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Background: Numerous studies have highlighted the inequitable access to medical and psychiatric care that people experiencing homelessness (PEH) face, yet the surgical needs of this population are not well understood. We sought to assess evidence describing surgical care for PEH and to perform a thematic analysis of the results. Methods: Ovid MEDLINE, Embase, and Web of Science were searched using the terms 'surgery' AND 'homelessness.' Grey literature was also searched. We used a stepwise scoping review methodology, followed by thematic analysis using an inductive approach. Results: We included 104 articles in our review. Studies were included from 5 continents; 63% originated in the United States. All surgical specialties were represented with varying surgical conditions and procedures for each. Orthopedic surgery (21%) was the most frequently reported specialty. Themes identified included characteristics of PEH receiving surgical care, homeless-to-housed participants, interaction with the health care system, educational initiatives, barriers and challenges, and interventions and future strategies. Conclusion: We identified significant variation and gaps, representing opportunities for further research and interventions. Further addressing the barriers and challenges that PEH face when accessing surgical care can better address the needs of this population. Contexte : Si de nombreuses études ont souligné l'accès inéquitable aux soins médicaux et psychiatriques pour les personnes en situation d'itinérance (PSI), les besoins chirurgicaux de cette population ne sont pas bien compris. Nous avons cherché à évaluer les données décrivant les soins chirurgicaux pour les PSI afin de faire une analyse thématique des résultats. Méthodes : Les bases de données Ovid MEDLINE, Embase, et Web of Science ont été interrogées avec les termes << surgery >> [chirurgie] ET << homelessness >> [itinérance]. La littérature grise a aussi été interrogée. Nous avons utilisé une méthode de synthèse exploratoire par étapes, suivie d'une analyse thématique par approche inductive. Résultats : Nous avons inclus 104 articles dans notre revue. Les études sélectionnées provenaient de 5 continents; 63% venaient des États-Unis. Toutes les spécialités chirurgicales étaient représentées, avec diverses conditions et interventions chirurgicales pour chacune. La chirurgie orthopédique (21%) était la spécialité la plus souvent rapportée. Les thèmes relevés comprenaient les caractéristiques des PSI recevant des soins chirurgicaux, les personnes participantes passées de l'itinérance au logement, l'interaction avec le système de santé, les initiatives d'éducation, les obstacles et défis, et les interventions et stratégies futures. Conclusion : Nous avons décelé une variation et des lacunes considérables, qui représentent des occasions de recherche et d'interventions. Il faudra s'attaquer davantage aux obstacles et aux défis rencontrés par les PSI dans l'accès aux soins chirurgicaux pour mieux répondre aux besoins de cette population., Homelessness is a major social and health-related concern globally. In Canada alone, there are 25000-35000 people experiencing homelessness (PEH) on any single night. (1) The circumstances surrounding an individual's homelessness [...]

A recent issue of Psychiatric Times featured an opinion piece by D.J. Jaffe who argued that there is little empirical support for the effectiveness of paid peer-support staff--persons in recovery [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2010.09.034 Byline: Marah A. Curtis (a), Hope Corman (b)(c), Kelly Noonan (b)(c), Nancy E. Reichman (d) Abstract: This study exploits an exogenous health shock -- the birth of a child with a severe health condition that is considered by the medical community to be random -- to investigate the effect of that shock on the family's housing situation. We use population-based data from an urban birth cohort study in the U.S. that oversampled non-marital births, resulting in a relatively disadvantaged sample that may be particularly susceptible to the effects of adverse life events. The health conditions were recorded in the infants' hospital medical records and coded by a pediatric consultant to capture conditions that are considered both severe and random. Seven different housing outcomes in the domains of quality, crowding, and stability were assessed from maternal interviews and in-home assessments when the children were 3 years old. We found that poor child health increases the likelihood of both overcrowding and homelessness and that it may also increase the likelihood of having inadequate utilities and generally poor housing quality. The effect sizes ranged from 1 to 17 percentage points, depending on the measure of poor child health and housing outcome. Author Affiliation: (a) Boston University, Boston, MA, United States (b) Rider University, Lawrenceville, NJ, United Statesa (c) National Bureau of Economic Research, New York, NY, United States (d) Robert Wood Johnson Medical School, New Brunswick, NJ, United States

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2010.04.013 Byline: Helena Tunstall (a), Kate Pickett (a), Sarah Johnsen (b) Abstract: People that move home within developed countries report, on average, better health than non-movers. Pregnant women, new mothers and infants are particularly mobile, but the limited evidence regarding the relationship between their mobility and health suggests they may not conform to the 'healthy migrant' effect. This paper examines the relationship between mobility and health among these groups in the UK, using logistic regression to analyse cross-sectional data for 18,197 families in the Millennium Cohort Study wave one. It compares health status variables among mobile and non-mobile families; describes mobile families' socio-demographic characteristics; explores associations between health outcomes, reasons for residential moves, and experiences of homelessness; and assesses the association between mobility and health care utilisation, social support and residential satisfaction. The paper concludes that mobile pregnant women, new mothers and infants do have poor health outcomes in comparison to non-movers, but this is primarily explained by their socio-demographic characteristics and the negative circumstances associated with a minority of their moves. Families that moved during pregnancy and infancy had worse self-rated health and depression among mothers, and lower birth weight and higher risk of accidents among infants, than non-movers. Mothers in mobile families were younger and had lower levels of education and owner-occupation than non-movers. After adjustment for socio-demographic characteristics mobility was weakly and non-significantly associated with most health variables with the exception of self-rated health and depression among mothers who moved for negative reasons (such as relationship breakdown or problems with neighbours), or had been homeless since birth. After adjustment mobile families had lower levels of most measures of health care utilisation compared to non-movers, but mothers did not report less frequent social contacts, and those that moved during infancy for positive reasons (such as wanting a better home or neighbourhood) had greater satisfaction with home and area. Author Affiliation: (a) Department of Health Sciences, University of York, United Kingdom (b) Centre for Housing Policy, University of York, United Kingdom

As a psychiatry resident, I worked at a community service agency in Los Angeles, treating chronically homeless patients with serious mental illness and substance use disorders (SUD) as they transitioned [...]

A central element of community response to controversial human service facilities is the socio-spatial construction of stigma. This paper develops a conceptual framework for understanding the constitution and role of stigma in community rejection of human services, particularly those associated with homelessness and HIV/AIDS. Three facets of stigma concerning homelessness and HIV/AIDS (non-productivity, dangerousness, and personal culpability) are offered as a way of understanding the rising tide of community rejection toward human service facilities. Key words - socio-spatial stigmatization, homelessness, HIV/AIDS

Limited research has been conducted on elderly homeless people, particularly in the UK. Data on the coping strategies of such groups, their daily needs and the story of their entry into homelessness are scarce. Concerned sectors are urged to develop and refine concepts and methodologies which can help elucidate the nature of homelessness in the aged and combine them with the political and social mechanics required to provide substantial solutions.

Homelessness between men and women, which markedly differ in fundamental ways, does not provide a clear information on gender differences. The selection process for classifying men and women into homelessness should be similar in attributes and experiences. The differences in the causes of physical symptoms do not account for higher female morbidity rates. Lastly, there is no sufficient evidence to conclude health status as a function of observed sex differences.