International Journal of Environmental Research and Public Health

Editorial

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3 pages, 259 KiB

Open AccessEditorial

Understanding and Tackling the Complex Challenges of Homelessness and Health

by Kate Frazer and Thilo Kroll

Int. J. Environ. Res. Public Health 2022, 19(6), 3439; https://doi.org/10.3390/ijerph19063439 - 15 Mar 2022

Cited by 2 | Viewed by 3244

Abstract

Homelessness is a complex global public health challenge [...] Full article

(This article belongs to the Special Issue Health and Homelessness)

Research

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24 pages, 1457 KiB

Open AccessArticle

Exploring the Potential of Implementing Managed Alcohol Programmes to Reduce Risk of COVID-19 Infection and Transmission, and Wider Harms, for People Experiencing Alcohol Dependency and Homelessness in Scotland

by Tessa Parkes, Hannah Carver, Wendy Masterton, Hazel Booth, Lee Ball, Helen Murdoch, Danilo Falzon, Bernie M. Pauly and Catriona Matheson

Int. J. Environ. Res. Public Health 2021, 18(23), 12523; https://doi.org/10.3390/ijerph182312523 - 28 Nov 2021

Cited by 5 | Viewed by 3767

Abstract

People who experience homelessness and alcohol dependency are more vulnerable than the general population to risks/harms relating to COVID-19. This mixed methods study explored stakeholder perspectives concerning the impact of COVID-19 and the potential utility of introducing managed alcohol programmes (MAPs) in Scotland [...] Read more.

People who experience homelessness and alcohol dependency are more vulnerable than the general population to risks/harms relating to COVID-19. This mixed methods study explored stakeholder perspectives concerning the impact of COVID-19 and the potential utility of introducing managed alcohol programmes (MAPs) in Scotland as part of a wider health/social care response for this group. Data sources included: 12 case record reviews; 40 semi-structured qualitative interviews; and meeting notes from a practitioner-researcher group exploring implementation of MAPs within a third sector/not-for-profit organisation. A series of paintings were curated as a novel part of the research process to support knowledge translation. The case note review highlighted the complexity of health problems experienced, in addition to alcohol dependency, including polysubstance use, challenges related to alcohol access/use during lockdown, and complying with stay-at-home rules. Qualitative analysis generated five subthemes under the theme of ‘MAPs as a response to COVID-19′: changes to alcohol supply/use including polysubstance use; COVID-19-related changes to substance use/homelessness services; negative changes to services for people with alcohol problems; the potential for MAPs in the context of COVID-19; and fears and concerns about providing MAPs as a COVID-19 response. We conclude that MAPs have the potential to reduce a range of harms for this group, including COVID-19-related harms. Full article

(This article belongs to the Special Issue Health and Homelessness)

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13 pages, 355 KiB

Open AccessArticle

Sociodemographic Determinants of Nonadherence to Depression and Anxiety Medication among Individuals Experiencing Homelessness

by Sahar S. Eshtehardi, Ashley A. Taylor, Tzuan A. Chen, Marcel A. de Dios, Virmarie Correa-Fernández, Darla E. Kendzor, Michael S. Businelle and Lorraine R. Reitzel

Int. J. Environ. Res. Public Health 2021, 18(15), 7958; https://doi.org/10.3390/ijerph18157958 - 28 Jul 2021

Cited by 4 | Viewed by 3450

Abstract

Psychiatric medication nonadherence continues to be a leading cause of poor health outcomes for individuals experiencing homelessness. Identifying the sociodemographic factors that contribute to medication nonadherence may help guide strategies to care for and support this group. This study examined 200 adults with [...] Read more.

