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Violence and Emergency Department Use among Community-Recruited Women Who Experience Homelessness and Housing Instability.
Riley, Elise D; Vittinghoff, Eric; Kagawa, Rose M C; Raven, Maria C; Eagen, Kellene V; Cohee, Alison; Dilworth, Samantha E; Shumway, Martha.
Afiliación
  • Riley ED; Department of Medicine, University of California, San Francisco, 1001 Potrero Ave., UCSF mailbox 0874, San Francisco, CA, 94143-0874, USA. Elise.Riley@ucsf.edu.
  • Vittinghoff E; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
  • Kagawa RMC; Department of Emergency Medicine, University of California, Davis, Davis, CA, USA.
  • Raven MC; Department of Emergency Medicine, University of California, San Francisco, San Francisco, CA, USA.
  • Eagen KV; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USA.
  • Cohee A; Department of Public Health, Tom Waddell Urban Health Clinic, San Francisco, CA, USA.
  • Dilworth SE; Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA, USA.
  • Shumway M; Department of Medicine, University of California, San Francisco, 1001 Potrero Ave., UCSF mailbox 0874, San Francisco, CA, 94143-0874, USA.
J Urban Health ; 97(1): 78-87, 2020 02.
Article en En | MEDLINE | ID: mdl-31907705
Women who experience housing instability are at high risk for violence and have disproportionately high rates of emergency department (ED) use. However, little has been done to characterize the violence they experience, or to understand how it may be related to ED use. We recruited homeless and unstably housed women from San Francisco shelters, free meal programs, and single room occupancy (SRO) hotels. We used generalized estimating equations to examine associations between violence and any ED use (i.e., an ED visit for any stated reason) every 6 months for 3 years. Among 300 participants, 44% were African-American, and the mean age was 48 years. The prevalence of violence experienced in the prior 6 months included psychological violence (87%), physical violence without a weapon (48%), physical violence with a weapon (18%), and sexual violence (18%). While most participants (85%) who experienced physical violence with a weapon or sexual violence in the prior 6 months had not visited an ED, these were the only two violence types significantly associated with ED use when all violence types were included in the same model (ORphysical/weapon = 1.83, 95% CI 1.02-3.28; ORsexual = 2.15, 95% CI 1.30-3.53). Only violence perpetrated by someone who was not a primary intimate partner was significantly associated with ED use when violence was categorized by perpetrator. The need to reduce violence in this population is urgent. In the context of health care delivery, policies to facilitate trauma-informed ED care and strategies that increase access to non-ED care, such as street-based medicine, could have substantial impact on the health of women who experience homelessness and housing instability.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Violencia / Personas con Mala Vivienda / Servicio de Urgencia en Hospital Tipo de estudio: Prevalence_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Adult / Female / Humans / Middle aged País/Región como asunto: America do norte Idioma: En Revista: J Urban Health Asunto de la revista: MEDICINA Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Violencia / Personas con Mala Vivienda / Servicio de Urgencia en Hospital Tipo de estudio: Prevalence_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Adult / Female / Humans / Middle aged País/Región como asunto: America do norte Idioma: En Revista: J Urban Health Asunto de la revista: MEDICINA Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos