Research on the economic effects of housing support expenditures under the perspective of consumption heterogeneity: Evidence from China.

What kind of impact does the government's housing support expenditure have on residents' consumption? This is a topic that deserves in-depth study and is of practical significance. This study constructs provincial equilibrium panel data based on China's guaranteed housing construction and financial expenditures on housing support data from 1999-2009 and 2000-2021. It applies the systematic GMM method to estimate the impact of government housing support expenditures on residents' consumption. The study found that whatever form of expenditure on housing support contributed to the total consumption of urban residents, while the impact on the consumption structure had different results. Based on the divisions of consumption structure, the results of the increase in government housing support expenditure on the consumption structure of urban residents are different. An examination of different forms of housing support reveals that the predominantly secure form of housing construction has a positive effect on all consumption structure divisions. Whereas the predominantly monetary subsidy form has a significant positive relationship with housing, necessity, and durability consumption expenditures, it has a weak or even negative relationship with non-housing, non-necessity, and non-durability consumption expenditures. The research in this paper makes up for the lack of current literature examining the economic effects of housing support from the perspective of consumption structure and provides a theoretical basis and policy reference for constructing a multi-level gradient housing support system.

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.

Rental Housing Deposits and Health Care Use.

Importance: Housing deposits and tenancy supports have become new Medicaid benefits in multiple states; however, evidence on impacts from these specific housing interventions is limited. Objective: To evaluate the association of rental housing deposits and health care use among Medicaid beneficiaries receiving social needs case management as part of a Whole-Person Care (Medicaid 1115 waiver) pilot program in California. Design, Setting, and Participants: This cohort study compared changes in health care use among a group of adults who received a housing deposit between October 2018 and December 2021 along with case management vs a matched comparison group who received case management only in Contra Costa County, California, a large county in the San Francisco Bay Area. All participants were enrolled in health and social needs case management based on elevated risk of acute care use. Data analysis took place from March 2023 to June 2024. Exposure: Rental housing deposit funds that covered 1-time moving transition costs. Funds averaged $1750 per recipient. Main Outcomes and Measures: Changes in hospitalizations, emergency department visits, primary care visits, specialty care visits, behavioral health visits, psychiatric emergency services, or detention intakes during the 6 months before vs 6 months after deposit receipt. Changes 12 months before and after deposit receipt were examined as a sensitivity analysis. Results: Of 1690 case management participants, 845 received a housing deposit (362 [42.8%] <40 years old; 422 [49.9%] male) and 845 received case management only (367 [43.4%] <40 years old; 426 [50.4%] male). In adjusted analyses, deposit recipients had no statistically significant differential changes in health care use for any measure compared to participants who received case management alone. Twelve-month sensitivity analyses yielded consistent results. Conclusions and Relevance: In this cohort study, compared to case management only, housing deposits with case management were not associated with short-term changes in health care use. There may be other unmeasured health benefits or downstream benefits from greater case management engagement. States considering housing deposits as an expanded Medicaid benefit may need to temper expectations about short-term health care use impacts.

The bioefficacy of a novel VECTRON™ T500 indoor residual spray formulation in an experimental huts trial against Anopheles gambiae s.l. populations.

BACKGROUND: The emergence of insecticide resistance and its spread through populations of malaria vectors has decreased the number of insecticides available for control. Insecticide resistance has been observed in vector populations across sub-Saharan Africa in malaria endemic areas. Therefore, new compounds with different modes of action are needed that can be used in the management of resistance. The current study assessed the bioefficacy of the new indoor residual spray formulation, VECTRON™ T500 against Klypson 500 WG and water against laboratory reared and wild populations of Anopheles gambiae s.l.. The comparative experimental hut trial was implemented between June 2022 and December 2022 to determine the efficacy of VECTRON™ T500, containing the active ingredient (ai) broflanilide as a 50 % wettable powder (WP). The efficacy of VECTRON™ T500 was compared with a positive control, Klypson 500 WG, a wettable granule (WG) formulation that contains 50 % clothianidin. Cement and mud walls were sprayed with VECTRON™ T500, Klypson 500 WG with water sprayed as a negative control. The two insecticides and negative control were evaluated monthly for six months against laboratory and the field-derived An. gambiae s.l. using the standard WHO cone bioassays. Each wall had two cones on each day of testing. VECTRON™ T500 was sprayed on both surface types at a rate of 100mg ai/m2 whilst Klypson 500 WG was applied at a rate of 300 mg ai/m2. For both wall surface types, the vector from the laboratory-reared and the wild populations exhibited a low knockdown effect to both VECTRON™ T500 and Klypson 500 WG. A total of 3,840 mosquitoes were used of which 2,880 (75 %) were susceptible colony of An. gambiae s.s. and 960 (25 %) were wild An. gambiae s.l.. The VECTRON™ T500 induced a mortality of 97.8 %-98.1 % in the laboratory population and 83.2-95.0 % wild population mosquitoes on cement and mud-walled huts respectively while Klypson 500 WG ranged from 89.6-99.0 % for wild and 99.0-99.3 % for the laboratory population mosquitoes on cement and mud walls respectively. The knockdown due to VECTRON™ T500 was 7.08 % in the sixth month, while for Klypson 500 WG was 16.04-17.50 %. The monthly wall cone bioassay mortality with VECTRON™ T500 remained over 80 % for 6 months post-spraying for both laboratory and wild populations. The findings of this study have shown VECTRON™ T500 to have extended efficacy against malaria vector mosquitoes when applied to cement and mud walls. The evaluated new IRS formulation, VECTRON™ T500, performed equally with the positive control, Klypson 500 WG, regarding its impact on vector mortality.

