ArticleBMJ open2016
Migration to the Downtown Eastside neighbourhood of Vancouver and changes in service use in a cohort of mentally ill homeless adults: a 10-year retrospective study.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Housing Quality in a Randomized Controlled Trial of Housing First for Homeless Individuals with Mental Illness: Correlates and Associations with Outcomes.Journal of urban health : bulletin of the New York Academy of Medicine · 2016Trial
- "Like an umbrella, protecting me from the rain until I get to my destination": Evaluating the implementation of a tailored primary care model for urban marginalized populations.BMC primary care · 2024Article
- Beyond individual factors: a critical ethnographic account of urban residential fire risks, experiences, and responses in single-room occupancy (SRO) housing.BMC public health · 2024Article
- Dealing with low access to harm reduction: a qualitative study of the strategies and risk environments of people who use drugs in a small Swedish city.Harm reduction journal · 2022Article
- Multivariable modelling of factors associated with criminal convictions among people experiencing homelessness and serious mental illness: a multi-year study.Scientific reports · 2021Article
- Met and unmet needs of homeless individuals at different stages of housing reintegration: A mixed-method investigation.PloS one · 2021Article
- Migration Patterns from an Open Illicit Drug Scene and Emergency Department Visits among People Who Use Illicit Drugs in Vancouver, Canada.Substance use & misuse · 2021Article
- Effect of COVID-19 on Pet Food Bank Servicing: Quantifying Numbers of Clients Serviced in the Vancouver Downtown Eastside, British Columbia, Canada.Frontiers in veterinary science · 2021Article
- The Vancouver Community Analytics Tool (VCAT): Software Enabling Operationalization of the Building Blocks of High-Performing Primary Care at Community Health Centers in British Columbia, Canada.The Permanente journal · 2020Article
- Impact of migration from an illicit drug scene on hospital outcomes among people who use illicit drugs in Vancouver, Canada.Drug and alcohol review · 2020Article
- Longitudinal migration patterns from an open illicit drug scene among people who use illicit drugs in Vancouver, Canada.Journal of substance abuse treatment · 2019Article
- Longitudinal Associations between Perceived Quality of Living Spaces and Health-Related Quality of Life among Homeless and Vulnerably Housed Individuals Living in Three Canadian Cities.International journal of environmental research and public health · 2019Article
- A Multi-sourced Data Analytics Approach to Measuring and Assessing Biopsychosocial Complexity: The Vancouver Community Analytics Tool Complexity Module (VCAT-CM).Community mental health journal · 2019Article
- Article
- Moving into an urban drug scene among people who use drugs in Vancouver, Canada: Latent class growth analysis.PloS one · 2019Article
- Clinical and functional characteristics of young adults living in single room occupancy housing: preliminary findings from a 10-year longitudinal study.Canadian journal of public health = Revue canadienne de sante publique · 2018Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesLittle research has investigated the role of migration as a potential contributor to the spatial concentration of homeless people with complex health and social needs. In addition, little is known concerning the relationship between possible migration and changes in levels of service use over time. We hypothesised that homeless, mentally ill individuals living in a concentrated urban setting had migrated from elsewhere over a 10-year period, in association with significant increases in the use of public services.
settingRecruitment was concentrated in the Downtown Eastside neighbourhood of Vancouver, Canada.
participantsParticipants (n=433) met criteria for chronic homelessness and serious mental illness, and provided consent to access administrative data.
methodsLinked administrative data were used to retrospectively examine geographic relocation as well as rates of health, justice, and social welfare service utilisation in each of the 10 years prior to recruitment. Generalised estimating equations were used to estimate the effect of migration on service use.
resultsOver a 10-year period there was significant movement into Vancouver's Downtown Eastside neighbourhood (from 17% to 52% of the cohort). During the same period, there were significant annual increases in community medical services (adjusted rate ratio (ARR) per year=1.08; 95% CI 1.06 to 1.10), hospital admissions (ARR=1.08; 95% CI 1.04 to 1.11), criminal convictions (ARR=1.08; 95% CI 1.03 to 1.13), and financial assistance payments (ARR=1.04; 95% CI 1.03 to 1.06). Migration was significantly associated with financial assistance, but not with other types of services.
conclusionsSignificant increases in service use over a 10-year period coincided with significant migration into an urban area where relevant services were concentrated. These results highlight opportunities for early intervention in spatially diverse neighbourhoods to interrupt trajectories marked by worsening health and extremely high service involvement. Further research is urgently needed to investigate the causal relationships between physical migration, health and social welfare, and escalating use of public services. TRIAL REGISTRATION NUMBERS: ISRCTN57595077 and ISRCTN66721740; Post-results.
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