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Residential moves and its association with substance use, healthcare needs, and acute care use among homeless and vulnerably housed persons in Canada

Author

Listed:
  • Miriam Harris

    (McGill University)

  • Anne Gadermann

    (St. Paul’s Hospital
    University of British Columbia)

  • Monica Norena

    (St. Paul’s Hospital)

  • Matthew To

    (St. Michael’s Hospital)

  • Anita M. Hubley

    (University of British Columbia)

  • Tim Aubry

    (University of Ottawa)

  • Stephen Hwang

    (St. Michael’s Hospital
    University of Toronto)

  • Anita Palepu

    (St. Paul’s Hospital
    University of British Columbia)

Abstract

Objectives To determine the relationship between housing instability, as measured by the number of residential moves, with problematic substance use, unmet healthcare needs, and acute care utilization. Methods A cohort of homeless or vulnerably housed persons from Vancouver (n = 387), Toronto (n = 390), and Ottawa (n = 396) completed interviewer-administered surveys at baseline and annually for 4 years from 2009 to 2013. Generalized mixed effects logistic regression models were used to examine the association between the number of residential moves and each of the three outcome variables, adjusting for potential confounders. Results The number of residential moves was significantly associated with higher acute care utilization [adjusted odds ratio (AOR) 1.25; 95% confidence interval (CI) CI: 1.17–1.33], unmet healthcare needs (AOR 1.14; 95% CI: 1.07–1.22), and problematic substance use (AOR 1.26; 95% CI: 1.16–1.36). Having chronic physical or mental conditions and recent incarceration were also found to be associated with the outcomes. Conclusions Housing instability increased the odds of all three poor health metrics, highlighting the importance of stable housing as a critical social determinant of health.

Suggested Citation

  • Miriam Harris & Anne Gadermann & Monica Norena & Matthew To & Anita M. Hubley & Tim Aubry & Stephen Hwang & Anita Palepu, 2019. "Residential moves and its association with substance use, healthcare needs, and acute care use among homeless and vulnerably housed persons in Canada," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(3), pages 399-409, April.
    • Handle: RePEc:spr:ijphth:v:64:y:2019:i:3:d:10.1007_s00038-018-1167-6
    DOI: 10.1007/s00038-018-1167-6
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    References listed on IDEAS

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    1. Baggett, T.P. & O'Connell, J.J. & Singer, D.E. & Rigotti, N.A., 2010. "The unmet health care needs of homeless adults: A national study," American Journal of Public Health, American Public Health Association, vol. 100(7), pages 1326-1333.
    2. Lasser, K.E. & Himmelstein, D.U. & Woolhandler, S., 2006. "Access to care, health status, and health disparities in the United States and Canada: Results of a Cross-National Population Based Survey," American Journal of Public Health, American Public Health Association, vol. 96(7), pages 1300-1307.
    3. Gelberg, L. & Gallagher, T.C. & Andersen, R.M. & Koegel, P., 1997. "Competing priorities as a barrier to medical care among homeless adults in Los Angeles," American Journal of Public Health, American Public Health Association, vol. 87(2), pages 217-220.
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