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Hispanic health disparities and housing: Comparing measured and self-reported health metrics among housed and homeless Latin individuals.

ABSTRACT: Previous studies argue that Hispanics are healthier and less likely to experience homelessness than other populations in their same socioeconomic position. However, earlier studies have not explored the relationship between housing status and health for Latin individuals. This study examines 1) the health disparities between homeless and housed Hispanics in El Paso, Texas, and 2) the Hispanic health and homelessness paradoxes using an intersectional framework to understand health risks. A large number of Hispanic residents of El Paso (N = 1152) were surveyed. Demographic, health, and housing data were collected. We contribute to the literature by providing detailed health indicators for homeless Hispanics. To our knowledge, this is the first study to examine health disparities between housed and homeless Hispanics. Bivariate analysis, as well as data coded from interviews, indicated that homeless Hispanics were more likely to have barriers to care, less likely to have health insurance, slightly more likely than housed Hispanics to experience mental illness, alcoholism, and addiction, and more likely to be underdiagnosed for health problems, including hypertension. This study shows how certain traditional methods for collecting health data, including self-rated health and reported diagnoses, can be ineffective at revealing health disparities. This paper calls for innovative, mixed-methods approaches to understand the social and structural determinants of health for marginalized populations.

SUBMITTER: Castaneda E

PROVIDER: S-EPMC8352211 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundPeople experiencing homelessness are often marginalized and are known to face barriers to accessing acceptable and respectful healthcare services. This study examines the experience of accessing hospital-based services of persons experiencing homelessness or vulnerable housing in southeastern Ontario and considers the potential of Equity-Oriented Health Care (EOHC) as an approach to improving care.MethodsFocus groups and in-depth interviews with people with lived experience of homelessness (n=31), as well as in-depth interviews of health and social service provider key informants (n=10) were combined with qualitative data from a survey of health and social service providers (n=136). Interview transcripts and written survey responses were analyzed using directed content analysis to examine experiences of people with lived experience of homelessness within the healthcare system.ResultsHealthcare services were experienced as stigmatizing and shaming particularly for patients with concurrent substance use. These negative experiences could lead to avoidance or abandonment of care. Despite supposed universality, participants felt that the healthcare system was not accountable to them or to other equity-seeking populations. Participants identified a system that was inflexible, designed for a perceived middle-class population, and that failed to take into account the needs and realities of equity-seeking groups. Finally, participants did identify positive healthcare interactions, highlighting the importance of care delivered with dignity, trust, and compassion.ConclusionsThe experiences of healthcare services among the homeless and vulnerably housed do not meet the standards of universally accessible patient-centered care. EOHC could provide a framework for changes to the healthcare system, creating a system that is more trauma-informed, equity-enhancing, and accessible to people experiencing homelessness, thus limiting identified barriers and negative experiences of care.

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Hispanic health disparities and housing: Comparing measured and self-reported health metrics among housed and homeless Latin individuals.

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