ArticleThe International journal on drug policy2021
Using a "Big Events" framework to understand emergency department use among women experiencing homelessness or housing instability in San Francisco during the COVID-19 pandemic.
Article in The International journal on drug policy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 11 citations in OpenAlex.
- Socioenvironmental disasters and the dialectics of overdose mortality.The International journal on drug policy · 2026Article
- Insights from COVID-19 pandemic-era innovations at the intersection of homelessness and substance use: in-depth qualitative interviews with key informants.Harm reduction journal · 2026Article
- Historical and theoretical roots of the big events framework.The International journal on drug policy · 2024Article
- Analysis of Emergency Department Encounters Among High Users of Health Care and Social Service Systems Before and During the COVID-19 Pandemic.JAMA network open · 2022Article
- Self-reported impacts of the COVID-19 pandemic among people who use drugs: a rapid assessment study in Montreal, Canada.Harm reduction journal · 2022Article
- A Scoping Review of the Health Impact of the COVID-19 Pandemic on Persons Experiencing Homelessness in North America and Europe.International journal of environmental research and public health · 2022Article
- Mortality Among People Experiencing Homelessness in San Francisco During the COVID-19 Pandemic.JAMA network open · 2022Article
- Emergency Department Use by Women Experiencing Homelessness in Los Angeles, California, USA.Women's health reports (New Rochelle, N.Y.) · 2022Article
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThe COVID-19 pandemic created a major public health crisis that disrupted economic systems, social networks and individual behaviors, which led to changes in patterns of health care use. Factors associated with emergency department (ED) visits during the pandemic among especially high-risk individuals are unknown. We used a "Big Events" approach, which considers major disruptions that create social instability, to investigate ED use in people experiencing homelessness or housing instability, many of whom use drugs.
methodsBetween July and December 2020, we conducted a community-based San Francisco study to compare homeless and unstably housed (HUH) women who did and did not use an ED during the first 10 months of the pandemic.
resultsAmong 128 study participants, 34% had ≥1 ED visit during the pandemic. In adjusted analysis, factors significantly associated with ED use included experiencing homelessness, cocaine use and increased difficulties receiving drug use treatment during the pandemic.
conclusionThese findings build on the "Big Events" approach to considering risk pathways among people who use drugs. They suggest the importance of ensuring access to housing and low-barrier non-COVID health services, including drug treatment, alongside crisis management activities, to reduce the health impacts of public health crises.
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