A multisector community-engaged collaborative for mental health integration in primary care and housing developments: Protocol for a stepped-wedge randomized controlled trial (the Harlem Strong Program).

BACKGROUND: Addressing mental health disparities following COVID-19 requires adaptive, multi-sectoral, equity-focused, and community-based approaches. Mental health task-sharing in gateway settings has been found to address mental health care gaps in low- and middle-income countries, but is not a common practice in the U.S., especially in non-medical settings, such as low-income housing developments (LIH). This research study will evaluate the effectiveness of a multisectoral community-engaged collaborative for task-sharing mental health care on consumer, provider, and implementation outcomes, as well as identify barriers and facilitators for implementation. METHODS: In this stepped-wedge randomized controlled trial with technology supplementation, LIH and primary care sites will be randomly assigned to one of five sequences of three implementation strategies: (1) Education and Resources (E&R), which involves online training and resources on basic mental health task-sharing skills, (2) Multisectoral Community Collaborative Care (MCC), which consists of all E&R resources plus additional community responsive implementation supports and participation in a multisectoral coalition and (3) MCC + Technology, which combines the MCC condition resources with a community crowdsourced technology solution to support implementation. The primary outcome is the effectiveness in meeting consumers' needs through direct service (e.g., adequately addressing depression and anxiety symptoms), and through implementation to increase access to mental health care (reach). The secondary outcome examines additional consumer outcomes including health functioning and social risks, as well as implementation outcomes including provider skills, program adoption, and factors related to barriers and facilitators of quality implementation. A total of 700 consumers receiving mental health care at 20 sites will be surveyed at baseline, 6-, and 12-month follow-ups. Additionally, 100 providers will be evaluated at baseline, 6-, 12-, and 24-month follow-ups before training and after randomization. DISCUSSION: We hypothesize that MCC and MCC + Technology conditions will demonstrate significantly higher efficacy in changing primary outcomes compared to E&R, and the MCC + Technology supplement will show significantly higher levels of reach of mental health tasks compared to the MCC condition alone. These findings will demonstrate the feasibility of mental health integration into accessible, non-medical community settings such as LIH. Moreover, it will help establish a multilevel system solution based on community engagement and planning with a multisectoral collaboration that can be sustained community-wide. TRIAL REGISTRATION: NCT05833555 on Clinicaltrials.gov. Registered April 26, 2023.

Patterns and perceptions of vaping among adults living in social housing: a representative survey in Great Britain, 2023.

BACKGROUND: Vaping products are effective for helping people to stop smoking and may therefore offer a potential means to reduce high rates of smoking in socioeconomically disadvantaged groups. This study aimed to examine current patterns and perceptions of vaping among people living in social housing in Great Britain compared with those living in other housing types. METHODS: Data were from the Smoking Toolkit Study; a nationally-representative survey conducted in 2023 (n = 23,245). Logistic regression tested cross-sectional associations between living in social (vs. other) housing and current vaping among adults; vaping frequency, device type, nicotine concentration, and source of purchase among current vapers; use of vaping products as a smoking cessation aid among past-year smokers who tried to quit; and harm perceptions of vaping products relative to cigarettes among current smokers. RESULTS: Current vaping prevalence was twice as high among adults living in social housing (19.4%) compared with those in other housing types (10.4%; OR = 2.07, 95%CI = 1.84-2.33). This was partly explained by differences in sociodemographic characteristics and smoking status; after adjustment, the odds of being a current vaper were 33% higher (ORadj=1.33, 95%CI = 1.14-1.54). Among vapers, there were no notable differences by housing tenure in vaping frequency, main device type used, usual nicotine concentration, usual source of purchase, or use as a smoking cessation aid. However, current smokers living in social housing were more likely to think vaping is more harmful than cigarettes (31.6% vs. 21.8%; ORadj=1.61, 95%CI = 1.30-1.99). CONCLUSIONS: In Great Britain, adults who live in social housing are more likely to vape than those who live in other housing types, even after accounting for their younger age and higher smoking rates. However, misperceptions about the relative harms of vaping products and tobacco are common among smokers living in social housing. Interventions addressing these misperceptions could help encourage more people living in social housing to switch from smoking to vaping and reduce smoking-related health inequalities. PRE-REGISTRATION: The study protocol and analysis plan were pre-registered on Open Science Framework (https://osf.io/n3mvs/).

