'You feel how you look': Exploring the impacts of unmet water, sanitation, and hygiene needs among rural people experiencing homelessness and their intersection with drug use

被引:15
作者
Ballard, April M. [1 ]
Cooper, Hannah L. F. [2 ]
Young, April M. [3 ,4 ]
Caruso, Bethany A. [1 ,5 ]
机构
[1] Emory Univ, Rollins Sch Publ Hlth, Gangarosa Dept Environm Hlth, Atlanta, GA 30322 USA
[2] Emory Univ, Rollins Sch Publ Hlth, Dept Behav Social & Hlth Educ Sci, Atlanta, GA USA
[3] Univ Kentucky, Coll Publ Hlth, Dept Epidemiol, Lexington, KY USA
[4] Univ Kentucky, Coll Med, Ctr Drug & Alcohol Res, Dept Behav Sci, Lexington, KY USA
[5] Emory Univ, Rollins Sch Publ Hlth, Hubert Dept Global Hlth, Atlanta, GA USA
来源
PLOS WATER | 2022年 / 1卷 / 05期
关键词
UNITED-STATES; RISK-FACTORS; HEALTH; URBAN; WOMEN; INJECTION; SKIN; INFECTIONS; CHALLENGES; CALIFORNIA;
D O I
10.1371/journal.pwat.0000019
中图分类号
X [环境科学、安全科学];
学科分类号
08 ; 0830 ;
摘要
Existing literature attests to water, sanitation, and hygiene (WASH) inequities among people experiencing homelessness (PEH) in the United States, but there is a dearth of research on such issues in rural areas. Homelessness is an emerging public health concern in rural areas where homelessness is on the rise, infectious disease outbreaks are becoming increasingly common, and PEH face unique WASH-related challenges compared to their urban counterparts. We conducted an exploratory study to understand the impacts of unmet WASH needs among rural PEH and their intersection with drug use through in-depth interviews (n = 10). Eligible participants were 18 years or older, lived in one of five Central Appalachian counties, and had experienced homelessness in the previous six months. Using thematic analysis, we identified factors that inhibit WASH access, and adverse health and well-being outcomes that result from unmet WASH needs. We also explore how WASH experiences compare among rural PEH who self-reported drug use to those who did not. Our findings revealed that factors at multiple levels inhibited WASH access, including stigma and place-based characteristics, which contributed to the adverse physical, mental, and emotional health of PEH. Comparisons between PEH who used drugs to those that did not revealed the intricate relationship between WASH, homelessness, and substance use in communities impacted by the opioid epidemic. Expanded WASH facilities that are safe and available with no prerequisites can address inadequate access among rural PEH and collaboration with harm reduction services may be advantageous to reach those who inject drugs.
引用
收藏
页数:21
相关论文
共 89 条
[21]  
Commission AR, 2019, Appalachian Regional CommissionDesignated Distressed Counties, Fiscal Year 2019
[22]  
Continuum of Care Program, 2019, Homeless Populations and Subpopulations Reports
[23]   Using Web-Based Pin-Drop Maps to Capture Activity Spaces Among Young Adults Who Use Drugs in Rural Areas: Cross-Sectional Survey [J].
Cooper, Hannah Luke Fenimore ;
Crawford, Natalie D. ;
Haardorfer, Regine ;
Prood, Nadya ;
Jones-Harrell, Carla ;
Ibragimov, Umedjon ;
Ballard, April M. ;
Young, April M. .
JMIR PUBLIC HEALTH AND SURVEILLANCE, 2019, 5 (04) :165-182
[24]   Syringe Service Programs for Persons Who Inject Drugs in Urban, Suburban, and Rural Areas - United States, 2013 [J].
Des Jarlais, Don C. ;
Nugent, Ann ;
Solberg, Alisa ;
Feelemyer, Jonathan ;
Mermin, Jonathan ;
Holtzman, Deborah .
MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT, 2015, 64 (48) :1337-1341
[25]   Recommendations of the Advisory Committee on Immunization Practices for Use of Hepatitis A Vaccine for Persons Experiencing Homelessness [J].
Doshani, Mona ;
Weng, Mark ;
Moore, Kelly L. ;
Romero, Jose R. ;
Nelson, Noele P. .
MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT, 2019, 68 (06) :153-156
[26]  
Ensign J, 2000, WOMEN HEALTH, V31, P133
[27]  
Fewtrell L., 2007, Water, sanitation, and hygiene: Quantifying the health impact at national and local levels in countries with incomplete water supply and sanitation coverage
[28]   Homelessness and health - Challenges for health psychology [J].
Flick, Uwe .
JOURNAL OF HEALTH PSYCHOLOGY, 2007, 12 (05) :691-695
[29]   Hepatitis A Virus Outbreaks Associated with Drug Use and Homelessness - California, Kentucky, Michigan, and Utah, 2017 [J].
Foster, Monique ;
Ramachandran, Sumathi ;
Myatt, Katie ;
Donovan, Danielle ;
Bohm, Susan ;
Fiedler, Jay ;
Barbeau, Bree ;
Collins, Jim ;
Thoroughman, Douglas ;
McDonald, Eric ;
Ballard, Jonathan ;
Eason, Jeffrey ;
Jorgensen, Cynthia .
MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT, 2018, 67 (43) :1208-1210
[30]  
Frame D., 1996, INTERCHANGE, V27, P13, DOI DOI 10.1007/BF01807482