Weinstein Lara Carson, Henwood Benjamin F, Matejkowski Jason, Santana Abbie J
Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA, USA.
J Prim Care Community Health. 2011 Jan 1;2(1):11-5. doi: 10.1177/2150131910383580. Epub 2010 Dec 30.
Housing First (HF) is an evidence-based practice that ends chronic homelessness for individuals with serious mental illness by providing immediate access to permanent independent housing and team-based community supports. Little is known about the health status of homeless individuals entering HF programs. Through a cross-sectional analysis, this paper reports on the chronic physical disease burden of people entering a newly established HF program and examines whether these individuals recognize and request support for ongoing health-related issues. The authors' evaluation confirmed significantly higher rates of chronic disease (60%) and fair/poor self-reported health status (47%) than the general urban population of Philadelphia. The majority of clients reported they wanted to address both medical (67%) and mental health (68%) problems, but a much lower percentage reported wanting to reduce substance use (23%) or take psychiatric medications (25%). The authors conclude that formerly homeless entrants to HF programs have a high burden of chronic disease with complex health-related needs. Additionally, these individuals look to the program for health-related assistance. As the HF model is disseminated throughout the United States to end chronic homelessness, these findings support the development of flexible, integrated, person-centered health services within the HF service delivery system as a potentially effective method to address complex health needs.
“先住房”（HF）是一种基于证据的实践方法，通过为患有严重精神疾病的个人立即提供永久性独立住房和基于团队的社区支持，来终结他们的长期无家可归状态。对于进入“先住房”项目的无家可归者的健康状况，人们知之甚少。通过横断面分析，本文报告了进入一个新设立的“先住房”项目的人群的慢性身体疾病负担，并考察这些人是否认识到并要求针对持续存在的健康相关问题提供支持。作者的评估证实，与费城的一般城市人口相比，慢性病发病率（60%）和自我报告的健康状况为一般/较差的比例（47%）显著更高。大多数客户表示他们希望解决医疗问题（67%）和心理健康问题（68%），但表示希望减少物质使用（23%）或服用精神科药物（25%）的比例要低得多。作者得出结论，进入“先住房”项目的前无家可归者有很高的慢性病负担，且有复杂的健康相关需求。此外，这些人期望该项目提供与健康相关的援助。随着“先住房”模式在美国各地推广以终结长期无家可归状态，这些发现支持在“先住房”服务提供系统内发展灵活、综合、以人为本的健康服务，作为满足复杂健康需求的一种潜在有效方法。