A qualitative study of healthy ageing and co-production.

Europe's ageing population increases the demand for housing solutions targeting older citizens' needs and preferences. Establishing age-friendly communities fostering social participation is essential for healthy ageing and various housing options with shared facilities prioritizing social contact have emerged. While involving older people in public service delivery is emphasized, studies on co-production with older people in building age-friendly communities remain limited. This study explores a co-production initiative between older citizens, a municipality and a real estate company in a newly established senior village focusing on organizational settings and physical facilities. A qualitative study inspired by the BIKVA methodology was conducted using focus group interviews with citizens, frontline staff, and management. Through reflexive thematic analysis, the physical environment, organizational setting and other factors influencing the co-production process were analysed. Citizens expressed satisfaction with the unique physical environment, the different activities and being involved in the co-production process on development and building up the senior village. However, the co-production initiative was influenced by the lack of frontline staff involvement, how the physical facilities were organized for building inclusive communities as well as the level of information provided to align expectations among stakeholders. Involving older citizens in the co-production of age-friendly community initiatives has the potential to take the identified challenges into account. To understand what constitutes an optimal environment for healthy ageing further research in collaboration with older citizens is needed.

"Give me the reigns of taking care of myself with a home": Healing environments in an Indigenous-led alcohol harm reduction program.

BACKGROUND: Distinct from western Managed Alcohol Programs (MAPs), Indigenous-led alcohol harm reduction programs can be defined by both 'culture as healing' and decolonized harm reduction philosophies. We sought to explore experiences of Indigenous 'family members' (participants) in an Indigenous-led alcohol harm reduction program and culturally supportive housing to identify appropriate supports according to family member perspectives, and to inform delivery of the program. METHODS: Situated within an Indigenous-western research partnership, we completed semi-structured interviews with seven family members of an Indigenous-led alcohol harm reduction and culturally supportive housing program. Community-guided protocols informed relational knowledge gathering practices including semi-structured in-depth interviews, qualitative thematic analysis, collaborative interpretation of findings, and development of knowledge products. RESULTS: Family members highlighted the importance of tailored Indigenous-led alcohol harm reduction in shifting their relationships to alcohol from survival to having choice and control of their drinking (It's a choice I'm making right now). The provision of varied and incremental culture-based opportunities (Multiple pathways for connecting to culture) facilitated engagement with culture as healing. Policies that honour respect and autonomy were identified as supportive to healing and harm reduction, countering family members' experiences in western spaces (Give me the reigns of taking care of myself with a home). CONCLUSIONS: An Indigenous-led alcohol harm reduction program within a model of culture as healing facilitated shifts in relationships to alcohol, providing a space where family members could explore long term goals of healing and connection to culture. Family members' experiences and recommendations offer key considerations for the design of Indigenous-led harm reduction and culture as healing models. Recommendations emphasize the provision of tailored alcohol harm reduction plans in parallel to multiple and accessible opportunities for connection to culture as healing in order to meet diverse participant goals and relationships to alcohol and culture.

A case-control study on risk factors for visceral leishmaniasis in West Pokot County, Kenya.

