TABLE 2.
Factors Associated With Past-Year Unmet Need for Medical or Surgical Care, Prescription Medications, Mental Health Care, Eyeglasses, and Dental Care Among Homeless US Adults: Health Care for the Homeless User Survey, 2003
| Unmet Need for Medical or Surgical Care, AOR (95% CI)a | Unmet Need for Prescription Medications, AOR (95% CI)a | Unmet Need for Mental Health Care, AOR (95% CI)a | Unmet Need for Eyeglasses, AOR (95% CI)a | Unmet Need for Dental Care, AOR (95% CI)a | |
| Predisposing factors | |||||
| Age, y | |||||
| 18–29 (Ref) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| 30–44 | 1.04 (0.42, 2.57) | 2.71* (1.20, 6.13) | 1.61 (0.47, 5.53) | 0.94 (0.51, 1.73) | 1.21 (0.38, 3.87) |
| ≥ 45 | 1.20 (0.58, 2.52) | 2.80* (1.47, 5.34) | 1.11 (0.38, 3.21) | 1.66 (0.97, 2.84) | 0.96 (0.34, 2.70) |
| Male | 0.91 (0.34, 2.42) | 0.86 (0.36, 2.03) | 0.57 (0.32, 1.02) | 0.60 (0.35, 1.03) | 0.72 (0.47, 1.09) |
| Race/ethnicity | |||||
| White, non-Hispanic (Ref) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| Black, non-Hispanic | 0.90 (0.60, 1.35) | 0.52 (0.25, 1.09) | 1.28 (0.75, 2.20) | 0.80 (0.45, 1.44) | 1.38 (0.81, 2.34) |
| Hispanic/other | 1.00 (0.47, 2.13) | 0.61 (0.29, 1.30) | 2.03* (1.17, 3.51) | 0.63 (0.29, 1.36) | 1.63 (0.77, 3.45) |
| Veteran | 1.76* (1.14, 2.70) | 0.74 (0.29, 1.85) | 0.71 (0.22, 2.33) | 2.00 (0.90, 4.44) | 1.42 (0.85, 2.38) |
| Married/partnered | 0.83 (0.43, 1.60) | 0.78 (0.41, 1.48) | 0.08* (0.02, 0.28) | 1.13 (0.51, 2.47) | 0.98 (0.49, 1.97) |
| High school diploma or higher | 1.07 (0.52, 2.18) | 1.06 (0.47, 2.40) | 1.25 (0.59, 2.65) | 0.58* (0.35, 0.95) | 1.05 (0.62, 1.76) |
| Out-of-home placement as minorb | 2.52* (1.80, 3.52) | 1.71* (1.08, 2.73) | 1.44 (0.77, 2.68) | 1.10 (0.63, 1.91) | 0.90 (0.54, 1.50) |
| Two or more homeless episodes at least 30 d in duration | 0.92 (0.65, 1.29) | 0.85 (0.49, 1.47) | 0.95 (0.49, 1.83) | 1.17 (0.70, 1.95) | 1.26 (0.72, 2.20) |
| Physical/sexual assault in past year | 0.91 (0.49, 1.67) | 2.26* (1.44, 3.55) | 1.97* (1.13, 3.42) | 1.22 (0.78, 1.93) | 0.77 (0.38, 1.54) |
| Substance abuse in past year | 0.96 (0.40, 2.31) | 1.06 (0.56, 2.01) | 1.10 (0.68, 1.77) | 1.26 (0.82, 1.96) | 1.36 (0.76, 2.43) |
| Mental illness history | 1.18 (0.51, 2.76) | 1.79 (0.91, 3.51) | 2.58* (1.27, 5.23) | 1.83* (1.14, 2.93) | 1.04 (0.53, 2.04) |
| Enabling factors | |||||
| No usual source of care | 1.72 (0.98, 3.04) | 2.16 (0.79, 5.88) | 3.36* (1.92, 5.89) | 0.89 (0.38, 2.07) | 1.17 (0.47, 2.92) |
| Uninsured | 1.75* (1.14, 2.69) | 1.94* (1.26, 3.00) | 2.03* (1.08, 3.82) | 1.72* (1.10, 2.67) | 1.08 (0.58, 1.99) |
| Employment in past year | 1.70* (1.22, 2.37) | 1.60* (1.09, 2.35) | 0.84 (0.45, 1.57) | 1.48 (0.87, 2.52) | 1.22 (0.75, 2.00) |
| Food insufficiencyc | 2.06* (1.19, 3.57) | 1.61* (1.04, 2.50) | 1.55* (1.02, 2.38) | 1.11 (0.58, 2.13) | 1.06 (0.65, 1.72) |
| Vision impairment | 1.11 (0.59, 2.09) | 1.48 (0.86, 2.56) | 2.17* (1.17, 4.01) | 1.88* (1.16, 3.04) | 1.81* (1.25, 2.63) |
| Need factors | |||||
| No. of medical comorbiditiesd | |||||
| 0 (Ref) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| 1 | 2.22* (1.08, 4.52) | 1.46 (0.88, 2.44) | 1.57 (0.70, 3.56) | 1.47 (0.93, 2.32) | 1.07 (0.63, 1.83) |
| ≥ 2 | 3.44* (1.61, 7.36) | 2.82* (1.39, 5.73) | 1.85 (0.61, 5.57) | 1.63 (0.89, 2.97) | 1.20 (0.57, 2.54) |
| Dental problem in past year | … | … | … | … | 2.97* (1.89, 4.67) |
Note. AOR = adjusted odds ratio; CI = confidence interval. Ellipses indicate that the factor was not applicable for that need.
Adjusted for all of the variables presented, via multivariable logistic regression.
Defined as placement into foster care, a group home, or an institution before the age of 18 years.
Defined as “sometimes” or “often” not getting enough food to eat.
Medical comorbidities included hypertension, diabetes, cardiovascular disease (coronary artery disease or stroke), obstructive lung disease (asthma or chronic obstructive pulmonary disease), HIV infection, cancer, kidney disease, liver disease, and arthritis or past-year chronic joint problems.
*P < .05.