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. 2016 Aug;93(4):666-81.
doi: 10.1007/s11524-016-0065-6.

Residential Stability Reduces Unmet Health Care Needs and Emergency Department Utilization Among a Cohort of Homeless and Vulnerably Housed Persons in Canada

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Residential Stability Reduces Unmet Health Care Needs and Emergency Department Utilization Among a Cohort of Homeless and Vulnerably Housed Persons in Canada

Denise Jaworsky et al. J Urban Health. .
Free PMC article

Abstract

This study examined the association of housing status over time with unmet physical health care needs and emergency department utilization among homeless and vulnerably housed persons in Canada. Homeless and vulnerably housed individuals completed interviewer-administered surveys on housing, unmet physical health care needs, health care utilization, sociodemographic characteristics, substance use, and health conditions at baseline and annually for 4 years. Generalized logistic mixed effects regression models examined the association of residential stability with unmet physical health care needs and emergency department utilization, adjusting for potential confounders. Participants were from Vancouver (n = 387), Toronto (n = 390), and Ottawa (n = 396). Residential stability was associated with lower odds of having unmet physical health needs (adjusted odds ratio (AOR), 0.82; 95 % confidence interval (CI), 0.67, 0.98) and emergency department utilization (AOR, 0.74; 95 % CI, 0.62, 0.88) over the 4-year follow-up period, after adjusting for potential confounders. Residential stability is associated with fewer unmet physical health care needs and lower emergency department utilization among homeless and vulnerably housed individuals. These findings highlight the need to address access to stable housing as a significant determinant of health disparities.

Keywords: Emergency department utilization; Homeless; Housing.

Figures

FIG. 1
FIG. 1
Unmet physical health care needs over the last 12 months by residential stability by city and follow-up among health and housing in transition participants: Vancouver, Toronto, and Ottawa, 2009–2013.
FIG. 2
FIG. 2
Unmet physical health care needs over the last 12 months of health and housing in transition participants who achieved or did not achieve residential stability at all five assessment points: Vancouver, Toronto, and Ottawa, 2009–2013. This plot includes only those participants who completed all four follow-up surveys and who either achieved residential stability at all five assessment points (n = 47) or at none of the assessment points (n = 83).
FIG. 3
FIG. 3
Percent of participants having received care from an emergency department by residential-stability status (breakdown by city and follow-up period): Vancouver, Toronto, and Ottawa, 2009–2013.

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