Predictors and consequences of homelessness in whole-population observational studies that used administrative data: a systematic review

Abstract Background Homelessness is a complex societal and public health challenge. Limited information exists about the population-level health and social care-related predictors and consequences of persons with lived experience of homelessness (PEH). Studies that focus on population subgroups or a...

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Main Authors: Eileen Mitchell, Tanisha Waring, Elayne Ahern, Diarmuid O’Donovan, Dermot O’Reilly, Declan T. Bradley
Format: Article
Language:English
Published: BMC 2023-08-01
Series:BMC Public Health
Subjects:
Online Access:https://doi.org/10.1186/s12889-023-16503-z
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author Eileen Mitchell
Tanisha Waring
Elayne Ahern
Diarmuid O’Donovan
Dermot O’Reilly
Declan T. Bradley
author_facet Eileen Mitchell
Tanisha Waring
Elayne Ahern
Diarmuid O’Donovan
Dermot O’Reilly
Declan T. Bradley
author_sort Eileen Mitchell
collection DOAJ
description Abstract Background Homelessness is a complex societal and public health challenge. Limited information exists about the population-level health and social care-related predictors and consequences of persons with lived experience of homelessness (PEH). Studies that focus on population subgroups or ad hoc questionnaires to gather data are of relatively limited generalisability to whole-population health surveillance and planning. The aim of this study was to find and synthesise information about the risk factors for, and consequences of, experiencing homelessness in whole-population studies that used routine administrative data. Method We performed a systematic search using EMBASE, MEDLINE, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO research databases for English-language studies published from inception until February 2023 that reported analyses of administrative data about homelessness and health and social care-related predictors and consequences. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results Of the 1224 articles reviewed, 30 publications met the inclusion criteria. The included studies examined a wide range of topic areas, and the homelessness definitions used in each varied considerably. Studies were categorised into several topic areas: Mortality, morbidity and COVID-19; health care usage and hospital re-admission; care home admission and shelter stay; and other (e.g. employment, crime victimisation). The studies reported that that the physical and mental health of people who experience homelessness was worse than that of the general population. Homeless individuals were more likely to have higher risk of hospitalisation, more likely to use emergency departments, have higher mortality rates and were at greater risk of needing intensive care or of dying from COVID-19 compared with general population. Additionally, homeless individuals were more likely to be incarcerated or unemployed. The effects were strongest for those who experienced being homeless as a child compared to those who experienced being homeless later on in life. Conclusions This is the first systematic review of whole-population observational studies that used administrative data to identify causes and consequences associated with individuals who are experiencing homelessness. While the scientific literature provides evidence on some of the possible risk factors associated with being homeless, research into this research topic has been limited and gaps still remain. There is a need for more standardised best practice approaches to understand better the causes and consequences associated with being homeless.
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spelling doaj.art-0468fe371e1f4d678b9fc73e8395f4d42023-11-26T14:28:32ZengBMCBMC Public Health1471-24582023-08-0123111210.1186/s12889-023-16503-zPredictors and consequences of homelessness in whole-population observational studies that used administrative data: a systematic reviewEileen Mitchell0Tanisha Waring1Elayne Ahern2Diarmuid O’Donovan3Dermot O’Reilly4Declan T. Bradley5Centre for Public Health, Queen’s University BelfastCentre for Public Health, Queen’s University BelfastUniversity of LimerickCentre for Public Health, Queen’s University BelfastCentre for Public Health, Queen’s University BelfastCentre for Public Health, Queen’s University BelfastAbstract Background Homelessness is a complex societal and public health challenge. Limited information exists about the population-level health and social care-related predictors and consequences of persons with lived experience of homelessness (PEH). Studies that focus on population subgroups or ad hoc questionnaires to gather data are of relatively limited generalisability to whole-population health surveillance and planning. The aim of this study was to find and synthesise information about the risk factors for, and consequences of, experiencing homelessness in whole-population studies that used routine administrative data. Method We performed a systematic search using EMBASE, MEDLINE, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO research databases for English-language studies published from inception until February 2023 that reported analyses of administrative data about homelessness and health and social care-related predictors and consequences. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results Of the 1224 articles reviewed, 30 publications met the inclusion criteria. The included studies examined a wide range of topic areas, and the homelessness definitions used in each varied considerably. Studies were categorised into several topic areas: Mortality, morbidity and COVID-19; health care usage and hospital re-admission; care home admission and shelter stay; and other (e.g. employment, crime victimisation). The studies reported that that the physical and mental health of people who experience homelessness was worse than that of the general population. Homeless individuals were more likely to have higher risk of hospitalisation, more likely to use emergency departments, have higher mortality rates and were at greater risk of needing intensive care or of dying from COVID-19 compared with general population. Additionally, homeless individuals were more likely to be incarcerated or unemployed. The effects were strongest for those who experienced being homeless as a child compared to those who experienced being homeless later on in life. Conclusions This is the first systematic review of whole-population observational studies that used administrative data to identify causes and consequences associated with individuals who are experiencing homelessness. While the scientific literature provides evidence on some of the possible risk factors associated with being homeless, research into this research topic has been limited and gaps still remain. There is a need for more standardised best practice approaches to understand better the causes and consequences associated with being homeless.https://doi.org/10.1186/s12889-023-16503-zHomelessnessAdministrative dataObservational studiesHealthcareRecord linkageData linkage
spellingShingle Eileen Mitchell
Tanisha Waring
Elayne Ahern
Diarmuid O’Donovan
Dermot O’Reilly
Declan T. Bradley
Predictors and consequences of homelessness in whole-population observational studies that used administrative data: a systematic review
BMC Public Health
Homelessness
Administrative data
Observational studies
Healthcare
Record linkage
Data linkage
title Predictors and consequences of homelessness in whole-population observational studies that used administrative data: a systematic review
title_full Predictors and consequences of homelessness in whole-population observational studies that used administrative data: a systematic review
title_fullStr Predictors and consequences of homelessness in whole-population observational studies that used administrative data: a systematic review
title_full_unstemmed Predictors and consequences of homelessness in whole-population observational studies that used administrative data: a systematic review
title_short Predictors and consequences of homelessness in whole-population observational studies that used administrative data: a systematic review
title_sort predictors and consequences of homelessness in whole population observational studies that used administrative data a systematic review
topic Homelessness
Administrative data
Observational studies
Healthcare
Record linkage
Data linkage
url https://doi.org/10.1186/s12889-023-16503-z
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