Special Issue "Homelessness and Public Health"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: 31 October 2020.

Special Issue Editors

Prof. Dr. Louis Hugo Francescutti
Website
Guest Editor
Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, Canada
Interests: homelessness; homeless patients; injury control; health advocacy; transformational leadership; media advocacy; safety culture assessment; firefighters wellness
Prof. Dr. David A. Sleet
Website
Guest Editor
Emeritus Professor, College of Health and Human Services, San Diego State University, San Diego, CA, USA
Interests: adolescent health/child health; injury and violence
Special Issues and Collections in MDPI journals

Special Issue Information

Dear Colleagues,

On any given night, hundreds of thousands of people are homeless in the United States and Canada, as well as in other developed countries. Globally, the problem is many times worse, making homelessness a global public health and environmental problem.

Homelessness is closely connected to declines in physical and mental health; homeless persons experience high rates of health problems, such as HIV infection, alcohol and drug abuse, mental illness, tuberculosis, and other serious conditions. The health problems facing homeless persons result from various factors, including barriers to healthcare, lack of access to adequate food and protection, and limited resources for social services. Legal and policy interventions have often been used to attempt to address homelessness, although not always from a public health perspective. In healthcare, for example, if someone experiencing homelessness comes to an emergency room with a need for medical aid, the only alternative once treated is to release the patient back onto the street. This creates an endless cycle of emergency room visits, not to mention the challenges patients face in having a successful recovery. The costs are severe, both to the person experiencing homelessness and to the healthcare system.

This Special Issue will explore the public health implications and potential solutions to homelessness, explore emerging research and innovative strategies, and highlight best practices to address homelessness among this key population. In addition to elevating and articulating a clear strategy to reduce homelessness and suggest how to provide more adequate health and housing for this population, authors in this Special Issue will explore solutions for important subpopulations, including young adults, veterans, and those experiencing chronic homelessness.

Prof. Dr. Louis Hugo Francescutti
Prof. Dr. David A. Sleet
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • homelessness and health
  • emergency department care
  • transitional housing
  • poverty and the environment
  • substance abuse and homeless populations
  • living on the street
  • injury and homelessness

Published Papers (7 papers)