Navigating social determinants of health barriers in the management of phenylketonuria.

Phenylketonuria (PKU) is an inborn error of amino acid metabolism that is typically identified by newborn screening. With lifelong treatment consisting of dietary management, frequent laboratory monitoring, and regular metabolic clinic visits, patients with PKU can maintain good health and metabolic control. Here, we describe the case of an 8-year-old patient with PKU who has been followed by a metabolic clinic since birth. Despite responsiveness to sapropterin, this patient has had periods of poor metabolic control throughout her life due to her family's economic hardships, including limited access to transportation, housing, food, and health insurance. This case illustrates how social determinants of health may negatively affect rare disease management and potential strategies for addressing barriers to care.

Exploring the impact of housing insecurity on the health and wellbeing of children and young people in the United Kingdom: a qualitative systematic review.

BACKGROUND: Housing insecurity can be understood as experiencing or being at risk of multiple house moves that are not through choice and related to poverty. Many aspects of housing have all been shown to impact children/young people's health and wellbeing. However, the pathways linking housing and childhood health and wellbeing are complex and poorly understood. METHODS: We undertook a systematic review synthesising qualitative data on the perspectives of children/young people and those close to them, from the United Kingdom (UK). We searched databases, reference lists, and UK grey literature. We extracted and tabulated key data from the included papers, and appraised study quality. We used best fit framework synthesis combined with thematic synthesis, and generated diagrams to illustrate hypothesised causal pathways. RESULTS: We included 59 studies and identified four populations: those experiencing housing insecurity in general (40 papers); associated with domestic violence (nine papers); associated with migration status (13 papers); and due to demolition-related forced relocation (two papers). Housing insecurity took many forms and resulted from several interrelated situations, including eviction or a forced move, temporary accommodation, exposure to problematic behaviour, overcrowded/poor-condition/unsuitable property, and making multiple moves. Impacts included school-related, psychological, financial and family wellbeing impacts, daily long-distance travel, and poor living conditions, all of which could further exacerbate housing insecurity. People perceived that these experiences led to mental and physical health problems, tiredness and delayed development. The impact of housing insecurity was lessened by friendship and support, staying at the same school, having hope for the future, and parenting practices. The negative impacts of housing insecurity on child/adolescent health and wellbeing may be compounded by specific life circumstances, such as escaping domestic violence, migration status, or demolition-related relocation. CONCLUSION: Housing insecurity has a profound impact on children and young people. Policies should focus on reducing housing insecurity among families, particularly in relation to reducing eviction; improving, and reducing the need for, temporary accommodation; minimum requirements for property condition; and support to reduce multiple and long-distance moves. Those working with children/young people and families experiencing housing insecurity should prioritise giving them optimal choice and control over situations that affect them.

Minibox: Custom solo or semi-group housing chambers for long term housing of rats with miniscopes.

In this detailed procedure, we include open-source methodologies using 'solidworks' designs for creating solo or semi-group housing units for rats wearing miniscopes for long periods of time. Builds are optimized to preserve rat health and prevent hardware destruction. We include all prices and suggestions for purchasing strategies to reduce overall build-costs.•Chambers are optimized for long-term housing to protect rats wearing delicate headstages (e.g., miniscopes).•Designed to be low-cost, efficient supplement to operant chambers and provides numerous benefits to long-term miniscope imaging. The housing chambers can be augmented by installing cameras, commutators, or different types of floor grids depending on experimental conditions.•The chambers can also be secured to one another to create "rat-duplexes", allowing experimenters to control the degree of social isolation.

Technical and economic performance favours fully automated climate control broiler housing.

1. This study compared two broiler housing models with different technologies (conventional versus fully automated climate control) to verify their performance and carcass characteristics at slaughter, as well as the economics of production.2. A database regarding 20 443 flocks of heavy broilers produced in an integrated operation during the years 2020 and 2021, in eight Brazilian regions was used in the analysis. The dependent variables included feed conversion, average live weight gain, total and partial carcass condemnation and the total mortality. For economic analysis, the production cost of each technology including feed, labour, energy, heating and depreciation was calculated.3. The technology used in the broiler houses had a significant effect on the technical indicators which were positive for fully automated climate control in most geographical regions. One important exception was the effect on total and partial carcass condemnations, with better results seen for conventional housing. The total cost per ton of broiler meat delivered, deducting condemnation losses, was lower in the automated climate controlled housing compared to conventional housing.4. In conclusion, there was a reduction in broiler chicken production costs for birds raised in fully automated climate controlled housing, indicating better economic results for this model in Brazil.

