Homeless Research Articles

Backgrounds and perspectives of San Antonio street sleepers

BackgroundThe question of what brings someone to homelessness and keeps them there has many varied and complex answers. The authors believe the answers lie within the persons experiencing homelessness (PEH). MethodsThis is an interpretive approach study based on convenience sampling of the San Antonio, TX, unsheltered population, utilizing semi-structured interviews from January 2022 through November 2022. ResultsThe six most common themes that emerged from the subjects’ backgrounds were 1) jail or prison time or other personally significant legal issues; 2) personal substance abuse or addiction struggles; 3) physical and mental health challenges as an adult; 4) disdain of shelters and preference for rough sleeping; 5) a problematic childhood; 6) did not enjoy school as a child or young adult. ConclusionTo gain more insight into a situation as complex as the state of homelessness, researchers should meet with those on the frontline of this epidemic and hear first-hand their personal histories, challenges, successes, and suggestions. Though not a novel approach, the researchers found limited previous literature in regard to approach, scope and in relation of causation related to homelessness, especially about the U.S. unsheltered population. The ultimate goal is for such research to help guide outreach services and legislation related to PEH.

SCOPING REVIEW OF PSYCHOLOGICAL RESEARCH AND PUBLICATIONS RELATED TO THE EFFECTS OF THE COVID-19 PANDEMIC AND THE MEASURES TAKEN

Publications of 21 scientific studies from the field of psychology and psychiatry related to the effects that the spread of COVID-19 has on mental health and the measures taken by mental health professionals to control the negative consequences on the psyche of people are presented. In this regard, the aim of the article is to present a summary of the main subjects in scientific research in the field of mental health. The article differentiates five main problem areas in relation to people's mental health and emotional response to COVID-19: in terms of age; gender differences; personality characteristics; professional activity and behaviour; telepsychiatry and telepsychology. The analysis of the publications shows that the effects can be divided into two categories: short-term and long-term, and in both categories the effects can be positive and negative; the authors emphasize the phenomenology of subjective experiences. Most researchers draw the following conclusions: the COVID-19 pandemic has provoked high levels of stress, mental instability, PTSD, depression, cognitive and neurological disorders; vulnerable groups (elderly people, young people, health professionals, people with mental health problems before the pandemic, homeless people and refugees) have more mental health problems during the pandemic and are slower to recover. Another important conclusion from the 21 studies studied is that it is necessary to formulate recommendations to improve people's mental health, to involve mental health professionals in the development of comprehensive public health policies and to support health care workforce as well as to improve public health prevention strategies, especially during health crises.

Hcv Reinfection in Active Drug Users from Facts to Explanations and Possible Solutions

Background and Aims: Perpignan (in south of France) was 600 000 people very low-income area. Main sociological characteristics associated, many homeless and drugs users local insecurity therefore low-price cocaine, national attractiveness for consumers and traffickers, overconsumption with these lower price, local manufacture of cannabis and road transport effects redistribution of drugs purchased in Spain. This was the only place where coke rail was sold under 5 dollars, 50% lower than the price in the rest of France. Mobile hepatitis team (MHT) was created in 2013 and cured about 1000 HCV patients in an outreach and test to cure approach. MHT used HCV POCT, HCV real time viral load, liver fibrosis measure by FIBROSCAN and nurse DAA prescription. For 2 years, MHT observed increase of reinfections. Method: Observational and Sociological Study of HCV Reinfections. Results: In 2023, MHT (nurses (44%) and hepatologist (56%) prescriptions) treated 89 HCV patients: men 68%, mean age 46 years, reinfection rate 21%. This rate was higher (31%) in patients treated by nurses. They were younger, more often homeless, and active drugs users. A clinical psychological study by patients’ interview showed than reinfected patients were younger, lower educational level, more often homeless, with history of psychiatric illnesses and prison. There was no correlation with precariousness score. More the patient thinks that he was responsible for his illness, the more impulsive he was (dimension urgency emotional impulsiveness). More the patient was aware of the consequences of his illness, the more impulsive he was (dimension urgency emotional impulsivity). The more impulsive the patient was (total score, emergency emotional impulsivity dimension), higher the neuroticism score (negativist personality trait). We individualized 2 specific groups of reinfected patients : gypsies in prison and homeless in the city. More the patient participates in harm reduction workshops, the more he feels responsible for his illness and the consequences of his illness, with magical thoughts about his contamination. The paradoxical outcome was people reinfected had more risk and harm reduction sessions after first infection. There was no fear about DAA treatment as HCV interferon and ribavirin treatment. DAA are always well tolerated and efficient, even in reinfection. Conclusion: Direct-acting antivirals are an effective tool for the treatment of hepatitis C virus, enabling the elimination of the virus. However, some patients who have been successfully treated with direct-acting antivirals are at risk of reinfection. Our findings showed that the risk of reinfection was highest among people with ractive injection drug use..In low-income population exposed to cocaine and other low price drugs, HCV reinfection was a trivialized life event. For reduce it, MHT had set up 3 specific projects: 1. home screening in gypsy women and neighborhood 2. Peers fingersticks HCV screening in homeless people and orientation of HCV positive patients to MHT 3. Prison zero hepatitis program with all HCV inmates same time treatment. Combination of these projects reduced to 22% rate of HCV reinfection in active drugs users during first quarter of their deployment.

