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2.1 The Relationship between Homelessness & Health: An Overview of Research in Canada
Frankish C. James, Stephen W. Hwang, Darryl Quantz
This chapter provide an overview of previous research on homelessness and the relationship between homelessness and health (particularly in Canada), to spur discussion on directions for future research. Homeless people suffer from higher levels of...
2.7 Primary Health Care for Homeless Persons: Evaluating the Options Using a Policy Analysis Approach
S. E. D. Shortt, Stephen W. Hwang, Heather Stuart, Melanie Bedore, Nadia Zurba, Margaret Darling
What is the most effective way to deliver point-of-first-contact or primary health care to homeless persons? A number of new models of payment and organization have been used in Canada over the last two decades, but there is little literature on...
Substance Use and Access to Health Care and Addiction Treatment among Homeless and Vulnerably Housed Persons in Three Canadian Cities
Anita Palepu, Anne Gadermann, Anita M. Hubley, Susan Farrell, Evie Gogosis, Tim Aubry, Stephen W Hwang
We examined the prevalence of substance use disorders among homeless and vulnerably housed persons in three Canadian cities and its association with unmet health care needs and access to addiction treatment using baseline data from the Health and...
Integrating Hospital and Community Care for Homeless People with Unmet Mental Health Needs: Program Rationale, Study Protocol and Sample Description of a Brief Multidisciplinary Case Management Intervention
Vicky Stergiopoulos, Agnes Gozdzik, Rosane Nisenbaum, Denise Lamanna, Stephen W. Hwang, Joshua Tepper, Don Wasylenki
The Coordinated Access to Care for Homeless People (CATCH) program is a brief multidisciplinary case management intervention for homeless adults discharged from hospital in Toronto, Canada. Here we describe the rationale for CATCH program...
Sustaining Housing First After a Successful Research Demonstration Trial: Lessons Learned in a Large Urban Center
Nishi Kumar, Erin Plenert, Stephen W. Hwang, Patricia O’Campo, Vicky Stergiopoulos
Objectives: This study aimed to identify challenges and facilitators of sustaining a Housing First intervention at the conclusion of a research demonstration project in Toronto. Methods: This qualitative study included key informant interviews with...
Morbidity and Mortality in Homeless Individuals, Prisoners, Sex Workers, and Individuals with Substance Use Disorders in High-Income Countries: A Systematic Review and Meta-Analysis
Robert W Aldridge, Alistair Story, Stephen W Hwang, Merete Nordentoft, Serena A Luchenski, Greg Hartwell
Inclusion health focuses on people in extremely poor health due to poverty, marginalisation, and multimorbidity. The study aimed to review morbidity and mortality data on four overlapping populations who experience considerable social exclusion:...
2.6 Traumatic Brain Injury in the Homeless Population: A Toronto Study
Stephen W. Hwang, Angela Colantonio, Shirley Chau, George Tolomiczenko, Alex Kiss, Laura Cowan, Donald A. Redelmeier, Wendy Levinson
The researchers investigated the relationship between traumatic brain injury and current health conditions in a representative sample of homeless people. They asked 601 men and 303 women at homeless shelters and meal programs in 2004–2005 in Toronto...
Healthcare Utilization Among Homeless Adults Prior to Death
J. E. Orav, Troyen A. Brennan, Stephen W. Hwang, J. J. O`Connell, J. M. Lebow, Bierer
This study characterizes health care utilization prior to death in a group of 558 homeless adults in Boston.
"Hospital was the Only Option": Experiences of Frequent Emergency Department Users in Mental Health
Deborah Wise-Harris, Daniel Pauly, Deborah Kahan, Jason Tan de Bibiana, Stephen W. Hwang, Vicky Stergiopoulos
The experiences of individuals with mental illness and addictions who frequently present to hospital emergency departments (EDs) have rarely been explored. This study reports findings from self-reported, quantitative surveys (n = 166) and in-depth,...
The Effect of Advance Directive Completion on Hospital Care Among Chronically Homeless Persons: a Prospective Cohort Study
Alexander K. Leung, Matthew J. To, Linh Luong, Zahra Syavash Vahabi, Victor L. Gonçalves, John Song, Stephen W. Hwang
Advance care planning is relevant for homeless individuals because they experience high rates of morbidity and mortality. The impact of advance directive interventions on hospital care of homeless individuals has not been studied. The objective of...
The effect of incarceration on housing stability among homeless and vulnerably housed individuals in three Canadian cities: A prospective cohort study
Matthew J. To, Anita Palepu, Flora I. Matheson, John Ecker, Susan Farrell, Stephen W. Hwang, Dan Werb
OBJECTIVES:  The objective of the study is to characterize the associations between a history of incarceration and subsequent housing stability over a two-year follow-up period among a sample of homeless and vulnerably housed individuals. METHODS: ...
The Impact of a 24 Month Housing First Intervention on Participants’ Body Mass Index and Waist Circumference: Results from the At Home / Chez Soi Toronto Site Randomized Controlled Trial
Julia Woodhall-Melnik, Vachan Misir, Vered Kaufman-Shriqui, Patricia O’Campo, Vicky Stergiopoulos, Stephen Hwang
Research suggests that individuals experiencing homelessness have high rates of overweight and obesity. Unhealthy weights and homelessness are both associated with increased risk of poor health and mortality. Using longitudinal data from 575...
Housing First for older homeless adults with mental illness: a subgroup analysis of the At Home/Chez Soi randomized controlled trial
Timothy E. Chung, Agnes Gozdzik, Luis I. Palma Lazgare, Matthew J. To, Tim Aubry, James Frankish, Stephen W. Hwang, Vicky Stergiopoulos
Objective This study compares the effect of Housing First on older (≥50 years old) and younger (18–49 years old) homeless adults with mental illness participating in At Home/Chez Soi, a 24-month multisite randomized controlled trial of Housing First...
Chronic Pain Among Homeless Persons with Mental Illness
Marc Vogel, Anastasia Frank, Fiona Choi, Verena Strehlau, Nooshin Nikoo, Mohammadali Nikoo, Stephen W. Hwang, Julian Somers, Michael R. Krausz, Christian G. Schu¨ tz
Objective Chronic pain is an important public health issue. However, characteristics and needs of marginalized populations have received limited attention. Studies on prevalence and correlates of chronic pain among homeless persons are lacking. We...
Food security among individuals experiencing homelessness and mental illness in the At Home/Chez Soi Trial
Patricia O’Campo, Stephen W Hwang, Agnes Gozdzik, Andrée Schuler, Vered Kaufman-Shriqui, Daniel Poremski, Luis Ivan Palma Lazgare, Jino Distasio, Slimane Belbraouet, Sindi Addorisio
Individuals experiencing homelessness are particularly vulnerable to food insecurity. The At Home/Chez Soi study provides a unique opportunity to first examine baseline levels of food security among homeless individuals with mental illness and...