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2. Social relationships, homelessness, and substance use among emergency department patients.

Author

Jurewicz, Amanda, Padgett, Deborah, Ran, Ziwei, Castelblanco, Donna, McCormack, Ryan, Gelberg, Lillian, Shelley, Donna, and Doran, Kelly

Subjects
Substance use, emergency department, homelessness, social relationships, Emergency Service, Hospital, Ill-Housed Persons, Humans, Interpersonal Relations, Qualitative Research, Substance-Related Disorders
Abstract

Background: Emergency department (ED) patients commonly experience both substance use and homelessness, and social relationships impact each in varied ways not fully captured by existing quantitative research. This qualitative study examines how social relationships can precipitate or ameliorate homelessness and the connection (if any) between substance use and social relationships among ED patients experiencing homelessness. Methods: As part of a broader study to develop ED-based homelessness prevention interventions, we conducted in-depth interviews with 25 ED patients who used alcohol or drugs and had recently become homeless. We asked patients about the relationship between their substance use and homelessness. Interviews were recorded, transcribed, and coded line-by-line by investigators. Final codes formed the basis for thematic analysis through consensus discussions. Results: Social relationships emerged as focal points for understanding the four major themes related to the intersection of homelessness and substance use: (1) Substance use can create strain in relationships; (2) Help is there until its not; (3) Social relationships can create challenges contributing to substance use; and (4) Reciprocal relationship of substance use and isolation. Sub-themes were also identified and described. Conclusions: The association between substance use and homelessness is multifaceted and social relationships are a complex factor linking the two. Social relationships are often critical for homelessness prevention, but they are impacted by and reciprocally affect substance use. ED-based substance use interventions should consider the high prevalence of homelessness and the impact of social relationships on the interaction between homelessness and substance use.

Published
2022

3. Cross-sectional Analysis of Food Insecurity and Frequent Emergency Department Use

Author

Estrella, Alex, Scheidell, Joy, Khan, Maria, Castelblanco, Donna, Mijanovich, Tod, Lee, David C., Gelberg, Lillian, and Doran, Kelly M.

Subjects
food insecurity, emergency departments, emergency service, social determinants of health
Abstract

Introduction: Emergency department (ED) patients have higher than average levels of food insecurity. We examined the association between multiple measures of food insecurity and frequent ED use in a random sample of ED patients.Methods: We completed survey questionnaires with randomly sampled adult patients from an urban public hospital ED (n = 2,312). We assessed food insecurity using four questions from the United States Department of Agriculture Household Food Security Survey. The primary independent variable was any food insecurity, defined as an affirmative response to any of the four items. Frequent ED use was defined as self-report of ≥4 ED visits in the past year. We examined the relationship between patient food insecurity and frequent ED use using bivariate and multivariable analyses and examined possible mediation by anxiety/depression and overall health status.Results: One-third (30.9%) of study participants reported frequent ED use, and half (50.8%) reported any food insecurity. Prevalence of food insecurity was higher among frequent vs. non-frequent ED users, 62.8% vs 45.4% (P

Published
2021

4. Health-related material needs and substance use among emergency department patients.

Author

Gerber, Evan, Gelberg, Lillian, Rotrosen, John, Castelblanco, Donna, Mijanovich, Tod, and Doran, Kelly

Subjects
Alcohol, drug use, emergency care, food insecurity, homelessness, social determinants, substance use, Adult, Alcoholism, Crisis Intervention, Emergency Service, Hospital, Employment, Female, Financial Stress, Food Insecurity, Health Expenditures, Health Services Accessibility, Ill-Housed Persons, Humans, Male, Mass Screening, Middle Aged, Needs Assessment, Referral and Consultation, Social Determinants of Health, Substance-Related Disorders
Abstract