Describing the development and implementation of a novel collaborative multidisciplinary approach to deliver foot health supports for individuals experiencing homelessness and its outcomes.

Basic foot care is a real need of people experiencing homelessness. To improve access to foot health for this group, three services structured to provide healthcare support for people experiencing homelessness collaborated in metropolitan Melbourne, Australia: an established nurse-led Homeless Persons Program (HPP), a specialty community health podiatry clinic servicing people experiencing homelessness, and a charity supporting disadvantaged communities providing free socks, foot first aid kits and second-hand footwear for distribution by nurses and podiatrists of participating services. This paper outlines the implementation and evaluation of this collaboration. A four stage implementation approach was used, addressing: 1. Who needs to do what differently? 2. What are the barriers and enablers that need to be addressed? 3. Which intervention components could overcome the modifiable barriers and enhance the enablers? 4. How can the changes be measured? The evaluation prospectively collected information about how HPP nurses referred adults to podiatry, and whether the referred individuals accessed the podiatry clinic, the outcomes of the podiatry visit, and how many received footwear, socks and foot first aid kits provided by the non-profit organisation. Over 1st June 2019 and 31st December 2020, 52 individuals were identified as adults who could potentially benefit from podiatry by the HPP nurses, of which 33 accessed podiatry. Those who did not visit the podiatry clinic were more likely to be born outside of Australia, live in more precarious housing (crisis accommodation and rough sleeping), have slightly more predisposing factors for homelessness, but have fewer medical, psychological and cognitive conditions. A structured approach including processes, education, regular, outreach to youth refuges and formal outcome monitoring enabled foot health care access in people experiencing homelessness. Further research is needed to ascertain how to support participants at risk of foot problems to access podiatry before their foot health issue reaches crisis point.

Demographic yearbooks as a source of weather-related fatalities: the Czech Republic, 1919–2022

Abstract. Demographic yearbooks of the Czech Republic, prepared by the Czech Statistical Office for the 1919–2022 period, contain official figures on the number of fatalities attributed to excessive natural cold, excessive natural heat, lightning, natural hazards, air pressure changes, and falls on ice or snow, as well as details about the sex and age of the deceased, covering a 104-year period or parts of it. These yearbooks, influenced by evolving international classifications of diseases, tend to underestimate the fatality numbers for excessive natural heat, natural hazards, and air pressure changes in particular. Out of a total of 9259 weather-related fatalities (with a mean annual rate of 89.0 fatalities), 74.9 % were caused by excessive natural cold and 19.3 % by lightning. No trend was identified in natural hazards, whilst statistically significant decreasing trends were found for lightning fatalities and increasing trends for excessive natural cold, excessive natural heat, and falls on ice or snow. Males and seniors aged ≥65 years were the most common sex and age categories affected. The number of fatalities attributed to excessive natural cold has partly increased as a result of the gradually ageing population and the rise in the number of homeless people since the 1990s. A statistically significant relationship between cold-related fatalities and mean January–February and winter (December–February) temperatures was established, evidenced by high negative correlation coefficients. Lightning deaths have notably decreased since the 1970s, primarily due to a significant reduction in the number of people employed in agriculture, an increase in urban population, better weather forecasting, lifestyle changes, and improved medical care. Although there is a significant positive correlation between these fatalities and the number of days with thunderstorms, the relationship is relatively weak. The results obtained for the Czech Republic align well with similar studies in Europe and elsewhere. While the demographic yearbooks cover only a part of weather-related fatalities, their circumstances, and characteristics, combining them with other similar databases is crucial to gain the necessary knowledge usable in risk management for the preservation of human lives.

