Health equity
Is homeless health just the bottom of the deprivation slope?
Open access · cc by · source: Europe PMC
Among 1336 homeless and 13,360 housed adults, chronic diseases jumped far above even the most deprived housed quintile (COPD 14% vs 2%), which the authors call a health ‘cliff’.
Study at a glance
- Design
- Cross-sectional — Cross-sectional survey of homeless people in London and Birmingham, age- and sex-matched to Health Survey for England housed participants by deprivation quintile.
- N
- N=14696 · 1336 homeless and 13,360 housed participants.
- Population
- Adults sleeping rough or in hostels with a history of sleeping rough, versus urban housed adults from HSE.
- Outcome
- Self-reported asthma, COPD, epilepsy, heart problems, stroke, diabetes, and EQ-5D-3L health-related quality of life.
Structured fields used in claim comparison tables when every cited study has a complete layer.
Key findings
Housed disease rose with deprivation, but homeless people were much more likely than the most deprived housed quintile to report every disease except diabetes. COPD was 1.1% (least deprived housed), 2.0% (most deprived housed), and 14.0% (homeless). EQ-5D problems otherwise resembled the most deprived housed group, except anxiety, which was far more common (prevalence ratio 3.8 vs 1.8 for most vs least deprived housed).
Methodology
Surveyed people sleeping rough or in hostels in London and Birmingham and compared them with an age- and sex-matched Health Survey for England sample, reporting six self-reported chronic diseases and EQ-5D-3L problems by housed deprivation quintile.
Limitations
Self-report and a cross-section cannot prove homelessness caused disease, and hostel/day-centre sampling misses some street populations.
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.
Among US Internet users in 2012, eHealth use gaps tracked education and sex more than race/ethnicity.
HINTS 2012 (N=3,959; 2,358 Internet users) found no racial/ethnic divide in online eHealth use, but lower education predicted lower odds of finding a clinician online (OR 0.50) or emailing a doctor (OR 0.46); women used eHealth more.
Scope note — homeless vs housed disease prevalence is not an Internet-user eHealth-usage gap
Limits the claim's scope: a different population, assay, or outcome.
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.
Evidence for the claim as stated.
In US adults, poor diet quality tracks race, rurality, and food-desert residence independently.
Among 155,331 CPS-3 adults, poor ACS diet quality was independently higher in Black (+16%) and rural (+61%) participants and in food deserts (+17%), while Hispanic (−16%) and Asian/NHPI (−33%) groups had lower risk; income and education effects differed by race/ethnicity.
Scope note — homeless vs housed disease prevalence is not a US diet-quality geography
Limits the claim's scope: a different population, assay, or outcome.
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.
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 155,331 CPS-3 adults, poor ACS diet quality was independently higher in Black (+16%) and rural (+61%) participants and in food deserts (+17%), while Hispanic (−16%) and Asian/NHPI (−33%) groups had lower risk; income and education effects differed by race/ethnicity.
Placed as a scope qualifier on Health Equity
HINTS 2012 (N=3,959; 2,358 Internet users) found no racial/ethnic divide in online eHealth use, but lower education predicted lower odds of finding a clinician online (OR 0.50) or emailing a doctor (OR 0.46); women used eHealth more.
Placed as supporting evidence 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.
Related papers in this topic
Same topic cluster — not a recommendation engine.