Background: Emergency department (ED) visits related to substance use are common. ED patients also have high levels of health-related material needs (HRMNs), such as homelessness and food insecurity. However, little research has examined the intersection between ED patient HRMNs and substance use. Methods: We surveyed a random sample of public hospital ED patients. Surveys included validated single-item screeners for unhealthy alcohol and any drug use and questions on self-reported past-year material needs. We compared individual HRMNs and cumulative number of HRMNs by substance use screening status using bivariate and multivariable analyses. Results: A total of 2312 surveys were completed. Nearly one third of patients (32.3%, n = 747) screened positive for unhealthy alcohol use, and 21.8% (n = 503) screened positive for drug use. Prevalence of HRMNs for all patients-including food insecurity (50.8%), inability to meet essential expenses (40.8%), cost barriers to medical care (24.6%), employment issues (23.8%), and homelessness (21.4%)-was high and was significantly higher for patients with unhealthy alcohol use or drug use. In multivariable analyses, homelessness was independently associated with unhealthy alcohol use (adjusted odds ratio [aOR]: 1.61, 95% confidence interval [CI]: 1.24-2.09) and drug use (aOR: 2.30, 95% CI: 1.74-3.05). There was a significant stepwise increase in the odds of patient unhealthy alcohol or drug use as number of HRMNs increased. Conclusions: ED patients with unhealthy alcohol or drug use have higher prevalence of HRMNs than those without. Our findings suggest that HRMNs may act additively and that homelessness is particularly salient. Patients comorbid HRMNs may affect the success of ED-based substance use interventions.

