2018-2019 年科罗拉多州丹佛市无家可归者横断面调查中的非自愿流离失所与自我报告的健康状况。
Involuntary displacement and self-reported health in a cross-sectional survey of people experiencing homelessness in Denver, Colorado, 2018-2019.
机构信息
Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA.
Our House Georgia, Atlanta, GA, USA.
出版信息
BMC Public Health. 2024 Apr 25;24(1):1159. doi: 10.1186/s12889-024-18681-w.
BACKGROUND
The number of people experiencing unsheltered homelessness in the U.S. is increasing. Municipalities have responded with punitive responses such as involuntary displacement (i.e., encampment sweeps, move along orders), but little is known about the impact of involuntary displacement on health. The purpose of this study was to investigate the association between broadly defined experiences of involuntary displacement and self-reported health conditions among people experiencing homelessness.
METHODS
We used logistic regression models to generate odds ratios using publicly available data from a cross-sectional sample of people experiencing homelessness in Denver, Colorado, during September 2018-February 2019. Hosmer-Lemeshow Goodness of Fit tests were used to assess model fit.
RESULTS
Among 397 people experiencing homelessness, involuntary displacement was significantly associated with self-reported infectious diseases (adjusted odds ratio (aOR) 2.09, 95% CI 1.27, 3.41), substance and alcohol use (aOR 2.83; 95% CI 1.70, 4.73), climate-related conditions (aOR 2.27; 95% CI 1.35, 3.83), and worsening mental health (aOR 2.00; 95% CI 1.24, 3.24) after controlling for potential confounders. No statistically significant associations were identified between involuntary displacement and injuries, musculoskeletal issues, chronic conditions, and chronic mental and emotional issues.
CONCLUSIONS
This research quantifies the association between involuntary displacement and multiple infectious and non-infectious health outcomes. While city officials attempt to grapple with increasing unsheltered homelessness, it is important to understand what harms are occurring that are associated with current policies. Our research adds to the growing body of literature that involuntary displacement is a harmful response to unsheltered homelessness. Alternative approaches focused on connections to housing and social services should be prioritized.
背景
美国无家可归者中露宿街头的人数正在增加。 各市政府对此做出了回应，采取了惩罚性措施，如非自愿搬迁（即营地扫荡、驱赶令）， 但对于非自愿搬迁对健康的影响知之甚少。 本研究旨在调查广义上的非自愿搬迁经历与无家可归者自我报告的健康状况之间的关联。
方法
我们使用逻辑回归模型，使用 2018 年 9 月至 2019 年 2 月在科罗拉多州丹佛市进行的一项横断面无家可归者样本的公开可用数据生成优势比。 Hosmer-Lemeshow 拟合优度检验用于评估模型拟合度。
结果
在 397 名无家可归者中，非自愿搬迁与自我报告的传染病（调整后的优势比（aOR）2.09，95%CI 1.27，3.41）、药物和酒精使用（aOR 2.83；95%CI 1.70，4.73）、与气候相关的疾病（aOR 2.27；95%CI 1.35，3.83）以及心理健康恶化（aOR 2.00；95%CI 1.24，3.24）显著相关，在控制了潜在的混杂因素后。 非自愿搬迁与伤害、肌肉骨骼问题、慢性疾病以及慢性心理和情绪问题之间未发现统计学上显著的关联。
结论
这项研究量化了非自愿搬迁与多种传染性和非传染性健康结果之间的关联。 虽然市政府官员试图应对不断增加的无家可归者露宿街头问题，但了解与当前政策相关的正在发生的危害非常重要。 我们的研究增加了越来越多的关于非自愿搬迁是对无家可归者的一种有害反应的文献。 应优先考虑以住房和社会服务联系为重点的替代方法。
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