TY - JOUR
T1 - Vital Needs of Dutch Homeless Service Users
T2 - Responsiveness of Local Services in the Light of Health Equity
AU - van Everdingen, Coline
AU - Peerenboom, Peter Bob
AU - van der Velden, Koos
AU - Delespaul, Philippe
N1 - Funding Information:
Municipalities and HS organizations commissioned and funded the data collection in the various subsamples and gave permission for scientific use. The data were collected by an independent researcher with total autonomy in the report and interpretation of the data. The Maastricht University and the Radboud University Nijmegen provide core financial support for the scientific use of the management data in the HOP-TR study.
Publisher Copyright:
© 2023 by the authors.
PY - 2023/2/1
Y1 - 2023/2/1
N2 - Background: Healthcare and social services aim to ensure health equity for all users. Despite ongoing efforts, marginalized populations remain underserved. The Dutch HOP-TR study intends to expand knowledge on how to enable the recovery of homeless service users. Methods: A naturalistic meta-snowball sampling resulted in a representative sample of homeless services (N = 16) and users (N = 436). Interviews collected health and needs from user and professional perspectives in a comprehensive, rights-based ecosystem strategy. We calculated the responsiveness to needs in four domains (mental health, physical health, paid work, and administration). Results: Most service users were males (81%) with a migration background (52%). In addition to physical (78%) and mental health needs (95%), the low education level (89%) and functional illiteracy (57%) resulted in needs related to paid work and administration support. Most had vital needs in three or four domains (77%). The availability of matching care was extremely low. For users with needs in two domains, met needs ranged from 0.6–13.1%. Combined needs (>2 domains) were hardly met. Conclusions: Previous research demonstrated the interdependent character of health needs. This paper uncovers some causes of health inequity. The systematic failure of local services to meet integrating care needs demonstrates the urgency to expand recovery-oriented implementation strategies with health equity in mind.
AB - Background: Healthcare and social services aim to ensure health equity for all users. Despite ongoing efforts, marginalized populations remain underserved. The Dutch HOP-TR study intends to expand knowledge on how to enable the recovery of homeless service users. Methods: A naturalistic meta-snowball sampling resulted in a representative sample of homeless services (N = 16) and users (N = 436). Interviews collected health and needs from user and professional perspectives in a comprehensive, rights-based ecosystem strategy. We calculated the responsiveness to needs in four domains (mental health, physical health, paid work, and administration). Results: Most service users were males (81%) with a migration background (52%). In addition to physical (78%) and mental health needs (95%), the low education level (89%) and functional illiteracy (57%) resulted in needs related to paid work and administration support. Most had vital needs in three or four domains (77%). The availability of matching care was extremely low. For users with needs in two domains, met needs ranged from 0.6–13.1%. Combined needs (>2 domains) were hardly met. Conclusions: Previous research demonstrated the interdependent character of health needs. This paper uncovers some causes of health inequity. The systematic failure of local services to meet integrating care needs demonstrates the urgency to expand recovery-oriented implementation strategies with health equity in mind.
KW - 3-D recovery
KW - health equity
KW - homelessness
KW - public health policy
KW - rights-based ecosystem approach
U2 - 10.3390/ijerph20032546
DO - 10.3390/ijerph20032546
M3 - Article
C2 - 36767905
SN - 1660-4601
VL - 20
JO - International Journal of Environmental Research and Public Health
JF - International Journal of Environmental Research and Public Health
IS - 3
M1 - 2546
ER -