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Publication Date: 2013
Health care office staff and providers may discriminate against people of low socioeconomic status, even in the absence of economic incentives to do so. We sought to determine whether socioeconomic status affects the response a patient receives when seeking a primary care appointment. <b>Methods:</b> In a single unannounced telephone call to a random sample of family physicians and general practices (n = 375) in Tor...
Publication Date: 2013
<i>Background </i> Homeless persons experience excess mortality, but US-based studies on this topic are outdated or lack information about causes of death. To our knowledge, no studies have examined shifts in causes of death for this population over time. <i>Methods </i> We assessed all-cause and cause-specific mortality rates in a cohort of 28 033 adults 18 years or older who were seen a...
Publication Date: 2012
Although lack of housing is linked with adverse health outcomes, little is known about the impacts of the qualitative aspects of housing on health. This study examined the association between structural elements of housing, housing affordability, housing satisfaction and health-related quality of life over a 1-year period. Participants were 509 individuals living with HIV in Ontario, Canada. Regression analyses were conducted to examine relations...
Publication Date: 2012
The At Home/Chez Soi (AH/CS) Project is a randomized controlled trial of a Housing First intervention to meet the needs of homeless individuals with mental illness in five cities across Canada. The objectives of this paper are to examine the approach to participant recruitment and community engagement at the Toronto site of the AH/CS Project, and to describe the baseline demographics of participants in Toronto.
Methods
Homeless individuals (n = 5...
Publication Date: 2012
Objectives: This study aimed to assess the oral health status of the Toronto adult homeless population; to learn how they perceive their own oral health; and to correlate the presence of oral disease with length of homelessness and unemployment.
Methods: This cross-sectional descriptive study collected data from 191 homeless adults who were randomly selected using a stratified cluster sample at 18 shelters. A questionnaire and clinical oral ex...
Publication Date: 2012
This study examines differences in services available at the time of discharge for homeless and housed psychiatric inpatients. Participants diagnosed with schizophrenia or schizoaffective disorder were recruited from a general hospital psychiatric inpatient unit. Thirty homeless individuals and 21 housed controls (matched for diagnosis, gender, and age) completed a questionnaire and clinical interview. Data on discharge services were extracted fr...
Publication Date: 2012
Homeless and marginally housed persons who use alcohol and/or illicit drugs often have endof- life care needs that go unmet due to barriers that they face to accessing end-of-life careservices. Many homeless and marginally housed persons who use these substances must therefore rely upon alternate sources of end-of-life care and support. This article explores the role of harm reduction services in end-of-life care services delivery to homeless and...
Publication Date: 2011
In this study, cognitive interviewing methods were used to test targeted questionnaire items from a battery of quantitative instruments selected for a large multisite trial of supported housing interventions for homeless individuals with mental disorders. Most of the instruments had no published psychometrics in this population. Participants were 30 homeless adults with mental disorders (including substance use disorders) recruited from service a...
Publication Date: 2012
The purpose of this article was to review the current literature on subjective quality of life (SQOL) in individuals who are homeless, with a focus on differences in SQOL (a) between homeless individuals and the general population, (b) based on housing situation, and (c) associated with demographic characteristics (such as age and gender), physical and mental health, and external variables such as service program type. A literature search was con...
Publication Date: 2004
Although the health impact of patients’ trust in physicians has been well documented, less is known about the possible health effects of trust in police or paramedics. Homeless people frequently interact with police officers and paramedics, and these experiences may affect their health and future willingness to seek emergency assistance. We examined homeless people’s self-reported interactions with police and paramedics in Toronto, Canada, and t...
Publication Date: 2007
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Publication Date: 2011
Housing Vulnerability and Health: Canada's Hidden Emergency: Dr. Stephen Hwang, Associate Professor, Department of Medicine and Director of the Division of General Internal Medicine, University of Toronto & Research Scientist, Centre for Research on Inner City Health, St. Michael's Hospital, Toronto.
Publication Date: 2011
Dr. Hwang describes how his work with homeless men in the downtown Toronto community around the Li Ka Shing Knowledge Institute influences his research into healthcare and other issues facing disadvantaged populations.
Publication Date: 2011
Dr. Stephen Hwang explains "Housing First", a simple and effective way to help people who are homeless and living with mental health problems.
The Centre for Research on Inner City Health (CRICH) is part of a national study to demonstrate how well "Housing First" works in Canada. Learn more about the project and participants' experiences here.
This video is part of CRICH's "Let's Get Talking: Social Innovation, Equity and Health" series.
CRI...
Publication Date: 2011
While substantial research has demonstrated the poor health status of homeless populations, the health status of vulnerably housed individuals is largely unknown. Furthermore, few longitudinal studies have assessed the impact of housing transitions on health. The health and housing in transition (HHiT) study is a prospective cohort study that aims to track the health and housing status of a representative sample of homeless and vulnerably housed...
Publication Date: 2011
Objective: To compare the Household Food Insecurity Access Scale (HFIAS), the US Food Security Survey Module (US FSSM) and a modified version of the US FSSM in which references to buying food were changed to references to getting food, in terms of their classification of food security levels among homeless individuals, and to determine which of these instruments was most preferred by homeless individuals.
Design: A cross-sectional survey.
Setting...
Publication Date: 2011
Background: Little information is available on the problem of chronic pain among homeless individuals. This study aimed to describe the characteristics of and treatments for chronic pain, barriers to pain management, concurrent medical conditions, and substance use among a representative sample of homeless single adult shelter users who experience chronic pain in Toronto, Canada.
Methods: Participants were randomly selected at shelters for single...
Publication Date: 2011
<br /><b>Objectives: </b>Aboriginal Canadians (i.e., First Nations, Inuit and Métis) are disproportionately affected by HIV/AIDS, and experience greater social and economic marginalization and poorer housing conditions. This study sought to understand the differences in the determinants of health and housingrelated characteristics between samples of Aboriginal and Caucasian adults living with HIV...
Publication Date: 2011
Background: Despite experiencing a disproportionate burden of acute and chronic health issues, many homeless people face barriers to primary health care. Most studies on health care access among homeless populations have been conducted in the United States, and relatively few are available from countries such as Canada that have a system of universal health insurance. We investigated access to primary health care among a representative sample of...
BACKGROUND The effectiveness of HAART is shown by an extraordinary decrease in mortality rate, improvement in HIV related quality of life (QOL) and increase in life expectancy. As a result, many people living with HIV/AIDS will age in coming years. However, the interaction of aging with health outcomes in HIV is largely unexplored in Canada. Yet, it is a critical priority for long-term care and management for older people with HIV.