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Results for “Homeless Persons”

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PubMed2001

Dietary inadequacies observed in homeless men visiting an emergency night shelter in Paris.

OBJECTIVE: To assess the dietary intake and the nutritional status of homeless men. SETTING: A night emergency shelter in Paris, France. DESIGN: Dietary survey (48-h) including alcohol intake and a questionnaire on age, duration of homelessness, smoking habits. Subjects were also weighed and measured. SUBJECTS: Ninety-seven men aged 18-72 years (mean 43.3), of whom 54% were homeless for more than 18 months, 82% were smokers and 53% were regular and/or excessive drinkers. RESULTS: The BMI distribution was shifted towards low values, the percentage of wasted persons being four times higher than in the reference population. The mean total energy intake was 2376 kcal and included a high and highly variable percentage of energy derived from alcohol (12.0% Among drinkers, the mean ethanol intake was 90 g and there was a significant negative correlation between ethanol and non-alcoholic energy intakes. The median intakes of potassium, calcium, zinc, vitamins B1, B2, and niacin were lower than European Population Reference Intakes but only the mean intake of vitamin B1 was significantly lower. Eighty percent of non-alcoholic energy was provided by charitable organisations. For most nutrients, the nutritional density of the shelter ration was not significantly different from the density of the foods purchased by the homeless. CONCLUSIONS: These data suggest that the content of some nutrients should be increased in existing food assistance programs for homeless people in France.

Adolescent↗
PubMed1998

[Social characteristics of patients in penitentiaries++].

Three hundred and forty five convicted patients with tuberculosis underwent sociohygienic examinations. Among the examinees, the disease was first detected in 74.2% in a reformatory, in 25.8% in an investigating cell. The persons who fell ill with tuberculosis in places of confinement were mainly young, their ages ranged from 20 to 39 years. Only every 4 patients with tuberculosis are condemned for the first time, more than half the patients have over 3 convictions and every 5 patients have over 5 convictions. The most socially disadapted individuals fall ill with tuberculosis in the reformatory; among the examinees, 7.6% were homeless before conviction. The overwhelming majority of the convicts had no social contacts: 52.2% were never married. The study ascertained that in addition to the negative social environment, some criminogenic, personal, and behavioral factors of this contingent predispose to tuberculosis.

Adult↗
PubMed1997

Mental illness in homeless women: an epidemiological study in Munich, Germany.

In an epidemiological survey of the prevalence of mental illness in homeless individuals in Munich, Germany, a probability sample of 32 homeless women were interviewed using a standardized diagnostic instrument (Diagnostic Interview Schedule for DSM-III diagnoses). Results point to very high prevalence rates of mental disorders among homeless women. The most frequent diagnostic groups were alcohol and drug abuse (lifetime prevalence rate 90.6%), affective disorders (50.0%), anxiety disorders (43.8%) and schizophrenia (21.9%). Prevalence rates are compared with a female household sample (Epidemiological Catchment Area Study in New Haven, Connecticut). All disorders tended to be more frequent in homeless women as compared with the household sample. Our results show the urgent need to provide medical and other assistance to homeless women. There is a need for adequate psychiatric care, supply with food and housing and the development of concepts for personal and vocational rehabilitation considering the specific needs of women.

Adolescent↗
PubMed1986

The homeless mentally ill in the general hospital: a question of fit.

The evolution of general hospital psychiatry and the growth of the homeless mentally ill population in the United States have coincided temporally. Although the two have many points of confluence, their interaction has largely been of a last-resort variety, sometimes occurring by default and rarely adequately planned. The general hospital psychiatric unit has an important role to play in serving the homeless mentally ill--a role that is consonant with its mission of providing care to individuals whose service needs include special treatment interventions in short-term settings. That role may be most effectively implemented in a pluralistic service system, where the general hospital psychiatric unit is one of many facilities responding appropriately, but differentially, to the needs of individual members of the homeless mentally ill population.

Delivery of Health Care↗
PubMed1991

Homeless women with children. The role of alcohol and other drug abuse.

For some women with children, alcohol and other drug use may be an important risk factor for homelessness because it may interfere with a woman's capacity to compete for scarce resources such as housing, employment, or services. The impact of various policy decisions on homeless women, their dependent children, and the family unit is considered, including women's right to privacy, criminalization of drug use, and scarcity of appropriate treatment programs for homeless women.

Adult↗
PubMed1997

Losing the housing game. The leveling effects of substance abuse.