BACKGROUND: Visceral leishmaniasis (VL) is a severe parasitic disease transmitted by phlebotomine sandflies. VL is endemic in West Pokot County, Kenya, where effective strategies to interrupt transmission are impeded by the limited understanding of VL risk factors. Therefore, this case-control study aimed to explore environmental, behavioural and household determinants of VL in West Pokot. METHODS: From November 2022 to January 2023, a structured questionnaire was administered to 36 symptomatic primary VL cases attending Kacheliba Sub-County Hospital in West Pokot and to 50 healthy controls from local villages. The VL status of all participants was confirmed using an rK39 rapid diagnostic test. Associations between questioned determinants and VL were investigated by means of age-corrected univariate logistic regression analysis. RESULTS: Significant associations were found between VL and housing characteristics, such as window presence and floor type. VL cases more frequently reported the presence of cattle, dogs and sheep in their house yards. VL was also associated with cutting down trees in the house yard and house proximity to several Acacia tree species. Furthermore, outdoor activities, including travelling outside the residence for more than 2 weeks, activities near termite mounds, and forest activities during the rainy season, increased the risk of VL. CONCLUSIONS: This work reports a number of previously undescribed risk factors for VL in the understudied West Pokot focus. The results suggest VL transmission occurs both peri-domestically at night and outdoors during the day, particularly when sandfly resting sites are disturbed. Our findings warrant further research into sandfly ecology and potential zoonotic parasite reservoirs in West Pokot.

Stability of Patient Social Determinants of Health With a Focus on Food Insecurity.

INTRODUCTION/OBJECTIVES: Many health systems screen patients for social determinants of health and refer patients with social needs to community service organizations for assistance. However, few studies have examined how social determinants of health change over time in the same individuals. METHODS: We examined patients screened by The MetroHealth System in Cleveland, Ohio for 11 social determinants of health, including food insecurity, financial strain, transportation, housing stability, utilities affordability, other housing problems, intimate partner violence, social connection, physical activity, daily stress, and digital connectivity. We determined changes in these social determinants among patients screened at baseline and again after 6 to 18 months of follow-up. We further examined correlates of changes in food insecurity, because it is a common need among our patients and leads to numerous referrals to community organizations for assistance. RESULTS: A substantial majority of patients had no change in each social determinant. For example, among 18 038 patients screened twice for food insecurity, 13 913 (77.1%) did not screen positive for food insecurity at baseline and follow-up and 1726 (9.6%) screened positive for food insecurity at both times. A total of 1080 (6.0%) did not screen positive for food insecurity at baseline but screened positive at follow-up while 1319 (7.3%) screened positive for food insecurity at baseline but not at follow-up. Among patients screening positive for food insecurity at baseline, screening negative at follow-up was independently associated with being age ≥60 years (odds ratio [OR] = 1.46, 95% confidence interval [CI] = 1.02-2.10), not screening positive for financial strain (OR = 1.64, CI = 1.27-2.13), not screening positive for housing problems (OR = 1.65, CI = 1.28-2.13), and not screening positive for intimate partner violence (OR = 1.45, OR = 1.02-2.08). A longer duration between baseline and follow-up screening was also independently associated with not screening positive for food insecurity at follow-up. Being referred for food assistance was not associated with absence of food insecurity at follow-up (OR = 0.71, CI = 0.47-1.08). CONCLUSIONS: Most patients report no change in specific social determinants of health over 6 to 18 months. Examining changes may identify subgroups at greatest risk for persistence of adverse determinants and help to evaluate the impact of assistance efforts.

Spatial-temporal differences and convergence analysis of residential building carbon emission efficiency in China.

Data indicate that carbon dioxide emissions from residential buildings in China constitute 60% of the country's total, making carbon reduction efforts in residential construction crucial for achieving dual carbon goals. From the perspective of eight major economic regions, this paper selects energy consumption, per capita residential area, and residential population as input indicators, per capita disposable income as the output indicator, and carbon dioxide emissions as the undesired output indicator. It employs the super-efficiency model based on the directional distance (super-DDF) function and the Malmquist-Luenberger (ML) index to measure the static and dynamic carbon emission efficiencies of residential buildings (RBCEE) during their operational phase from 2010 to 2020. After analyzing the differences and equity in RBCEE among regions using the Theil index and Gini coefficient, the σ-convergence, absolute ß-convergence, and conditional ß-convergence methods are utilized to explore the changing trends of RBCEE across the eight major economic regions. Results show that the static RBCEE in China is at a medium level; dynamic efficiency has improved across all eight regions, though at varying rates; overall, RBCEE exhibits poor equity and significant differences, with intra-group differences being a major cause. In terms of convergence, all eight economic regions display significant absolute ß-convergence and conditional ß-convergence. Finally, based on the research findings, this paper proposes corresponding emission reduction recommendations for the eight major economic regions.

