无家可归与自评健康：来自西班牙全国无家可归者调查的证据。
Homelessness and self-rated health: evidence from a national survey of homeless people in Spain.
机构信息
Department of Development and Educational Psychology. Faculty of Education, University of Extremadura, Badajoz, Spain.
Department of Development and Educational Psychology. Faculty of Education (Avenida de Tolosa, 20018, San Sebastián), University of the Basque Country, UPV/EHU, Leioa, Spain.
出版信息
BMC Public Health. 2019 Aug 9;19(1):1081. doi: 10.1186/s12889-019-7380-2.
BACKGROUND
Internationally, acute homelessness is commonly associated with complex health and social care needs. While homelessness can be understood as an outcome of structural housing exclusion requiring housing led solutions, the health care issues faced by homeless people equally require attention. A substantive evidence base on the health needs of homeless people exists, but relatively little is known about what influences the self-rated health of homeless people. This article presents new evidence on whether drug use (alcohol consumption, ever having used drugs), health variables (visiting a hospital once in the last year, visiting the doctor in the last month, having a health card, sleeping difficulties, and having a disabling impairment) and sociodemographic characteristics are significantly associated with Self-Rated Health (SRH) among Spanish homeless people.
METHOD
The approach applies secondary analysis to cross-sectional data from a sample of 2437 homeless adults in Spain (83.8% were male). Multinomial logistic regression modelling was used to analyse the relationships between drug use, other health variables and SRH.
RESULTS
Being male, an abstainer, having a health card and being in the youngest age groups were significant factors associated with perceived good health. On the other hand, ever having used drugs, having been a night in hospital, having gone to the doctor in the last month, having sleeping difficulties, having a disabling impairment and being in the older age group were all significant risk factors associated with perceived poor health.
CONCLUSIONS
These results help to improve understanding of the key factors that influence the SRH among homeless people. The findings can contribute to development and delivery of preventive policies, suggesting that interventions to reduce drug consumption and ensure access to a health card/health services, as well as enhancing services for older, female and disabled homeless people are all measures which could improve health and well-being for those who face homelessness. Effective housing interventions (e.g. Housing First or Permanent Supported Housing programmes) are equally important to underpin the effectiveness of measures to improve the self-rated health of homeless people.
背景
在国际上，急性无家可归通常与复杂的健康和社会关怀需求相关。虽然无家可归可以被理解为住房排斥的结果，需要住房解决方案，但无家可归者面临的健康问题同样需要关注。无家可归者的健康需求存在大量实质性证据，但对于影响无家可归者自评健康的因素知之甚少。本文介绍了新的证据，说明吸毒（饮酒、曾经吸毒）、健康变量（去年去过一次医院、上个月看过医生、有健康卡、睡眠困难、有残疾）和社会人口特征是否与西班牙无家可归者的自评健康（SRH）显著相关。
方法
该方法应用于来自西班牙 2437 名成年无家可归者样本的横断面数据的二次分析（83.8%为男性）。采用多项逻辑回归模型分析吸毒、其他健康变量与 SRH 之间的关系。
结果
男性、不饮酒者、有健康卡和处于最年轻年龄组是与感知健康良好相关的显著因素。另一方面，曾经吸毒、在医院过夜、上个月看过医生、睡眠困难、有残疾和处于较年长年龄组都是与感知健康不良相关的显著风险因素。
结论
这些结果有助于更好地理解影响无家可归者自评健康的关键因素。这些发现有助于制定和实施预防政策，表明减少吸毒和确保获得健康卡/健康服务的干预措施，以及增强对老年、女性和残疾无家可归者的服务，都是改善面临无家可归者健康和福祉的措施。有效的住房干预措施（例如“无家可归者优先入住”或“永久支持性住房”方案）同样重要，可以增强改善无家可归者自评健康的措施的效果。
Zotero 插件