ObjectivesTo describe COVID-19 vaccine coverage (i.e., the estimated percentage of people who have received a vaccine) and determinants of vaccine receipt among individuals with a recent experience ...of homelessness in Ontario, Canada.
ApproachWe conducted a retrospective, population-based cohort study of 23,247 individuals (≥18 years) with a recent experience of homelessness as recorded in routinely collected healthcare databases. Participants were followed from December 14, 2020 to September 30, 2021 for the receipt of a COVID-19 vaccine. Using modified Poisson regression, we identified sociodemographic, healthcare usage, and clinical factors associated with the receipt of one or more doses of a COVID-19 vaccine.
ResultsBy September 30, 14,271 (61.4%) of participants with a recent experience of homelessness had received a first dose of a COVID-19 vaccine and 11,082 (47.7%) had received two doses. Over the same period, 86.6% and 81.6% of the total adult population of Ontario had received a first dose and second dose, respectively. In multivariable analysis, factors associated with increased COVID-19 uptake included ≥1 visit to a general practitioner (adjusted Risk Ratio aRR:1.3795% CI 1.31-1.42), older age (vs. 18-29 years: 50-59 years, aRR:1.181.14-1.22; 60+ years, aRR:1.271.22-1.31), receipt of an influenza vaccine (aRR:1.251.23-1.28), receipt of ≥1 SARS-CoV-2 test (aRR:1.231.20-1.26) and the presence of chronic health conditions (vs. 0 conditions: 1 condition, aRR:1.051.03, 1.08; 2+ conditions, aRR:1.111.08-1.14). In contrast, living in a smaller metropolitan region (aRR:0.920.90-0.94) or rural location (aRR:0.930.90-0.97) compared to a large metropolitan region was associated with lower uptake.
ConclusionsAs of September 30, 2021, COVID-19 vaccine coverage among individuals with a recent experience of homelessness in Ontario was substantially lower than the general adult population of Ontario for a first and second dose. Findings underscore the importance of leveraging organizations that are accessed and trusted by people who experience homelessness for targeted vaccine delivery.
ObjectivesAdministrative data linkage is relatively under-utilised as a way of generating evidence to guide homelessness policy and service delivery in the UK. Our objective is to contribute insight ...into the ethical, legal, and practical challenges of using data linkage with data from people experiencing homelessness (PEH).
ApproachWe outline the data collection and linkage methodologies for two UK-based studies related to PEH. The first design aimed to explore the acceptability and feasibility of consented linkage of trial data (‘Moving On’ trial) to NHS Digital records in a cohort of recruited PEH in two English local authorities (n=50). The second design used administrative data originating from a local authority homelessness service in Wales (n=17,000 cases) to explore educational outcomes of children in homeless households. The resultant data linkage rates are contrasted and discussed in relation to the mechanisms for obtaining and linking personal data.
ResultsThe Moving On trial demonstrated high rates of consent for data linkage and the ability to collect sufficient personal identifiable data to increase the chance of successful matching. Aggregate match rates will be discussed. Of the roughly 17,000 cases included in the local authority administrative data, 75% could be linked to unique individuals using probabilistic matching and were therefor ‘useable’ in linkage research. The proportion of useable cases rapidly decreased as the cut-off for matching quality was increased, to roughly 50% of cases being useable when a 99% match probability cut-off was used. Matching rates were higher amongst priority need homeless cases, possibly reflecting business need to identify and work closely with these people.
ConclusionWhere homelessness administrative data systems are not designed to enable data linkage, low matching rates can result, reducing study sample sizes and potentially leading to bias towards more extreme cases of homelessness if missed-matches are not random. Consented linkage within large-scale trials offers one possibility for generating long-term evidence.
The Escape from Poverty De Schutter, Olivier; Frazer, Hugh; Guio, Anne-Catherine ...
10/2023
eBook
Open access
ePDF and ePUB available Open Access under CC-BY-NC-ND license.
The perpetuation of poverty across generations damages lives. It weakens social cohesion and the economy and undermines environmental ...sustainability. This book examines why poverty is carried on from one generation to the next and what needs to be done to eradicate it.
This book draws on a wide variety of sources and academic disciplines (social sciences, economics, law, community development, neuroscience and developmental psychology) along with the lived experience of people in poverty. Challenging the myths and prejudices about poverty that hinder progress, it calls for a comprehensive approach based on ensuring real equality of opportunity for all. It stresses the need to intervene early to combat child poverty and break the vicious cycles that perpetuate poverty and disadvantage.
LGBTQ+ youth in out-of-home care experience multiple stressors due to being a minority group, in out-of-home care, and rejected by their families. Therefore, they tend to be vulnerable.
The purpose ...of this study is to explore the sources of the resilience of homeless LGBTQ+ youth in out-of-home care in the Israeli context. The research question was: What are the experiences, perceptions, and constructions of “resilience” among LGBTQ+ youth who aged out of out-of-home care for homeless LGBTQ+ youth in Israel?
The study employed a critical constructivist grounded theory approach. Thirty-one in-depth semi-structured interviews were conducted with LGBTQ+ youth aged 16 to 32 (average age of 21.5) and analyzed.
The data analysis presents the sources of resilience according to four levels. (1) The individual level refers to self-acceptance, faith and hope, and creativity and productiveness. (2) The interpersonal level refers to friends and peer groups, educational institutions, employment environments, professionals, and LGBTQ+ out-of-home care services. (3) The macro level refers to public visibility of the LGBTQ+ community and financial support. (4) Finally, the chrono level refers to the development of rights and recognition over time.
An ecological model was implemented to conceptualize resilience among LGBTQ+ youth in out-of-home care in Israel. This multidimensional model was used to construct resilience sources that could assist in overcoming adversities among these youth. Implications for practice and future research are discussed.
•Among unstably housed women, 69 % were current smokers and 58 % were daily smokers.•Cigarette smoking intensity was associated with past 7-days methamphetamine use.•Integrating cigarette smoking and ...methamphetamine use treatment for high-frequency cigarette smokers is warranted.
Recent insights into substance use cessation suggest that outcomes short of long-term abstinence are clinically meaningful and may offer more realistic incremental goals, particularly for highly vulnerable individuals. With the goal of informing tobacco treatment programs, we examined distinct patterns of cigarette smoking and their association with the ongoing use of other substances in women who experience housing instability.
We recruited participants from a longitudinal study of women experiencing housing instability. Between June 2017 and January 2019, participants completed six monthly survey interviews regarding social conditions and the use of multiple substances. We examined associations between cigarette smoking intensity, including number of cigarettes smoked per day, heavy smoking, and an increase in number of cigarettes smoked from the previous 30-days, and other substance use in the past 7-days.
Of the 243 participants, 69 % were current smokers and 58 % were daily smokers. Number of cigarettes smoked per day (Adjusted odds ratio AOR 1.02, 95 % CI 1.00–1.03), heavy cigarette smoking, compared to none or light smoking (AOR 2.02, 95 % CI 1.46–2.79), and an increase in number of cigarettes smoked from the previous 30-days (AOR 1.06, 95 % CI 1.01–1.12) were all significantly associated with methamphetamine use in the past 7-days. Associations with other substance use were not as strong.
In a sample of unstably housed women, where almost half used multiple substances, methamphetamine use was associated with higher cigarette smoking intensity. Our findings highlight a potential role for integrating tobacco and methamphetamine use treatment to reduce tobacco use among unstably housed women.
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