Published
2020

8. Proceedings of the 14th annual conference of INEBRIA

Author

Holloway, Aisha S., primary, Ferguson, Jennifer, additional, Landale, Sarah, additional, Cariola, Laura, additional, Newbury-Birch, Dorothy, additional, Flynn, Amy, additional, Knight, John R., additional, Sherritt, Lon, additional, Harris, Sion K., additional, O’Donnell, Amy J., additional, Kaner, Eileen, additional, Hanratty, Barbara, additional, Loree, Amy M., additional, Yonkers, Kimberly A., additional, Ondersma, Steven J., additional, Gilstead-Hayden, Kate, additional, Martino, Steve, additional, Adam, Angeline, additional, Schwartz, Robert P., additional, Wu, Li-Tzy, additional, Subramaniam, Geetha, additional, Sharma, Gaurav, additional, McNeely, Jennifer, additional, Berman, Anne H., additional, Kolaas, Karoline, additional, Petersén, Elisabeth, additional, Bendtsen, Preben, additional, Hedman, Erik, additional, Linderoth, Catharina, additional, Müssener, Ulrika, additional, Sinadinovic, Kristina, additional, Spak, Fredrik, additional, Gremyr, Ida, additional, Thurang, Anna, additional, Mitchell, Ann M., additional, Finnell, Deborah, additional, Savage, Christine L., additional, Mahmoud, Khadejah F., additional, Riordan, Benjamin C., additional, Conner, Tamlin S., additional, Flett, Jayde A. M., additional, Scarf, Damian, additional, McRee, Bonnie, additional, Vendetti, Janice, additional, Gallucci, Karen Steinberg, additional, Robaina, Kate, additional, Clark, Brendan J., additional, Jones, Jacqueline, additional, Reed, Kathryne D., additional, Hodapp, Rachel M., additional, Douglas, Ivor, additional, Burnham, Ellen L., additional, Aagaard, Laura, additional, Cook, Paul F., additional, Harris, Brett R., additional, Yu, Jiang, additional, Wolff, Margaret, additional, Rogers, Meighan, additional, Barbosa, Carolina, additional, Wedehase, Brendan J., additional, Dunlap, Laura J., additional, Mitchell, Shannon G., additional, Dusek, Kristi A., additional, Gryczynski, Jan, additional, Kirk, Arethusa S., additional, Oros, Marla T., additional, Hosler, Colleen, additional, O’Grady, Kevin E., additional, Brown, Barry S., additional, Angus, Colin, additional, Sherborne, Sidney, additional, Gillespie, Duncan, additional, Meier, Petra, additional, Brennan, Alan, additional, de Vargas, Divane, additional, Soares, Janaina, additional, Castelblanco, Donna, additional, Doran, Kelly M., additional, Wittman, Ian, additional, Shelley, Donna, additional, Rotrosen, John, additional, Gelberg, Lillian, additional, Edelman, E. Jennifer, additional, Maisto, Stephen A., additional, Hansen, Nathan B., additional, Cutter, Christopher J., additional, Deng, Yanhong, additional, Dziura, James, additional, Fiellin, Lynn E., additional, O’Connor, Patrick G., additional, Bedimo, Roger, additional, Gibert, Cynthia, additional, Marconi, Vincent C., additional, Rimland, David, additional, Rodriguez-Barradas, Maria C., additional, Simberkoff, Michael S., additional, Justice, Amy C., additional, Bryant, Kendall J., additional, Fiellin, David A., additional, Giles, Emma L., additional, Coulton, Simon, additional, Deluca, Paolo, additional, Drummond, Colin, additional, Howel, Denise, additional, McColl, Elaine, additional, McGovern, Ruth, additional, Scott, Stephanie, additional, Stamp, Elaine, additional, Sumnall, Harry, additional, Vale, Luke, additional, Alabani, Viviana, additional, Atkinson, Amanda, additional, Boniface, Sadie, additional, Frankham, Jo, additional, Gilvarry, Eilish, additional, Hendrie, Nadine, additional, Howe, Nicola, additional, McGeechan, Grant J., additional, Ramsey, Amy, additional, Stanley, Grant, additional, Clephane, Justine, additional, Gardiner, David, additional, Holmes, John, additional, Martin, Neil, additional, Shevills, Colin, additional, Soutar, Melanie, additional, Chi, Felicia W., additional, Weisner, Constance, additional, Ross, Thekla B., additional, Mertens, Jennifer, additional, Sterling, Stacy A., additional, Shorter, Gillian W., additional, Heather, Nick, additional, Bray, Jeremy, additional, Cohen, Hildie A., additional, McPherson, Tracy L., additional, Adam, Cyrille, additional, López-Pelayo, Hugo, additional, Gual, Antoni, additional, Segura-Garcia, Lidia, additional, Colom, Joan, additional, Ornelas, India J., additional, Doyle, Suzanne, additional, Donovan, Dennis, additional, Duran, Bonnie, additional, Torres, Vanessa, additional, Gaume, Jacques, additional, Grazioli, Véronique, additional, Fortini, Cristiana, additional, Paroz, Sophie, additional, Bertholet, Nicolas, additional, Daeppen, Jean-Bernard, additional, Satterfield, Jason M., additional, Gregorich, Steven, additional, Alvarado, Nicholas J., additional, Muñoz, Ricardo, additional, Kulieva, Gozel, additional, Vijayaraghavan, Maya, additional, Adam, Angéline, additional, Cunningham, John A., additional, Díaz, Estela, additional, Palacio-Vieira, Jorge, additional, Godinho, Alexandra, additional, Kushir, Vladyslav, additional, O’Brien, Kimberly H. M., additional, Aguinaldo, Laika D., additional, Sellers, Christina M., additional, Spirito, Anthony, additional, Chang, Grace, additional, Blake-Lamb, Tiffany, additional, LaFave, Lea R. Ayers, additional, Thies, Kathleen M., additional, Pepin, Amy L., additional, Sprangers, Kara E., additional, Bradley, Martha, additional, Jorgensen, Shasta, additional, Catano, Nico A., additional, Murray, Adelaide R., additional, Schachter, Deborah, additional, Andersen, Ronald M., additional, Rey, Guillermina Natera, additional, Vahidi, Mani, additional, Rico, Melvin