Health equity
Discrimination in care for homeless adults
Open access · cc by · source: Europe PMC
Among homeless adults with mental illness, perceived healthcare discrimination—especially for mental illness/poverty—linked to worse symptoms and more ED use.
How this study connects
Role on claims
Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.
Multiple studies in this library examine health equity with empirical patient or population outcomes rather than opinion alone.
Evidence for the claim as stated.
42% reported any discrimination; mental illness/substance use (33%) and homelessness/poverty (30%) were most common; discrimination associated with greater lifetime substance/mental severity and more frequent ED use.
Evidence for the claim as stated.
Homeless adults sit on a health ‘cliff’ above even the most deprived housed quintile.
Among 1,336 homeless and 13,360 housed adults, chronic disease was far higher in homeless people than the most deprived housed quintile (COPD 14% vs 2%), except diabetes; EQ-5D problems otherwise resembled extreme deprivation.
Scope note — perceived discrimination among homeless adults with mental illness — not a housed-deprivation comparison of six diseases
Limits the claim's scope: a different population, assay, or outcome.
Effect sizes and settings differ across health equity studies — digital vs clinic, trial vs observational — so results should not be pooled casually.
Evidence for the claim as stated.
eHealth usage among Internet users, a homeless–housed disease cliff, US diet-quality geography, and Korean PM×gender MMSE are related equity problems with different exposures and endpoints.
Evidence for the claim as stated.
Open questions
Tensions this paper is part of
From concept pages' “where studies disagree.” Disagreement means the same question; scope means different assays, populations, or outcomes.
Effect sizes and settings differ across health equity studies — digital vs clinic, trial vs observational — so results should not be pooled casually.
eHealth usage among Internet users, a homeless–housed disease cliff, US diet-quality geography, and Korean PM×gender MMSE are related equity problems with different exposures and endpoints.
History
When this study was placed
Dated entries from the concept change log — when this paper was added or removed as support, challenge, or qualifier on a claim.
Placed as a scope qualifier on Health Equity
Among 1,336 homeless and 13,360 housed adults, chronic disease was far higher in homeless people than the most deprived housed quintile (COPD 14% vs 2%), except diabetes; EQ-5D problems otherwise resembled extreme deprivation.
Placed as supporting evidence on Health Equity
eHealth usage among Internet users, a homeless–housed disease cliff, and perceived healthcare discrimination are related equity problems with different exposures and endpoints.
Study at a glance
- Design
- Cross-sectional — Baseline analysis from Toronto At Home/Chez Soi Housing First trial sample
- N
- N=550 · Final analytic sample with baseline interviews
- Population
- Homeless adults with mental illness at the Toronto At Home/Chez Soi site
- Outcome
- Past-year perceived discrimination in healthcare and associations with ED use
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Inspect source passages
Discrimination in care for homeless adults
These passages occur verbatim in the stored paper text. They support the points listed below; they do not verify every statement in the explanation.
40% reported unmet healthcare needs despite high access markers.
Although the majority of respondents had a regular medical doctor (66%), a usual source of outpatient care (90%), and a provincial health card (93%), 40% reported unmet healthcare needs.
Which discrimination types were most prevalent?
After grouping variables in the three categories of interest, the most prevalent forms of perceived discrimination were due to mental illness/substance use (33%) and homelessness/poverty (30%).
Key findings
42% reported any discrimination; mental illness/substance use (33%) and homelessness/poverty (30%) were most common; discrimination associated with greater lifetime substance/mental severity and more frequent ED use.
Methodology
Using Toronto At Home/Chez Soi baseline data, researchers measured past-year perceived discrimination in healthcare and associations with mental health, substance use, and emergency department use.
Limitations
Causal direction (discrimination vs illness severity) and whether anti-discrimination interventions reduce ED use.
Related papers in this topic
Same topic cluster — not a recommendation engine.