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Universal health insurance and health care access for homeless persons

Author

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  • Hwang, S.W.
  • Ueng, J.J.M.
  • Chiu, S.
  • Kiss, A.
  • Tolomiczenko, G.
  • Cowan, L.
  • Levinson, W.
  • Redeimeier, D.A.

Abstract

Objectives. We examined the extent of unmet needs and barriers to accessing health care among homeless people within a universal health insurance system. Methods. We randomly selected a representative sample of 1169 homeless individuals at shelters and meal programs In Toronto, Ontario. We determined the prevalence of self-reported unmet needs for health care in the past 12 months and used regression analyses to identify factors associated with unmet needs. Results. Unmet health care needs were reported by 17% of participants. Compared with Toronto's general population, unmet needs were significantly more common among homeless individuals, particularly among homeless women with dependent children. Factors independently associated with a greater likelihood of unmet needs were younger age, having been a victim of physical assault in the past 12 months, and lower mental and physical health scores on the 12-ltem Short Form Health Survey. Conclusions. Within a system of universal health Insurance, homeless people still encounter barriers to obtaining health care. Strategies to reduce nonfinancial barriers faced by homeless women with children, younger adults, and recent victims of physical assault should be explored.

Suggested Citation

  • Hwang, S.W. & Ueng, J.J.M. & Chiu, S. & Kiss, A. & Tolomiczenko, G. & Cowan, L. & Levinson, W. & Redeimeier, D.A., 2010. "Universal health insurance and health care access for homeless persons," American Journal of Public Health, American Public Health Association, vol. 100(8), pages 1454-1461.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2009.182022_6
    DOI: 10.2105/AJPH.2009.182022
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    Cited by:

    1. Waldbrook, Natalie, 2015. "Exploring opportunities for healthy aging among older persons with a history of homelessness in Toronto, Canada," Social Science & Medicine, Elsevier, vol. 128(C), pages 126-133.
    2. Maeva Jego & Julien Abcaya & Diana-Elena Ștefan & Céline Calvet-Montredon & Stéphanie Gentile, 2018. "Improving Health Care Management in Primary Care for Homeless People: A Literature Review," IJERPH, MDPI, vol. 15(2), pages 1-21, February.
    3. Valérie Dauriac-Le Masson & Alain Mercuel & Marie Jeanne Guedj & Caroline Douay & Pierre Chauvin & Anne Laporte, 2020. "Mental Healthcare Utilization among Homeless People in the Greater Paris Area," IJERPH, MDPI, vol. 17(21), pages 1-13, November.
    4. M Eugenia Socías & Jean Shoveller & Chili Bean & Paul Nguyen & Julio Montaner & Kate Shannon, 2016. "Universal Coverage without Universal Access: Institutional Barriers to Health Care among Women Sex Workers in Vancouver, Canada," PLOS ONE, Public Library of Science, vol. 11(5), pages 1-15, May.
    5. Chris Sanders & Kristin Burnett & Steven Lam & Mehdia Hassan & Kelly Skinner, 2020. "“You Need ID to Get ID”: A Scoping Review of Personal Identification as a Barrier to and Facilitator of the Social Determinants of Health in North America," IJERPH, MDPI, vol. 17(12), pages 1-20, June.

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