Psychiatric medication nonadherence continues to be a leading cause of poor health outcomes for individuals experiencing homelessness. Identifying the sociodemographic factors that contribute to medication nonadherence may help guide strategies to care for and support this group. This study examined 200 adults with depression diagnoses and active anti-depressant prescriptions (Mage = 43.98 ± 12.08, 59.4% Caucasian, 58.5% male, 70% uninsured, 89.5% unemployed) and 181 adults with anxiety diagnoses and active anti-anxiety prescriptions (Mage = 43.45 ± 11.02, 54.4% Caucasian, 57.5% male, 66.3% uninsured, 88.9% unemployed) recruited from six homeless-serving agencies in Oklahoma City. Self-reported sociodemographic variables included: age, sex, race/ethnicity, education, monthly income, employment status, and health insurance status. Adjusted logistic regression analyses revealed that employed (OR = 4.022, CI_0.95: 1.244–13.004) and insured (OR = 2.923, CI_0.95: 1.225–6.973) participants had greater odds of depression medication nonadherence. For anxiety, being employed (OR = 3.573, CI_0.95: 1.160–11.010) was associated with greater odds of anxiety medication nonadherence, whereas having depression and anxiety diagnostic comorbidity (OR = 0.333, CI_0.95: 0.137–0.810) was associated with lower odds of anxiety medication nonadherence. Interventions aimed at facilitating accessible prescription acquisition or otherwise reducing barriers to prescription medications for employed adults, including those with health insurance, may benefit adherence, but more research is needed. Future studies would benefit from using a qualitative approach to better delineate nuanced barriers to psychiatric medication adherence. Full article

(This article belongs to the Special Issue Health and Homelessness)

7 pages, 1021 KiB

Open AccessArticle

The Unmet Rehabilitation Needs in an Inclusion Health Integrated Care Programme for Homeless Adults in Dublin, Ireland

by Áine Carroll, Siobhan O’Brien, Dee Harrington, Clíona Ní Cheallaigh, Ann-Marie Lawlee and Prasanth Sukumar

Int. J. Environ. Res. Public Health 2021, 18(15), 7917; https://doi.org/10.3390/ijerph18157917 - 27 Jul 2021

Cited by 6 | Viewed by 3437

Abstract

Background: People who become homeless have higher morbidity and mortality, use a disproportionate amount of healthcare resources, and generate a large volume of potentially preventable healthcare and other costs compared to more privileged individuals. Although access to rehabilitation is a human right under [...] Read more.

Background: People who become homeless have higher morbidity and mortality, use a disproportionate amount of healthcare resources, and generate a large volume of potentially preventable healthcare and other costs compared to more privileged individuals. Although access to rehabilitation is a human right under article 26 of the United Nations Convention on the Rights of Persons with Disabilities, the rehabilitation needs of individuals with homelessness have not been explored, and this project’s purpose was to establish a baseline of need for this cohort. Methods: A prospective audit of case discussions at an inclusion health service over a 2-month period in 2018. Results: Four multidisciplinary inclusion health clinics were observed with over 20 cases discussed in each and data were extracted using a bespoke audit data extraction tool. The inclusion health needs were diverse and complex with many unmet rehabilitation needs. Physical and cognitive rehabilitation needs were identified in over 50% of cases discussed. Musculoskeletal problems and acquired brain injuries were the most common cause of activity limitation. Most had concurrent medical conditions and addiction and/or mental health needs. None had access to rehabilitation services. Conclusion: The results of this study show that the rehabilitative needs of this cohort are significant and are not being met through traditional models of care. We are currently exploring innovative ways to provide appropriate services to these individuals. Full article

(This article belongs to the Special Issue Health and Homelessness)

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16 pages, 361 KiB

Open AccessArticle

Multimorbidity among People Experiencing Homelessness—Insights from Primary Care Data

by Shannen Vallesi, Matthew Tuson, Andrew Davies and Lisa Wood

Int. J. Environ. Res. Public Health 2021, 18(12), 6498; https://doi.org/10.3390/ijerph18126498 - 16 Jun 2021

Cited by 26 | Viewed by 6251

Abstract

Background: Although the poor health of people experiencing homelessness is increasingly recognised in health discourse, there is a dearth of research that has quantified the nature and magnitude of chronic health issues and morbidity among people experiencing homelessness, particularly in the Australian context. [...] Read more.

