Heffron W A, Skipper B J, Lambert L
Department of Family and Community Medicine, University of New Mexico, Albuquerque 87131-5241, USA.
J Am Board Fam Pract. 1997 Jan-Feb;10(1):6-12.
The objective of this study was to test the hypothesis that there are health and lifestyle issues among homeless persons that differentiate them from other segments of the population and that can be described as risk factors for homelessness.
This case-control study investigated health and lifestyle issues in a panel of patients visiting a health care clinic for homeless persons. The same information was collected from a panel of county indigent patients and an equal number of privately insured patients enrolled in a nearby academic family practice center.
We found significant differences among these three groups. Differences in health problems were evident, as significantly more homeless persons reported mental health, drug and alcohol abuse, and smoking problems. There were no differences in the prevalence of other general medical conditions as listed by the patients. Homeless persons were younger than the control group respondents and more likely to be male, a member of a minority group, and unmarried. The childhood experiences of homeless persons were distinctive; they were more likely to have lived in a group home or some other nonfamily situation, considered themselves to have been delinquent, run away from home, been expelled from school, or been placed in reform school. The same held true for having been in jail as an adult. They had significantly less education, their job experiences were in manual and unskilled arenas, and they were more likely to have a gambling problem. A continuum of risk also appeared in that for the most part the characteristics and experiences of the indigent group members ranked in frequency between those of the homeless and insurance groups.
Causes of homelessness appear to be multifactorial. Issues related to mental health, alcohol, nicotine, and other drug and substance abuse could be responsible for their medical problems, whereas other lifestyle issues might be regarded as risk factors for homelessness.
本研究的目的是检验以下假设：无家可归者存在一些健康和生活方式问题，这些问题使他们有别于其他人群，并且可被描述为导致无家可归的风险因素。
这项病例对照研究调查了一组前往无家可归者医疗诊所就诊的患者的健康和生活方式问题。从一组县贫困患者以及在附近一家学术性家庭医疗中心登记的同等数量的私人保险患者那里收集了相同的信息。
我们发现这三组之间存在显著差异。健康问题的差异很明显，因为有更多无家可归者报告存在心理健康、药物和酒精滥用以及吸烟问题。患者列出的其他一般医疗状况的患病率没有差异。无家可归者比对照组受访者更年轻，更有可能是男性、少数群体成员且未婚。无家可归者的童年经历与众不同；他们更有可能生活在集体之家或其他非家庭环境中，认为自己有过违法行为、离家出走、被学校开除或被送进教养学校。成年后入狱的情况也是如此。他们受教育程度明显较低，工作经历多集中在体力劳动和非技术领域，并且更有可能有赌博问题。一种风险连续体也似乎存在，因为在很大程度上，贫困群体成员的特征和经历在出现频率上介于无家可归者群体和有保险群体之间。
无家可归的原因似乎是多因素的。与心理健康、酒精、尼古丁以及其他药物和物质滥用相关的问题可能导致了他们的医疗问题，而其他生活方式问题可能被视为导致无家可归的风险因素。
