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Schedule:
Thursday, June 2, 2016
Garden Room A (Hyatt Regency San Francisco)
* noted as presenting author
INTRODUCTION: Permanent supportive housing (PSH) has been identified as the “clear solution” to chronic homelessness by the US federal government. Previous research has documented that this population experiences high rates of chronic health conditions. Increasingly, coordinated entry systems are prioritizing those who are most vulnerable with highest mortality risk for placement into PSH through a practice known as vulnerability indexing. This study examines a sample of homeless adults entering PSH in Los Angeles County (LAC), which has implemented a coordinated entry system. We hypothesize that the rates of chronic health conditions in our LAC sample will not only be higher than the generable population but also higher than those reported in previous published study of PSH that did not employ vulnerability indexing.
METHODS: Our sample consists of adults aged 40 years old and above entering PSH (N=398). Self-reported health conditions were collected upon program entry and compared to those of the general population of California and LAC as well as a sample of homeless adults in Philadelphia (n=106) who were placed into PSH between 2008-2009 without vulnerability indexing.
RESULTS: The study sample reported substantially higher rates of diabetes (26.86%) when compared to the general population from LAC (13.4%), CA (15.7%), and the earlier sample of PSH residents (12.9%). This trend held for heart failure [6.78% versus 2.8% in LAC, 2.3% in CA, and 5.4% in other PSH], respiratory conditions [27.64% versus 12.5% in LAC, 9.6% in CA, and 18.3% in other PSH.], and hypertension [51.26% versus 40.2% in LAC, 37.7% in CA, and 40.9% in other PSH.]. Self-reported health status of ‘Excellent’ to ‘Good’ comprised 43.5% in our sample versus 70.5% in LAC, 74.8% CA, and 53.4% in other PSH.
CONCLUSIONS: The findings from this study suggest that the trend of prioritizing the most vulnerable for PSH results in higher rates of chronic health conditions than previously encountered within PSH. This highlights the need for increased capacity to address chronic health conditions within PSH, and underscores the importance of tracking rates of chronic health conditions for those entering PSH. Adopting disease registries could allow PSH programs to take a population health perspective and may reduce the heavy burden of care coordination that is often left to individual PSH staff.
METHODS: Our sample consists of adults aged 40 years old and above entering PSH (N=398). Self-reported health conditions were collected upon program entry and compared to those of the general population of California and LAC as well as a sample of homeless adults in Philadelphia (n=106) who were placed into PSH between 2008-2009 without vulnerability indexing.
RESULTS: The study sample reported substantially higher rates of diabetes (26.86%) when compared to the general population from LAC (13.4%), CA (15.7%), and the earlier sample of PSH residents (12.9%). This trend held for heart failure [6.78% versus 2.8% in LAC, 2.3% in CA, and 5.4% in other PSH], respiratory conditions [27.64% versus 12.5% in LAC, 9.6% in CA, and 18.3% in other PSH.], and hypertension [51.26% versus 40.2% in LAC, 37.7% in CA, and 40.9% in other PSH.]. Self-reported health status of ‘Excellent’ to ‘Good’ comprised 43.5% in our sample versus 70.5% in LAC, 74.8% CA, and 53.4% in other PSH.
CONCLUSIONS: The findings from this study suggest that the trend of prioritizing the most vulnerable for PSH results in higher rates of chronic health conditions than previously encountered within PSH. This highlights the need for increased capacity to address chronic health conditions within PSH, and underscores the importance of tracking rates of chronic health conditions for those entering PSH. Adopting disease registries could allow PSH programs to take a population health perspective and may reduce the heavy burden of care coordination that is often left to individual PSH staff.