| Title: |
Population-Level Health Effects of Involuntary Displacement of People Experiencing Unsheltered Homelessness Who Inject Drugs in US Cities |
| Authors: |
Barocas, Joshua A.; Nall, Samantha K.; Axelrath, Sarah; Pladsen, Courtney; Boyer, Alaina; Kral, Alex H.; Meehan, Ashley A.; Savinkina, Alexandra; Peery, David; Bien, Michael; Agnew-Brune, Christine; Goldshear, Jesse; Chiang, Joey; Linas, Benjamin P.; Gonsalves, Gregg; Bluthenthal, Ricky N.; Mosites, Emily; Wortley, Pascale; Todd, Jeff; Melton, David; Flynn, Colin; German, Danielle; Klevens, Monina; Doherty, Rose; O'Cleirigh, Conall; Jimenez, Antonio; Clyde, Thomas; Poe, Jonathon; Vaaler, Margaret; Deng, Jie; Al-Tayyib, Alia; Shodell, Danielle; Higgins, Emily; Griffin, Vivian; Sanger, Corrine; Khuwaja, Salma; Lopez, Zaida; Padgett, Paige; Kwa Sey, Ekow; Ma, Yingbo; Santacruz, Hugo; Brantley, Meredith; Mathews, Christopher; Marr, Jack; Spencer, Emma; Nixon, Willie; Forrest, David; Anderson, Bridget; Tate, Ashley; Abrego, Meaghan |
| Source: |
JAMA ; volume 329, issue 17, page 1478 ; ISSN 0098-7484 |
| Publisher Information: |
American Medical Association (AMA) |
| Publication Year: |
2023 |
| Description: |
Importance At least 500 000 people in the US experience homelessness nightly. More than 30% of people experiencing homelessness also have a substance use disorder. Involuntary displacement is a common practice in responding to unsheltered people experiencing homelessness. Understanding the health implications of displacement (eg, “sweeps,” “clearings,” “cleanups”) is important, especially as they relate to key substance use disorder outcomes. Objective To estimate the long-term health effects of involuntary displacement of people experiencing homelessness who inject drugs in 23 US cities. Design, Setting, and Participants A closed cohort microsimulation model that simulates the natural history of injection drug use and health outcomes among people experiencing homelessness who inject drugs in 23 US cities. The model was populated with city-level data from the Centers for Disease Control and Prevention’s National HIV Behavioral Surveillance system and published data to make representative cohorts of people experiencing homelessness who inject drugs in those cities. Main Outcomes and Measures Projected outcomes included overdose mortality, serious injection–related infections and mortality related to serious injection–related infections, hospitalizations, initiations of medications for opioid use disorder, and life-years lived over a 10-year period for 2 scenarios: “no displacement” and “continual involuntary displacement.” The population-attributable fraction of continual displacement to mortality was estimated among this population. Results Models estimated between 974 and 2175 additional overdose deaths per 10 000 people experiencing homelessness at 10 years in scenarios in which people experiencing homelessness who inject drugs were continually involuntarily displaced compared with no displacement. Between 611 and 1360 additional people experiencing homelessness who inject drugs per 10 000 people were estimated to be hospitalized with continual involuntary displacement, and there will be an estimated 3140 to ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1001/jama.2023.4800 |
| Availability: |
https://doi.org/10.1001/jama.2023.4800; https://jamanetwork.com/journals/jama/articlepdf/2803839/jama_barocas_2023_oi_230038_1682611592.93127.pdf |
| Accession Number: |
edsbas.5D9394B |
| Database: |
BASE |