The demography and disease burden of the homeless shelter population of Tshwane during COVID-19.

BACKGROUND:  Homeless people are a vulnerable population susceptible to physical and mental health care problems. There are, however, limited studies and information regarding the health of the homeless population. AIM:  To describe and understand the burden of disease among the homeless population in Tshwane District, Gauteng, South Africa. SETTING:  Data were collected from 15 different homeless shelters created during the South African 2020 coronavirus disease 2019 (COVID-19) lockdown in the Tshwane District, from April to July 2020. METHODS:  A cross-sectional survey was conducted among the homeless people in the shelters to provide information of self-reported conditions that the homeless populations at the shelters had during the lockdown period. The participants were also screened for medical conditions like, human immunodeficiency virus (HIV), hypertension (HPT) and diabetes mellites (DM). RESULTS:  Results showed a total of 2066 homeless population out of which 1391 took part in the survey. Most of the participants consisted of African males 93.83%, with substance use prevalence in 52.77%. The study showed that the population was very reluctant to share information and had less chronic conditions than originally thought. CONCLUSION:  Efforts should be made to improve education and research around the homeless population, by government and non-government facilities by building relationships with homeless shelters in their areas.Contribution: This study provides awareness of the homeless population's health and challenges, with the intention to attempt a better understanding of the population that may present themselves to primary healthcare (PHC) facilities and encourage future investigation into how to improve care.

The role played by family physicians in providing health services for the sheltered homeless populations during COVID-19 lockdown in the Tshwane district.

This short report describes the role that family physicians (FPs) (and family medicine registrars) played to provide care for the homeless people in shelters (both temporary and permanent) during the coronavirus disease 2019 (COVID-19) lockdown in the City of Tshwane, South Africa. The lockdown resulted in the establishment of a large number of temporary shelters. The FPs took on the task to provide comprehensive and coordinated primary care, whilst extending their activities in terms of data management, quality improvement, capacity building and research. The FPs worked in teams with other healthcare providers and contributed a unique set of skills to the process. This report demonstrates the value of responding quickly and appropriately through communication, cooperation and innovation. It also demonstrates the large number of areas in which FPs can make a difference when engaged appropriately, with the necessary support and collaboration, thus making a positive impact in the already overburdened health services.

Perceived discrimination and mental health disorders: the South African Stress and Health study.

OBJECTIVES: To describe the demographic correlates of perceived discrimination and explore the association between perceived discrimination and psychiatric disorders. DESIGN: A national household survey was conducted between 2002 and 2004 using the World Health Organization Composite International Diagnostic Interview (CIDI) to generate diagnoses of psychiatric disorders. Additional instruments provided data on perceived discrimination and related variables. SETTING: A nationally representative sample of adults in South Africa. SUBJECTS: 4351 individuals aged 18 years and older. OUTCOMES: 12-month and lifetime mood, anxiety and substance use disorders. RESULTS: In the multivariate analyses, acute and chronic racial discrimination were associated with an elevated risk of any 12-month DSM-IV disorder when adjusted for socio-demographic factors, but this association was no longer statistically significant when adjusted for other sources of social stress. In fully adjusted models, acute racial discrimination was associated with an elevated risk of lifetime substance use disorders. Acute and chronic non-racial discrimination were associated with an elevated risk of 12-month and lifetime rates of any disorder, even after adjustment for other stressors and potentially confounding psychological factors. The association of chronic non-racial discrimination and 12-month and lifetime disorder was evident across mood, anxiety, and substance use disorders in the fully adjusted models. CONCLUSION: The risk of psychiatric disorders is elevated among persons who report experiences of discrimination. These associations are more robust for chronic than for acute discrimination and for non-racial than for racial discrimination. Perceived discrimination constitutes an important stressor that should be taken into account in the aetiology of psychiatric disorders.