Judicial problem-solving: An evaluation of Grobler v Phillips and Others [2022] ZACC 32

The South African Constitutional Court was recently tasked with considering whether the "just and equitable" requirement of the Prevention of Illegal Eviction from and Unlawful Occupation of Land Act had been complied with when an eviction order was granted in the Somerset West Magistrates' Court. The Magistrates' Court found that the occupier unlawfully occupied the land and determined that the eviction was just and equitable in the circumstances. However, the High Court and the Supreme Court of Appeal held that the order of the Magistrates' Court could not be confirmed. With certain conditions attached, the Constitutional Court held that the eviction was just and equitable. These judgments are noteworthy as they highlight the in consistencies in the reasoning of the various courts that considered the same facts. The conclusion is that judicial reasoning which creates tension between the rights of private landowners and unlawful occupiers is not constructive. Ideally, evictions should be resolved by enforcing a potentially homeless person's right to access adequate housing by holding the state to account for its constitutional obligations.

Service Users’ and Providers’ Experiences and Perceptions of Mental Health Accommodation Services: A Rapid Qualitative Synthesis of International Evidence

Background. There is a high prevalence of homeless people with psychotic disorders and supported housing is often required. However, there is little evidence about supported housing services, especially in low-middle income countries. This rapid review synthesizes evidence about the experiences of users and providers of community-based accommodation services for people living with serious mental illness internationally to understand priorities for policy and practice. Methods. PubMed, PsycINFO, Google Scholar, and reference lists were searched to identify 1344 studies. The inclusion criteria specified qualitative studies about users’ and/or providers’ views of the accommodation services for adults aged 18+ years with serious mental illness. Title, abstract, and full-text screening were conducted in duplicate, and quality appraisal was conducted using the standard for reporting qualitative research tool. Data extraction was conducted using both Excel and Word documents, and we used thematic analysis to report findings. Results. Only 43 studies were identified for inclusion. Service users’ and providers’ experiences of accommodation services from high income countries and low-middle income countries were similar. Both the service providers and users appreciated housing, and service providers mentioned it was not a sufficient step towards independent living. Shortage of resources in low-middle income countries made it challenging for some service providers to provide care because they had to choose between buying medicine or food. While service users needed greater availability of service providers, providers were at risk of burnout. Although some service providers were trained to respond to stigmatizing events, some users continued to experience stigma from their family members, society, and service providers. Conclusions. People living with serious mental illness and service providers value the housing provision but globally their experience of this provision is relatively poor compared to mainstream society, suggesting people living with serious mental illness remain disadvantaged. Further research should explore low-cost housing options that will provide quality person-centered care for people living with serious mental illness.

Burdens on the gateway to the state: Administrative burdens in the registration of people experiencing homelessness in Belgium and the Netherlands

AbstractPopulation registries are the gateway to public services, benefits, and rights. However, despite clear formal rules and procedures, people eligible for registration may still face administrative burdens in obtaining access. In this article, we study the case of the municipal registration of people who experience homelessness in Belgium and the Netherlands—a group that typically suffers from administrative vulnerability. Using data from 61 interviews with social workers and civil servants, we find that burdens are constructed at the municipal level to disincentivize homeless people's access to registration. However, using the Institutional Analysis and Development Framework, we also identify mechanisms in the governance of population registrations and the decentralization of social policies that create incentives for strategic behavior by municipal policy makers and street‐level bureaucrats. By analyzing the interaction between multiple institutional levels, we contribute to understanding how structural mechanisms influence policymakers’ agency in the construction of administrative burdens.

‘Back Off! Stop Making US Illegal!’: The Criminalisation of Homelessness in Australia

In Australia, vagrancy and public order laws have been used to criminalise homelessness since colonisation. Such laws have never provided an effective deterrent against ‘offending’ because most crimes committed by homeless people are survival-related or otherwise associated with their homeless status. It is generally agreed that a welfare-oriented rather than a punitive approach is needed if these ‘crimes’ are to be prevented, however the perspectives of homeless people on this subject remain largely unknown. We undertook a national study where we asked homeless individuals and criminal law practitioners to comment on whether and how criminal law processes could respond more appropriately to the ‘offending’ behaviour of homeless people. Practitioners viewed criminal law interventions as an opportunity to connect homeless individuals with the services they required. However, the homeless participants were not supportive of mandated social service intervention. They eschewed a criminal identity and wanted state actors to leave them alone.

