Housing Boston's Chronically Homeless Unsheltered Population: 14 Years Later.
Housing Boston's Chronically Homeless Unsheltered Population: 14 Years Later.
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DOI：
10.1097/mlr.0000000000001409
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发表时间：
2021-04-01
期刊：
影响因子：
3
通讯作者：
O'Connell JJ
中科院分区：
文献类型：
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作者：
Roncarati JS;Tiemeier H;Tachick R;VanderWeele TJ;O'Connell JJ
长期无庇护个人或露宿者的永久性支助性住房的长期结果在很大程度上是未知的。因此，我们评估了一组没有庇护的个人的住房结果，他们在外面生活了几十年后直接从街道上被安置。使用开放式队列设计，73名长期无庇护的个人从2005年至2019年直接从波士顿街道登记并安置在永久性支持性住房中。通过描述性、回归和生存分析，我们评估了住房保留、住房稳定性和生存预测因素。≥1年时的住房保留率为82%，但≥5年时降至36%;相应的Kaplan Meier估计值为≥1年时的72%，≥5年时的42.5%，≥10年时的37.5%。近一半的队列（45%）在收容期间死亡。同时发生的医疗，精神和物质使用障碍，或'三病，'是常见的。搬到新公寓也很常见; 38%的人为了避免被驱逐而搬了45次家。随后的每一次住房搬迁都增加了租户返回无家可归的风险。三次或三次以上的住房搬迁大大增加了死亡风险。长期的长期无庇护的个人这个永久性的支持性住房计划的结果显示，低住房保留和生存差。这一弱势群体的住房稳定可能需要更有力、更灵活和更长期的医疗和社会支持。
The long-term outcomes of permanent supportive housing for chronically unsheltered individuals, or rough sleepers, are largely unknown. We therefore assessed housing outcomes for a group of unsheltered individuals who were housed directly from the streets after living outside for decades. Using an open-cohort design, 73 chronically unsheltered individuals were enrolled and housed in permanent supportive housing directly from the streets of Boston from 2005–2019. Through descriptive, regression and survival analysis, we assessed housing retention, housing stability and predictors of survival. Housing retention at ≥1 year was 82% yet fell to 36% at ≥5 years; corresponding Kaplan Meier estimates for retention were 72% at ≥1, 42.5% at ≥5, and 37.5% at ≥10 years. Nearly half of the cohort (45%) died while housed. The co-occurrence of medical, psychiatric, and substance use disorder, or ‘trimorbidity,’ was common. Moves to a new apartment were also common; 38% were moved 45 times to avoid an eviction. Each subsequent housing relocation increased the risk of a tenant returning to homelessness. Three or more housing relocations substantially increased the risk of death. Long-term outcomes for this permanent supportive housing program for chronically unsheltered individuals showed low housing retention and poor survival. Housing stability for this vulnerable population likely requires more robust and flexible and long-term medical and social supports.