Rental Housing Type and Self-Reported General Health and Mental Health Status: Evidence from the Canadian Housing Survey 2018-2019.

Using the Canadian Housing Survey, 2018-2019, we examined self-reported general and mental health among tenants residing in various housing types, including cooperative, non-profit, government, and private housing. Adjusting for confounders, we discovered that tenants in not-for-profit housing reported the highest odds, over four and half times (odds ratio 4.63), of poor general health compared to tenants in privately owned housing in Canada. On the other hand, the odds were reversed for tenants in cooperative housing and government housing, with 24% and 33% lower odds of poor general health, respectively, compared to tenants in privately owned housing. Moreover, we found that tenants in not-for-profit (1.26) and government housing (1.43) reported higher odds of poor mental health. On the other hand, tenants in cooperative housing reported 42% lower odds of poor mental health than tenants in privately owned housing. Furthermore, we observed variations in the odds of poor general and poor mental health among tenants from different equity-seeking groups across different housing types. These findings highlight the importance of considering housing type and equity factors in understanding health outcomes among tenants.

Exploring the Connection between Social Housing and Employment: A Scoping Review.

Adequate housing is a social determinant of health and well-being, providing stability from which people can engage in important life activities, including self-care and productivity. Social housing is a system-level intervention that aims to provide affordable housing to people vulnerable to experiencing social and economic marginalisation. Given the importance of employment to social-economic status and overall health and well-being, we sought to better understand the available knowledge and research related to employment and living in a social housing environment. We used scoping review methodology to explore peer-reviewed research published between 2012-2022 regarding social housing and employment, identifying 29 relevant articles. Using the Psychology of Working Theory and neighbourhood effects as interpretive theoretical frameworks, we analysed the extracted data. Overall, the results affirmed that social housing residents have low employment rates conceptualised as related to the complex interplay of a range of personal and environmental factors. Most published literature was quantitative and originated from the United States. Policy and research implications are discussed, including the need for more multifaceted, person-centred interventions that support employment and ultimately promote health and quality of life for social housing residents.

Native Hawaiian and Pacific Islanders' Identity and Housing Status: The Impact on Historical Trauma and Perceived Stress.

Native Hawaiian and Pacific Islanders (NHPIs) are overrepresented in Hawai'i's houseless population. Indigenous populations, such as NHPIs, may encounter experiences of historical trauma that impact their well-being. This original research project examines how NHPI identity and houselessness compound to affect the perceived stress and historical trauma of transition-aged youth. Fifty-one participants aged 18 to 24 (M = 21.37, SD = 1.93) completed a survey that included the historical traumatic events scale, historical loss scale, perceived stress scale, and a demographic questionnaire. Over half (n = 26, 51.0%) of the participants identified as NHPI. A two-way ANOVA indicated a non-significant effect of NHPI identity and housing status on perceived stress. However, housed participants scored significantly higher than participants experiencing houselessness on the historical traumatic events scale (p = 0.006). Our findings elucidate the role of knowledge in the experience of historical trauma. Further results, limitations, and future directions are offered.

Belonging through meaningful activity in the transition from unhoused to housed.

BACKGROUND: Belonging is closely associated with well-being, yet individuals with experiences of being unhoused are likely to experience social exclusion and challenges with developing a sense of belonging. Engagement in meaningful activity has been linked to belonging; however, there are no focused studies exploring experiences of how engaging in meaningful activities influences belonging. Meaningful activities are things we do that bring value to our lives. PURPOSE: To explore how engaging in meaningful activities may influence experiences of belonging following homelessness through a secondary analysis of qualitative interviews. METHOD: Using interviews conducted in a community-based participatory action study exploring the transition to housing following homelessness (n = 19), we conducted a thematic analysis using the method described by Braun and Clarke. Participants were recruited through communication with local organizations supporting individuals with lived and living experiences of being unhoused as well as through presentations at drop-in organizations. An intentional effort was made to recruit diverse participants regarding housing status, age, and gender. Inductive analysis was used to conduct initial coding, focusing on belonging and engaging in meaningful activities. We then analyzed the codes abductively, using Bourdieu's Social Capital Theory to inform this analysis. FINDINGS: The overarching essence generated in our analysis was: "I don't feel like I belong…everything in the world is not for me…it's for people with…enough money to…enjoy those things". Within this overall essence, we generated three themes: 1) Human connection: "being where I am with people who care about me, I actually feel good"; 2) Social exclusion: being a "regular member of society"; and 3) Non-human connection: "my cats…are like my kids to me." Participants described numerous contextual factors that challenged them as they sought belonging following homelessness, including financial limitations and other societal factors. CONCLUSION: Our findings suggest that meaningful activity was an important pathway to belonging for participants in this study.

