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Association Between Time Homeless and Perceived Health Status Among The Homeless in San Francisco

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Abstract

The purpose of this study was to describe the perceived health of the homeless, and to measure the effect of time homeless on perceived health status, after controlling for sociodemographic characteristics and health conditions. The design was cross-sectional; the population was a representative sample of homeless in San Francisco, interviewed on health issues. Analysis of predictors of poor or fair health status was by logistic regression. In this sample of 2780 persons, 37.4% reported that their health status was poor or fair as compared to good or excellent. Reporting poor or fair health status was significantly associated with time homeless, after controlling for sociodemographic variables and health problems including results from screening for HIV and TB (OR = 1.49, 95%CI 1.24–1.79). Comparisons with data from the National Health Interview Survey (NHIS) showed poorer health status among the homeless persons in this study. Standardized morbidity ratios were highest for asthma; there was twice the number of homeless persons reporting asthma, in younger as well as older adults, as would be expected using NHIS rates. There was also an excess of arthritis, high blood pressure and diabetes in those age 18–44 as compared to adults in the Health Interview Survey. The time spent homeless remains associated with self-reported health status, after known contributors to poor health are controlled. Persons who have been homeless for longer periods of time may be the persons to whom health care interventions should be aimed.

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REFERENCES

  1. Winkelby MA. Comparison of risk factors for ill health in a sample of homeless and nonhomeless poor. Public Health Rep. 1990; 105:404–410.

    Google Scholar 

  2. Roth D, Bean J. New perspectives on homelessness: Findings from a statewide epidemiological study. Hosp Commun Psychiatry. 1986; 37:712–719.

    Google Scholar 

  3. Robertson MJ, Cousineau MR. Health status and access to health services among the urban homeless. Amer J Public Health. 1986; 76:561–563.

    Google Scholar 

  4. Linn LS, Gelberg L. Priority of basic needs among homeless adults. Psych Epidemiol 1989; 32: 33–48.

    Google Scholar 

  5. Breakey WR, Fischer PJ, Kramer M, et al. Health and mental problems of homeless men and women in Baltimore. J Amer Med Assoc 1989; 262:1352–1357.

    Google Scholar 

  6. Stephens D, Dennis E, Toomer M, Holloway J. The diversity of case management needs for the care of homeless persons. Public Health Rep. 1991; 106: 15–19.

    Google Scholar 

  7. Hibbs JR et al. Mortality in a cohort of homeless adults in Philadelphia. New Engl J Med 1994; 331: 304–309.

    Google Scholar 

  8. Stewart AL, Greenfield S, Hays RD, Wells K, et al. Functional status and well-being of patients with chronic conditions. J Amer Med Assoc 1989; 262:907–913.

    Google Scholar 

  9. Hennessy CH, Moriary DG, Zack MM, Scherr PA, Brackbill R. Measuring health-related quality of life for public health surveillance. Public Health Rep 1994; 109:665–672.

    Google Scholar 

  10. Stewart AL, Hays RD, Ware JE. The MOS short-form general health survey: reliability and validity in a patient population. Med Care. 1988;26:724–735.

    Google Scholar 

  11. Ware JE, Sherbourne CD, Davies AR, Stewart AL. The MOS Short-Form General Health Survey: Development and Test in a General Population. Santa Monica, CA: The Rand Corp; 1988. Publication P-7444.

    Google Scholar 

  12. Zolopa AR, Hahn JA, Gorter R, et al. HIV and tuberculosis infection in San Francisco's homeless adults: Prevalence and risk factors in a representative sample. J Amer Med Assoc 1994; 272:455–461.

    Google Scholar 

  13. Burnham MA, Koegel P. Methodology for obtaining a representative sample of homeless persons: The Los Angeles Skid Row Study. Eval Rev 1988; 12: 117–152.

    Google Scholar 

  14. Ewing JA. Detecting alcoholism: the CAGE questionnaire. J Amer Med Assoc 1984; 252: 1905–1907.

    Google Scholar 

  15. National Center for Health Statistics (US DHHS). Design and estimation for the NHIS, 1985–1994. Vital and Health Statistics Series 2, no. 110, 1994.

  16. Hennekins CH, Buring JE. Epidemiology in Medicine. Boston: Little, Brown & Co., 1987.

    Google Scholar 

  17. Gardner MJ, Altman DG. Statistics with Confidence. London; British Medical Journal, 1989.

    Google Scholar 

  18. Hosmer DW, Lemeshow SL. Applied Logistic Regression. New York; Wiley & Sons, 1989.

    Google Scholar 

  19. Annis HM. Self-report reliability of skid-row alcoholics. Br J Psychiatry. 1979;134:459–465.

    Google Scholar 

  20. Shanks NJ. Consistency of data collected from inmates of a common lodging house. J Epidemiol Community Health. 1981;35:133–135.

    Google Scholar 

  21. Ritchey FJ, LaGory M, Mullis J. Gender differences in health risks and physical symptoms among the homeless. J Health Soc Beh 1991; 32:33–48.

    Google Scholar 

  22. Gelberg L, Linn LS, Usatine RP, Smith MH. Health, homelessness, and poverty. Arch Intern Med 1990; 150:2325–2330.

    Google Scholar 

  23. Ropers RH, Boyer R. Perceived health status among the new urban homeless. Soc Sci Med 1987; 24:669–678.

    Google Scholar 

  24. Health-related quality of life measures—United States, 1993. Morbid Mortal Weekly Rep 1995; 44:195–200.

    Google Scholar 

  25. Gottlieb DJ, Beiser AS, O'Connor GT. Poverty, race, and medication use are correlates of asthma hospitalization rates. Chest 1995; 108:28–35.

    Google Scholar 

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White, M.C., Tulsky, J.P., Dawson, C. et al. Association Between Time Homeless and Perceived Health Status Among The Homeless in San Francisco. Journal of Community Health 22, 271–282 (1997). https://doi.org/10.1023/A:1025152403545

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  • DOI: https://doi.org/10.1023/A:1025152403545

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