The issue of homelessness in America

Homelessness is a serious societal issue that affects most nations and has been becoming worse over time. The main causes of the issue may be institutional, personal, structural, and interpersonal. Increased rates of unemployment, rising levels of poverty, and the current economic crisis all contribute to these concerns. Due to tight property markets, changes to benefits, and rising unemployment, young people are most at risk from the problem. Also, the problems of social isolation and drug abuse increase the likelihood of them becoming homeless. The reason behind this is that these individuals do not have sufficient funds to fend for their needs and cannot afford to acquire or pay rent for stable housing.
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Intervention 1- Health intervention for the homeless

Article 1- Intervention 1

Authors

-Stephen W. Hwang, MD, MPH, George Tolomiczenko, MPH, PhD, Fiona G. Kouyoumdjian, MD, MPH and Rochelle E. Garner, MSc

Population sampling method

-Simple random sampling of individuals, from ages 1-58 years, with no residence and those living in shelters not intended for humans.

Research questions and hypotheses

-What are some of the health issues caused by the problem of homelessness?

-What can be done to increase the well-being of homeless individuals?

Hypotheses

-Homelessness is one of the known widespread problems in the United states.

-Homelessness affects the health of the people of all ages.

Independent variables and operational definitions

Homelessness

-This is a condition that involves people’s lack of a permanent and stable place to dwell.

Dependent variables and operational definitions

-Drug abuse- use of drugs in a harmful way.

-Mental health- emotional, social and psychological well-being.

Statistical methods

Inferential statistics

-This involves the extraction of data from secondary sources and resolving any disagreements by use of consensus.

Results/findings

The results were positive in that the case management was effective, but there was no noteworthy variance in the effects of the interventions to improve the mental health and drug abuse.

Strength and limitations of the study

-The strength of the study is that it addressed a diverse topic area.

-Limitations include insufficient information and biasness due to the inclusion of studies published in English alone.



Article 2- Intervention 1

Authors

-Jeffrey Turnbull, MD MEd, Wendy Muckle, RN MHA, and Christina Masters, BSc

Population sampling method

-Random sampling

Research questions and hypotheses

-What is the approximate rate of homelessness in urban population?

-Does homelessness have any relationship with the increase in urbanization?

-How does the homeless individuals affect the distribution of social and health care resources

Hypotheses

-Homeless people are believed to be the ones that take part mainly in violent activities and enhance drugs availability.

- Eradication of homelessness and improving health among the homeless is a major social problem

Independent variables and operational definitions

-Rate of homelessness

Dependent variables and operational definitions

-Violence and drug abuse- Violence is an intentional use of physical power that can result in injury while drug abuse is the consumptions of drugs in methods that are harmful.

Statistical methods

-Descriptive statistics- The method involves the explanation of data found out about the sample.

Results/findings

-Most crises of health and family breakdown result from lack of stable housing. Most homeless individuals move to the streets and become part of the culture of the streets that involve sexual abuse, drug addiction and violence.

Strength and limitations of the study

-The strength of this study lies in the fact that it shows that there is hope despite the challenges.

- The limitation is that the solutions to the problem are more complex and require much courage to implement.



Intervention 2- Poverty intervention for the homeless

Article 3- Intervention 2

Authors

- de Vet R1, van Luijtelaar MJ, Brilleslijper-Kater SN, Vanderplasschen W, Beijersbergen MD and Wolf JR

Population sampling method

-Randomized

Research questions and hypotheses

-What is the efficiency intensive case management (ICM) for homeless individuals?

-What is the efficiency assertive community treatment (ACT) for homeless individuals?

-What is the effectiveness critical time intervention (CTI) for homeless individuals?

-What is the effectiveness standard case management (SCM) for homeless individuals?

Hypothesis

-Case management services are more effective in improving house stability than other services.

Independent variables and operational definitions

-Poverty management- employing some trusted measures to alleviate poverty.

Dependent variables and operational definitions

-Homelessness- When poverty is reduces, people will have money to spent in housing hence the level of homelessness will reduce.

Statistical methods

-Inferential statistics

Results/findings

There was little proof for the ICM efficiency, but SCM enhanced housing constancy. ACT on the other hand was cost effective and improved housing stability. CTI gave positive results also since it was very effective for the mentally ill homeless people.

Strength and limitations of the study

-The strength of the study it used a wide perspective research.

- Its limitation is that it does not explain how case management can be effectively used to reduce the rated of homelessness.



Article 4- Intervention 2

Authors

- Yong Liu, MD, MS; Rashid S. Njai, PhD, MPH; Kurt J. Greenlund, PhD; Daniel P. Chapman, PhD, MSc and Janet B. Croft, PhD

Population sampling method

-Simple random sampling

Research questions and hypotheses

-How are food and housing insecurity related to mental distress?

-What is the connection between food and housing insecurity and insufficient sleep?

Hypothesis

-Interventions that reduce poverty will improve both sleep and mental health.

Independent variables and operational definitions

- Housing insecurity- Worry caused by unstable housing conditions or a total absence of money to par rent.

-Food insecurity- being worried due to insufficient money to buy nutritious food.

Dependent variables and operational definitions

-Mental distress- experiences of a person’s life which are troubling and confusing.

-Insufficient sleep- a syndrome that occurs due to sleep deprivation.

Statistical methods

-A state based randomized telephone survey.

Results/findings

-The prevalence of mental distress due to food and housing insecurity was greater than the prevalence of insufficient sleep.

Strength and limitations of the study

-The strength is that it used the available data, thus more representative of the population.

-A limitation is that it does not give a clear explanation on the effects of the two insecurities.







Links to the electronic copies

https://www.cdc.gov/pcd/issues/2014/13_0334.htm

https://www.ncbi.nlm.nih.gov/books/NBK71506/#_d12006006132_selection_

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2025621/

https://www.ncbi.nlm.nih.gov/pubmed/23947309

























References

de Vet, R., van Luijtelaar, M. J., Brilleslijper-Kater, S. N., Vanderplasschen, W., Beijersbergen, M. D., & Wolf, J. R. (2013). Effectiveness of case management for homeless persons: a systematic review. American Journal of Public Health, 103(10), e13-e26.

Hwang, S. W., Tolomiczenko, G., Kouyoumdjian, F. G., & Garner, R. E. (2005). Interventions to improve the health of the homeless: a systematic review. American journal of preventive medicine, 29(4), 311-311.

Liu, Y., Njai, R. S., Greenlund, K. J., Chapman, D. P., & Croft, J. B. (2014). Peer Reviewed: Relationships Between Housing and Food Insecurity, Frequent Mental Distress, and Insufficient Sleep Among Adults in 12 US States, 2009. Preventing chronic disease, 11.

Turnbull, J., Muckle, W., & Masters, C. (2007). Homelessness and health. Canadian Medical Association Journal, 177(9), 1065-1066.