Division of General Internal Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
Department of Education Counselling Psychology and Special Education, University of British Columbia, Vancouver, BC, Canada.
PLoS One. 2019 Feb 7;14(2):e0211704. doi: 10.1371/journal.pone.0211704. eCollection 2019.
We sought to characterize the association between a forensic event (arrest or incarceration) with housing vulnerability and mental and physical health status over a four-year follow-up among a cohort of homeless and vulnerably housed individuals in Vancouver, Toronto and Ottawa. Data were obtained from the Health and Housing in Transition Study, a prospective cohort study of homeless and vulnerably housed individuals between 2009 and 2012. Participants were interviewed in-person at baseline (N = 1190) and at four annual follow-up time points. We used generalized estimating equations to characterize the independent associations between a forensic event and the number of residential moves and SF-12 physical and mental health component scores over the four-year follow-up period. We analyzed data from 1173 homeless and vulnerably housed participants. Forensic events were reported by 446 participants at baseline. In multivariate analyses, a history of forensic event in the preceding twelve months was independently associated with an increased number of residential moves over the four-year follow-up period (ARR 1.24; 95% CI 1.19-1.3). It was not, however, independently associated with a change in physical or mental health status (respective ß-estimates; 95% CI: -0.34; -1.02, 0.34, and -0.69; -1.5, 0.2). Female gender and a history of problematic substance use were significantly associated with all three primary outcomes. This suggests arrest or incarceration is associated with increased housing vulnerability. The results underline the importance of supporting individuals experiencing arrest or incarceration with post-release planning in order to obtain stable housing after discharge.
我们试图描述在温哥华、多伦多和渥太华的一个无家可归和住房脆弱的队列中，在四年的随访中，与住房脆弱性相关的法医事件（逮捕或监禁）与心理健康和身体健康状况之间的关系。数据来自于健康和住房过渡研究，这是一项对 2009 年至 2012 年期间无家可归和住房脆弱的个体进行的前瞻性队列研究。在基线时（N=1190）和每年四次的随访中，对参与者进行了面对面访谈。我们使用广义估计方程来描述在四年的随访期间，法医事件与居住变动次数以及 SF-12 身体和心理健康成分得分之间的独立关联。我们分析了来自 1173 名无家可归和住房脆弱的参与者的数据。在基线时，有 446 名参与者报告了法医事件。在多变量分析中，过去十二个月内有法医事件的历史与四年随访期间居住变动次数的增加独立相关（ARR 1.24；95%CI 1.19-1.3）。然而，它与身体或心理健康状况的变化没有独立关联（分别的β估计值；95%CI：-0.34；-1.02，0.34 和-0.69；-1.5，0.2）。女性性别和有问题的物质使用史与所有三个主要结局都显著相关。这表明逮捕或监禁与住房脆弱性增加有关。这些结果强调了支持经历逮捕或监禁的个人进行出狱后规划的重要性，以便在出院后获得稳定的住房。
