(Press-News.org) TORONTO, Oct. 24, 2014—Health care providers should recognize that any effective strategy to address homelessness needs to include both interventions to improve the health of homeless individuals as well as larger-scale policy changes, according to a paper published today.
"It is essential to recognize that homelessness is equally the result of structural factors within a society, such as systematic inequities in educational and employment opportunities, a shortage of affordable housing, and social policies that are targeted against marginalized populations," said Dr. Stephen Hwang of St. Michael's Hospital.
Dr. Hwang's paper was published today in The Lancet, half of a two-part series on homelessness in high-income countries. Dr. Hwang, a general internal medicine physician and a researcher at the hospital's Centre for Research on Inner City Health, is one of the world's leading experts on health and homelessness. He also holds the hospital's Chair in Homelessness, Housing and Health, which is believed to be the first hospital-based chair in homelessness in the world.
As many as 3.5 million Americans and 200,000 Canadians experience homelessness every year, and the numbers are rising. Homeless people "are the sickest in our society," but just treating ill health might not be enough to help get people off the streets, according to the author of the first Lancet paper, Seena Fazel, professor of forensic psychiatry at the University of Oxford.
The series highlights that being homeless is not only bad for a person's physical and mental health but also has dramatic effects on life expectancy. Previous studies by Dr. Hwang and others have found that homeless people use the most expensive acute health care services, such as accident and emergency care, and need longer hospital stays than people with homes.
The Lancet series says that while government targets to improve the health of homeless people should be introduced (e.g. for the identification and management of infectious diseases, mental illness and diseases of old age), health care providers should also advocate for changes to the social policies and structural factors that result in homelessness, including the lack of affordable housing and employment opportunities for low-skilled workers.
The papers note there are some programs in high-income countries bridging the gap between homelessness and health services, such as the Housing First programs that provide housing and support services for homeless individuals with severe mental illness or substance abuse problems. Dr. Hwang is the principal investigator in Toronto for the At Home/Chez Soi project evaluating Housing First in Canada.
Medical respite programmes for homeless patients leaving hospital reduce the risk of readmission and the number of days spent in hospital.
St. Michael's also has two interventions aimed at helping people with unmet, complex health care needs access health resources in the community: CATCH-Homeless and CATCH-ED, specifically for people who use Emergency Departments five or more times a year, at least one of those times for a mental health and-or addiction problem. CATCH case managers work with family physicians, psychiatrists and other service providers to support patients' access to such things as medical care and mental health and addiction services
However, these examples are not the norm and much more needs to be done, said Dr. Hwang.
"It needs to be recognised that preventing homelessness, by creating more opportunities for housing, work, education, and health care during high risk periods, such as being discharged from institutional care, psychiatric hospital or prisons to the community, could effectively reduce homelessness and makes sound economic sense."
INFORMATION:
About St. Michael's Hospital
St Michael's Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 23 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital's recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.
For more information, or to interview Dr. Hwang, contact:
Leslie Shepherd
Manager, Media Strategy
St. Michael's Hospital
416-864-6094
shepherdl@smh.ca
http://www.stmichaelshospital.com
Follow us on Twitter: http://www.twitter.com/stmikeshospital
Washington, DC (October 23, 2014) — People who develop kidney stones may be at increased risk of experiencing bone fractures, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN). The findings suggest that preventive efforts may be needed to help protect stone formers' bone health.
People who form stones in the kidneys and urinary tract—a condition called urolithiasis—may have reduced bone mineral density and an increased risk of bone fractures. To assess the link between urolithiasis ...
Costs to treat strokes caused by bleeding in the brain may increase significantly 10 years later, according to a study in the American Heart Association journal Stroke.
The Australian study is the first to include 10 years of follow-up data on stroke cost estimates, which may also apply to the United States, researchers said.
Generally, expenses associated with a stroke peak within the first year and decline over time. Previous estimates of lifetime costs in Australia were based on a five-year average and may have underestimated costs, specifically for hemorrhagic (bleeding) ...
