Competing priorities as a barrier to medical care among homeless adults in Los Angeles

Am J Public Health. 1997 Feb;87(2):217-20. doi: 10.2105/ajph.87.2.217.


Objectives: The role of competing priorities as a barrier to the utilization of physical health services was assessed in a subset (n = 363) of a probability sample of homeless adults in Los Angeles.

Methods: Unadjusted odds of four measures of health services utilization were calculated for those with frequent difficulty in meeting their subsistence needs. These odds were then adjusted for a range of characteristics assumed to affect the utilization of health services among the homeless.

Results: Before and after adjustment, those with frequent subsistence difficulty were less likely to have a regular source of care (odds ratio [OR] = 0.30, 95% confidence interval [CI] = 0.16, 0.53) and more likely to have gone without needed medical care (OR = 1.77, 95% CI = 1.04, 3.00). Subsistence difficulty had no impact on the likelihood of having an outpatient visit or having been hospitalized. Conclusions remained the same after adjustment.

Conclusions: Frequent subsistence difficulty appears to be an important nonfinancial barrier to the utilization of health services perceived as discretionary among homeless adults.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Health Priorities
  • Health Services / statistics & numerical data*
  • Health Status
  • Humans
  • Ill-Housed Persons*
  • Los Angeles / epidemiology
  • Male
  • Patient Acceptance of Health Care*
  • Probability