Long-term effects of pre-weaning social housing on response to a social and housing transition in pregnant heifers.

Dairy cattle are routinely managed in social groups and subject to various management and social transitions, yet conventional approaches to rearing dairy calves limit social experience during early weeks of life. The objective of this study was to evaluate long-term effects of dairy calf social housing, with calves housed individually or in pairs, on long-term behavioral responses observed in pregnant heifers following social regrouping and introduction to a novel housing environment. Holstein heifers were raised during the milk-feeding period (provided 8 L/d milk replacer) in either individual pens (n = 20 heifers) or paired pens (n = 20 pens; 1 focal heifer/pen) and subsequently identically managed in groups on pasture from 9 weeks of age. At 30 d before expected calving, pregnant heifers were moved from pasture to a free stall barn, which represented introduction to a novel social group and an unfamiliar housing environment. Behavior was continuously recorded from video for 24 h, beginning at 0000 h on the day after introduction, to characterize feeding behavior, locomotor activity, and stall usage, as well as social proximity and competitive behavior surrounding the feed bunk and stall. Stocking density of the free stall barn fluctuated and was categorized as low (≤75%, 100 × animals in pen/available stalls), medium (>75%, 100%), or high (≥100%). Body weights obtained following calving indicated that previously PH heifers were heavier (632.3 vs. 593.4 kg; PH vs. IH), and body weight was included as a covariate in analysis of feeding behavior. Upon introduction to the free stall pen, previously PH heifers spent more time walking (1.9 vs. 1.3 min/h) with no effect of calf social housing on duration of lying time. However, stall use was subject to an interaction between previous housing treatment and stocking density and differed overall between previous housing treatments; previously PH heifers spent less time in the stall, particularly at high stocking density (29.4 vs. 48 min/h), due to shorter (29.6 vs. 95.7 min/visit) but marginally more frequent stall visits. Previously pair-housed heifers were also less likely to be displaced from a stall (44 vs. 85% of heifers replaced; PH vs. IH). Feeding behavior was similarly influenced by previous housing treatment particularly at high stocking density, with previously PH heifers spending more time feeding (8.2 vs. 4.2 min/h) and visiting the feed bunk more frequently (1.5 vs. 0.8 visits/h). These results suggest that preweaning social housing had long-term effects on behavior and ability to adapt to a novel environment which became most apparent under heightened competitive pressure.

Examining the importance of neighborhood natural, and built environment factors in predicting older adults' mental well-being: An XGBoost-SHAP approach.

BACKGROUND: Previous studies have shown that urban neighborhood environmental factors significantly influence the health outcomes of urban older adults. However, most cross-sectional studies exploring the health effects of these factors have failed to quantify the relative importance of each factor. METHODS: We use XGBoost machine learning techniques and SHAPley Additive Interpretation (SHAP) to rank the importance of urban neighborhood environmental factors in shaping the mental health of urban older adults. To address self-selection bias in housing choice, we distinguish older adults living in private housing from those living in public as residents in private housing have more freedom to choose where to live. RESULTS: The results show that both natural and built environmental factors in urban neighborhoods are important predictors of mental well-being scores. Five natural environmental factors (blue space, perceived greenery quantity, NDVI, street view greenness, aesthetic quality) and three built environmental factors (physical activity facilities quality, physical activity facilities quantity, neighborhood disorder) had considerable predictive power for mental well-being scores in two groups. Among them, blue space, perceived greenery quantity and street view greenness quantity became less important after controlling for self-selection bias, possibly because of the unequal distribution of quantity and quality, and the performance of neighborhood disorder, aesthetic quality and physical activity facilities quality was more sensitive in public housing. CONCLUSIONS: These results highlight the nuanced and differential effects of neighborhood environmental exposures on mental well-being outcomes, depending on housing preferences. The results of this study can provide support for decision makers in urban planning, landscape design and environmental management in order to improve the mental well-being status of urban older adults.

Falls as a mental health risk among Korean-American residents in subsidized senior housing: mediating effect of fall-related self-efficacy.

