Department of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada.
Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada.
J Public Health (Oxf). 2021 Sep 22;43(3):532-540. doi: 10.1093/pubmed/fdaa018.
We examined clinically significant substance use among homeless or vulnerably housed persons in three Canadian cities and its association with residential stability over time using data from the Health and Housing in Transition study.
In 2009, 1190 homeless or vulnerably housed individuals were recruited in three Canadian cities and followed for 4 years. We collected information on housing and incarceration history, drug and alcohol use, having a primary care provider at baseline and annually for 4 years. Participants who screened positive for substance use at baseline were included in the analyses. We used a generalized logistic mixed effect regression model to examine the association between clinically significant substance use and residential stability, adjusting for confounders.
Initially, 437 participants met the criteria for clinically significant substance use. The proportion of clinically significant substance use declined, while the proportion of participants who achieved residential stability increased over time. Clinically significant substance use was negatively associated with achieving residential stability over the 4-year period (AOR 0.7; 95% CI 0.57, 0.86).
In this cohort of homeless or vulnerably housed individuals, clinically significant substance use was negatively associated with achieving residential stability over time, highlighting the need to better address substance use in this population.
我们使用“过渡时期的健康与住房”研究的数据，研究了加拿大三个城市中无家可归或住房不稳定人群中的临床显著物质使用情况及其与随时间推移的居住稳定性的关联。
2009 年，在加拿大三个城市招募了 1190 名无家可归或住房不稳定的个体，并对他们进行了 4 年的随访。我们收集了住房和监禁史、药物和酒精使用、在基线时和每年 4 年期间有主要医疗服务提供者的信息。在基线时筛查出物质使用阳性的参与者被纳入分析。我们使用广义逻辑混合效应回归模型，调整混杂因素后，检验了临床显著物质使用与居住稳定性之间的关联。
最初，437 名参与者符合临床显著物质使用的标准。随着时间的推移，临床显著物质使用的比例下降，而实现居住稳定性的参与者比例增加。临床显著物质使用与在 4 年期间实现居住稳定性呈负相关（AOR 0.7；95%CI 0.57，0.86）。
在这个无家可归或住房不稳定的人群队列中，临床显著的物质使用与随时间推移的居住稳定性呈负相关，这突出表明需要更好地解决这一人群的物质使用问题。
