Delaware journal of public health最新文献

There are several paths to homelessness for adults and families, including a lack of affordable housing, financial crises such as unemployment, underemployment and low wages, and domestic violence. For youth, homelessness can be the result of running away from family conflict, family poverty, domestic violence, being put out of their homes, or loss of resources after aging out of state programs like foster care. The aim of this essay is to discuss the common paths to homelessness for adults, youth, and survivors of domestic violence as well as the associated health outcomes related to homelessness in relation to health equity and the social determinants of health. Additionally, this piece identifies existing disparities in homelessness, highlights Delaware resources, and seeks ways that Delaware can end involuntary homelessness in Delaware. Homelessness disproportionately affects minority populations more than other groups and has direct adverse health consequences on these populations. The poor health outcomes linked to homelessness can be many, co-occurring, and lifelong. If social determinants continue to be lacking, homelessness can become chronic. Homelessness is a prevalent public health issue in Delaware. With a health equity lens, state and community resources and solutions can be applied to help reduce homelessness and its disparities.

Poverty and homelessness have significant impacts on the health outcomes of individuals and communities. Lack of safe, healthy, affordable housing in Sussex County requires attention and action to move the needle on the health of our impoverished and housing insecure populations. Health concerns descend on the scale of importance when an individual's housing and financial circumstances are unstable. Employment opportunities exist, however, housing costs in the area are prohibitive resulting in negative impacts on an individual's potential for social mobility as well as on local businesses and organizations seeking employees. Social determinants of health are indicated as prominent factors affecting health outcomes, even more so than access to and the delivery of healthcare. Findings from several reports highlight the correlation between financial insecurity, housing insecurity, and health. Innovative and collaborative solutions are necessary to create and hardwire health equity, housing stability, and social mobility within our county and state.

We review the extent of the need for home repair assistance for low-income homeowners in Delaware, and steps being taken to address this need. Delaware contains an estimated 25,000 homes owned by low-income households that need repair, of which an estimated 5,000 are in substandard condition. There is an estimated $96 million total cost associated with this home repair need, with eighty percent of this cost ($76 million) coming from the twenty percent (5,000) of these homes that are in substandard condition. In order to address this need for repair assistance, Delaware's three Habitat for Humanity organizations have designed the Statewide Healthy Homes Program, which centers on the intersection of health and housing. The vision of the Habitat for Humanity Statewide Healthy Homes Program is to increase capacity for home repair assistance across Delaware. Additionally, the program seeks to include partnerships with healthcare providers to ensure a holistic approach to home repairs, improving each resident's quality of life.

Delaware's 2017-2021 five-year average poverty rate was 11.4%, which is lower than the rate of 12.6% throughout the United States as a whole. Poverty rates by race and ethnic background show disparities. Black Delaware residents were more than twice as likely to live in poverty as white Delawareans, with poverty rates of 17.8% and 8.4%, respectively, while Asian individuals had a poverty rate of 10.5%. Hispanic or Latino/x individuals of any race were the most likely to experience poverty and had a five-year average poverty rate of 18.2%. Tracking the overall poverty rate (most commonly through the American Community Survey 5-Year Averages) is valuable when studying trends over time but lacks the power to display the true economic status of individuals and families. Access: work, income supports, shelter, food, and healthcare all complete each whole person. Level of access within each of these sectors of life determines well-being, and varies based on race and ethnic background, geography, and age. A new challenge is now faced as the Public Health Emergency (PHE) has ended, repealing a multitude of supports with the risk of putting individuals and families into a new phase of crisis.

: Social capital is positively associated with healthcare access such as healthcare practitioner visits. There does not appear to be any literature on social capital through online social media and its association with healthcare access such as healthcare practitioner visits. This paper studies the relationship between social capital through online social media use and healthcare practitioner visits. Methods: Data were analyzed from 663 participants in New York City in 2017 with exposure to social media prescription medication advertisements from social media (e.g., Facebook, Twitter, LinkedIn, Instagram, YouTube). The main predictor variable was visiting a healthcare practitioner at least once a year. Outcome variables were bonding social capital and bridging social capital from online social media. Results: Those who visited a healthcare practitioner at least once a year had greater mean bonding social capital and bridging social capital from online social media than those who did not visit a healthcare practitioner at least once a year. Multivariate linear regression analyses showed a similar pattern for not visiting a healthcare practitioner at least once a year (bonding social capital: b=-5.31, SE=1.68, p=0.002; bridging social capital: b=-3.27, SE=1.55, p=0.04). Conclusions: Government organizations, healthcare practitioners, and healthcare organizations should continue marketing and disseminating health education for young adults through online social media. This public health online social media health education is likely to be considered bonding social capital and/or bridging social capital by young adults and this may be associated with more young adults visiting healthcare practitioners at least once a year.

While resources available to public health entities increased during the COVID-19 pandemic, the need to focus mitigation efforts on Delaware's most vulnerable citizens was evident. The higher risk of community-spread and complications resulting from COVID-19 associated with individuals residing in congregate settings such as homeless shelters and encampments prompted the Delaware Division of Public Health to leverage existing and new resources to provide technical assistance, education and to build valuable partnerships with community-based homeless service providers to reduce the public health threat to those experiencing homelessness.

Individuals with intellectual and developmental disabilities (IDD) encounter numerous barriers in attempting to access housing. Those barriers - financial, physical, and cultural in nature - have been exacerbated by the COVID-19 public health emergency and the related, or co-occurring, shifts that have characterized the housing market in the United States, and Delaware specifically, over these last three years. In this brief introductory research report, we examine the system of housing supports and their availability to individuals with IDD through a subset of those served by the state's Division of Developmental Disabilities Services through interviews with representatives across the housing support system. Our findings fall into four areas of work: scale and scope; housing availability; housing assistance; and housing supports. We find that: the estimated scale of the housing crisis (in terms of homelessness and insecurity) affecting this population is much greater than the general population, but in line with other national estimates for individuals with IDD; there is limited available housing that is accessible to individuals with IDD available in the state; there is limited assistance available for navigating the housing that might be available; and that there are too few options for providing more supports for individuals living, or trying to live, independently. We conclude with a few suggested recommendations that could provide more reliable data and tracking of need and a call for research that connects housing for individuals with IDD into the growing body of research looking at the relationship between access to housing and health.