Agnes Stenius-Ayoade1,2,3, Peija Haaramo4, Hannu Kautiainen1,5,6, Sanna Sunikka3,7, Mika Gissler8,9,10, Kristian Wahlbeck11, Johan G Eriksson1,5,12. 1. Folkhälsan Research Center, Helsinki, Finland. 2. National Institute for Health and Welfare, Mental Health Unit, Helsinki, Finland. 3. Department of Social Services and Health Care, City of Helsinki, Helsinki, Finland. 4. National Institute for Health and Welfare, Public Health Promotion Unit, Helsinki, Finland. 5. Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland. 6. Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland. 7. The Finnish Foundation for Supporting Ex-Offenders, Helsinki, Finland. 8. Information Services Department, National Institute for Health and Welfare, Helsinki, Finland. 9. Research Centre for Child Psychiatry, University of Turku, Turku, Finland. 10. Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden. 11. The Finnish Association for Mental Health, Helsinki, Finland. 12. National Institute for Health and Welfare, Chronic Disease Prevention Unit, Helsinki, Finland.
Abstract
Background: Homelessness is associated with increased mortality, morbidity and social difficulties and periods of homelessness are sometimes prolonged or repeated. However, there are no long-term follow-up studies focusing upon housing status among homeless people. The aim of this study was to examine morbidity and housing outcomes and to identify factors predicting being independently housed 10 years after shelter use. Methods: By combining data from several registers we followed all 552 homeless men who stayed in shelter in Helsinki during 2004 and determined their housing situation and morbidity 10 years later. Their situation was compared with an age-matched control group from the general population (N = 946). Using logistic regression analysis, we assessed the predictive effects of socioeconomic factors and health service use at baseline on becoming independently housed. Results: By the end of the follow-up 52.0% of the formerly homeless study group had died, compared with 14.6% of the controls. At 10 years, 6.0% were independently housed, 37.5% lived in supported housing and 4.5% were still or again homeless. Psychiatric disorders, including substance use disorder, were present in 77.5% of the homeless, compared with 16.1% among the controls. Being married (OR 8.3, 95% CI 3.0 to 23.2) and having less than four shelter nights in year 2004 (OR 9.1, 95% CI 2.7 to 30.8) strongly predicted being independently housed 10 years later. Conclusions: Homeless staying in shelters have high mortality and morbidity and most of those surviving, are in need of support in their everyday lives even years after the shelter period.
Background: Homelessness is associated with increased mortality, morbidity and social difficulties and periods of homelessness are sometimes prolonged or repeated. However, there are no long-term follow-up studies focusing upon housing status among homeless people. The aim of this study was to examine morbidity and housing outcomes and to identify factors predicting being independently housed 10 years after shelter use. Methods: By combining data from several registers we followed all 552 homeless men who stayed in shelter in Helsinki during 2004 and determined their housing situation and morbidity 10 years later. Their situation was compared with an age-matched control group from the general population (N = 946). Using logistic regression analysis, we assessed the predictive effects of socioeconomic factors and health service use at baseline on becoming independently housed. Results: By the end of the follow-up 52.0% of the formerly homeless study group had died, compared with 14.6% of the controls. At 10 years, 6.0% were independently housed, 37.5% lived in supported housing and 4.5% were still or again homeless. Psychiatric disorders, including substance use disorder, were present in 77.5% of the homeless, compared with 16.1% among the controls. Being married (OR 8.3, 95% CI 3.0 to 23.2) and having less than four shelter nights in year 2004 (OR 9.1, 95% CI 2.7 to 30.8) strongly predicted being independently housed 10 years later. Conclusions: Homeless staying in shelters have high mortality and morbidity and most of those surviving, are in need of support in their everyday lives even years after the shelter period.
Authors: Ruth Yoo; Noa Krawczyk; Eileen Johns; Ryan P McCormack; John Rotrosen; Tod Mijanovich; Lillian Gelberg; Kelly M Doran Journal: Subst Abus Date: 2022 Impact factor: 3.984