Care-seeking correlates of acute respiratory illness among sheltered adults experiencing homelessness in Seattle, WA, 2019: a community-based cross-sectional study

Frontiers in Public Health

Public Health

Stephen E. Hawes¹  Caitlin R. Wolf²  Helen Y. Chu²  Julia H. Rogers³  Janet A. Englund⁴  James P. Hughes⁵  Lea M. Starita⁶ 

[1] Department of Epidemiology, University of Washington, Seattle, WA, United States;Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, United States;Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, United States;Department of Epidemiology, University of Washington, Seattle, WA, United States;Division of Pediatric Infectious Diseases, Department of Pediatrics, Seattle Children’s Research Institute, University of Washington, Seattle, WA, United States;Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States;Department of Biostatistics, University of Washington, Seattle, WA, United States;Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States;Department of Genome Sciences, University of Washington, Seattle, WA, United States;

关键词: health care utilization;    respiratory virus infection;    homeless shelters;    cross-sectional study;    predictors of interest;   

DOI  :  10.3389/fpubh.2023.1090148

 received in 2022-11-07, accepted in 2023-05-15,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveMultifarious barriers to accessing healthcare services among people experiencing homelessness (PEH) lead to delays in seeking care for acute infections, including those caused by respiratory viruses. PEH are at high risk of acute respiratory illness (ARI)-related complications, especially in shelter settings that may facilitate virus spread, yet data characterizing healthcare utilization for ARI episodes among sheltered PEH remained limited.MethodsWe conducted a cross-sectional study of viral respiratory infection among adult residents at two homeless shelters in Seattle, Washington between January and May 2019. We assessed factors associated with seeking medical care for ARI via self-report. We collected illness questionnaires and nasal swabs were tested for respiratory viruses by reverse transcription quantitative real-time PCR (RT-qPCR).ResultsWe observed 825 encounters from 649 unique participants; 241 (29.2%) encounters reported seeking healthcare for their ARI episode. Seasonal influenza vaccine receipt (adjusted prevalence ratio [aPR] 1.39, 95% CI 1.02–1.88), having health insurance (aPR 2.77, 95% CI 1.27–6.02), chronic lung conditions (aPR 1.55, 95% CI 1.12-2.15), and experiencing influenza-like-illness symptoms (aPR 1.63, 95% CI 1.20 - 2.20) were associated with increased likelihood of seeking care. Smoking (aPR 0.65, 95% CI 0.45-0.92) was associated with decreased likelihood of seeking care.DiscussionFindings suggest that care seeking for viral respiratory illness among PEH may be supported by prior engagement with primary healthcare services. Strategies to increase healthcare utilization may lead to earlier detection of respiratory viruses.

【 授权许可】

Unknown   
Copyright © 2023 Rogers, Hawes, Wolf, Hughes, Englund, Starita and Chu.