Physical therapy interventions for people experiencing homelessness to improve pain and self-perceived health status

BackgroundHomeless shelters have emerged as components of the social services network, playing an important role in providing health care to the homeless population. The aim of this study was to evaluate an individualized physical therapy intervention for people experiencing homelessness and to determine the relationship between self-perceived variables.MethodsPre and post study, setting at the “Santa y Real Hermandad de Nuestra Señora del Refugio y Piedad” homeless shelter in Zaragoza, Spain. Participants were people experiencing homelessness with musculoskeletal disorders who attended a physical therapy service at shelter facilities. A physical therapy program was implemented including health education, exercise and manual therapy, electrotherapy, thermotherapy and bandaging. Demographic variables (age and gender), nationality, employment situation, educational level, pain location, number of painful areas, feeling of loneliness (3-Item Loneliness Scale; values from 3 to 9), pain intensity (Numerical Pain Rating Scale [NPRS]; from 0 to 10) and self-perceived health (Clinical Global Impression [CGI]; from 1 to 7).ResultsSixty-four homeless people (age of 46.4 ± 10.9 years) participated in the study. Musculoskeletal pain was reported by 98.4% of subjects, with moderate pain intensities (6.1), and 48.4% presenting with pain at multiple sites. Perceptions of loneliness were low (3.7 ± 2.5) and self-perceived health status was moderately ill (3.5 ± 1.7). Positive significant correlations were identified between pain intensity and self-perceived health. The average number of sessions was 1.5 (± 0.8), with manual therapy (35.6%) followed by health education (23.5%) being the most frequently used techniques. Both pain and self-perceived health improved after treatment, even following a brief intervention.ConclusionsThis study demonstrates the potentially negative impact of untreated pain on the self-perceived health of homeless individuals with musculoskeletal disorders that should be targeted for consideration. The findings suggest that a paradigm shift in pain management, including a physical therapy service in shelters, is needed to address the rehabilitation demands of these individuals in a real-life context. This study was approved by the Aragon Ethics Committee (PI19/438) and performed according to the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) statement.

Reinventing the self through participatory art: writing and performing among rough sleepers

Abstract (Cupchik, Gerald. 2013. I am, therefore I think, act, and express both in life and in art. Art and identity 32. 67–91) claims that being is associated with artistic expressions of various kinds. In line with this notion, the present paper reports on a socially engaged art project that involved the clients at a day centre for people experiencing homelessness. For nearly four months, the participants met once a week for a few hours under the direction of a facilitator and a film-maker who video-recorded the group activities. The experimental ethnographic project aimed to establish whether engagement in creative art can provide these usually ‘invisible’ individuals with an opportunity to reflect on their self and find a voice. The paper describes the group’s activities and the individuals’ responses. The focus is on the minimal narratives the clients produced from surrealistic scenarios to personal memories and political reprieves. The study shows how intrinsically participatory art, centred on the encounter of the participants’ different subjectivities, can encourage self-reflection among individuals with problematic lives.

Estigma hacia habitantes de calle, consumo de drogas y género. Consecuencias en derechos humanos y salud pública

Objective: comprehend the stigmatization of the homeless population, its relationship with drug use, gender and its consequences from the perspective of the assistance personnel in Medellin. Methods: qualitative research with a descriptive-interpretative scope. Data were generated through focus groups. The information was analyzed with grounded theory techniques and contrasted with the scientific literature on the subject. Results: two conceptions of the homeless person emerged: disposable and citizen. About gender, the multiple stigmas towards women and the LGBTI population living on the streets were highlighted, and the consequences of stigmatization were described. Conclusion: Living on the street and having a lifestyle contrary to the dominant values, makes homeless people to be discriminated, dehumanized and corrected by society, which is worse when belong to non-hegemonic genders, this situation limits the guarantee of fundamental human rights, especially the right to health.

