To Matthew J, Palepu Anita, Aubry Tim, Nisenbaum Rosane, Gogosis Evie, Gadermann Anne, Cherner Rebecca, Farrell Susan, Misir Vachan, Hwang Stephen W
Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.
Centre for Health Evaluation and Outcome Sciences, Division of General Internal Medicine, University of British Columbia, Vancouver, BC, Canada.
BMC Public Health. 2016 Oct 3;16(1):1041. doi: 10.1186/s12889-016-3711-8.
Homelessness is a major concern in many urban communities across North America. Since vulnerably housed individuals are at risk of experiencing homelessness, it is important to identify predictive factors linked to subsequent homelessness in this population. The objectives of this study were to determine the probability of experiencing homelessness among vulnerably housed adults over three years and factors associated with higher risk of homelessness.
Vulnerably housed adults were recruited in three Canadian cities. Data on demographic characteristics, chronic health conditions, and drug use problems were collected through structured interviews. Housing history was obtained at baseline and annual follow-up interviews. Generalized estimating equations were used to characterize associations between candidate predictors and subsequent experiences of homelessness during each follow-up year.
Among 561 participants, the prevalence of homelessness was 29.2 % over three years. Male gender (AOR = 1.59, 95 % CI: 1.14-2.21) and severe drug use problems (AOR = 1.98, 95 % CI: 1.22-3.20) were independently associated with experiencing homelessness during the follow-up period. Having ≥3 chronic conditions (AOR = 0.55, 95 % CI: 0.33-0.94) and reporting higher housing quality (AOR = 0.99, 95 % CI: 0.97-1.00) were protective against homelessness.
Vulnerably housed individuals are at high risk for experiencing homelessness. The study has public health implications, highlighting the need for enhanced access to addiction treatment and improved housing quality for this population.
无家可归是北美许多城市社区的一个主要问题。由于住房条件脆弱的个体面临无家可归的风险，因此识别与该人群随后无家可归相关的预测因素很重要。本研究的目的是确定住房条件脆弱的成年人在三年内无家可归的概率以及与无家可归高风险相关的因素。
在加拿大的三个城市招募了住房条件脆弱的成年人。通过结构化访谈收集了人口统计学特征、慢性健康状况和药物使用问题的数据。在基线和年度随访访谈中获取住房历史。使用广义估计方程来描述候选预测因素与每次随访年度无家可归的后续经历之间的关联。
在561名参与者中，三年内无家可归的患病率为29.2%。男性（比值比[AOR]=1.59，95%置信区间[CI]：1.14 - 2.21）和严重药物使用问题（AOR = 1.98，95% CI：1.22 - 3.20）与随访期间无家可归的经历独立相关。患有≥3种慢性疾病（AOR = 0.55，95% CI：0.33 - 0.94）和报告住房质量较高（AOR = 0.99，95% CI：0.97 - 1.00）可预防无家可归。
住房条件脆弱的个体面临无家可归的高风险。该研究具有公共卫生意义，强调了需要为该人群增加成瘾治疗的可及性并改善住房质量。
