Social determinants of inadequate prenatal care utilization in sheltered homeless mothers in the Greater Paris area in France
BackgroundSheltered homeless families suffer from deleterious living conditions such as housing instability (i.e., moving from one shelter to another) that could be an additional barrier to healthcare utilization. Few studies have specifically examined perinatal health in homeless mothers and their...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1080594/full |
| _version_ | 1797866759910326272 |
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| author | Elodie Richard Cécile Vuillermoz Sandrine Lioret Raquel Rico Berrocal Emmanuelle Guyavarch Yann Lambert Elie Azria Karen Leffondre Stéphanie Vandentorren |
| author_facet | Elodie Richard Cécile Vuillermoz Sandrine Lioret Raquel Rico Berrocal Emmanuelle Guyavarch Yann Lambert Elie Azria Karen Leffondre Stéphanie Vandentorren |
| author_sort | Elodie Richard |
| collection | DOAJ |
| description | BackgroundSheltered homeless families suffer from deleterious living conditions such as housing instability (i.e., moving from one shelter to another) that could be an additional barrier to healthcare utilization. Few studies have specifically examined perinatal health in homeless mothers and their utilization of prenatal healthcare. This study aimed to identify social determinants such as living conditions (i.e., housing instability) associated with inadequate prenatal care utilization (PCU) in sheltered homeless mothers in the Greater Paris area in France.MethodsThe homeless children and families cross-sectional survey [ENFAMS: (Enfants et familles sans logement)] was performed on a random representative sample of homeless families living in shelters in the greater Paris area in 2013. Following French guidelines, PCU was deemed inadequate if one or more of the following criteria was met: attending fewer than 50% of recommended prenatal visits, PCU initiation after the first trimester of pregnancy, and fewer than three ultrasounds during the entire pregnancy. Families were interviewed in 17 languages by trained peer interviewers in face-to-face interviews. Structural equation modeling was used to identify factors associated with inadequate PCU and to estimate correlations between them.ResultsThis study analyzed data on 121 homeless sheltered mothers who had at least one child less than one year old. They were socially disadvantaged and most were born outside France. One in five (19.3%) had inadequate PCU. Associated factors were socio-demographic characteristics (young age, primiparous), health status (dissatisfaction with self-perceived general health), and living conditions (housing instability in the second and third trimesters).ConclusionIt is essential to reduce housing instability to help sheltered mothers to benefit from social, territorial and medical support and healthcare utilization. Housing stability for pregnant sheltered homeless mothers should be a priority to ensure better PCU and guarantee the newborn's health as much as possible. |
| first_indexed | 2024-04-09T23:29:27Z |
| format | Article |
| id | doaj.art-2e67f40ab711491191991964fc14ed2f |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-09T23:29:27Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-2e67f40ab711491191991964fc14ed2f2023-03-21T06:16:04ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-03-011110.3389/fpubh.2023.10805941080594Social determinants of inadequate prenatal care utilization in sheltered homeless mothers in the Greater Paris area in FranceElodie Richard0Cécile Vuillermoz1Sandrine Lioret2Raquel Rico Berrocal3Emmanuelle Guyavarch4Yann Lambert5Elie Azria6Karen Leffondre7Stéphanie Vandentorren8Santé Publique France, University of Bordeaux, Bordeaux Population Health Laboratory, INSERM U1219, Bordeaux, FranceSorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, Paris, FranceUniversité de Paris, CRESS, INSERM, INRAE, Paris, FranceÉcole des Hautes Études en Sciences Sociales (EHESS), Center d'étude des Mouvements Sociaux (CEMS), EHESS/CNRS UMR 8044/INSERM U1276, Paris, FranceObservatoire du Samu social de Paris, Paris, FranceCIC Guyane, Cayenne, FranceMaternity Unit, Paris Saint Joseph Hospital, Université de Paris, U1153 CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, Paris, FranceUniversity of Bordeaux, Bordeaux Population Health Laboratory, INSERM U1219, Bordeaux, FranceSanté Publique France, University of Bordeaux, Bordeaux Population Health Laboratory, INSERM U1219, Bordeaux, FranceBackgroundSheltered homeless families suffer from deleterious living conditions such as housing instability (i.e., moving from one shelter to another) that could be an additional barrier to healthcare utilization. Few studies have specifically examined perinatal health in homeless mothers and their utilization of prenatal healthcare. This study aimed to identify social determinants such as living conditions (i.e., housing instability) associated with inadequate prenatal care utilization (PCU) in sheltered homeless mothers in the Greater Paris area in France.MethodsThe homeless children and families cross-sectional survey [ENFAMS: (Enfants et familles sans logement)] was performed on a random representative sample of homeless families living in shelters in the greater Paris area in 2013. Following French guidelines, PCU was deemed inadequate if one or more of the following criteria was met: attending fewer than 50% of recommended prenatal visits, PCU initiation after the first trimester of pregnancy, and fewer than three ultrasounds during the entire pregnancy. Families were interviewed in 17 languages by trained peer interviewers in face-to-face interviews. Structural equation modeling was used to identify factors associated with inadequate PCU and to estimate correlations between them.ResultsThis study analyzed data on 121 homeless sheltered mothers who had at least one child less than one year old. They were socially disadvantaged and most were born outside France. One in five (19.3%) had inadequate PCU. Associated factors were socio-demographic characteristics (young age, primiparous), health status (dissatisfaction with self-perceived general health), and living conditions (housing instability in the second and third trimesters).ConclusionIt is essential to reduce housing instability to help sheltered mothers to benefit from social, territorial and medical support and healthcare utilization. Housing stability for pregnant sheltered homeless mothers should be a priority to ensure better PCU and guarantee the newborn's health as much as possible.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1080594/fullinadequate prenatal care utilizationhomelesssocial determinantsinequalitieshousing instability |
| spellingShingle | Elodie Richard Cécile Vuillermoz Sandrine Lioret Raquel Rico Berrocal Emmanuelle Guyavarch Yann Lambert Elie Azria Karen Leffondre Stéphanie Vandentorren Social determinants of inadequate prenatal care utilization in sheltered homeless mothers in the Greater Paris area in France Frontiers in Public Health inadequate prenatal care utilization homeless social determinants inequalities housing instability |
| title | Social determinants of inadequate prenatal care utilization in sheltered homeless mothers in the Greater Paris area in France |
| title_full | Social determinants of inadequate prenatal care utilization in sheltered homeless mothers in the Greater Paris area in France |
| title_fullStr | Social determinants of inadequate prenatal care utilization in sheltered homeless mothers in the Greater Paris area in France |
| title_full_unstemmed | Social determinants of inadequate prenatal care utilization in sheltered homeless mothers in the Greater Paris area in France |
| title_short | Social determinants of inadequate prenatal care utilization in sheltered homeless mothers in the Greater Paris area in France |
| title_sort | social determinants of inadequate prenatal care utilization in sheltered homeless mothers in the greater paris area in france |
| topic | inadequate prenatal care utilization homeless social determinants inequalities housing instability |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1080594/full |
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