OBJECTIVES: The study examined the mediating role of fall-related self-efficacy in the association between falls and mental health among older Korean Americans living in subsidized senior housing in the greater Los Angeles area. We focused on serious fall incidents (i.e. multiple falls or any fall with a fracture) and used symptoms of depression and anxiety as indicators of mental health. METHOD: Survey data from 315 participants (M age = 79.4 years) were used to examine the direct effects of serious fall incidents on mental health symptoms, as well as indirect effects through fall-related self-efficacy. RESULTS: The mediating effect of fall-related self-efficacy was found to be significant in both models for depressive symptoms (B [SE] = 0.15 [0.07], bias-corrected 95% CI = [0.03, 0.31]) and anxiety symptoms (B [SE] = 0.11 [0.05], bias-corrected 95% CI = [0.02, 0.23]). CONCLUSION: The mental health impact of serious fall incidents was shaped by older individuals' perceived concerns about falls and confidence in performance. The findings highlight the importance of addressing fall-related psychological responses in preventing falls and promoting mental health among senior housing residents.

Population-based estimates of major forms of housing insecurity among community-living older Americans.

OBJECTIVES: The number of older adults struggling to maintain adequate housing is growing. Prior studies have used various criteria to measure housing insecurity; however, no standardized definition exists to date. Using a multidimensional approach, our study sought to calculate population-based estimates of various forms of housing insecurity among community-living older Americans and determine how these estimates differ across key characteristics. METHODS: This study utilized data from the 2011 round of the National Health and Aging Trends Study (NHATS), a prospective longitudinal study of Medicare beneficiaries aged 65 years or older. Three key forms of housing insecurity were operationalized: poor housing affordability (PHA), poor housing quality (PHQ), and poor neighborhood quality (PNQ). Population-based estimates of these forms of housing insecurity were calculated using analytic sampling weights and stratified by age, gender, race and ethnicity, frailty status, and dementia status. RESULTS: Totally 6466 participants were included in the analysis, representing 29,848,119 community-living older Americans. The mean (standard deviation) age was 77.3 (7.7) years; by weighted percentages, 56.0% identified as female, 81.3% as White, 8.2% Black, and 7.1% Hispanic. At least one form of housing insecurity was identified in 38.5% of older Americans. Individually, the prevalence of PHA was 14.8%, PHQ 24%, and PNQ 12.5%. The prevalence of at least one form of housing insecurity was higher among persons of color (62.9% Black and 66% Hispanic vs White; p < 0.001), those with frailty (40.9% pre-frail and 49.4% frail vs robust; p < 0.001), and those with cognitive impairment (48.1% possible and 51% probable dementia vs no dementia; p < 0.001). DISCUSSION: Nearly one in three community-living older Americans experience at least one form of housing insecurity. This was most common among vulnerable subgroups. Our multidimensional approach to defining various forms of housing insecurity can be used for future studies focused on improving social determinants of health among high-risk older adults.

Exploring effects of light intensity on sustainability indicators in finishing pig production.

With an ongoing transition towards the use of Light Emitting Diodes, more knowledge is needed on which light settings optimise sustainability parameters in pig production. We studied the effects of four light intensities on social, environmental and economic sustainability indicators, including ammonia emissions, space use, pen fouling, weight gain, carcass quality, perception of the stockkeeper, costs of the light system, and use of drinking water, electricity and medicines. Light treatments included a low (45 lux), medium (198 lux) and high (968 lux) uniform intensity, and a spatial gradient treatment ranging from 71 lux in the front to 330 lux in the back of each pen. The latter treatment aimed to improve the space use of functional areas. A total of 448 growing-finishing pigs were studied on a commercial farm using two consecutive batches of four rooms containing eight pens with seven pigs. Light intensity influenced some aspects of space use and pen fouling. For example, the proportion of pigs lying in the resting area was higher in the high and medium light intensity treatment than in the low intensity and gradient treatment. Moreover, the high-intensity treatment resulted in more fouling with faeces in the feeding area compared with the low-intensity and the gradient treatment. Ammonia emissions were higher in the gradient than in the low intensity treatment (not measured in medium and high intensity treatment). Furthermore, light intensity did not affect weight gain, carcass quality, water use and medicine use. The stockkeeper was content to work in all light conditions, but slightly preferred the medium intensity due to optimal visibility. Concerning economic performance, the costs of the light system and electricity use increased in the following order: low intensity, gradient, medium intensity, and high intensity. In conclusion, contrary to expectation the spatial gradient did not notably improve space use or reduce pen fouling, but rather increased ammonia emissions in comparison with uniform light. This is likely because the gradient could not be applied in an optimal way in the existing housing conditions. Among the other sustainability indicators, mainly electricity use and costs of the light system differed per treatment. These aspects can be improved by further optimising the number of light sources needed per pen to achieve the targeted intensities.

