A cross-sectional observational study of unmet health needs among homeless and vulnerably housed adults in three Canadian cities

BMC Public Health

Stephen W Hwang⁴  Fran Klodawsky²  Anita Palepu³  Susan Farrell¹  Evie Gogosis⁴  Catharine Chambers⁴  Niran Argintaru⁴ 

[1] Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada;School of Geography and Environmental studies, Carlton University, Ottawa, ON, Canada;Department of Medicine, University of British Columbia, Vancouver, BC, Canada;Centre for Research on Inner City Health, Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada

关键词: Public health policy;    Primary care;    Housing;    Homelessness;    Access to care;   

Others  :  1162105
DOI  :  10.1186/1471-2458-13-577

 received in 2012-09-14, accepted in 2013-05-28,  发布年份 2013

【 摘 要 】

Background

Homeless persons experience a high burden of health problems; yet, they face significant barriers in accessing health care. Less is known about unmet needs for care among vulnerably housed persons who live in poor-quality or temporary housing and are at high risk of becoming homeless. The objectives of this study were to examine the prevalence of and factors associated with unmet needs for health care in a population-based sample of homeless and vulnerably housed adults in three major cities within a universal health insurance system.

Methods

Participants were recruited at shelters, meal programs, community health centers, drop-in centers, rooming houses, and single room occupancy hotels in Vancouver, Toronto, and Ottawa, Canada, throughout 2009. Baseline interviews elicited demographic characteristics, health status, and barriers to health care. Logistic regression was used to identify factors associated with self-reported unmet needs for health care in the past 12 months.

Results

Of the 1,181 participants included in the analysis, 445 (37%) reported unmet needs. In adjusted analyses, factors associated with a greater odds of reporting unmet needs were having employment in the past 12 months (AOR = 1.40, 95% CI = 1.03–1.91) and having ≥3 chronic health conditions (AOR = 2.17, 95% CI = 1.24–3.79). Having higher health-related quality of life (AOR = 0.21, 95% CI = 0.09–0.53), improved mental (AOR = 0.97, 95% CI = 0.96–0.98) or physical health (AOR = 0.98, 95% CI = 0.96–0.99), and having a primary care provider (AOR = 0.63, 95% CI = 0.46–0.85) decreased the odds of reporting unmet needs.

Conclusions

Homeless and vulnerably housed adults have a similar likelihood of experiencing unmet health care needs. Strategies to improve access to primary care and reduce barriers to accessing care in these populations are needed.

【 授权许可】

   
2013 Argintaru et al.; licensee BioMed Central Ltd.

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