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Annotated Bibliography on Safety Net for the Homeless
- Kertesz, S. G., McNeil, W., Cash, J. J., Desmond, R., McGwin, G., Jr, Kelly, J., & Baggett, T. P. (2014). Unmet need for medical care and safety net accessibility among Birmingham’s homeless. Journal Of Urban Health: Bulletin Of The New York Academy Of Medicine, 91(1), 33–45. https://doi.org/10.1007/s11524-013-9801-3
The purpose of this article is to identify the percentage of homeless individuals in Birmingham Alabama that require healthcare or health services but whose needs have been unmet. The article goes on to break down each health need and evaluate what percentage of homeless persons had needs for each kind of medical care.
The research was conducted using random sampling in four locations in Birmingham Alabama that the homeless persons were known to congregate at. After screening and excluding individuals who did not meet the requirements for research, 200 out of 266 people were used for the survey with the incentive of a few toiletries for their participation (Kertesz et. al,2014). Participants were selected in the common areas keeping a gender ratio in proportion to the local census of 40% women and 60% men (Kertesz et. al,2014).
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Frequency of the data collected was not mentioned in the research but can be presumed to be more than one day of sampling due to exclusions listed stating that no person could take the survey that had taken it before on a previous day. The data was collected using a qualitative scale in reference to how hard it was to receive healthcare and in what health the individual being surveyed would describe themselves.
Information gathered was organized through the adaptation and behavior model and validity of statements were compared with the likelihood of drugs and alcohol abuse to come up with a sensitivity of 79% and a specificity of 78% (Kertesz et. al,2014). Independent predictors of unmet needs were identified using multivariable adjustments through logistic regression in ways to analyze the data collected (Kertesz et. al,2014). The resulting data showed that 46% of homeless persons surveyed had unmet needs with a range of 23-84% reported for specialty cares such as dental care and obstetrical care (Kertesz et. al,2014).
This article is useful for continued community health promotion because it outlines general and specific health needs in the homeless population. This will allow our service learning group to target more specific needs in the homeless community when developing educational materials and gathering available information on low cost clinics in the area that pertain to their needs.
Annotated Bibliography of Diabetes and Hypertension Prevalence in the Homeless
- Bernstein, R. S., Meurer, L. N., Plumb, E. J., & Jackson, J. L. (2015). Diabetes and hypertension prevalence in homeless adults in the United States: a systematic review and meta- analysis. American Journal Of Public Health, 105(2), e46– e60.https://doi.org/10.2105/AJPH.2014.302330
The purpose of this research article was to compare the rates of diabetes and hypertension between the homeless and general population in order to identify the needs for better safety nets for the homeless. This is done by comparing the average age of both groups while calling attention to the equal percentage of chronic illness found in the two.
The design of this research was a large systematic review with meta-analysis following the PRISMA recommendations for reporting on systematic reviews (Bernstein et. al,2014). Articles chosen in this study had to be written in English, conducted in the USA, and pertain to diabetes and hypertension in homeless individuals over nineteen years old. Of the 1,837 articles searched 53 were chosen yielding 97,366 homeless Americans for the health study (Bernstein et. al,2014). Majority of articles were prospective cross-sectional samples and 23% were retrospective medical chart reviews (Bernstein et. al,2014). The average age and most prevalent characteristic of the individuals sampled were 43.3-year-old black men (Bernstein et. al,2014).
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An adaptation of the disease prevalence quality tool was used to identify the quality of each article when narrowing down reliable sources. Three components were essential when analyzing the value of each source. The researchers compared the validity of each article, the accuracy of interpretation, and the applicability of the results to the study (Bernstein et. al,2014).
Random effects met-analysis was implemented in order to distinguish the ratio of diabetes and hypertension found in the general population and the reported homeless individuals (Bernstein et. al,2014). With the data collected it was discerned that the prevalence rates of the diseases are similar between the two. This shows that lifestyles associated with being homeless decreases the onset age of chronic disease in this population.
This information is pertinent to future research and our study because chronic diseases appearing in younger age groups associated with the homelessness is likely to trend up as the number of baby boomers over 50 years old increase. This shows the importance of starting primary, secondary, and tertiary interventions now to prevent diabetes and hypertension from causing more severe cardiovascular outcomes in the future for a population that already has limited resources available to combat these chronic diseases.
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