Peran Pemerintah dalam Upaya Penanganan Permasalahan Gelandangan dan Pengemis di Kota Jakarta

In Indonesia in urban centers, vagrants and beggars are a concern for the government. This role is the implementation of the 4th paragraph related to social welfare. The government has directly played a role and is directly involved in handling the problem of vagrants and beggars. Various ways have been done including by using Government Regulation Number 31 of 1980, but these efforts have not been able to produce results. The study of what the author describes provides the latest alternative solution as an effort to overcome and provide a feasible solution by the homeless beggars, namely by providing skills, education, and religious teachings in order to be able to bring them to a better direction. After the problem has been resolved, the second is to strengthen the legal substance, namely by regulating clear and more specific rules, After the substance has been regulated, the most appropriate alternative and solution is to record how many homeless people are in the center of the Capital City, after that they are given temporary placement by those who do not have a clear home, and see who is not physically strong to be treated and given skills when they are healthy later, and for those who are still healthy, they are given decent work skills with skills according to the fields they want. The last is to provide residential placement and the budget will be funded by the APBD for this, data is collected and calculated who deserves the placement and sees the eligibility of homeless people and beggars who are entitled to occupy it.

Exploring the impact of religiosity and spirituality on depressive symptoms in homeless people

IntroductionDepression is a major concern among homeless individuals. Studies link religiosity and spirituality (RS) with lesser depressive symptoms, but evidence is scarce among the homeless.ObjectivesThis study aims to assess the association between RS and depressive symptoms in homeless individuals in Brazil.MethodsThis cross-sectional study involved 456 homeless individuals in São Paulo, Brazil. It received approval from the Ethics and Research Committee of the Faculty of Medicine of Itajubá, Brazil. We used adjusted linear regression models to analyze the association between RS and participants’ depressive symptoms. Depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9). We used the P-DUREL to measure religiosity, FACIT-Sp12 for spirituality, and the Brief-RCOPE scale for religious-spiritual coping strategies.ResultsOut of 482 invited participants, 456 (94.6%) completed all questionaries, mostly males (75%) with an average age of 44.53 (SD 12.62) years. About 49.6% had depressive symptoms (PHQ-9 ≥10 points). After controlling for sociodemographic and health variables, factors such as temple/church attendance (≥ 3 times per month), increased religiousness (both organizational and intrinsic), positive religious/spiritual coping, and peace, faith and meaning were inversely related to depressive symptoms. Conversely, dysfunctional use of RS, such as in negative spiritual-religious coping strategies, correlated with heightened depressive symptoms.ConclusionsHigh depressive symptom prevalence was found among Brazilian homeless individuals. Functional use of RS was negatively linked to depressive symptoms, while dysfunctional RS, like negative spiritual-religious coping strategies, correlated with higher depressive symptoms. These findings can aid healthcare professionals, particularly psychologists and psychiatrists, in addressing RS in the homeless population.Disclosure of InterestNone Declared

Prevalence of Sexually Transmitted Infections and Predictors for Loss to Follow Up among Marginalized Homeless and Migrant Communities: a Cross-Sectional Study.

In Europe and Italy, marginalized communities have a higher risk for both contracting sexually transmitted infections (STI) and progressing towards adverse outcomes. This study focuses on the screening of HIV, HBV, HCV, and syphilis among homeless individuals and agricultural migrant workers living in Apulia, Italy. It aims to assess STI prevalence and investigate factors that might hinder return to collect test results. In addition, it explores STI knowledge, attitudes, and practices among these vulnerable populations. A cross-sectional study was conducted from September 1, 2022, to September 30, 2023. Participants were recruited from community health centers and migrant camps. Blood tests for HBV, HCV, HIV, and syphilis were performed, and Knowledge, Attitude, and Practices (KAP) survey were conducted via face-to-face interviews. Descriptive and logistic regression analyses were used to assess factors influencing the return for test results. A total of 149 persons were recruited, including 64 agricultural migrant workers and 85 homeless people. Overall, 24.8% (n = 37) tested positive for at least one infection, and only 50.3% (n = 75) of the screened participants returned to collect their test results. Significant disparities in STI knowledge and healthcare access were observed between the two populations, with only 14.1% (n = 9) of migrants having access to primary healthcare. At multivariable analysis, the strongest predictor for not returning for test results was being positive for HCV. Among homeless people and agricultural migrant workers, STI prevalence was high, and only half of the population returned to collect test results. The study underscores the urgent need for targeted interventions and policy reevaluation to address healthcare disparities in marginalized communities.

