aspect was the interviewees’ experiences and understanding them as spatial and temporal processes. The home experience is constructed in everyday practices that are connected to various places and spaces. Another important perspective is understanding the strong connection between memory and place. The interviewees had both fractured housing histories and various traumatic or harsh experiences connected to the notion of home. They also narrated stories about their past and present homes through relationships and everyday practices. The conclusion of this research is that social workers should use more narrative methods to understand how clients’ identities and experiences are constructed in their life course and help their clients build new empowering narratives.

Masculinity and Suicidal Desire in a Community Sample of Homeless Men: Bringing Together Masculinity and the Interpersonal Theory of Suicide

Men’s high suicide death rates are likely associated with a range of factors, notably men’s conformity to predominant masculine gender role norms and men’s gender-related attitudes toward suicide death based on those norms. The purpose of this study was to investigate how two models integrating men’s conformity to hegemonic masculine gender role norms, perceived burdensomeness, and thwarted belongingness predict the existence and severity of suicidal ideation in a sample of men at high risk for suicide, homeless men. The study results indicated that multiple norms were predictive of the existence or severity of suicidal ideation while perceived burdensomeness predicted both suicide ideation and the severity of ideation.

Seven Easy Steps.

On Being a Doctor16 April 2019Seven Easy StepsJack Coulehan, MD, MPHJack Coulehan, MD, MPHCenter for Medical Humanities, Compassionate Care, and Bioethics, Stony Brook University, Stony Brook, New York (J.C.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-2714 Audio Reading - “Seven Easy Steps” Audio. Michael A. Lacombe, MD, Annals Associate Editor, reads “Seven Easy Steps” by Jack Coulehan, MD, MPH Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail I arrive in the waiting room nearly a half hour early and validate myself with two insurance cards and a questionnaire that asks me yet another time to list my illnesses, allergies, and medications. I notice that most of the seats are occupied by elderly people. They must be older and sicker than I am, because … well, they look old. One man is sitting with a walker poised in front of his chair. Another hasn't removed his plaid woolen coat, the kind of coat I imagine homeless men wore during the Depression as they warmed themselves around a bonfire. ... Author, Article, and Disclosure InformationAffiliations: Center for Medical Humanities, Compassionate Care, and Bioethics, Stony Brook University, Stony Brook, New York (J.C.)Corresponding Author: Jack Coulehan, MD, MPH, 51 Pineview Lane, Coram, NY 11727; e-mail, john.[email protected]edu. PreviousarticleNextarticle Advertisement Audio Reading - “Seven Easy Steps” Audio. Michael A. Lacombe, MD, Annals Associate Editor, reads “Seven Easy Steps” by Jack Coulehan, MD, MPH Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 16 April 2019Volume 170, Issue 8Page: 575KeywordsAnxietyCranial nervesElderlyEmotionsFearHappinessMemoryProstate cancerQuestionnairesTouch ePublished: 16 April 2019 Issue Published: 16 April 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

MON-019 Noncommunicable Disease Prevalence among Homeless Men in Nagoya, Japan: Relationship between Physiological Data and Social Background

[Aims/Introduction] In-depth physical health data of homeless people has not been analyzed in Japan. We conducted a survey on the severity level and prevalence of metabolic abnormalities among homeless men in Nagoya, Japan. We also assessed its association with sociodemographic characteristics and mental illness/cognitive disability. [Methods] We interviewed 106 homeless men (average age, 54.2 ± 12.7 years) with regards to sociodemographic background, mental illness, and cognitive ability; blood sampling was also performed. Blood pressure, body mass index, and metabolic parameters, including levels of serum creatinine, uric acid, hemoglobin A1c, triglyceride, low-density and high-density lipoprotein cholesterol, aspartate aminotransferase, alanine aminotransferase, and γ-glutamyl transpeptidase were measured. Mental illness and cognitive disability were diagnosed using the Mini-International Neuropsychiatric Interview and Wechsler Adult Intelligence Scale-III test, respectively. Associations between level and prevalence of metabolic abnormalities and mental illness/cognitive disability or sociodemographic background were analyzed. [Results] Hypertension incidence and average blood pressure level were significantly higher in participants who were living on the street and who had been homeless for more than 2 years than in the others who were non-street living and less than one year homelessness. Renal function, based on estimated glomerular filtration rate, was low in participants who had been homeless for more than 2 years. Levels of systolic blood pressure, triglyceride, and aspartate aminotransferase were significantly higher in participants with both mental illness and cognitive disability than in others. [Conclusions] Homelessness (living on the street, homelessness for over 2 years, and mental illness/cognitive disability) affected the prevalence and level of metabolic disorders in Japanese homeless men. The social support should provide for development of skills in homeless people to sustain independent housing and a healthy food life style regards to their physical health.

Differences between homeless women and men before and after the transition from shelter to community living: A longitudinal analysis.

Social quality is the extent to which people are able to participate in social relationships under conditions which enhance their well‐being, capacities and potential and enables them to shape their own circumstances and contribute to societal development. We assessed whether women in homeless shelters differed from men on social quality factors that constitute the quality of their daily life and whether factor scores changed at a different rate for women and men after shelter exit. Data were collected as part of a randomised controlled trial. In 18 shelters across the Netherlands, 183 participants were recruited between December 2010 and December 2012 and followed for 9 months. Adults were eligible if they were about to move from shelter to (supported) independent housing and their shelter stay had been shorter than 14 months. At baseline, women were significantly younger than men. They were more likely to have children, to have minor children staying with them, to be lower educated, to be unemployed and to have been victimised than men. Women had used more services and reported lower self‐esteem, less satisfaction with health and empowerment and higher psychological distress. They were less likely than men to have used alcohol excessively or cannabis. We found no significant differences between women and men in changes over time on the social quality factors. As women were disadvantaged at baseline compared to men regarding many factors, we concluded that women in homeless shelters are a particularly vulnerable group. Moreover, an opportunity remains for shelter services to improve women's social quality during and after their shelter stay.

Finding home after homelessness: older men’s experiences in single-site permanent supportive housing

Although research on supportive housing models for older homeless adults is gaining momentum, few studies have considered the unique experiences of formerly homeless older adults residing in single-site permanent supportive housing (PSH). Drawing on the concepts of home and social exclusion, this qualitative case study explored the everyday experiences of 10 formerly homeless older men residing in single-site PSH. A constructivist grounded theory methodology and in-depth interviews revealed that participants felt largely at home in PSH because the congregate design and surveillance fostered a sense of safety. However, certain design features coupled with housing rules triggered processes of territorial exclusion. Further, members of minority groups experienced identity and institutional exclusion because of discrimination linked to their ethnicity, language, and sexual orientation. Recommendations are provided to promote more inclusive, home-like models of supportive housing for older homeless adults.