Self‐reported health, healthcare service use and health‐related needs

A comparison of older and younger homeless people

S.I. van Dongen*, B. van Straaten, J.R.L.M. Wolf, B. D Onwuteaka‐Philipsen, A. van der Heide, J. A. Rietjens, D. van de Mheen

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

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.
Original languageEnglish
Pages (from-to)E379-E388
JournalHealth & Social Care in the Community
Volume27
Issue number4
DOIs
Publication statusPublished - 2019

Fingerprint

Health Services
Delivery of Health Care
health
Age Groups
Community-Institutional Relations
age group
Life Expectancy
Netherlands
Young Adult
life expectancy
Social Problems
Logistic Models
Alcohols
social support
logistics
alcohol
Disease
regression
community
Group

Keywords

  • ACCURACY
  • ADULTS
  • MEDICAL-CARE
  • MORTALITY
  • OUTCOMES
  • POPULATION
  • PSYCHIATRIC-DISORDERS
  • care needs
  • homelessness
  • older people
  • perceived health
  • service use
  • social support

Cite this

van Dongen, S. I., van Straaten, B., Wolf, J. R. L. M., Onwuteaka‐Philipsen, B. D., van der Heide, A., Rietjens, J. A., & van de Mheen, D. (2019). Self‐reported health, healthcare service use and health‐related needs: A comparison of older and younger homeless people. Health & Social Care in the Community , 27(4), E379-E388. https://doi.org/10.1111/hsc.12739
van Dongen, S.I. ; van Straaten, B. ; Wolf, J.R.L.M. ; Onwuteaka‐Philipsen, B. D ; van der Heide, A. ; Rietjens, J. A. ; van de Mheen, D. / Self‐reported health, healthcare service use and health‐related needs : A comparison of older and younger homeless people. In: Health & Social Care in the Community . 2019 ; Vol. 27, No. 4. pp. E379-E388.
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title = "Self‐reported health, healthcare service use and health‐related needs: A comparison of older and younger homeless people",
abstract = "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.",
keywords = "ACCURACY, ADULTS, MEDICAL-CARE, MORTALITY, OUTCOMES, POPULATION, PSYCHIATRIC-DISORDERS, care needs, homelessness, older people, perceived health, service use, social support",
author = "{van Dongen}, S.I. and {van Straaten}, B. and J.R.L.M. Wolf and Onwuteaka‐Philipsen, {B. D} and {van der Heide}, A. and Rietjens, {J. A.} and {van de Mheen}, D.",
year = "2019",
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pages = "E379--E388",
journal = "Health & Social Care in the Community",
issn = "1365-2524",
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van Dongen, SI, van Straaten, B, Wolf, JRLM, Onwuteaka‐Philipsen, BD, van der Heide, A, Rietjens, JA & van de Mheen, D 2019, 'Self‐reported health, healthcare service use and health‐related needs: A comparison of older and younger homeless people', Health & Social Care in the Community , vol. 27, no. 4, pp. E379-E388. https://doi.org/10.1111/hsc.12739

Self‐reported health, healthcare service use and health‐related needs : A comparison of older and younger homeless people. / van Dongen, S.I.; van Straaten, B.; Wolf, J.R.L.M.; Onwuteaka‐Philipsen, B. D; van der Heide, A.; Rietjens, J. A.; van de Mheen, D.

In: Health & Social Care in the Community , Vol. 27, No. 4, 2019, p. E379-E388.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Self‐reported health, healthcare service use and health‐related needs

T2 - A comparison of older and younger homeless people

AU - van Dongen, S.I.

AU - van Straaten, B.

AU - Wolf, J.R.L.M.

AU - Onwuteaka‐Philipsen, B. D

AU - van der Heide, A.

AU - Rietjens, J. A.

AU - van de Mheen, D.

PY - 2019

Y1 - 2019

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 - ACCURACY

KW - ADULTS

KW - MEDICAL-CARE

KW - MORTALITY

KW - OUTCOMES

KW - POPULATION

KW - PSYCHIATRIC-DISORDERS

KW - care needs

KW - homelessness

KW - older people

KW - perceived health

KW - service use

KW - social support

U2 - 10.1111/hsc.12739

DO - 10.1111/hsc.12739

M3 - Article

VL - 27

SP - E379-E388

JO - Health & Social Care in the Community

JF - Health & Social Care in the Community

SN - 1365-2524

IS - 4

ER -

van Dongen SI, van Straaten B, Wolf JRLM, Onwuteaka‐Philipsen BD, van der Heide A, Rietjens JA et al. Self‐reported health, healthcare service use and health‐related needs: A comparison of older and younger homeless people. Health & Social Care in the Community . 2019;27(4):E379-E388. https://doi.org/10.1111/hsc.12739