Health status and self-perception of health among homeless people in Spain: a mixed-methods study

IntroductionHomelessness is a phenomenon of social exclusion and poverty that has increased alarmingly during recent years. Homeless people (HP) experience violations of several basic human rights or needs that impact their well-being. Therefore, the aim of this research was to assess the health sta...

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Main Authors: Miguel A. Bedmar, Laura Capitán-Moyano, Miquel Bennasar-Veny, Cristina Moreno-Mulet, Alba Carrero-Planells, Aina M. Yáñez
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-08-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2024.1444888/full
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author Miguel A. Bedmar
Laura Capitán-Moyano
Laura Capitán-Moyano
Miquel Bennasar-Veny
Miquel Bennasar-Veny
Miquel Bennasar-Veny
Miquel Bennasar-Veny
Cristina Moreno-Mulet
Cristina Moreno-Mulet
Cristina Moreno-Mulet
Alba Carrero-Planells
Alba Carrero-Planells
Alba Carrero-Planells
Aina M. Yáñez
Aina M. Yáñez
Aina M. Yáñez
Aina M. Yáñez
author_facet Miguel A. Bedmar
Laura Capitán-Moyano
Laura Capitán-Moyano
Miquel Bennasar-Veny
Miquel Bennasar-Veny
Miquel Bennasar-Veny
Miquel Bennasar-Veny
Cristina Moreno-Mulet
Cristina Moreno-Mulet
Cristina Moreno-Mulet
Alba Carrero-Planells
Alba Carrero-Planells
Alba Carrero-Planells
Aina M. Yáñez
Aina M. Yáñez
Aina M. Yáñez
Aina M. Yáñez
author_sort Miguel A. Bedmar
collection DOAJ
description IntroductionHomelessness is a phenomenon of social exclusion and poverty that has increased alarmingly during recent years. Homeless people (HP) experience violations of several basic human rights or needs that impact their well-being. Therefore, the aim of this research was to assess the health status and self-perceived health of HP and examining the impact of homelessness on their health.MethodsWe used an explanatory sequential mixed-methods approach that integrated a quantitative cross-sectional study within critical social and ethno-sociological qualitative frameworks. Data were collected in Palma, Spain, from December 1, 2020, to January 1, 2023. A total of 198 HP were recruited from the streets and public areas. Basic human needs (Virginia Henderson model), medical diagnoses, substance abuse (DAST-10), diet quality (IASE), depression (PHQ-9), and social support (SSQ-6) were assessed. Then, 17 semi-structured interviews were conducted and were analyzed using thematic content and discourse analysis. Quantitative and qualitative data were integrated and jointly analyzed.ResultsThe 79.3% of the participants were men, mean age of 47.8 ± 12.2 years. The 76.4% were Spanish. The participants reported severe difficulties in accessing the labor market, and that this greatly affected their self-esteem and mental health. The 48.9% of the participants suffered from one or more chronic diseases, and 50.3% were diagnosed with a mental health disorder. The participants generally did not consider health problems as a central concern. The health needs that most affected the participants were related to food, safety, and social support. HP frequently felt unsafe, fearfully, and anxious.ConclusionHomelessness, unemployment, and social exclusion have significant negative impacts on the health and wellbeing of HP. Precarious work conditions and deficiencies in the welfare system contribute significantly to homelessness. These results highlight the need for systemic solutions that extend beyond short-term housing initiatives.
