“Housing First” Intervention May Not Reduce Obesity-related Issues in Homeless People With Mental Health Difficulties

“Housing First” Intervention May Not Reduce Obesity-related Issues in Homeless People With Mental Health Difficulties

Housing is an important factor in public health. In general, individuals who experience long-term homelessness also experience worse health outcomes and premature mortality compared to people who live in a domicile, with studies conducted in the United States indicating that homeless individuals experience high rates of overweight and obesity.

In a recent study published in the journal PLOS ONE, a team of researchers at St. Michael’s Hospital explored the question of whether having stable housing could lead to weight loss, since access to housing generally means that people have the opportunity to buy, store and prepare food with higher nutritional value than they would if they were living on the street. In addition, making the transition to stable housing may be part of a positive lifestyle modification for those who are homeless.

However, results from a recent study entitled “The Impact of a 24 Month Housing First Intervention on Participants’ Body Mass Index and Waist Circumference: Results from the At Home / Chez Soi Toronto Site Randomized Controlled Trial, conducted Dr. Stephen Hwang, director of the hospital’s Centre for Research on Inner City Health and colleagues, showed that over 24 months, neither the Body Mass Index nor the waistline circumference of the people involved in their study changed significantly.

In the study, the researchers used longitudinal data from 575 participants at the Toronto site of the At Home/Chez Soi randomized controlled trial, a study that evaluated a “housing first” approach, where people are given a house without any prerequisites like seeing a psychiatrist or achieving sobriety. Then, people were offered support as necessary.

The study aim was to investigate the impact of receiving a Housing First intervention on the Body Mass Index (BMI) and waist circumference of participants with moderate and high needs for mental health support services.

According to Dr. Hawang, all study participants had mental health difficulties, and if they were engaged in the study they could have been prescribed appropriate drugs that can either cause weight loss or weight gain (as a side effect). The same types of weight changes could have also occurred if there were changes in drug and alcohol use.

“Our findings suggest we need a better understanding of factors contributing to overweight, obesity and high waist circumference in people who have a history of precarious housing and poverty as well as other concerns such as mental illness and additions,” Dr. Hwang said.

The researchers further indicated that additional research is needed to determine which support programs are necessary and could be included to improve weight status in individuals who receive housing through Housing First interventions.

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