Differentiating specific health needs of recent homeless immigrants: moving forward from an integrated approach to placate the “healthy immigrant effect”

摘要

In Spain, shelters are the main public resource to provide housing to homeless people. The shelters provide housing to two target groups: local people who have been in an exclusion process that led them to homelessness, and an immigrant population consisting of mostly newcomers to the country and have no place to stay. In this regard, homelessness has been associated with poor health, morbidity and earlier mortality, but there is a lack of studies conducted comparing local and immigrant homeless populations. The “healthy immigrant effect” explains that immigrants arriving in the host country are, on average, healthier than comparable natives and that the length of time since immigration reduces this advantage. In this regard, the evidence shows that homeless newcomers are generally healthier than homeless locals and may have different service needs. This study aims to examine the relationship between immigrant status and the health status of homeless people in Valencia (Spain). Recruitment took place from August to September 2018 (ongoing). The sample consists of 80 homeless individuals recruited at shelters. Chi-square analyses were performed to examine the relationship between immigrant status and health status (assessed by whether they have no, one or more than one chronic conditions). The preliminary results show a relationship between immigration status and the number of chronic conditions they report. Specifically, the occurrence of comorbid conditions (more than one chronic condition) was more prevalent in the local homeless population compared to the immigrant homeless population. Although the impact of homelessness on health has been studied previously, the results of this study highlight the importance of continuing to evaluate the specific needs of the different homeless populations. In this regard, the results also support the “healthy immigrant effect”; comorbid health conditions were more prevalent in the local homeless population compared to the recent immigrant homeless population. These findings also may have implications for services organisation, highlighting the need to develop health and social care programmes tailored to newcomers, in order to avoid further risk factors associated with homelessness and its future deterioration in health.