Analysis of the housing dynamics and individual characteristics of a sample of 670 participants in the New Orleans Homeless Substance Abusers Program reveals substantial diversity with respect to income, education, and occupational attainment. Nevertheless, drug consumption and dependence serve as socioeconomic levelers, dissolving otherwise potentially critical differences in human-capital and economic capacities. The need to focus concurrently on both structural and individual causes of homelessness is emphasized.

Employment↗
PubMed2002

Social context of work injury among undocumented day laborers in San Francisco.

OBJECTIVE: To identify ways in which undocumented day laborers' social context affects their risk for occupational injury, and to characterize the ways in which these workers' social context influences their experience of disability. DESIGN: Qualitative study employing ethnographic techniques of participant-observation, supplemented by semistructured in-depth interviews. SETTINGS: Street corners in San Francisco's Mission District, a homeless shelter, and a nonprofit day labor hiring hall. PARTICIPANTS: Thirty-eight Mexican and Central American male day laborers, 11 of whom had been injured. PRIMARY THEMES: Anxiety over the potential for work injury is omnipresent for day laborers. They work in dangerous settings, and a variety of factors such as lack of training, inadequate safety equipment, and economic pressures further increase their risk for work injury. The day laborers are isolated from family and community support, living in a local context of homelessness, competition, and violence. Injuries tend to have severe emotional, social, and economic ramifications. Day laborers frequently perceive injury as a personal failure that threatens their masculinity and their status as patriarch of the family. Their shame and disappointment at failing to fulfill culturally defined masculine responsibilities leads to intense personal stress and can break family bonds. Despite the high incidence of work injuries and prevalence of work-related health conditions, day laborers are frequently reluctant to use health services due to anxiety regarding immigration status, communication barriers, and economic pressure. IMPLICATIONS: On the basis of these ethnographic data, we recommend strategies to improve ambulatory care services to day laborers in 3 areas: structural changes in ambulatory care delivery, clinical interactions with individual day laborers, and policymaking around immigration and health care issues.

Accidents, Occupational↗
PubMed2004

Hepatitis C virus infection in San Francisco's HIV-infected urban poor.

OBJECTIVE: To measure Hepatitis C Virus (HCV) prevalence, incidence, and initiation of HCV therapy in a representative HIV-infected cohort of the urban poor. DESIGN: Cohort analysis. SETTING: The Research and Access to Care for the Homeless (REACH) Cohort is a systematic sample of HIV-infected marginally housed individuals identified from single-room occupancy hotels, homeless shelters, and free lunch programs in San Francisco. PARTICIPANTS: Two hundred forty-nine participants with 28.9 months (median) of follow-up were studied. Mean age was 44 (range 24 to 75, standard deviation 8.4) years. Eighty-two percent were male, 43% were African-American, 64% were lifetime injection drug users, and 24% had been on the street or in a shelter in the prior month. INTERVENTIONS: We measured HCV testing and treatment history with structured interviews; additionally, participants were tested for HCV antibodies (EIA-2) with RNA viral load confirmation. MAIN RESULTS: At baseline, 172 (69.1%) were HCV-positive and 182 (73.1%) were HCV-positive at follow-up, including 155 (62.2%) with viremia. HCV-positive status was associated with having injected drugs, elevated serum alanine aminotransferase, homelessness in the last 1 year, and more severe depressive symptoms. The incidence of new HCV infection was 4.63% per person-year (ppy; 95% confidence interval, 2.31 to 8.13) in the entire cohort and 16.77% ppy among injection drug users. The prevalence of HCV antibody-negative HCV-viremia was 13.2% (10/76). Nonwhites were less likely to receive HCV testing and subspecialty referral, controlled for drug use and other confounders. Sixty-eight percent (123/182) were aware treatment was available; however, only 3.8% (7/182) or 1.16% ppy received HCV treatment. CONCLUSIONS: While HCV infection is common, HCV treatment is rare in the HIV-HCV coinfected urban poor. Urban poor, nonwhite individuals are less likely to receive HCV testing and subspecialty referral than their white counterparts. Antibody-negative infection may complicate screening and diagnosis in HIV-infected persons. J

Adult↗
PubMed1992

Treatment issues and treatment configurations for mentally ill homeless women.

This article reviews and discusses various issues pertinent to effective delivery of treatment services to mentally ill homeless women. The central emphasis is upon the gender-specific issues unique to this population and includes attention to distinctive features of effective case management, utilization of group therapy techniques, and greater integration of the psychiatrist into the treatment team. The article concludes with a discussion of the future issues relevant to community based services to homeless mentally ill women.

Female↗