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Research

Open AccessArticle
I Felt Safe”: The Role of the Rapid Rehousing Program in Supporting the Security of Families Experiencing Homelessness in Salt Lake County, Utah
Int. J. Environ. Res. Public Health 2020, 17(13), 4840; https://doi.org/10.3390/ijerph17134840 - 05 Jul 2020
Abstract
Homelessness is a public health issue that many organizations are addressing through a Housing First Model. One such organization is The Road Home (TRH), which provides services to homeless individuals and families in Salt Lake County. TRH is perhaps best known for their [...] Read more.
Homelessness is a public health issue that many organizations are addressing through a Housing First Model. One such organization is The Road Home (TRH), which provides services to homeless individuals and families in Salt Lake County. TRH is perhaps best known for their emergency shelters, but the organization also administers the Rapid Rehousing Program (RRHP), designed to help families experiencing homelessness transition back into stable housing. Those experiencing homelessness tend to have high rates of chronic mental/physical disabilities as well as issues related to substance abuse. Having a home is the first step toward achieving some kind of stability in their lives. The RRHP allows families to find housing in the private rental market and will cover the initial costs and several months of rent for clients. While the program has been praised by policymakers and social service providers for helping homeless families find rental housing, there is no empirical research about participant perspectives regarding their residential (in)security. The research question of this article is: what is the role of the RRHP in supporting the security of families experiencing homelessness? Researchers collected qualitative data through focus groups and interviews with 31 participants, 23 families experiencing homelessness, two landlords, six case managers, and service providers. Lastly, we identify recommendations for program improvements based on information gathered from research participants. It is our hope that the information presented in this article can and will be used in a way that improves public health by increasing the residential security of families experiencing homelessness. Full article
(This article belongs to the Special Issue Homelessness and Public Health)
Open AccessArticle
“It’s Just a Band-Aid on Something No One Really Wants to See or Acknowledge”: A Photovoice Study with Transitional Aged Youth Experiencing Homelessness to Examine the Roots of San Diego’s 2016–2018 Hepatitis A Outbreak
Int. J. Environ. Res. Public Health 2020, 17(13), 4721; https://doi.org/10.3390/ijerph17134721 - 30 Jun 2020
Abstract
San Diego, California is consistently ranked among regions with the highest rates of homelessness in the United States. From 2016 to 2018, San Diego experienced an unprecedented outbreak of hepatitis A virus (HAV), largely attributed in media and public health discourse to the [...] Read more.
San Diego, California is consistently ranked among regions with the highest rates of homelessness in the United States. From 2016 to 2018, San Diego experienced an unprecedented outbreak of hepatitis A virus (HAV), largely attributed in media and public health discourse to the region’s growing population of people experiencing homelessness. Little attention, however, was devoted to examining the experiences and needs of this population, particularly transitional aged youth (TAY, aged 18–24) experiencing homelessness who may have been uniquely affected by the outbreak. This community-based participatory research study leveraged diverse qualitative methods, principally photovoice, to explore how the social and built environment shapes health among TAY experiencing homelessness in San Diego, how these environments may have contributed to the HAV outbreak, and TAY’s perceptions of HAV-related public health interventions. Emergent findings include stigmatization of TAY and other people experiencing homelessness, interventions that failed to address root causes of the outbreak, and interactions with housing-related and other social support resources that limit rather than support economic and social mobility. Findings have implications for understanding how media and public discourse, public health interventions, and availability and delivery of resources can contribute to and perpetuate stigma and health inequities faced by TAY experiencing homelessness. Full article
(This article belongs to the Special Issue Homelessness and Public Health)
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Open AccessCommunication
Predictors of Overnight and Emergency Treatment among Homeless Adults
Int. J. Environ. Res. Public Health 2020, 17(12), 4271; https://doi.org/10.3390/ijerph17124271 - 15 Jun 2020
Abstract
High usage of emergency treatment and hospitalization has been reported among homeless individuals. Hence, this study aimed to identify the sociodemographic predictors associated with overnight and emergency hospital treatment among a sample of homeless adults. Participants were recruited from a shelter in Dallas, [...] Read more.
High usage of emergency treatment and hospitalization has been reported among homeless individuals. Hence, this study aimed to identify the sociodemographic predictors associated with overnight and emergency hospital treatment among a sample of homeless adults. Participants were recruited from a shelter in Dallas, Texas (N = 354; Mage = 43.7 ± 11.7) and were predominantly uninsured, low-income men from various racial groups. The outcome variables were: (a) stayed overnight for treatment in a hospital; and (b) treated in a hospital emergency room. In logistic regression models, sex emerged as the only predictor of overnight treatment in a hospital (OR = 2.68, 95% CI = 1.61–4.47), and treatment in an emergency room (OR = 2.21, 95% CI = 1.34–3.65), such that women were more likely than men to be treated overnight and use emergency care. Targeted interventions and policies are needed to address homeless women’s primary care needs and reduce costlier treatment. Full article
(This article belongs to the Special Issue Homelessness and Public Health)
Open AccessCommunication
Association of Problematic Alcohol Use and Food Insecurity among Homeless Men and Women
Int. J. Environ. Res. Public Health 2020, 17(10), 3631; https://doi.org/10.3390/ijerph17103631 - 21 May 2020
Abstract
Food insecurity results from unreliable access to affordable and nutritious food. Homeless adults are particularly vulnerable to both food insecurity and problematic alcohol use. The current study examined the link between problematic alcohol use and food insecurity among homeless adults. Participants (N = [...] Read more.