Historical redlining, neighborhood disadvantage, and reports of child maltreatment in a large urban county.

BACKGROUND: Child protective services (CPS) reports are spatially concentrated in disadvantaged neighborhoods and Black children are more likely than White children to reside in these neighborhoods. Entrenched patterns of racial residential segregation reflect the lasting impact of historical redlining - a racist practice spearheaded by the federally sponsored Home Owners' Loan Corporation (HOLC) in the 1930s that assigned worst risk grades to minoritized neighborhoods. Research has established links between historically redlined areas and the present-day wellbeing of children and families; however, little is known about the relationship between historical redlining and CPS report rates in neighborhoods. OBJECTIVE: Using census tracts as a proxy for neighborhood, this study examines the relationship between historical redlining and the number of CPS reports within neighborhoods. PARTICIPANTS, SETTING, AND METHOD: This study combines data on HOLC risk grades and sociodemographic data from the American Community Survey with the aggregate number of CPS reports per census tract in Los Angeles County, CA (n = 1137). RESULTS: We used Bayesian conditionally autoregressive models to examine the relationship between historical redlining score (A = 1, B = 2, C = 3, D = 4) and the number of CPS reports within neighborhoods. In the unadjusted model, each unit increase in redlining score is associated with a 21.6 % higher number of CPS reports (95 % CI; 1.140, 1.228). In adjusted models that included concentrated disadvantage, each unit increase in redlining score is associated with a 7.3 % higher number of CPS reports (95 % CI; 1.021, 1.136). CONCLUSION: Housing policy reforms through a racial equity lens should be considered as a part of a national strategy to prevent child maltreatment.

Housing instability patterns among low-income, urban Black young adults in California and associations with mental health outcomes: baseline data from a randomized waitlist-controlled trial.

BACKGROUND: Deep-rooted racial residential segregation and housing discrimination have given rise to housing disparities among low-income Black young adults in the US. Most studies have focused on single dimensions of housing instability, and thus provide a partial view of how Black young adults experience multiple, and perhaps overlapping, experiences of housing instability including homelessness, frequent moves, unaffordability, or evictions. We aimed to illuminate the multiple forms of housing instability that Black young adults contend with and examine relationships between housing instability and mental health outcomes. METHODS: Using baseline data from the Black Economic Equity Movement (BEEM) guaranteed income trial with 300 urban low-income Black young adults (aged 18-24), we conducted a three-stage latent class analysis using nine housing instability indicators. We identified distinct patterns by using fit indices and theory to determine the optimal number of latent classes. We then used multinomial logistic regression to identify subpopulations disproportionately represented within unstable housing patterns. Finally, we estimated associations between housing experience patterns and mental health outcomes: depression, anxiety, and hope. RESULTS: We found high prevalence of housing instability with 27.3% of participants reporting experiences of homelessness in the prior year and 39.0% of participants reporting multiple measures of housing instability. We found the 4-class solution to be the best fitting model for the data based on fit indices and theory. Latent classes were characterized as four housing experience patterns: 1) more stably housed, 2) unaffordable and overcrowded housing, 3) mainly unhoused, and 4) multiple dimensions of housing instability. Those experiencing unaffordable and overcrowded housing and being mainly unhoused were more than four times as likely to have symptoms of depression (Unaffordable: aOR = 4.57, 95% CI: 1.64, 12.72; Unhoused: aOR = 4.67, 95% CI:1.18, 18.48) and more than twice as likely to report anxiety (Unaffordable: aOR = 2.28, 95% CI: 1.03, 5.04; Unhoused: aOR = 3.36, 95% CI: 1.12, 10.05) compared to the more stably housed pattern. We found that hope scores were similarly high across patterns. CONCLUSIONS: High prevalence of housing instability and mental health challenges among low-income Black young adults demands tailored interventions to reduce instability, given widening racial disparities and implications for future well-being into adulthood.

Racial Disparities in COVID-19 Case Positivity and Social Context: The Role of Housing, Neighborhood, and Health Insurance.

