TY - JOUR
T1 - Self-reported health, healthcare service use and health-related needs: A comparison of older and younger homeless people
AU - van Dongen, Sophie I.
AU - van Straaten, Barbara
AU - Wolf, Judith R. L. M.
AU - Onwuteaka-Philipsen, Bregje D.
AU - van der Heide, Agnes
AU - Rietjens, Judith A. C.
AU - van de Mheen, Dike
N1 - Funding Information: 3Radboud Institute for Health Sciences, Impuls ‐ Netherlands Centre for Social Care Research, Radboud University Medical Centre, Nijmegen, the Netherlands 4Department of Public and Occupational Health, Expertise Centre for Palliative Care, VU University Medical Centre, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands 5School of Social and Behavioural Sciences, Tranzo Scientific Centre for Care and Welfare, Tilburg University, Tilburg, the Netherlands Funding Information: This study was funded by the Dutch Ministry of Health, Welfare and Sport and the Netherlands Organisation for Health Research and Development (ZonMw). The funding organisations had no role in study design, selection of respondents, data collection, data analysis and interpretation, and preparation of the manuscript. Publisher Copyright: © 2019 The Authors. Health and Social Care in the Community Published by John Wiley & Sons Ltd Copyright: Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - The number of older homeless people with a limited life expectancy is increasing. European studies on their health-related characteristics are lacking. This study compared self-reported health, healthcare service use and health-related needs of older and younger homeless people in the Netherlands. It is part of a cohort study that followed 513 homeless people in the four major Dutch cities for a period of 2.5 years, starting from the moment they registered at the social relief system in 2011. Using cross-sectional data from 378 participants who completed 2.5-year follow-up, we analysed differences in self-reported health, healthcare service use, and health-related needs between homeless adults aged ≥50 years (N = 97) and <50 years (N = 281) by means of logistic regression. Results show that statistically significantly more older than younger homeless people reported cardiovascular diseases (23.7% versus 10.3%), visual problems (26.8% versus 14.6%), limited social support from family (33.0% versus 19.6%) and friends or acquaintances (27.8% versus 14.6%), and medical hospital care use in the past year (50.5% versus 34.5%). Older homeless people statistically significantly less often reported cannabis (12.4% versus 45.2%) and excessive alcohol (16.5% versus 27.0%) use in the past month and dental (20.6% versus 46.6%) and mental (16.5% versus 25.6%) healthcare use in the past year. In both age groups, few people reported unmet health-related needs. In conclusion, compared to younger homeless adults, older homeless adults report fewer substance use problems, but a similar number of dental and mental problems, and more physical and social problems. The multiple health problems experienced by both age groups are not always expressed as needs or addressed by healthcare services. Older homeless people seem to use more medical hospital care and less non-acute, preventive healthcare than younger homeless people. This vulnerable group might benefit from shelter-based or community outreach programmes that proactively provide multidisciplinary healthcare services.
AB - The number of older homeless people with a limited life expectancy is increasing. European studies on their health-related characteristics are lacking. This study compared self-reported health, healthcare service use and health-related needs of older and younger homeless people in the Netherlands. It is part of a cohort study that followed 513 homeless people in the four major Dutch cities for a period of 2.5 years, starting from the moment they registered at the social relief system in 2011. Using cross-sectional data from 378 participants who completed 2.5-year follow-up, we analysed differences in self-reported health, healthcare service use, and health-related needs between homeless adults aged ≥50 years (N = 97) and <50 years (N = 281) by means of logistic regression. Results show that statistically significantly more older than younger homeless people reported cardiovascular diseases (23.7% versus 10.3%), visual problems (26.8% versus 14.6%), limited social support from family (33.0% versus 19.6%) and friends or acquaintances (27.8% versus 14.6%), and medical hospital care use in the past year (50.5% versus 34.5%). Older homeless people statistically significantly less often reported cannabis (12.4% versus 45.2%) and excessive alcohol (16.5% versus 27.0%) use in the past month and dental (20.6% versus 46.6%) and mental (16.5% versus 25.6%) healthcare use in the past year. In both age groups, few people reported unmet health-related needs. In conclusion, compared to younger homeless adults, older homeless adults report fewer substance use problems, but a similar number of dental and mental problems, and more physical and social problems. The multiple health problems experienced by both age groups are not always expressed as needs or addressed by healthcare services. Older homeless people seem to use more medical hospital care and less non-acute, preventive healthcare than younger homeless people. This vulnerable group might benefit from shelter-based or community outreach programmes that proactively provide multidisciplinary healthcare services.
KW - care needs
KW - homelessness
KW - older people
KW - perceived health
KW - service use
KW - social support
UR - http://www.scopus.com/inward/record.url?scp=85064935842&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/hsc.12739
DO - https://doi.org/10.1111/hsc.12739
M3 - Article
C2 - 31020738
SN - 0966-0410
VL - 27
SP - e379-e388
JO - Health and Social Care in the Community
JF - Health and Social Care in the Community
IS - 4
ER -