Background: Although the poor health of people experiencing homelessness is increasingly recognised in health discourse, there is a dearth of research that has quantified the nature and magnitude of chronic health issues and morbidity among people experiencing homelessness, particularly in the Australian context. Methods: Analysis of the medical records of 2068 “active” patients registered with a specialist homeless health service in Perth, Western Australia as of 31 December 2019. Results: Overall, 67.8% of patients had at least one chronic physical health condition, 67.5% had at least one mental health condition, and 61.6% had at least one alcohol or other drug (AOD) use disorder. Nearly half (47.8%) had a dual diagnosis of mental health and AOD use issues, and over a third (38.1%) were tri-morbid (mental health, AOD and physical health condition). Three-quarters (74.9%) were multimorbid or had at least two long-term conditions (LTCs), and on average, each patient had 3.3 LTCs. Conclusions: The study findings have substantial implications from both a health risk and healthcare treatment perspective for people experiencing homeless. The pervasiveness of preventable health conditions among people experiencing homelessness also highlights the imperative to improve the accessibility of public health programs and screening to reduce their morbidity and premature mortality. Full article

(This article belongs to the Special Issue Health and Homelessness)

13 pages, 358 KiB

Open AccessArticle

Health and Social Care Inequalities: The Impact of COVID-19 on People Experiencing Homelessness in Brazil

by Nilza Rogéria de Andrade Nunes, Andréa Rodriguez and Giovanna Bueno Cinacchi

Int. J. Environ. Res. Public Health 2021, 18(11), 5545; https://doi.org/10.3390/ijerph18115545 - 22 May 2021

Cited by 13 | Viewed by 3487

Abstract

This article aims to reflect on the challenges affecting people experiencing homelessness in Rio de Janeiro, Brazil, due the COVID-19 pandemic. Participatory research was carried out to identify data related to sociodemographic profile; strategies for survival; health and social care support; and access [...] Read more.

This article aims to reflect on the challenges affecting people experiencing homelessness in Rio de Janeiro, Brazil, due the COVID-19 pandemic. Participatory research was carried out to identify data related to sociodemographic profile; strategies for survival; health and social care support; and access to services during the pandemic. The research methodology was co-designed with NGOs and people with lived experience of homelessness and involved conducting semi-structured questionnaires with 304 participants in 2020. The results highlighted the worsening of the situation of extreme vulnerability and poverty already experienced by this population before the pandemic. Key strategies led by Third Sector organizations to reduce the spread of the virus, to minimize the financial impact of lockdown, and to increase emotional support and information on COVID-19 were presented. The conclusions show the complexity of issues affecting these groups and the need for urgent response from public policies and Government support to guarantee their rights, dignity, and respect during and after the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Health and Homelessness)

12 pages, 440 KiB

Open AccessArticle

Developing an Embedded Nursing Service within a Homeless Shelter: Client’s Perspectives

by Denise Warren, John Patrick Gilmore and Christine Wright

Int. J. Environ. Res. Public Health 2021, 18(9), 4719; https://doi.org/10.3390/ijerph18094719 - 28 Apr 2021

Cited by 7 | Viewed by 3403

Abstract

This phenomenological case study of a newly developed nursing service, embedded within a homeless shelter in the South East of England, uses semi-structured to elicit experiences and perceptions of clients within the service. Participants (n = 6) were interviewed using a semi-structured [...] Read more.

This phenomenological case study of a newly developed nursing service, embedded within a homeless shelter in the South East of England, uses semi-structured to elicit experiences and perceptions of clients within the service. Participants (n = 6) were interviewed using a semi-structured approach and identified three broad themes: impact of previous healthcare experiences, benefits of embedding healthcare within the shelter, and future service development. The study illuminates the diversity and complexity of healthcare needs of homeless people, as well as offers a unique insight into the service user’s perception of the service. Full article

(This article belongs to the Special Issue Health and Homelessness)

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11 pages, 321 KiB

Open AccessArticle

E-Cigarette Use among Current Smokers Experiencing Homelessness

by Arturo Durazo, Marlena Hartman-Filson, Holly Elser, Natalie M. Alizaga and Maya Vijayaraghavan

Int. J. Environ. Res. Public Health 2021, 18(7), 3691; https://doi.org/10.3390/ijerph18073691 - 1 Apr 2021

Cited by 2 | Viewed by 2757

Abstract

Two-thirds of cigarette smokers experiencing homelessness report using alternative tobacco products, including blunts, cigarillos (little cigars) or roll-your-own tobacco or electronic nicotine delivery systems such as e-cigarettes. We examined attitudes toward e-cigarette use and explored whether e-cigarette use patterns were associated with past-year [...] Read more.