Research on racial-ethnic COVID-19 disparities has yet to employ housing variables measured at the individual level, limiting our understanding of housing's role in determining early exposure to the virus. To address this gap, we linked data from SARS-CoV-2 polymerase chain reaction (PCR) tests within the Duke University Health System between March 12, 2020, and July 31, 2020 (N = 23,057 individuals), with housing parcel data. We then analyzed how housing, neighborhood, and health insurance explain disparities in case positivity between and within racial-ethnic groups in Durham County, North Carolina. We find that 55% of the Black-White disparity and 25% of the Hispanic-White disparity in positive cases are explained by these social-contextual variables. Neighborhood-fixed effects explained the largest portion (27%) of the Black-White disparity, whereas health insurance type explained the largest portion (14%) of the Hispanic-White disparity. We conclude that housing, neighborhood, and health insurance had a significant role in producing racial-ethnic disparities in COVID-19 case positivity.

Homelessness and mortality: gender, age, and housing status inequity in South Korea.

Objectives: We compared mortality rates among various housing statuses within the homeless population and investigated factors contributing to their deaths, including housing status, gender, and age. Methods: Using a comprehensive multi-year dataset (n=15,445) curated by the National Tuberculosis (TB) Screening and Case Management Programs, matched with the 2019-2021 Vital Statistics Death Database and National Health Insurance claims data, we calculated age-standardized mortality rates and conducted survival analysis to estimate differences in mortality rates based on housing status. Results: The mortality rate among the homeless population was twice as high as that of the general population, at 1159.6 per 100,000 compared to 645.8 per 100,000, respectively. Cancer and cardiovascular diseases were the primary causes of death. Furthermore, individuals residing in shelter facilities faced a significantly higher risk of death than those who were rough sleeping, with an adjusted hazard ratio of 1.702 (95% CI, 1.369-2.115). This increased risk was especially pronounced in older adults and women. Conclusion: The study highlights the urgent need for targeted interventions, as the homeless population faces significantly higher mortality rates. Older adults and women in shelter facilities are at the highest risk.

Single housing of juveniles accelerates early-stage growth but extends adult lifespan in African turquoise killifish.

Within the same species, individuals exhibiting faster growth tend to have shorter lifespans, even if their fast growth arises from early-life pharmacological interventions. However, in vertebrates, the impact of the early-life environment on the growth rate and lifespan has not been fully elucidated. In this study, by utilizing the short-lived African turquoise killifish, which is suitable for a comprehensive life-stage analysis in a brief timeframe, we explored the effects of housing density during the juvenile stage on holistic life traits. As a result, we found that lower housing densities resulted in faster growth, but led to longer adult lifespan, which was contrary to the common notion. Furthermore, the single-housed adult fish displayed a longer egg-laying period than did their group-housed counterparts. Our transcriptome analysis also demonstrated that, in terms of internal transcriptional programs, the life stage progression and aging process of single-housed fish were slower than those of group-housed fish. Collectively, our results suggest that sharing housing with others in early life might influence whole-life attributes, potentially leading to specific life history traits beyond the typical relationship between the growth rate and lifespan.

Strategies to Reduce Frequent Emergency Department Use among Persons Experiencing Homelessness with Mental Health Conditions: a Scoping Review.

The USA has some of the highest utilization rates of the Emergency Department (ED) worldwide, leading to increased healthcare costs, constrained resources, and fragmented care. Many of the highest ED utilizers are persons experiencing homelessness (PEH) and those with mental health conditions, with even higher use by those with comorbid social challenges. This study reviewed the literature assessing interventional approaches in the ED to minimize the burden of ED utilization by PEH with associated mental health conditions. We first conducted an informal literature review of high ED utilizers and their most common presenting symptoms. We then conducted a scoping review of articles according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines; we used PubMed and Web of Science databases as well as Google Scholar. We screened the titles and abstracts of studies that evaluated programs that aimed to reduce ED usage by patients with mental illness who were also experiencing homelessness. Of the 1574 titles and abstracts screened, 49 full texts were examined for eligibility. Of those, 35 articles were excluded for a final count of 14 included studies. We found that the studies fell under two main interventional categories: housing support and care management. There were various approaches to reduce ED visits from PEH with mental illness around the world. Overall, these studies found varying degrees of success in reducing ED visits for both housing intervention and care management strategies. Comparison of these studies reveals that the success of related strategies like housing support often have different outcomes which can be attributed to the differences between the populations studied, previously available community resources, and other psychosocial factors affecting study participants. Overall, the most successful studies found that a tailored approach that addresses the unique needs of participants had the greatest impact on reducing ED visits and hospitalizations. Further research is needed to determine the best strategies for specific populations and how to promote health equity among PEH with associated mental health conditions.

