ArticleBMC public health2022
Chronic diseases and multi-morbidity in persons experiencing homelessness: results from a cross-sectional study conducted at three humanitarian clinics in Germany in 2020.
Article in BMC public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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11 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- The prevalence of multimorbidity with mental and physical health for people who experience homelessness: a systematic review.European journal of public health · 2025Pooled it
- [Access to healthcare for undocumented migrants in Germany-a scoping review].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2026Article
- National and subnational analysis of self-reported diabetes mellitus and health inequalities in Europe.Scientific reports · 2026Article
- Using Normalisation Process Theory to Develop a Complex Intervention: A Qualitative Case Study of Screening for Homelessness in Healthcare Settings.Health science reports · 2026Article
- Understanding Healthcare-Seeking Patterns of People Experiencing Homelessness: A Quantitative Multi-Centre Analysis of Emergency Department Utilisation.The Psychiatric quarterly · 2026Article
- A Qualitative Inquiry Into Sarcopenia Among Formerly Homeless Older Thais.Nursing open · 2026Article
- Multimorbidity of mental health and substance use disorders among housed and homeless U.S. veterans.Scientific reports · 2025Article
- Homeless Persons in the Emergency Room—A Single-Center Study on the Performance and Completeness of Recommended Diagnostic Tests.Deutsches Arzteblatt international · 2024Article
- Variables Associated with Quality of Life Among Individuals Living in Permanent Supportive Housing.Community mental health journal · 2024Article
- Burden of long COVID among adults experiencing sheltered homelessness: a longitudinal cohort study in King County, WA between September 2020-April 2022.BMC public health · 2023Article
- Morbidity and mortality in a prospective cohort of people who were homeless during the COVID-19 pandemic.Frontiers in public health · 2023Observational
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4 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPersons experiencing homelessness (PEH) suffer a high burden of chronic diseases and multi-morbidity, yet face significant barriers in accessing healthcare services. These health inequalities were further aggravated during the COVID-19 pandemic. While there is a lack of comprehensive health data on PEH, even less is known about populations experiencing housing exclusion, a hidden form of homelessness. This study examines and compares chronic diseases and multi-morbidity in PEH, persons experiencing housing exclusion, and persons with secure housing who lacked access to regular healthcare services in the wake of the COVID-19 pandemic in Germany.
methodsStudy participants were adults who sought medical care at clinics of the humanitarian organisation "Ärzte der Welt" in Munich, Hamburg and Berlin in 2020. The patients were categorised into three housing groups according to the ETHOS classification of homelessness and housing exclusion. Socio-demographic characteristics, self-rated health, chronic diseases and multi-morbidity were described in each group. Logistic regression analysis was used to identify socio-demographic factors associated with higher odds of chronic diseases and multi-morbidity in each housing group.
resultsOf the 695 study participants, 333 experienced homelessness, 292 experienced housing exclusion and 70 had secure housing. 92.3% of all patients had either no or limited health coverage, and 96.7% were below the poverty line. Males and EU/EEA citizens were highly represented among PEH (74.2% and 56.8% respectively). PEH had lower self-rated health (47.8%, p = 0.04), and a higher prevalence of psychiatric illness (20.9%, p = 0.04). In adjusted analyses, belonging to the age group 35-49 and ≥ 50 years were associated with greater odds of chronic disease (AOR = 2.33, 95% CI = 1.68-3.24; AOR = 3.57, 95% CI = 2.55-5.01, respectively) while being ≥ 50 years old was associated with multi-morbidity (AOR = 2.01, 95% CI = 1.21, 3.33). Of the 18 participants tested for SARS-COV-2, 15 were PEH, 1 of whom tested positive.
conclusionsHousing status was not an independent risk factor for chronic disease and multi-morbidity in our study population. However, PEH reported poorer self-rated and psychiatric health. Strategies to improve access to healthcare services amongst persons experiencing homelessness and housing exclusion are needed in Germany.
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