Food insecurity results from unreliable access to affordable and nutritious food. Homeless adults are particularly vulnerable to both food insecurity and problematic alcohol use. The current study examined the link between problematic alcohol use and food insecurity among homeless adults. Participants (N = 528; 62.7% men; Mage = 43.6 ± 12.2) were recruited from homeless-serving agencies in Oklahoma City. Problematic alcohol use was measured using the Alcohol Quantity and Frequency Questionnaire and the Patient Health Questionnaire. The latter used DSM-IV diagnostic criteria to assess probable alcohol use dependence/abuse. Heavy drinking was considered >7 drinks (women) and >14 drinks (men) per week. Food insecurity was measured with the USDA Food Security Scale-Short Form. The link between alcohol problems and food insecurity was examined with logistic regression analyses controlling for sex, age, education, income, and months homeless. Overall, 28.4% of the sample had probable alcohol dependence, 25% were heavy drinkers, and 78.4% were food insecure. Probable alcohol dependence and heavy drinking were correlated at 0.53 (p < 0.001). Results indicated that heavy drinking (OR = 2.12, CI.95 = 1.21, 3.73) and probable alcohol dependence/abuse (OR = 2.72, CI.95 = 1.55, 4.77) were each associated with increased odds of food insecurity. Food insecurity and problematic alcohol use are major issues among homeless populations; this study suggests they are associated. Future research is needed to shed light on potential causal mechanisms and on whether alcohol may take precedence over eating or food purchases. Full article
(This article belongs to the Special Issue Homelessness and Public Health)
Open AccessArticle
Exploring Tiny Homes as an Affordable Housing Strategy to Ameliorate Homelessness: A Case Study of the Dwellings in Tallahassee, FL
Int. J. Environ. Res. Public Health 2020, 17(2), 661; https://doi.org/10.3390/ijerph17020661 - 20 Jan 2020
Cited by 1
Abstract
An emerging strategy to combat homelessness is the development of “tiny homes”. However, the advent of tiny homes as a new form of housing intervention raises a number of questions about their intentions, efficacy, and policy feasibility. This paper seeks to understand the [...] Read more.
An emerging strategy to combat homelessness is the development of “tiny homes”. However, the advent of tiny homes as a new form of housing intervention raises a number of questions about their intentions, efficacy, and policy feasibility. This paper seeks to understand the strategies used by stakeholders to plan, design, and implement a tiny home community to meet the needs of those experiencing homelessness, and to understand where these plans were effective and where challenges arose in meeting the intended project goals. Utilizing the recent development of Tallahassee’s “The Dwellings” project as a case study, we examine how the community was planned, resident experiences, and constraints to implementing a tiny home development. We use qualitative methods that include interviews with stakeholders who were integral to the planning and development process. Our findings highlight how funding constraints and NIMBYism (Not in My Backyard-ism) stymied stakeholder efforts to achieve equity and affordability at The Dwellings, resulting in the inability to achieve project aims of developing housing that serves the homeless population. We conclude by offering some observations and lessons learned for future research on tiny homes as a solution to ameliorate homelessness. Full article
(This article belongs to the Special Issue Homelessness and Public Health)
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Open AccessArticle
Predictors of Emergency Department Use among Individuals with Current or Previous Experience of Homelessness
Int. J. Environ. Res. Public Health 2019, 16(24), 4965; https://doi.org/10.3390/ijerph16244965 - 06 Dec 2019
Cited by 2
Abstract
This study assessed the contributions of predisposing, enabling, and needs factors in predicting emergency department (ED) use among 270 individuals with current or previous experience of homelessness. Participants were recruited from three different types of housing (shelter, temporary housing and permanent housing) in [...] Read more.
This study assessed the contributions of predisposing, enabling, and needs factors in predicting emergency department (ED) use among 270 individuals with current or previous experience of homelessness. Participants were recruited from three different types of housing (shelter, temporary housing and permanent housing) in Montreal, Quebec (Canada). They were interviewed at baseline (T0), and again 12 months after recruitment (T1). Longitudinal data analyses were conducted on associations between a set of baseline predictors (T0) with the dependent variable (ED users vs. non-users) from T1. Predictors were identified according to the Gelberg–Andersen Behavioral Model. Findings revealed two needs factors associated with ED use: having a substance use disorder (SUD) and low perceived physical health. Two enabling factors, use of ambulatory specialized services and stigma, were also related to ED use. No predisposing factors were retained in the model, and ED use was not associated with type of housing. Improvements are needed in SUD and physical health management in order to reduce ED use, as well as interventions aimed at stigma prevention for this vulnerable population. Full article
(This article belongs to the Special Issue Homelessness and Public Health)
Open AccessArticle
Being at the Bottom Rung of the Ladder in an Unequal Society: A Qualitative Analysis of Stories of People without a Home
Int. J. Environ. Res. Public Health 2019, 16(23), 4620; https://doi.org/10.3390/ijerph16234620 - 21 Nov 2019
Cited by 2
Abstract
Background: Homelessness is rising in the United Kingdom, despite investment in measures to eradicate it made by the government and charity organisations. Aim: The aim is to examine the stories of homeless people in order to document their perceptions of their social status, [...] Read more.
Background: Homelessness is rising in the United Kingdom, despite investment in measures to eradicate it made by the government and charity organisations. Aim: The aim is to examine the stories of homeless people in order to document their perceptions of their social status, the reasons that led to their homelessness, and propose a conceptual explanation. Method: We conducted 26 semi-structured interviews in three centres for homeless people in Cheshire, North West of England. Results: Three categories—education, employment, and health—emerged from the data and provided a theoretical explanation for the reasons that led to their homelessness. These are vital not only for the successful negotiation of one’s way out of homelessness, but also for achieving other social goods, including social connections, social mobility, and engaging in positive social relationships. Conclusion: Participants catalogued the adverse childhood experiences, which they believe limited their capacity to meaningfully engage with the social institution for social goods, such as education, social services, and institutions of employment. Since not all people who have misfortunes of poor education, poor health, and loss of job end up being homeless, we contend that a combination of these with multiple adverse childhood experiences may have weakened their resilience to traumatic life changes, such as loss of job and poor health. Full article
(This article belongs to the Special Issue Homelessness and Public Health)
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