Housing Initiatives to Address Strep A Infections and Reduce RHD Risks in Remote Indigenous Communities in Australia.

Group A Streptococcus (Strep A) skin infections (impetigo) can contribute to the development of acute rheumatic fever (ARF) and rheumatic heart disease (RHD). This is of particular concern for Indigenous residents of remote communities, where rates of ARF and RHD are much higher than their urban and non-Indigenous counterparts. There are three main potential Strep A transmission pathways: skin to skin, surface to skin, and transmission through the air (via droplets or aerosols). Despite a lack of scientific certainty, the physical environment may be modified to prevent Strep A transmission through environmental health initiatives in the home, identifying a strong role for housing. This research sought to provide an outline of identified household-level environmental health initiatives to reduce or interrupt Strep A transmission along each of these pathways. The identified initiatives addressed the ability to wash bodies and clothes, to increase social distancing through improving the livability of yard spaces, and to increase ventilation in the home. To assist with future pilots and evaluation, an interactive costing tool was developed against each of these initiatives. If introduced and evaluated to be effective, the environmental health initiatives are likely to also interrupt other hygiene-related infections.

The effect of dwelling size on the mental health and quality of life of female caregivers living in informal tiny homes in Hong Kong.

BACKGROUND: Although the adverse impact of substandard informal housing has been widely documented, most studies concentrated on developing societies, thereby leaving informal housing in developed regions underexplored. This study examines Hong Kong, where limited dwelling size is a distinctive feature that characterises informal housing, to explore the impact of housing informality on mental health, with a particular focus on dwelling size. It centers on subdivided units (SDUs), which are tiny compartments partitioned from a large domestic quarter, to understand how housing informality and housing size affect the mental well-being of female caregivers, who typically bear the brunt of the housework. METHODS: In partnership with nongovernment organisations in three SDU-abundant districts, this mixed-methods study conducted a survey on 413 female caregivers aged 18-65 and qualitative research combining ethnographic observations and in-depth interviews on 36 families living in SDUs in Hong Kong between 2021 and 2023. The mental health outcomes and health-related quality of life (HRQoL) of the participants were assessed by using the Depression, Anxiety, and Stress Scale-21 and a EuroQol-5 Dimension-5 Level questionnaire. RESULTS: Depression, anxiety and stress were prevalent across the female caregivers living in SDUs (12.4%), as well as a significantly lower HRQoL compared with that of the general population (0.882 vs. 0.919). Findings showed that a total floor area smaller than 13.0 m2 was associated with increased likelihood of experiencing anxiety and depression and reduced HRQoL. Cramped living space adversely affected the caregivers' well-being through the 1) physical, 2) relational and 3) personal aspects of home experiences. Negative experiences at home can cause housework burnout, exacerbate family conflicts and lead to feelings of repression and low self-efficacy. CONCLUSIONS: This study contributes to the understanding of the consequences of housing informality in diverse geographical contexts and illuminates the effect of dwelling size by identifying the mechanisms through which housing size can affect the mental well-being of residents, which may vary depending on their family status. The findings yield important policy implications, including the need to establish a minimum space standard for subdivided residential dwellings and ensure equitable access to community spaces for deprived families.

Development of a High-Resolution Indoor Radon Map Using a New Machine Learning-Based Probabilistic Model and German Radon Survey Data.