Having age-related macular degeneration (AMD) in one eye was associated with an increased incidence of AMD and accelerated progression of the debilitating disease in the other eye, writes author Ronald E. Gangnon, Ph.D., of the University of Wisconsin School of Medicine and Public Health, Madison, and colleagues.
AMD is thought to be a symmetric disease, although one eye may precede the other in progression.
The authors examined the effect of severity of AMD in one eye on the incidence, progression and regression in the other eye. Data from 4,379 participants in the ...
Two new studies suggest that while individuals enrolling in the armed forces do not share the exact psychological profile as socio-demographically comparable civilians, they are more similar than previously thought.
The first study found that new soldiers and matched civilians are equally likely to have experienced at least one major episode of mental illness in their lifetime (38.7 percent of new soldiers; 36.5 percent of civilians) but that some mental disorders (generalized anxiety disorder, post-traumatic stress disorder and conduct disorder) are more common among ...
NASA's Hurricane Severe Storms Sentinel or HS3 mission flew the unmanned Global Hawk aircraft on two missions between Sept. 11 and 15 into Hurricane Edouard and scored a bullseye by gathering information in the eye of the strengthening storm. Scientists saw how upper-level wind shear was affecting Edouard on the HS3's Global Hawk flight of the 2014 campaign over Sept. 11 and 12, and saw the hurricane strengthen during the sixth flight on Sept. 15 and 16.
NASA's HS3 mission returned to NASA's Wallops Flight Facility, in Wallops Island Virginia for the third year to investigate ...
Toronto – Countries with higher levels of compassion and openness score better when it comes to environmental sustainability, says research from the University of Toronto.
A new study by Jacob Hirsh, an Assistant Professor of Organizational Behaviour & Human Resource Management at the University of Toronto Mississauga's Institute for Management & Innovation, who is cross-appointed to UofT's Rotman School of Management, demonstrates that a country's personality profile can predict its environmental sustainability records.
While Prof. Hirsh's previous work has ...
Exposure to moderate amounts of sunshine may slow the development of obesity and diabetes, a study suggests.
Scientists who looked at the effect of sunlight on mice say further research will be needed to confirm whether it has the same effect on people.
The researchers showed that shining UV light at overfed mice slowed their weight gain. The mice displayed fewer of the warning signs linked to diabetes, such as abnormal glucose levels and resistance to insulin.
The beneficial effects of UV treatment were linked to a compound called nitric oxide, which is released ...
OAKLAND, Calif., October 23, 2014 – Women who developed gestational diabetes and were overweight before pregnancy were at a higher risk of having daughters who were obese later in childhood, according to new research published today in Diabetes Care.
Based on long-term research that included a multi-ethnic cohort of 421 girls and their mothers (all members of Kaiser Permanente Northern California), the study is among the first to directly link maternal hyperglycemia (high blood glucose) to offspring being overweight later.
"Glucose levels during pregnancy, particularly ...
DOWNERS GROVE, Ill. – October 23, 2014 – An international multicenter study reports that over-the-scope clip (OTSC) placement is a safe and effective therapy for the closure of gastrointestinal (GI) defects, which includes anastomotic leaks, fistulae and perforations. Clinical success was best achieved in patients undergoing closure of perforations or leaks when OTSC placement was used for primary or rescue therapy. The overall clinical success for the closure of perforations and leaks ranged between 90 percent and 73 percent; however, successful closure of ...
An ocean's oxygen levels may play a role in the impact of marine predators on bodies when they are immersed in the sea, according to Simon Fraser University researchers in a new study published this week in the journal PLoS One.
SFU criminologist Gail Anderson led the study, based on the deployment of a trio of pig carcasses into Saanich Inlet at a depth of 100 metres and studied over the past three years. Anderson assessed scavenger activity while co-author and SFU criminologist Lynne Bell continues her investigation of what happens to submerged bones.
The work is ...
