Homelessness and health: Integrating structural, social, and behavioral pathways

这项研究旨在全面了解导致美国无住房人群健康状况变化的因素。没有住房的人在所有类别中都面临着很高的疾病和死亡风险，但导致这一弱势群体健康结果变化的具体途径尚未得到充分调查。该项目调查了影响无住房人群健康的个人、社区和结构性因素，旨在了解不同层面的因素可能相互作用以影响特定脆弱性的细微方式。该项目的成果通过学术出版物和为决策者和公众制作的情况介绍广泛传播。它包括一个公共教育播客项目，在那里没有住房的人与广大听众分享他们的经历。它培养来自弱势群体的研究生和本科生。这项研究创新性地结合了健康科学和社会科学的方法，收集了有关无家可归者生活经历的信息，并评估了他们的身体健康状况和导致健康风险的因素。它试图回答以下一系列问题：庇护所和强制搬迁等实体结构如何影响健康；无家可归者如何利用社会关系来管理资源和健康短缺；以及如何有效实施干预措施以取得更好的健康和福利成果。为了回答这些问题，我们比较了四种不同的无家可归者：露宿街头的人；居住在未经批准的营地的人；那些睡在临时避难所的人；以及那些住在永久性支持性住房安排中的人。以前没有研究采用这种比较和整体的方法；因此，它将为影响这一弱势群体健康的最重要因素提供新的见解，有助于文化人类学、人类生物学、公共卫生和流行病学的科学理论和应用。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

This research aims to develop a holistic understanding of the factors that drive variation in health among people without housing in the United States. People without housing endure high risks of illness and death across all categories, yet the specific pathways leading to variable health outcomes in this vulnerable population are under-investigated. This project investigates the individual, community, and structural factors that shape health for people without housing, aiming to understand the nuanced ways that factors at different levels may interact to affect specific vulnerabilities. The results of this project are disseminated broadly through scholarly publications and fact sheets produced for policymakers and the public. It includes a public education podcast project, where people without housing share their experiences with a wide audience of general listeners. It trains graduate and under-graduate students from under-represented groups.This research uses an innovative combination of methods from the health and social sciences to collect information about people’s lived experiences with houselessness and to assess their physical health and factors that contribute to health risks. It seeks to answer a range of questions surrounding: how physical structures such as shelters and forced relocation impact health; how social relationships are leveraged by people without homes to manage resource and health shortfalls; and how interventions can be implemented effectively to achieve better health and welfare outcomes. To answer these questions, we compare four distinct groups of people experiencing houselessness: those who sleep unsheltered on the street; those who live in unsanctioned encampments; those who sleep in temporary shelters; and those who have lived in permanent supportive housing arrangements. No previous study has taken this comparative and holistic approach; as such, it will provide new insights into the most important factors that shape health for people in this vulnerable population, contributing to scientific theories and applications in cultural anthropology, human biology, public health, and epidemiology.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.