Open AccessThe Association of Residential Instability and Hospitalizations among Homeless and Vulnerably Housed Individuals: Results from a Prospective Cohort Study
Author(s) -
Anne M. Gadermann,
Mohammad Ehsanul Karim,
Monica Norena,
Scott D. Emerson,
Anita M. Hubley,
Lara B. Russell,
Rosane Nisenbaum,
Stephen W. Hwang,
Tim Aubry,
Anita Palepu
Publication year - 2020
Publication title -
journal of urban health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.211
H-Index - 92
eISSN - 1468-2869
pISSN - 1099-3460
DOI - 10.1007/s11524-019-00406-9
Subject(s) - medicine , confidence interval , generalized estimating equation , prospective cohort study , demography , odds ratio , odds , cohort , cohort study , gerontology , social support , psychology , logistic regression , statistics , mathematics , surgery , pathology , sociology , psychotherapist
The present study examined the association of residential instability with hospitalizations among homeless and vulnerably housed individuals over a 4-year time period. Survey data were linked to administrative records on hospitalizations. Specifically, we used data from the Health and Housing in Transition study, a prospective cohort study that tracked the health and housing status of homeless and vulnerably housed individuals in Canada. Responses from Vancouver-based participants (n = 378) from baseline and 3 follow-ups were linked to their administrative health records on hospitalizations (Discharge Abstract Database - Hospital Separation Files; 2008-2012). A generalized estimating equations model was used to examine associations between the number of residential moves and any hospitalizations during each year (none versus ≥ 1 hospitalizations). Analyses included demographic and health variables. Survey data were collected via structured interviews. Hospitalizations were derived from provincial administrative health records. A higher number of residential moves were associated with hospitalization over the study period (adjusted odds ratio: 1.14; 95% confidence interval: 1.01, 1.28). Transgender, female gender, perceived social support, better self-reported mental health, and having ≥ 3 chronic health conditions also predicted having been hospitalized over the study period, whereas high school/higher education was negatively associated with hospitalizations. Our results indicate that residential instability is associated with increased risk of hospitalization, illustrating the importance of addressing housing as a social determinant of health.