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spelling doaj-art-177b28e5b2ea40b69a4b3235222499542025-08-20T02:28:32ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-08-011210.3389/fpubh.2024.14448881444888Health status and self-perception of health among homeless people in Spain: a mixed-methods studyMiguel A. Bedmar0Laura Capitán-Moyano1Laura Capitán-Moyano2Miquel Bennasar-Veny3Miquel Bennasar-Veny4Miquel Bennasar-Veny5Miquel Bennasar-Veny6Cristina Moreno-Mulet7Cristina Moreno-Mulet8Cristina Moreno-Mulet9Alba Carrero-Planells10Alba Carrero-Planells11Alba Carrero-Planells12Aina M. Yáñez13Aina M. Yáñez14Aina M. Yáñez15Aina M. Yáñez16Research Group on Global Health and Human Development, University of the Balearic Islands, Palma, SpainResearch Group on Global Health and Human Development, University of the Balearic Islands, Palma, SpainDepartment of Nursing and Physiotherapy, University of the Balearic Islands, Palma, SpainResearch Group on Global Health and Human Development, University of the Balearic Islands, Palma, SpainDepartment of Nursing and Physiotherapy, University of the Balearic Islands, Palma, SpainHealth Research Institute of the Balearic Islands (IdISBa), Palma, SpainCIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, SpainDepartment of Nursing and Physiotherapy, University of the Balearic Islands, Palma, SpainHealth Research Institute of the Balearic Islands (IdISBa), Palma, SpainQualitative and Critical Health Research Group, University of the Balearic Islands, Palma, SpainDepartment of Nursing and Physiotherapy, University of the Balearic Islands, Palma, SpainHealth Research Institute of the Balearic Islands (IdISBa), Palma, SpainQualitative and Critical Health Research Group, University of the Balearic Islands, Palma, SpainResearch Group on Global Health and Human Development, University of the Balearic Islands, Palma, SpainDepartment of Nursing and Physiotherapy, University of the Balearic Islands, Palma, SpainHealth Research Institute of the Balearic Islands (IdISBa), Palma, SpainResearch Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Madrid, SpainIntroductionHomelessness is a phenomenon of social exclusion and poverty that has increased alarmingly during recent years. Homeless people (HP) experience violations of several basic human rights or needs that impact their well-being. Therefore, the aim of this research was to assess the health status and self-perceived health of HP and examining the impact of homelessness on their health.MethodsWe used an explanatory sequential mixed-methods approach that integrated a quantitative cross-sectional study within critical social and ethno-sociological qualitative frameworks. Data were collected in Palma, Spain, from December 1, 2020, to January 1, 2023. A total of 198 HP were recruited from the streets and public areas. Basic human needs (Virginia Henderson model), medical diagnoses, substance abuse (DAST-10), diet quality (IASE), depression (PHQ-9), and social support (SSQ-6) were assessed. Then, 17 semi-structured interviews were conducted and were analyzed using thematic content and discourse analysis. Quantitative and qualitative data were integrated and jointly analyzed.ResultsThe 79.3% of the participants were men, mean age of 47.8 ± 12.2 years. The 76.4% were Spanish. The participants reported severe difficulties in accessing the labor market, and that this greatly affected their self-esteem and mental health. The 48.9% of the participants suffered from one or more chronic diseases, and 50.3% were diagnosed with a mental health disorder. The participants generally did not consider health problems as a central concern. The health needs that most affected the participants were related to food, safety, and social support. HP frequently felt unsafe, fearfully, and anxious.ConclusionHomelessness, unemployment, and social exclusion have significant negative impacts on the health and wellbeing of HP. Precarious work conditions and deficiencies in the welfare system contribute significantly to homelessness. These results highlight the need for systemic solutions that extend beyond short-term housing initiatives.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1444888/fullhomelessnesssocial justiceemploymentsocial exclusionhealth inequitiessocial determinants of health
spellingShingle Miguel A. Bedmar
Laura Capitán-Moyano
Laura Capitán-Moyano
Miquel Bennasar-Veny
Miquel Bennasar-Veny
Miquel Bennasar-Veny
Miquel Bennasar-Veny
Cristina Moreno-Mulet
Cristina Moreno-Mulet
Cristina Moreno-Mulet
Alba Carrero-Planells
Alba Carrero-Planells
Alba Carrero-Planells
Aina M. Yáñez
Aina M. Yáñez
Aina M. Yáñez
Aina M. Yáñez
Health status and self-perception of health among homeless people in Spain: a mixed-methods study
Frontiers in Public Health
homelessness
social justice
employment
social exclusion
health inequities
social determinants of health
title Health status and self-perception of health among homeless people in Spain: a mixed-methods study
title_full Health status and self-perception of health among homeless people in Spain: a mixed-methods study
title_fullStr Health status and self-perception of health among homeless people in Spain: a mixed-methods study
title_full_unstemmed Health status and self-perception of health among homeless people in Spain: a mixed-methods study
title_short Health status and self-perception of health among homeless people in Spain: a mixed-methods study
title_sort health status and self perception of health among homeless people in spain a mixed methods study
topic homelessness
social justice
employment
social exclusion
health inequities
social determinants of health
url https://www.frontiersin.org/articles/10.3389/fpubh.2024.1444888/full
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