Two-thirds of cigarette smokers experiencing homelessness report using alternative tobacco products, including blunts, cigarillos (little cigars) or roll-your-own tobacco or electronic nicotine delivery systems such as e-cigarettes. We examined attitudes toward e-cigarette use and explored whether e-cigarette use patterns were associated with past-year cigarette quit attempts among current smokers experiencing homelessness. Among the 470 current cigarette smokers recruited from homeless service sites in San Francisco, 22.1% (n = 65) reported the use of e-cigarettes in the past 30 days (‘dual users’). Compared to cigarette-only smokers, dual users considered e-cigarettes to be safer than cigarettes. Patterns of e-cigarette use, including the number of times used per day, duration of use during the day, manner of use and nicotine concentration were not associated with past-year cigarette quit attempts. Studies that examine the motivations for use of e-cigarettes, particularly for their use as smoking cessation aids, could inform interventions for tobacco use among people experiencing homelessness. Full article

(This article belongs to the Special Issue Health and Homelessness)

10 pages, 572 KiB

Open AccessArticle

Mortality Risk Factors for Individuals Experiencing Homelessness in Catalonia (Spain): A 10-Year Retrospective Cohort Study

by Fran Calvo, Oriol Turró-Garriga, Carles Fàbregas, Rebeca Alfranca, Anna Calvet, Mercè Salvans, Cristina Giralt, Sandra Castillejos, Mercè Rived-Ocaña, Paula Calvo, Paz Castillo, Josep Garre-Olmo and Xavier Carbonell

Int. J. Environ. Res. Public Health 2021, 18(4), 1762; https://doi.org/10.3390/ijerph18041762 - 11 Feb 2021

Cited by 8 | Viewed by 3249

Abstract

(1) Background: Current evidence suggests that mortality is considerably higher in individuals experiencing homelessness. The aim of this study was to analyze the mortality rate and the mortality risk factors in a sample of individuals experiencing homelessness in the city of Girona over [...] Read more.

(1) Background: Current evidence suggests that mortality is considerably higher in individuals experiencing homelessness. The aim of this study was to analyze the mortality rate and the mortality risk factors in a sample of individuals experiencing homelessness in the city of Girona over a ten-year period. (2) Methods: We retrospectively examined the outcomes of 475 people experiencing homelessness with the available clinical and social data. Our sample was comprised of 84.4% men and 51.8% foreign-born people. Cox’s proportional hazard models were used to identify mortality risk factors between origin groups. (3) Results: 60 people died during the ten-year period. The average age of death was 49.1 years. After adjusting for demographic characteristics and the duration of homelessness, the risk factors for mortality were origin (people born in Spain) (HR = 4.34; 95% CI = 1.89–10.0), type 2 diabetes (HR = 2.9; 95% CI = 1.62–5.30), alcohol use disorder (HR = 1.9; 95% CI = 1.12–3.29), and infectious diseases (HR = 1.6; 95% CI = 1.09–2.39). Our results show a high prevalence of infectious and chronic diseases. Type 2 diabetes emerges as an important risk factor in homelessness. The average age of death of individuals experiencing homelessness was significantly lower than the average age of death in the general population (which is greater than 80 years). (4) Conclusions: Foreign-born homeless people were generally younger and healthier than Spanish-born homeless people. Chronic diseases were controlled better in Spanish-born people, but this group showed an increased risk of mortality. Full article

(This article belongs to the Special Issue Health and Homelessness)

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11 pages, 675 KiB

Open AccessArticle

Feasibility of a Broad Test Battery to Assess Physical Functioning Limitations of People Experiencing Homelessness

by Julie Broderick, Sinead Kiernan, Niamh Murphy, Joanne Dowds and Cliona Ní Cheallaigh

Int. J. Environ. Res. Public Health 2021, 18(3), 1035; https://doi.org/10.3390/ijerph18031035 - 25 Jan 2021

Cited by 7 | Viewed by 2803

Abstract

Background: People who are homeless experience poor health. Reflective of overall health and factors such as acquired injuries, physical ability or functioning is often low among people who are homeless, but there is a lack of consistency of measures used to evaluate this [...] Read more.

Background: People who are homeless experience poor health. Reflective of overall health and factors such as acquired injuries, physical ability or functioning is often low among people who are homeless, but there is a lack of consistency of measures used to evaluate this construct. The aim of this study was to evaluate the feasibility of a broad test battery to evaluate limitations in physical functioning among people who are homeless. Methods: This cross-sectional, observational study occurred in a hospital in Dublin, Ireland. We evaluated lower extremity physical function (Short Physical Performance Battery), falls risk (timed up and go), functional capacity (six-minute walk test), stair-climbing ability (stair climb test), frailty (Clinical Frailty Scale), grip strength (handgrip dynamometer) and muscular mass (calf circumference measurement) in a population of people experiencing homelessness admitted for acute medical care. The test completion rate was evaluated for feasibility. Results: The completion rate varied: 65% (Short Physical Performance Battery), 55.4% (timed up and go), 38% (six-minute walk test), 31% (stair climb test), 97% (Clinical Frailty Scale), 75% (handgrip dynamometer), 74% (calf circumference measurement)). Collectively, the most common reasons for test non-participation were pain (24.1%, n = 40), not feeling well or able enough (20.1%, n = 33), and declined (11%, n = 18). Conclusion: The feasibility of the test battery was mixed as test participation rates varied from 31% to 97%. Physical functioning tests need to be carefully chosen for people who are homeless as many standard tests are unsuitable due to pain and poor physical ability. Full article

(This article belongs to the Special Issue Health and Homelessness)

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12 pages, 992 KiB

Open AccessArticle

Making the Case for Proactive Strategies to Alleviate Homelessness: A Systems Approach

by Sara Nourazari, Kristina Lovato and Suzie S. Weng

Int. J. Environ. Res. Public Health 2021, 18(2), 526; https://doi.org/10.3390/ijerph18020526 - 10 Jan 2021

Cited by 5 | Viewed by 8140

Abstract

Homelessness is a complex public health issue that affects some of the most vulnerable populations in the United States. This study takes a holistic approach to better understand and analyze the multiple factors and their interconnections that contribute to the complexity of this [...] Read more.

Homelessness is a complex public health issue that affects some of the most vulnerable populations in the United States. This study takes a holistic approach to better understand and analyze the multiple factors and their interconnections that contribute to the complexity of this problem. A systems analysis was conducted by utilizing the system dynamics method, which allows analyzing and comparing trends and behavior of system outcomes for different “what if” scenarios, interventions, and policy implications. Three leverage points were identified in this study to increase the effectiveness and efficiency of the current strategies to address homelessness: (1) increasing the number of affordable permanent housing units, (2) increasing the utilization of transitional housing units or shelters by the individuals experiencing homelessness, and (3) providing preventative services to at-risk populations before the onset of homelessness. Our results demonstrate that the most effective strategy is an amalgam of the solutions identified by these three leverage points. In addition, a policy analysis was conducted to study and estimate the effectiveness of various potential scenarios. This research provides data-driven and model-based insights into how decision-makers can utilize a systems approach to analyze new policy implications and create effective solutions to homelessness. Full article

(This article belongs to the Special Issue Health and Homelessness)

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14 pages, 609 KiB

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Acceptability and Feasibility of a Nurse-Led, Community Health Worker Partnered Latent Tuberculosis Medication Adherence Model for Homeless Adults

by Benissa E. Salem, Erin Klansek, Donald E. Morisky, Sanghyuk S. Shin, Kartik Yadav, Alicia H. Chang and Adeline M. Nyamathi

