Centre for Social Impact UWA, The Business School, The University of Western Australia, Crawley, Western Australia, Australia.
Health Soc Care Community. 2022 Nov;30(6):e4175-e4190. doi: 10.1111/hsc.13811. Epub 2022 Apr 24.
This study seeks to assess the health, social and economic outcomes associated with rough sleeping among women and compare those outcomes with those of (1) men sleeping rough, and (2) women experiencing other forms of homelessness (such as being housed in temporary supported accommodation due to family and domestic violence). The paper analyses survey data using the Vulnerability Index-Service Prioritization Decision Analysis Tool (VI-SPDAT) collected from 2735 women experiencing homelessness and 3124 men sleeping rough in Australian cities from 2010 to 2017. We find that women sleeping rough report poorer physical and mental health outcomes and greater problematic drug and or alcohol use relative to both men sleeping rough and women experiencing other types of homelessness (all p < 0.5). Women sleeping rough report significantly higher levels of crisis service utilisation (Β = 17.9, SE = 3.9, p < 0.001) and interactions with police in the previous 6 months (Β = 1.9, SE = 0.3, p < 0.001) than women experiencing homelessness not sleeping rough. Women sleeping rough also report greater healthcare utilisation, and, therefore, healthcare costs, than women experiencing homelessness not sleeping rough and men sleeping rough (all p < 0.05). From a policy perspective, the evidence presented in this paper supports a social determinants approach that moves from addressing symptoms of poor health outcomes associated with homelessness to preventing and ending homelessness with a particular focus on the life trajectories of women. Integrated services and homelessness strategies need to be developed through a gender lens, providing women sleeping rough with tailored permanent housing with wrap-around supportive housing to address poor health outcomes.
本研究旨在评估女性流浪街头与（1）男性流浪街头，以及（2）女性遭遇其他形式的无家可归（如因家庭暴力而暂居临时收容所）相关的健康、社会和经济后果，并对这些后果进行比较。本文使用 Vulnerability Index-Service Prioritization Decision Analysis Tool (VI-SPDAT) 分析了 2010 年至 2017 年期间澳大利亚城市中 2735 名流浪女性和 3124 名流浪男性的调查数据。研究发现，与男性流浪街头者和遭遇其他形式无家可归的女性相比，流浪街头的女性报告的身心健康状况更差，且滥用毒品或酗酒的情况更严重（所有 p 值均<0.5）。流浪街头的女性在过去 6 个月中报告的危机服务利用率（β=17.9，SE=3.9，p<0.001）和与警察的互动次数（β=1.9，SE=0.3，p<0.001）显著高于未流浪街头的遭遇无家可归的女性。流浪街头的女性还报告了更多的医疗保健利用，因此，医疗保健费用也高于未流浪街头的遭遇无家可归的女性和男性流浪街头者（所有 p 值均<0.05）。从政策角度来看，本文提出的证据支持一种社会决定因素方法，即从解决与无家可归相关的健康不良后果的症状转向预防和结束无家可归，尤其关注女性的生活轨迹。需要通过性别视角制定综合服务和无家可归战略，为流浪街头的女性提供量身定制的永久性住房和全面的住房支持，以解决健康不良后果问题。
