Icahn School of Medicine at Mount Sinai (Morningside/West), New York, USA.
Baylor College of Medicine, Houston, TX, USA.
Qual Life Res. 2023 Jul;32(7):2003-2011. doi: 10.1007/s11136-023-03370-9. Epub 2023 Feb 20.
The growing homeless population in the U.S.A. is disproportionately impacted by poor mental and physical health status, including a higher incidence of acute and chronic health problems, increased hospitalizations, and premature mortality compared to the general population. This study examined the association between demographic, social, and clinical factors and perceptions of general health status among the homeless population during admission to an integrated behavioral health treatment program.
The study sample included 331 adults experiencing homelessness with a serious mental illness or co-occurring disorder. Participants were enrolled in services at a day program for unsheltered homeless adults, a residential substance use treatment program for males experiencing homelessness, a psychiatric step-down respite program for those experiencing homelessness following psychiatric hospitalization, permanent supportive housing for formerly chronically homeless adults, a faith-based food distribution program, and homeless encampment sites in a large urban area. Participants were interviewed using The Substance Abuse and Mental Health Services Administration's National Outcome Measures tool and a validated health-related quality of life measurement tool, SF-36. Data were examined using in elastic net regression.
The study found seven factors to be particularly strong predictors of SF-36 general health scores. Male gender, "other" sexual identity, stimulant use, and Asian race were all associated with better perceptions of health status, while transgender status, inhalant use, and number of times arrested were associated with poorer perceptions.
This study suggests targeted areas for health screening within the homeless population; however, more studies are necessary to demonstrate generalizability of the results.
美国不断增长的无家可归人口受到较差的身心健康状况的不成比例影响，与一般人群相比，他们更易出现急性和慢性健康问题、住院率增加和过早死亡。本研究调查了人口统计学、社会和临床因素与综合行为健康治疗计划入院时无家可归人群对一般健康状况认知之间的关联。
本研究样本包括 331 名患有严重精神疾病或共病的无家可归成年人。参与者参加了一个为无家可归成年人提供服务的日间项目、一个为男性无家可归者提供的住所物质使用治疗项目、一个为精神病住院后无家可归者提供的精神病缓解住宿项目、一个为以前长期无家可归者提供的永久性支持性住房、一个基于信仰的食品分发项目以及一个大型城市地区的无家可归者营地。参与者使用药物滥用和心理健康服务管理局的国家结果措施工具和经过验证的与健康相关的生活质量测量工具 SF-36 进行了访谈。使用弹性网络回归对数据进行了检查。
该研究发现了七个对 SF-36 一般健康评分具有特别强预测力的因素。男性性别、“其他”性身份、兴奋剂使用和亚洲种族与更好的健康状况认知相关，而跨性别状态、吸入剂使用和被捕次数与较差的健康状况认知相关。
本研究表明在无家可归人群中需要有针对性地进行健康筛查；但是，还需要更多的研究来证明结果的普遍性。