The relationship between homelessness and psychiatric disorders in an inpatient sample

IntroductionThere are more than ten thousand homeless people in Hungary. Earlier studies confirmed the connection between mental health issues and homelessness. Furthermore, homeless care places a significant burden on the healthcare system, with psychiatric departments being no exception.Objectivesto compare demographic and treatment characteristis of homeless and not homeless inpatients in the psychiatric department of Jahn Ferenc South Pest Hospital (JFSPH), and thus providing a different perspective compared to previous studies, shedding light on the relationships from a different angle.MethodsIn our retrospective study, we analyzed all inpatients’ data treated in the psychiatric department of JFSPH over a 4-month period (03/2023-07/2023). Patients were divided into two groups: those with housing and those who were homeless. We compared the two groups based on the following variables: gender, age, length of inpatient treatment, diagnosis, psychiatric history, employment status; smoking, alcohol and drug use; valid health insurance, invalidity pension and guardianship status; and long-acting injectable antipsychotic treatment.ResultsThe percentage of homeless individuals treated in the psychiatric department of JFSPH was 18%. There was a significant difference in the length of inpatient stay between the two groups, homeless patients spent more than 100% longer time under inpatient treatment. Regarding psychiatric history, there was no significant difference between the two patient groups. When examining the employment status of the sample, we found significantly more unemployed patients im the homeless group. Comparing to the control group, there were significantly more alcohol consumers, smokers, and substance users among the homeless. Long-acting antipsychotic injections were administered significantly more frequently to homeless patients. A significantly higher percentage of homeless individuals were declared invalidated, and a significantly higher proportion of them were placed under guardianship compared to the group with housing. Homeless individuals were significantly more likely to have no social insurance compared to the control group.ConclusionsIn summary, we can conclude that significant difference have been found between the homeless and not homeless groups in most of the examined variables. These results implicates that the inpatient care of homeless patients poses significant bourden on the inpatient system. Early prevention and effective rehabilitation of substance use disorders could decrease this burden. Establishing a proper social safety network and enhancing community psychiatric care could potentially also relieve the burden of inpatient care system.Disclosure of InterestNone Declared

Initially homeless people in the Netherlands: housing status, prevalence of risk factors and changes in this prevalence 5.5 years after shelter entry

ABSTRACT This observational longitudinal cohort study examines housing status, the prevalence of a comprehensive set of individual modifiable risk factors for homelessness, and changes in the prevalence of housing status and these risk factors among initially homeless people from Amsterdam over a period of 5.5 years. The four constitutional conditions of the Social Quality Approach (namely living conditions, interpersonal embeddedness, societal embeddedness and self-regulation), were used to cluster the risk factors included in this study. Data were collected with a quantitative questionnaire that was orally administered at two time points; at baseline (at shelter entry), and at follow-up (5.5 years after shelter entry). At baseline (n = 172), as expected, the participants were seriously disadvantaged regarding all four constitutional conditions of social quality. At the 5.5 year follow-up (n = 72), 69% of the participants were stably housed, and, although for all four constitutional conditions of social quality significant improvements were found, the prevalence of the majority of risk factors had not decreased after 5.5 years. Findings indicate that, even 5.5 years after shelter entry, Dutch initially homeless people still experienced high levels of social exclusion, which leaves them particularly vulnerable for recurrent homelessness. Implications for policy and practice are discussed.

Homeless people’s experiences of the illicit drug supply during COVID-19

Purpose The COVID-19 pandemic has affected many industries, and reports indicate that this includes the illicit drug market. Recent research suggests that the homeless are particularly vulnerable during the pandemic, and the UK Government has acted to house rough sleepers. Research is scarce regarding homeless people’s experiences of the illicit drug market. This study aims to explore homeless people’s experiences of the drug supply in the UK during COVID-19. Design/methodology/approach Eight homeless people who use illicit drugs, residing in hostels for homeless people in Southampton, participated in semi-structured one-on-one telephone-based interviews. Findings A thematic analysis revealed five themes: availability of drugs, presence of dealers, quality of drugs, finances and personal experiences. Participants reported varying experiences of the drug supply, with lockdown measures expressed as the main reason for reduced supplies, as users found it difficult to find dealers and generate income for purchasing drugs. Research limitations/implications The results may lack generalisability to the wider population, such as rough sleepers and drug dealers, suggesting a need for further research into people’s experiences of the drug supply during COVID-19. Research on this topic could be more in-depth through the use of research methods that are convenient for the homeless population. Practical implications Services should invest in harm reduction services and encourage homeless people who use drugs to engage in substitution treatment. Homeless services should provide psychological support for homeless people who use drugs. Social implications The changes in homeless people’s behaviour following the pandemic may have implications for their interactions with the rest of society (e.g. begging in town centres may reduce). These changes in behaviour may also change the way society can best support homeless people. Originality/value The results are partially consistent with other research findings about the illicit drug supply; however, they also suggest that some individuals experienced minimal change in the illicit drug supply.

