[Health Service Utilization by Homeless Persons: Analysis of the Role of Enabling Factors, Pain and Gender using the Gelberg-Andersen Model]. / Inanspruchnahme medizinischer Versorgung durch wohnungslose Menschen ­ der Einfluss von zugangsförderlichen Faktoren, Schmerzen und Gender untersucht anhand des Gelberg-Andersen-Modells.

The aim of the study was to find factors that influence health service utilization by homeless people. In a field study, a sample of 51 homeless men and 47 homeless women in the German county of Baden-Württemberg participated in face-to-face-interviews with a questionnaire designed for this study. Analyses were performed using multiple logistic regression models. Variables were organized using the Gelberg-Andersen Behavioral Model for Vulnerable Populations. Satisfied subsistence needs (OR 1.33, 95%-CI [1.03-1.72] regarding utilization of vaccinations), a stable source of primary care (OR 12.2 [1.81-82] regarding utilization of early detection examinations; quasi-complete separation regarding use of GP services) social networks (OR 2.9 [1.13-7.5] regarding utilisation of early detection examinations; OR 0.63 [0.41-0.98] regarding emergency department visits) and technological ressources (OR 2.2 [1.13-4.4] regarding use of GP services) had a positive influence on the pattern of health service utilization. Pain was correlated with more emergency department visits (OR 1.72 [1.22-2.4]) and hospitalizations (OR 1.66 [1.19-2.3]). The results showed differences between homeless men and women. The factors of influence found in this study should be addressed in the care of homeless persons. Integration of social care into the regular health care system is necessary for early detection and treatment of complex social and medical needs of vulnerable populations. This requires interprofessional approaches in medical education and training focussing on the situation of vulnerable populations and on social determinants of health.

[Mental Health in Children from Families Seeking Asylum in Mecklenburg-Western Pomerania 2007-2009 - Personal and Contextual Risk Factors]. / Psychische Gesundheit von Kindern aus asylsuchenden Familien in den Jahren 2007­2009 ­ Person- und kontextseitige Risikofaktoren.

Mental Health in Children from Families Seeking Asylum in Mecklenburg-Western Pomerania 2007-2009 - Personal and Contextual Risk Factors The study presented describes severity and conditions of various psychiatric symptoms in children from families seeking refuge in Germany 2007-2009 and registered in the province of Mecklenburg-Western Pomerania. Mothers of 58 children (aged 12 years on average, 23 girls, 33 boys) answered the items of the Child Behavior Checklist (Achenbach, 1991). First, the burden of disease among refugee children was compared to standard burdens of German children. Second, the extent of symptoms was predicted by person- and context-related factors. Internalizing symptoms were predicted by more proximal factors, such as parental burden of stress and parental education. Externalizing symptoms and social problems were rather predicted by the length of stay in Germany, the reason for migration, the school career and parental education. On one hand, the study underscores the immediate need for intervention among refugee parents and children. On the other hand, structural factors in the country of arrival (length of stay, schooling) play an important role.