Department of Social and Preventive Medicine, School of Public Health, University of Montreal, 7101 Avenue du Parc, Montreal, QC, H3N 1X9, Canada.
School of Optometry, University of Montreal, 3744 Rue Jean Bureau 110, Montreal, QC, H3T 1P1, Canada.
Can J Public Health. 2023 Feb;114(1):113-124. doi: 10.17269/s41997-022-00676-y. Epub 2022 Aug 15.
Homelessness is a serious social and public health concern in Canada. Individuals experiencing homelessness face numerous health problems and barriers in accessing health services. Visual impairment can exacerbate the lower quality of life experienced by people who are homeless, but its incidence among this population has been poorly documented in the literature. Our study aimed to describe health and sociodemographic characteristics and determine their association with visual impairment, ocular pathology and uncorrected refractive errors in a homeless population in Montreal, Canada.
This cross-sectional study was conducted between May 2019 and September 2020 in eight homeless shelters selected using a stratified random sampling approach on the island of Montreal. An eye examination was performed on all participants, who were also administered a survey on social determinants of health. Descriptive analysis was used to analyze survey data, and logistic regression was used for each of the three study outcomes.
A total of 124 individuals experiencing homelessness (93 men, 31 women) were recruited. Participants were mostly Caucasian (> 70%) with an average age of 48 years (standard deviation = 13 years). Our sample reported a high level of education (68% had a high school diploma or higher), a high level of health insurance coverage (77%), social assistance benefits (71%), and social support (over 50%). There was a high prevalence of chronic conditions including diabetes (14%), hypertension (25%), and HIV/AIDS (3%). Results from eye examinations showed a high prevalence of visual impairment (22%), ocular pathology (23%), and uncorrected refractive error (75%). Age was statistically significantly associated with each outcome variable.
Despite a high level of social and health support, individuals experiencing homelessness in Montreal, Canada, experience high levels of chronic conditions and visual impairment. Our study highlights the unmet need for eye healthcare among homeless populations, and that eye health can be a unique entry point for intervening with homeless populations.
无家可归是加拿大严重的社会和公共卫生问题。无家可归者面临许多健康问题，并且在获得医疗服务方面存在障碍。视力障碍会加剧无家可归者的生活质量下降，但文献中对这一人群的视力障碍发生率记录甚少。我们的研究旨在描述无家可归者的健康和社会人口学特征，并确定这些特征与视力障碍、眼部疾病和未矫正屈光不正的关系。
本横断面研究于 2019 年 5 月至 2020 年 9 月在蒙特利尔岛采用分层随机抽样方法选择的 8 家无家可归者收容所进行。对所有参与者进行眼部检查，并对他们进行健康的社会决定因素调查。使用描述性分析来分析调查数据，并对每个研究结果进行逻辑回归分析。
共招募了 124 名无家可归者（93 名男性，31 名女性）。参与者大多为白种人（>70%），平均年龄为 48 岁（标准差为 13 岁）。我们的样本报告了较高的教育水平（68%有高中文凭或更高学历）、较高的健康保险覆盖率（77%）、社会援助福利（71%）和社会支持（超过 50%）。有许多慢性疾病，包括糖尿病（14%）、高血压（25%）和 HIV/AIDS（3%）。眼部检查结果显示，视力障碍（22%）、眼部疾病（23%）和未矫正屈光不正（75%）的患病率较高。年龄与每个结果变量均呈统计学显著相关。
尽管有较高的社会和健康支持，加拿大蒙特利尔的无家可归者仍面临较高水平的慢性疾病和视力障碍。我们的研究强调了无家可归人群对眼部保健的需求未得到满足，并且眼部健康可能是干预无家可归人群的独特切入点。
