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

这项研究旨在全面了解美国无房人群健康变化的驱动因素。没有住房的人承受着各种疾病和死亡的高风险，但导致这一弱势群体不同健康结果的具体途径却没有得到充分调查。该项目调查了影响无住房者健康的个人、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微妙方式。该项目的成果通过为决策者和公众制作的学术出版物和概况介绍广泛传播。它包括一个公共教育播客项目，让没有住房的人与广大的普通听众分享他们的经验。这项研究采用了卫生科学和社会科学方法的创新组合，收集有关人们无家可归的生活经历的信息，并评估他们的身体健康状况和导致健康风险的因素。它试图回答一系列问题，包括：庇护所和强迫搬迁等物质结构如何影响健康;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实现更好的健康和福利结果。 为了回答这些问题，我们比较了四个不同的无家可归者群体：那些睡在街上没有庇护的人;那些住在未经批准的营地的人;那些睡在临时避难所的人;以及那些住在永久支持性住房安排中的人。以前没有任何研究采取这种比较和整体的办法;因此，它将为塑造这一弱势群体健康的最重要因素提供新的见解，为文化人类学，人类生物学，公共卫生，该奖项反映了NSF的法定使命，并被认为值得通过使用基金会的知识产权进行评估来支持。优点和更广泛的影响审查标准。

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.