W., additional, Baumeister, Sebastian E., additional, Johansson, Magnus, additional, Sinadinovic, Christina, additional, Hermansson, Ulric, additional, Andreasson, Sven, additional, O’Grady, Megan A., additional, Kapoor, Sandeep, additional, Akkari, Cherine, additional, Bernal, Camila, additional, Pappacena, Kristen, additional, Morley, Jeanne, additional, Auerbach, Mark, additional, Neighbors, Charles J., additional, Kwon, Nancy, additional, Conigliaro, Joseph, additional, Morgenstern, Jon, additional, Magill, Molly, additional, Apodaca, Timothy R., additional, Borsari, Brian, additional, Hoadley, Ariel, additional, Scott Tonigan, J., additional, Moyers, Theresa, additional, Fitzgerald, Niamh M., additional, Schölin, Lisa, additional, Barticevic, Nicolas, additional, Zuzulich, Soledad, additional, Poblete, Fernando, additional, Norambuena, Pablo, additional, Sacco, Paul, additional, Ting, Laura, additional, Beaulieu, Michele, additional, Wallace, Paul George, additional, Andrews, Matthew, additional, Daley, Kate, additional, Shenker, Don, additional, Gallagher, Louise, additional, Watson, Rod, additional, Weaver, Tim, additional, Bruguera, Pol, additional, Oliveras, Clara, additional, Gavotti, Carolina, additional, Barrio, Pablo, additional, Braddick, Fleur, additional, Miquel, Laia, additional, Suárez, Montse, additional, Bruguera, Carla, additional, Brown, Richard L., additional, Capell, Julie Whelan, additional, Paul Moberg, D., additional, Maslowsky, Julie, additional, Saunders, Laura A., additional, McCormack, Ryan P., additional, Scheidell, Joy, additional, Gonzalez, Mirelis, additional, Bauroth, Sabrina, additional, Liu, Weiwei, additional, Lindsay, Dawn L., additional, Lincoln, Piper, additional, Hagle, Holly, additional, Wallhed Finn, Sara, additional, Hammarberg, Anders, additional, Andréasson, Sven, additional, King, Sarah E., additional, Vargo, Rachael, additional, Kameg, Brayden N., additional, Acquavita, Shauna P., additional, Van Loon, Ruth Anne, additional, Smith, Rachel, additional, Brehm, Bonnie J., additional, Diers, Tiffiny, additional, Kim, Karissa, additional, Barker, Andrea, additional, Jones, Ashley L., additional, Skinner, Asheley C., additional, Hinman, Agatha, additional, Svikis, Dace S., additional, Thacker, Casey L., additional, Resnicow, Ken, additional, Beatty, Jessica R., additional, Janisse, James, additional, Puder, Karoline, additional, Bakshi, Ann-Sofie, additional, Milward, Joanna M., additional, Kimergard, Andreas, additional, Garnett, Claire V., additional, Crane, David, additional, Brown, Jamie, additional, West, Robert, additional, Michie, Susan, additional, Rosendahl, Ingvar, additional, Andersson, Claes, additional, Gajecki, Mikael, additional, Blankers, Matthijs, additional, Donoghue, Kim, additional, Lynch, Ellen, additional, Maconochie, Ian, additional, Phillips, Ceri, additional, Pockett, Rhys, additional, Phillips, Tom, additional, Patton, R., additional, Russell, Ian, additional, Strang, John, additional, Stewart, Maureen T., additional, Quinn, Amity E., additional, Brolin, Mary, additional, Evans, Brooke, additional, Horgan, Constance M., additional, Liu, Junqing, additional, McCree, Fern, additional, Kanovsky, Doug, additional, Oberlander, Tyler, additional, Zhang, Huan, additional, Hamlin, Ben, additional, Saunders, Robert, additional, Barton, Mary B., additional, Scholle, Sarah H., additional, Santora, Patricia, additional, Bhatt, Chirag, additional, Ahmed, Kazi, additional, Hodgkin, Dominic, additional, Gao, Wenwu, additional, Merrick, Elizabeth L., additional, Drebing, Charles E., additional, Larson, Mary Jo, additional, Sharma, Monica, additional, Petry, Nancy M., additional, Saitz, Richard, additional, Weisner, Constance M., additional, Young-Wolff, Kelly C., additional, Lu, Wendy Y., additional, Blosnich, John R., additional, Lehavot, Keren, additional, Glass, Joseph E., additional, Williams, Emily C., additional, Bensley, Kara M., additional, Chan, Gary, additional, Dombrowski, Julie, additional, Fortney, John, additional, Rubinsky, Anna D., additional, Lapham, Gwen T., additional, Forray, Ariadna, additional, Olmstead, Todd A., additional, Gilstad-Hayden, Kathryn, additional, Kershaw, Trace, additional, Dillon, Pamela, additional, Weaver, Michael F., additional, Grekin, Emily R., additional, Ellis, Jennifer D., additional, and McGoron, Lucy, additional

Published
2017
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9. The Road to Paris: What is at Stake for Health in COP21 Negotiations?

Author

Tcholakov, Yassen, Wiley, Elizabeth, Hornung, Thorsten, Walker, Xaviour, Mello, Arthur, Hall, Deborah Vozzella, Mattar, Caline, Williams, Kimberly, Castelblanco, Donna, P-Desrosiers, Claudel, Singh, Sudhvir, Guinto, Renzo, Essafi, Skander, and De Leon, Samantha

Subjects
INTERNATIONAL cooperation on climate change, WORLD health, INFECTION prevention, HEALTH policy, INTERNATIONAL cooperation, UNITED Nations Climate Change Conference
Abstract

The article provides a brief introduction to the United Nations Framework on Climate Change (UNFCCC), current climate change negotiations and health sector engagement as part of efforts globally to tackle climate change. It outlines the threats to human health highlighted by the Intergovernmental Panel on Climate Change including the spread of infectious diseases. Specific advocacy for health professionals includes urging policy makers to ensure binding action and to invest on climate-change.

Published
2015

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