BACKGROUND: Radon is a carcinogenic, radioactive gas that can accumulate indoors and is undetected by human senses. Therefore, accurate knowledge of indoor radon concentration is crucial for assessing radon-related health effects or identifying radon-prone areas. OBJECTIVES: Indoor radon concentration at the national scale is usually estimated on the basis of extensive measurement campaigns. However, characteristics of the sampled households often differ from the characteristics of the target population owing to the large number of relevant factors that control the indoor radon concentration, such as the availability of geogenic radon or floor level. Furthermore, the sample size usually does not allow estimation with high spatial resolution. We propose a model-based approach that allows a more realistic estimation of indoor radon distribution with a higher spatial resolution than a purely data-based approach. METHODS: A multistage modeling approach was used by applying a quantile regression forest that uses environmental and building data as predictors to estimate the probability distribution function of indoor radon for each floor level of each residential building in Germany. Based on the estimated probability distribution function, a probabilistic Monte Carlo sampling technique was applied, enabling the combination and population weighting of floor-level predictions. In this way, the uncertainty of the individual predictions is effectively propagated into the estimate of variability at the aggregated level. RESULTS: The results show an approximate lognormal distribution of indoor radon in dwellings in Germany with an arithmetic mean of 63 Bq/m3, a geometric mean of 41 Bq/m3, and a 95th percentile of 180 Bq/m3. The exceedance probabilities for 100 and 300 Bq/m3 are 12.5% (10.5 million people affected) and 2.2% (1.9 million people affected), respectively. In large cities, individual indoor radon concentration is generally estimated to be lower than in rural areas, which is due to the different distribution of the population on floor levels. DISCUSSION: The advantages of our approach are that is yields a) an accurate estimation of indoor radon concentration even if the survey is not fully representative with respect to floor level and radon concentration in soil, and b) an estimate of the indoor radon distribution with a much higher spatial resolution than basic descriptive statistics. https://doi.org/10.1289/EHP14171.

Study concerning the design and functionality of individual emergency shelters.

The divide between the rich and poor in the European housing market is fast rising. Latest research indicates that Europe is dealing with an increasing number of homeless people. Every city in Europe has them-homeless people compelled to live on street corners, frequently hiding themselves with cardboard. Rain, snow, and temperatures below zero pose a threat to their lives on a daily basis. There are many varied kinds of services that have been discovered, but it is difficult to keep track of everyone and guarantee that they have a warm night's sleep in the winter. The current article suggests accommodation as a workaround until they can receive high-intensity support, a way to keep a single person warm and safe during the winter. The focus is on devising a strategy that not only ensures the warmth and safety of individuals during the harsh winter months but also seeks to industrialize the construction of shelters, ensuring affordability below the cost of winter hospitalization for a homeless person. Crucially, the article introduces an additional layer to this initiative by highlighting the dual purpose of these individual shelters. Beyond being a means to provide respite for the homeless during severe weather, these shelters are envisioned as immediate response units in the event of emergencies such as earthquakes in urban areas. The article explores the potential impact of this multi-layered approach on transforming urban landscapes and fostering resilient communities.

Association of housing status and cancer diagnosis, care coordination and outcomes in a public hospital: a retrospective cohort study.

OBJECTIVES: Cancer is a leading cause of death in unhoused adults. We sought to examine the association between housing status, stage at diagnosis and all-cause survival following cancer diagnosis at a public hospital. DESIGN: Retrospective cohort study examining new cancer diagnoses between 1 July 2011 and 30 June 2021. SETTING: A public hospital in San Francisco. EXPOSURE: Housing status (housed, formerly unhoused, unhoused) was ascertained via a county-wide integrated dataset that tracks both observed and reported homelessness. METHODS: We reported univariate analyses to investigate differences in demographic and clinical characteristics by housing group. We then constructed Kaplan-Meier curves stratified by housing group to examine unadjusted all-cause mortality. Finally, we used multivariable Cox proportional hazards models to compare the hazard rate of mortality for each housing status group, adjusting for demographic and clinical factors. RESULTS: Our cohort included 5123 patients with new cancer diagnoses, with 4062 (79%) in housed patients, 623 (12%) in formerly unhoused patients and 438 (9%) in unhoused patients. Unhoused and formerly unhoused patients were more commonly diagnosed with stage 4 disease (28% and 27% of the time, respectively, vs 22% of housed patients). After adjusting for demographic and clinical characteristics, unhoused patients with stage 0-3 disease had a 50% increased hazard of death (adjusted HR (aHR) 1.5, 95% CI 1.1 to 1.9; p<0.004) as did formerly unhoused patients (aHR 1.5, 95% CI 1.2 to 1.9; p=0.001) compared with housed individuals 3 months after diagnosis. CONCLUSIONS: Unhoused and formerly unhoused patients diagnosed with non-metastatic cancer had substantially increased hazards of death compared with housed patients cared for in a public hospital setting. Current or former lack of housing could contribute to poor outcomes following cancer diagnoses via multiple mechanisms.

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.