Considering Residents' Health and Well-Being in the Process of Social Housing Redevelopment: A Rapid Scoping Literature Review.

Many aging mid-twentieth-century social housing developments worldwide are set to undergo major redevelopment, aiming to improve residents' living conditions. Nevertheless, the associated processes, particularly the challenges of relocation during the demolition and reconstruction phase, can significantly disrupt communities and social networks. Understanding the multifaceted impacts of social housing redevelopment projects is crucial to inform planning, design, and consultation for these projects. This scoping literature review explores how residents' health and well-being are considered in the process of social housing redevelopment. We identified eight studies through a search performed on EMBASE, PubMed, and Scopus databases, with an additional hand search of the bibliographies of selected studies. A thematic analysis was conducted to identify the health and well-being impacts of the different phases during redevelopment projects. The findings demonstrate that social housing redevelopment projects have varied impacts on residents' health and well-being depending on the subgroup of residents and the contextual characteristics of the original social housing estate. While improved physical infrastructure provides opportunities for better health outcomes, the disruption and lack of control during the relocation process may cause significant adverse health impacts. Moreover, the different phases during the redevelopment process expose different subgroups to varying risks. Based on these findings, we recommend that social housing redevelopment initiatives prioritize engaging and empowering residents to have better control in decision-making throughout all phases of the redevelopment.

Beyond COVID: towards a transdisciplinary synthesis for understanding responses and developing pandemic preparedness in Alaska.

Pandemics are regularly occurring events, and there are foundational principles of pandemic preparation upon which communities, regions, states, and nations may draw upon for elevated preparedness against an inevitable future infectious disease threat. Many disciplines within the social sciences can provide crucial insight and transdisciplinary thinking for the development of preparedness measures. In 2023, the National Science Foundation funded a conference of circumpolar researchers and Indigenous partners to reflect on COVID-19-related research. In this article, we synthesise our diverse social science perspectives to: (1) identify potential areas of future pandemic-related research in Alaska, and (2) pose new research questions that elevate the needs of Alaska and its people, pursuant of a specific body of pandemic knowledge that takes into account the ecological and sociocultural contexts of the region. In doing so, we highlight important domains of research in the social sciences from transdisciplinary perspectives, including the centering of Indigenous knowledges and needs, the contexts of risk perception and resilience, food and housing security, and more. We highlight the contributions of social sciences to pandemic knowledge and provide a foundation for future pandemic-related research in Alaska.

Social isolation and loneliness among people living with experience of homelessness: a scoping review.

Social isolation and loneliness (SIL) are public health challenges that disproportionally affect individuals who experience structural and socio-economic exclusion. The social and health outcomes of SIL for people with experiences of being unhoused have largely remained unexplored. Yet, there is limited synthesis of literature focused on SIL to appropriately inform policy and targeted social interventions for people with homelessness experience. The aim of this scoping review is to synthesize evidence on SIL among people with lived experience of homelessness and explore how it negatively impacts their wellbeing. We carried out a comprehensive literature search from Medline, Embase, Cochrane Library, PsycINFO, CINAHL, Sociological Abstracts, and Web of Science's Social Sciences Citation Index and Science Citation Index for peer-reviewed studies published between January 1st, 2000 to January 3rd, 2023. Studies went through title, abstract and full-text screening conducted independently by at least two reviewers. Included studies were then analyzed and synthesized to identify the conceptualizations of SIL, measurement tools and approaches, prevalence characterization, and relationship with social and health outcomes. The literature search yielded 5,294 papers after removing duplicate records. Following screening, we retained 27 qualitative studies, 23 quantitative studies and two mixed method studies. SIL was not the primary objective of most of the included articles. The prevalence of SIL among people with homelessness experience varied from 25 to 90% across studies. A range of measurement tools were used to measure SIL making it difficult to compare results across studies. Though the studies reported associations between SIL, health, wellbeing, and substance use, we found substantial gaps in the literature. Most of the quantitative studies were cross-sectional, and only one study used health administrative data to ascertain health outcomes. More studies are needed to better understand SIL among this population and to build evidence for actionable strategies and policies to address its social and health impacts.