Health-related quality of life and prevalence of six chronic diseases in homeless and housed people: a cross-sectional study in London and Birmingham, England
Health-related quality of life and prevalence of six chronic diseases in homeless and housed people: a cross-sectional study in London and Birmingham, England
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DOI：
10.1136/bmjopen-2018-025192
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发表时间：
2019-06-01
期刊：
影响因子：
2.9
通讯作者：
Story, Alistair
中科院分区：
文献类型：
--
作者：
Lewer, Dan;Aldridge, Robert W.;Story, Alistair
Objectives To comparison health-related quality of life and prevalence of chronic diseases in housed and homeless populations.Design横断面调查与年龄匹配和性别匹配的住房comparison group.Setting旅馆，日间中心和汤运行在伦敦和伯明翰，England.Participants无家可归的参与者要么睡粗糙或住在宿舍，并有睡粗糙的历史。对照组来自英国健康调查。该研究包括1336无家可归者和13360住房participators. OutcomeMeasures慢性疾病是自我报告的哮喘，慢性阻塞性肺疾病（COPD），癫痫，心脏问题，中风和糖尿病。采用EQ-5D-3L量表测量健康相关生活质量。结果居住在贫困社区的被调查者报告疾病的可能性更高。无家可归的参与者比居住在最贫困的五分之一的参与者更有可能报告除糖尿病以外的所有疾病（无家可归的参与者和最贫困的居住群体的患病率相似）。例如，在住房条件最差的五分之一人群中，慢性阻塞性肺病的患病率为1.1%（95% CI 0.7%至1.6%）;在住房条件最差的五分之一人群中，慢性阻塞性肺病的患病率为2.0%（95% CI 1.5%至2.6%）;在无家可归人群中，慢性阻塞性肺病的患病率为14.0%（95% CI 12.2%至16.0%）。在居住人群中，每个EQ-5D-3L领域的问题也存在社会梯度，但无家可归的参与者报告问题的可能性与最贫困的居住群体相似。例外的是焦虑相关的问题，这是更常见的无家可归的人比任何housedgroup.Conclusions之间的差异，而居住的社会经济群体的健康可以被描述为“斜坡”，居住和无家可归的人之间的健康差异更好地理解为“悬崖”。
Objectives To compare health-related quality of life and prevalence of chronic diseases in housed and homeless populations.Design Cross-sectional survey with an age-matched and sex-matched housed comparison group.Setting Hostels, day centres and soup runs in London and Birmingham, England.Participants Homeless participants were either sleeping rough or living in hostels and had a history of sleeping rough. The comparison group was drawn from the Health Survey for England. The study included 1336 homeless and 13 360 housed participants.Outcome measures Chronic diseases were self-reported asthma, chronic obstructive pulmonary disease (COPD), epilepsy, heart problems, stroke and diabetes. Health-related quality of life was measured using EQ-5D-3L.Results Housed participants in more deprived neighbourhoods were more likely to report disease. Homeless participants were substantially more likely than housed participants in the most deprived quintile to report all diseases except diabetes (which had similar prevalence in homeless participants and the most deprived housed group). For example, the prevalence of chronic obstructive pulmonary disease was 1.1% (95% CI 0.7% to 1.6%) in the least deprived housed quintile; 2.0% (95% CI 1.5% to 2.6%) in the most deprived housed quintile; and 14.0% (95% CI 12.2% to 16.0%) in the homeless group. Social gradients were also seen for problems in each EQ-5D-3L domain in the housed population, but homeless participants had similar likelihood of reporting problems as the most deprived housed group. The exception was problems related to anxiety, which were substantially more common in homeless people than any of the housed groups.Conclusions While differences in health between housed socioeconomic groups can be described as a 'slope', differences in health between housed and homeless people are better understood as a 'cliff'.