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Clinical and functional characteristics of young adults living in single room occupancy housing: preliminary findings from a 10-year longitudinal study

  • Special Section on Substance Use: Quantitative Research
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Abstract

Objective

Young adults living in single room occupancy (SRO) hotels, a form of low-income housing, are known to have complex health and substance problems compared to their peers in the general population. The objective of this study is to comprehensively describe the mental, physical, and social health profile of young adults living in SROs.

Methods

This study reports baseline data from young adults aged 18–29 years, as part of a prospective cohort study of adults living in SROs in Vancouver, British Columbia, Canada. Baseline and follow-up data were collected from 101 young adults (median follow-up period 1.9 years [IQR 1.0–3.1]). The comprehensive assessment included laboratory tests, neuroimaging, and clinician- and patient-reported measures of mental, physical, and social health and functioning.

Results

Three youth died during the preliminary follow-up period, translating into a higher than average mortality rate (18.6, 95% CI 6.0, 57.2) compared to age- and sex-matched Canadians. High prevalence of interactions with the health, social, and justice systems was reported. Participants were living with median two co-occurring illnesses, including mental, neurological, and infectious diseases. Greater number of multimorbid illnesses was associated with poorer real-world functioning (ρ = − 0.373, p < 0.001). All participants reported lifetime alcohol and cannabis use, with pervasive use of stimulants and opioids.

Conclusion

This study reports high mortality rates, multimorbid illnesses, poor functioning, poverty, and ongoing unmet mental health needs among young adults living in SROs. Frequent interactions with the health, social, and justice systems suggest important points of intervention to improve health and functional trajectories of this vulnerable population.

Résumé

Objectif

Les jeunes adultes qui vivent dans des maisons de chambres (une forme d’habitation à loyer modique) sont connus pour avoir des problèmes de santé et de consommation complexes comparativement à leurs pairs dans la population générale. Nous avons cherché à décrire de façon exhaustive leur profil de santé mentale, physique et sociale.

Méthode

Nos données de référence sur les jeunes adultes de 18 à 29 ans proviennent d’une étude prospective de cohortes d’adultes vivant dans des maisons de chambres à Vancouver (Colombie-Britannique), au Canada. Les données de référence et de suivi ont été recueillies auprès de 101 jeunes adultes (période de suivi médiane de 1,9 an [écart interquartile 1,0–3,1]). L’évaluation exhaustive a reposé sur des tests de laboratoire, sur la neuroimagerie et sur des indicateurs de santé et de fonctionnement sur le plan mental, physique et social fournis par les cliniciens et les patients.

Résultats

Trois jeunes sont décédés durant la période de suivi préliminaire, ce qui représente un taux de mortalité supérieur à la moyenne (18,6, IC de 95 % : 6,0, 57,2) comparativement aux Canadiens de mêmes groupes d’âge et de sexe. Une forte prévalence d’interactions avec les systèmes sociosanitaire et judiciaire a été déclarée. Les participants vivaient avec un nombre médian de deux maladies concomitantes, notamment des maladies mentales, neurologiques et infectieuses. Le nombre élevé de multimorbidités était associé à des problèmes de fonctionnement dans le monde réel (ρ = −0,373, p < 0,001). Tous les participants ont indiqué avoir consommé de l’alcool et du cannabis au cours de leur vie, et la consommation de stimulants et d’opioïdes était omniprésente chez eux.

Conclusion

L’étude fait état de taux de mortalité élevés, de multimorbidités, de problèmes de fonctionnement, de pauvreté et de besoins de santé mentale non comblés chez les jeunes adultes vivant dans des maisons de chambres. Leurs interactions fréquentes avec les systèmes sociosanitaire et judiciaire pourraient être d’importants points d’intervention pour améliorer la santé et les trajectoires fonctionnelles de cette population vulnérable.

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Notes

  1. For the purposes of this paper, we define “young adults” or “youth” as the developmental stage in late adolescence to early adulthood (15–29 years). See Mental Health Commission of Canada, “Making transitions a priority.”

  2. Many terms exist to describe marginal housing. Of note, the Canada Mortgage and Housing Corporation describes “severe housing need” as “Housing below standards refers to housing that falls short of at least one of the adequacy, affordability, and suitability housing standards”.