Int. J. Environ. Res. Public Health 2020, 17(22), 8342; https://doi.org/10.3390/ijerph17228342 - 11 Nov 2020

Cited by 11 | Viewed by 3985

Abstract

Homeless adults are at increased risk of latent tuberculosis infection (LTBI), which can lead to active tuberculosis (TB) disease. The purpose of this study was to assess acceptability and feasibility of a six-month, nurse-led, community health worker-partnered short-course treatment (3HP) LTBI adherence model [...] Read more.

Homeless adults are at increased risk of latent tuberculosis infection (LTBI), which can lead to active tuberculosis (TB) disease. The purpose of this study was to assess acceptability and feasibility of a six-month, nurse-led, community health worker-partnered short-course treatment (3HP) LTBI adherence model for a high risk, LTBI positive, homeless population. Informed by our community advisory board (CAB) and community-based participatory research principles (CBPR), a qualitative study was undertaken and used focus group discussions to identify perspectives of homeless men and women who had undergone LTBI treatment (N = 11, M_age = 51.2, SD 8.60, range 35–60). Three themes formed, which were engaging and recruiting LTBI intervention participants, delivering an LTBI intervention, and retaining LTBI intervention participants. Within those themes, barriers (e.g., lack of LTBI treatment readiness, substance use, etc.), and facilitators (e.g., LTBI and TB health education, familiarity with homeless population, etc.) were discussed to facilitate program recruitment, program delivery and program retention. These findings provide a greater understanding of how to effectively utilize a nurse-led, Community Health Worker (CHW) intervention delivery method to not only improve 3HP LTBI medication adherence, but also decrease substance use, improve mental health, and decrease unstable housing among this vulnerable population at high risk for active tuberculosis. Full article

(This article belongs to the Special Issue Health and Homelessness)

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18 pages, 1170 KiB

Open AccessArticle

Determinants of Implementation of a Clinical Practice Guideline for Homeless Health

by Olivia Magwood, Amanda Hanemaayer, Ammar Saad, Ginetta Salvalaggio, Gary Bloch, Aliza Moledina, Nicole Pinto, Layla Ziha, Michael Geurguis, Alexandra Aliferis, Victoire Kpade, Neil Arya, Tim Aubry and Kevin Pottie

Int. J. Environ. Res. Public Health 2020, 17(21), 7938; https://doi.org/10.3390/ijerph17217938 - 29 Oct 2020

Cited by 16 | Viewed by 5978

Abstract

Clinical practice guidelines can improve the clinical and social care for marginalized populations, thereby improving health equity. The aim of this study is to identify determinants of guideline implementation from the perspective of patients and practitioner stakeholders for a homeless health guideline. We [...] Read more.

Clinical practice guidelines can improve the clinical and social care for marginalized populations, thereby improving health equity. The aim of this study is to identify determinants of guideline implementation from the perspective of patients and practitioner stakeholders for a homeless health guideline. We completed a mixed-method study to identify determinants of equitable implementation of homeless health guidelines, focusing on the Grading of Recommendations Assessment, Development and Evaluation Feasibility, Acceptability, Cost, and Equity Survey (GRADE-FACE) health equity implementation outcomes. The study included a survey and framework analysis. Eighty-eight stakeholders, including practitioners and 16 persons with lived experience of homelessness, participated in the study. Most participants favourably rated the drafted recommendations’ priority status, feasibility, acceptability, cost, equity impact, and intent-to-implement. Qualitative analysis uncovered stakeholder concerns and perceptions regarding “fragmented services”. Practitioners were reluctant to care for persons with lived experience of homelessness, suggesting that associated social stigma serves as a barrier for this population to access healthcare. Participants called for improved “training of practitioners” to increase knowledge of patient needs and preferences. We identified several knowledge translation strategies that may improve implementation of guidelines for marginalized populations. Such strategies should be considered by other guideline development groups who aim to improve health outcomes in the context of limited and fragmented resources, stigma, and need for advocacy. Full article