A conceptual framework to model social determinants of COVID-19 vaccination uptake among underserved homeless populations

BackgroundHomeless people have a higher risk of COVID-19 infection, linked to several social, economic and environmental determinants, frequent comorbidities, obstacles to exercising their constitutional social and health rights, poor medical cover, and insufficient use of the healthcare system. Data on COVID-19 vaccine uptake and its main determinants are lacking for this underserved population. ObjectivesTo construct and testa conceptual framework to model structural social determinants of COVID-19 vaccine uptake among underserved homeless populations, and to test this model to identify the determinants of COVID-19 vaccine uptake on the homeless population living in two metropolitan areas in France. MethodsWe implemented a multicenter cross-sectional survey from 15/11/2021 to 22/12/2021 in homeless adults in the city of Marseille and in the greater Paris area.Persons sheltered in migrant worker hostels or in emergency social shelters, members of the COVID HOMELESS cohort study in Marseille, and Travelers living in traditional housing were all eligible. A standardized face-to-face questionnaire was administered to the participants where they lived in various languages by trained interviewers. We used structural equation modeling to analyze the structural social determinants of COVID-19 vaccine uptake, the latter defined as receiving at least one dose. ResultsThe participation rate was 64 %, accounting for 3811 participants. There were three main factors associated with greater vaccine uptake: i) opportunity, which included having a personal general practitioner (β = 0.05, p < 0.05), healthcare cover (β = 0.05, p < 0.05), and somebody to accompany the participant for medical appointments (β = -0.04, p < 0.05); ii) motivation, which included attitudes towards vaccination (β = 0.55, p < 0.05), press- and poster-based information (β = 0.03, p < 0.05), and vaccination history (β = 0.03, p < 0.05); iii) type of housing (β = 0.13, p < 0.05) and housing stability (β = 0.04, p < 0.05). ConclusionOur results highlight that housing exclusion is a structural social determinant of COVID-19 vaccine uptake in homeless people in France. They also underline the role which opportunity and motivation play in improving uptake in this underserved homeless population.

Livable cities in the global south: Buenos Aires city in the new normal

Purpose Social sciences have discussed the host–guest relation from many theoretical lenses and perspectives. Violence as well as local crime has been studied as one of the major risks concerning tourism security. Anyway, less attention was given to homeless people and their interaction with foreign or local tourists. The purpose of this paper is oriented to explain how globalization has winners and losers, in which case, as noted, thousands of persons are excluded from the formal labor marketplace or the economic system year by year. Design/methodology/approach This is a conceptual paper that discusses critically not only the recent advances of sociology in urban tourism but also the connection between homeless people and tourists. Findings There is an urban underclass formed by those who have been excluded from the economic system. What is more important, such an underclass situates nearby luxury hotels and tourist destinations creating serious contradictions or zones of disputes. These contradictions have been approached by different sociologists since the turn of the 20th century. Research limitations/implications The question of sustainability, as well as the idea of liveable cities, and the efficient organization of the city, have occupied a central position in the academic debate, above all after the COVID-19 pandemic. In the present paper, the authors put in dialogue the contributions of Marc Auge with Zyggy Bauman toward a new understanding of this postmodern phenomenon. Originality/value Based on the metaphor of vagabonds and tourists, we give a snapshot of the problem of homelessness in Buenos Aires city and its effects on the tourism industry. Unlike other English-speaking countries where the cities are actively organized by the state, Buenos Aires city lacks a planned program to regulate and relocate homeless people. They dwell in nonplaces nearby tourists sleeping in the streets near luxury hotels (but for sure escaping any planning or governmental control).