  3. This cohort excluded youth < 18 years of age.

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Authors and Affiliations

  1. Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada

    Skye P. Barbic, Andrea A. Jones, Melissa Woodward, Steve Mathias, Fidel Vila-Rodriguez, Olga Leonova, Geoffrey N. Smith, Tari Buchanan, William J. Panenka, Ric M. Procyshyn, G. William MacEwan, Donna J. Lang, Adelena M. Leon, Michael Krausz & William G. Honer

  2. Department of Occupational Science and Occupational Therapy, UBC, Vancouver, BC, Canada

    Skye P. Barbic & Adelena M. Leon

  3. Department of Psychiatry, UBC, Vancouver, BC, Canada

    Skye P. Barbic, Andrea A. Jones, Steve Mathias, Fidel Vila-Rodriguez, Olga Leonova, Geoffrey N. Smith, Tari Buchanan, William J. Panenka, Ric M. Procyshyn, G. William MacEwan, Michael Krausz & William G. Honer

  4. Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada

    Skye P. Barbic, Steve Mathias & Michael Krausz

  5. Foundry, Vancouver, BC, Canada

    Skye P. Barbic, Matt Piercy, Steve Mathias, Alexandra T. Vertinsky, Stephanie Gillingham, Alexander Rauscher & Manraj K. Heran

  6. Faculty of Medicine, Department of Occupational Science and Occupational Therapy, The University of British Columbia St. Paul’s Hospital, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada

    Skye P. Barbic

  7. Department of Radiology, UBC, Vancouver, BC, Canada

    Melissa Woodward & Donna J. Lang

  8. St. Paul’s Hospital, Vancouver, BC, Canada

    Steve Mathias & G. William MacEwan

  9. Vancouver General Hospital, Vancouver, BC, Canada

    Alexandra T. Vertinsky & Manraj K. Heran

  10. Department of Pediatrics, UBC, Vancouver, BC, Canada

    Alexander Rauscher

  11. Department of Anesthesiology, Pharmacology & Therapeutics, UBC, Vancouver, BC, Canada

    Alasdair M. Barr

  12. Department of Psychology, Simon Fraser University, Burnaby, BC, Canada

    Allen E. Thornton

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  1. Skye P. Barbic
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  2. Andrea A. Jones
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  3. Melissa Woodward
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  4. Matt Piercy
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  6. Fidel Vila-Rodriguez
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  7. Olga Leonova
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  8. Geoffrey N. Smith
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  19. Manraj K. Heran
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  20. Adelena M. Leon
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  21. Michael Krausz
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  22. William G. Honer
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Correspondence to Skye P. Barbic.

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Conflict of interest

Dr. Vila-Rodriguez has received Advisory Board fees from Janssen. Dr. Panenka is on the board of directors (Abbatis Bioceuticals) or scientific advisory boards (Medipure Pharmaceuticals and Vinergy Inc) of three local emerging biotechnology companies. Dr. Rauscher has received advisory board fees from Hofmann-La Roche. Dr. Barr has received consulting fees or sat on Advisory Boards for Bristol-Myers Squibb, Eli Lilly, and Roche. Dr. Procyshyn has received speaking and Advisory Board fees from Janssen, Lundbeck, and Otsuka. He has also received Royalties as the Principal Editor of The Clinical Handbook of Psychotropic Drugs. Dr. MacEwan has received speaking or consulting fees or sat on advisory boards for Apotex, AstraZeneca, Bristol-Myers Squibb, Janssen, Lundbeck, Otsuka, Pfizer, and Sunovion and has received research grant support from Janssen. Dr. Honer has received consulting fees or sat on Advisory Boards for In Silico, Lundbeck, Otsuka, and Alphasights. The remaining authors declare no conflict of interest.

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Skye P. Barbic and Andrea A. Jones share co-first authorship.

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Barbic, S.P., Jones, A.A., Woodward, M. et al. Clinical and functional characteristics of young adults living in single room occupancy housing: preliminary findings from a 10-year longitudinal study. Can J Public Health 109, 204–214 (2018). https://doi.org/10.17269/s41997-018-0087-9

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