(This article belongs to the Special Issue Health and Homelessness)

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Review

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21 pages, 905 KiB

Open AccessReview

Scoping Review: Suicide Specific Intervention Programmes for People Experiencing Homelessness

by Rachael McDonnell Murray, Eilis Conroy, Michelle Connolly, Diarmuid Stokes, Kate Frazer and Thilo Kroll

Int. J. Environ. Res. Public Health 2021, 18(13), 6729; https://doi.org/10.3390/ijerph18136729 - 22 Jun 2021

Cited by 6 | Viewed by 4742

Abstract

Background: The homeless population are among the most vulnerable groups to experience suicide ideation and behavior. Several studies have shown that people who are homeless experience more significant suicidal ideation and behavior than the general population. However, there is limited information about what [...] Read more.

Background: The homeless population are among the most vulnerable groups to experience suicide ideation and behavior. Several studies have shown that people who are homeless experience more significant suicidal ideation and behavior than the general population. However, there is limited information about what suicide interventions exist, to what extent they are grounded in robust research, and which intervention components effectively reduce suicidal ideation and behavior in the homeless community. This research aimed to characterise the current evidence base in the area of suicide prevention for homeless individuals. Methods: A scoping review guided by Arksey and O’Malley’s five-stage framework was conducted and a narrative synthesis was performed. Pubmed, EMBASE, PsychInfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Open Grey, and Bielefeld Academic Search Engine were searched up to 8 May 2020. Results: A total of 3209 records were identified through database and grey literature searching. Three studies are included in this review. Key outcomes identify suicide intervention prevention programmes; similarities and differences across interventions, and examples of staff training. A quality review of the studies was completed. Conclusion: A stark gap in the evidence of suicide specific prevention interventions targeted at homeless populations. Full article

(This article belongs to the Special Issue Health and Homelessness)

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16 pages, 510 KiB

Open AccessReview

Climate Change, Weather, Housing Precarity, and Homelessness: A Systematic Review of Reviews

by Mariya Bezgrebelna, Kwame McKenzie, Samantha Wells, Arun Ravindran, Michael Kral, Julia Christensen, Vicky Stergiopoulos, Stephen Gaetz and Sean A. Kidd

Int. J. Environ. Res. Public Health 2021, 18(11), 5812; https://doi.org/10.3390/ijerph18115812 - 28 May 2021

Cited by 50 | Viewed by 16344

Abstract

This systematic review of reviews was conducted to examine housing precarity and homelessness in relation to climate change and weather extremes internationally. In a thematic analysis of 15 reviews (5 systematic and 10 non-systematic), the following themes emerged: risk factors for homelessness/housing precarity, [...] Read more.

This systematic review of reviews was conducted to examine housing precarity and homelessness in relation to climate change and weather extremes internationally. In a thematic analysis of 15 reviews (5 systematic and 10 non-systematic), the following themes emerged: risk factors for homelessness/housing precarity, temperature extremes, health concerns, structural factors, natural disasters, and housing. First, an increased risk of homelessness has been found for people who are vulnerably housed and populations in lower socio-economic positions due to energy insecurity and climate change-induced natural hazards. Second, homeless/vulnerably-housed populations are disproportionately exposed to climatic events (temperature extremes and natural disasters). Third, the physical and mental health of homeless/vulnerably-housed populations is projected to be impacted by weather extremes and climate change. Fourth, while green infrastructure may have positive effects for homeless/vulnerably-housed populations, housing remains a major concern in urban environments. Finally, structural changes must be implemented. Recommendations for addressing the impact of climate change on homelessness and housing precarity were generated, including interventions focusing on homelessness/housing precarity and reducing the effects of weather extremes, improved housing and urban planning, and further research on homelessness/housing precarity and climate change. To further enhance the impact of these initiatives, we suggest employing the Human Rights-Based Approach (HRBA). Full article

(This article belongs to the Special Issue Health and Homelessness)

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