•  
  •  
 

Abstract

Background: Homelessness is a growing concern since it affects many individuals worldwide. Homeless people are vulnerable to health problems but tend to underutilise health services. Despite being a worldwide concern, there is little research on health issues and healthcare utilisation among homeless people in Malaysia.

Method: Three databases were used to search for relevant articles: Scopus, Web of Science, and PubMed. Studies published between 2011 and 2021 that examined the health problems and health service utilisation among homeless adults in Malaysia were considered. Manual searches in reference lists and grey literature were also performed to add reports. Data were extracted manually. The authors conducted a descriptive analysis and narrative synthesis.

Results: A total of seven articles fulfilled the pre-determined inclusion and exclusion criteria. Three themes emerged from the studies: health problems, healthcare service utilisation, and associated factors of healthcare services utilisation. Of the seven articles, reported health problems included drug abuse, alcohol abuse, HIV-positive status, mental health problems, oral health, and other chronic diseases. All included articles reported none to under-utilised health care services. The associated factors of health care utilisations were financial issues, low levels of self-care awareness, feeling embarrassed, low health literacy, and poor social support.

Conclusion: Evidence shows that the homeless suffer from a range of health problems. Poor health care utilisations among the homeless are a significant issue, with several associated factors contributing to that worrying scenario. Future studies among homeless people are needed to provide more information, especially about their health care utilisations. In addition, effective multi-agency interventions are required to address health vulnerabilities.

Keywords: Homeless, Health, Health care utilisations, Systematic review, Malaysia

References

[1] UNHCR. Education report 2016. UNHCR; 2016.

[2] Stafford A, Wood L. Tackling health disparities for people who are homeless? Start with social determinants. Int J Environ Res Publ Health 2017;14(12):1535. https://doi.org/10.3390/ijerph14121535.

[3] Raden Mahendra Haryo B, Iin I, Nursahidin N. Beggars, homeless, and displaced people: psycho-social phenomena and the implementation of local government policy. Proceedings of the international conference on agriculture, social sciences, education, technology and health (ICASSETH 2019). Atlantis Press; 2020. https://doi.org/10.2991/assehr.k.200402.052.

[4] Chandran R. Manila's homeless set to move into more empty homes if official handover delayed [updated. 2018 Mar. cited 2021 Dec 12] Available from: https://www.reuters.com/article/us-philippines-landrights-lawmaking-idUSKBN1H41L7.

[5] Homelessness in kuala lumpur an intractable problem. Uta Dietrich. 2018 Version 2. [cited 2021 Dec 12]. Available from: https://thinkcity.com.my/wp/wp-content/uploads/2019/09/Homelessness-Report-Final-07-May-2018.pdf.

[6] Kamus Dewan Edisi Keempat [Internet]. Kuala lumpur. Dewan Bahasa dan Pustaka, c2017. Gelandangan; [cited 2022 Jan 7]. Available from: https://prpm.dbp.gov.my/Cari1?keyword=gelandangan.

[7] Clifford B, Wilson A, Harris P. Homelessness, health and the policy process: a literature review. Health Pol 2019;123(11):1125-32. https://doi.org/10.1016/j.healthpol.2019.08.011.

[8] Amoah PA, Phillips DR, Gyasi RM, Koduah AO, Edusei J. Health literacy and self-perceived health status among street youth in Kumasi, Ghana. Cogent Medicine 2017;4(1):1275091. https://doi.org/10.1080/2331205X.2016.1275091.

[9] Ayano G, Assefa D, Haile K, Chaka A, Solomon H, Hagos P, et al. Mental, neurologic, and substance use (MNS) disorders among street homeless people in Ethiopia. Ann Gen Psychiatr 2017;16:40. https://doi.org/10.1186/s12991-017-0163-1.

[10] Dwyer P, Bowpitt G, Sundin E, Weinstein M. Rights, responsibilities and refusals: homelessness policy and the exclusion of single homeless people with complex needs. Crit Soc Pol 2015;35(1):3-23. https://doi.org/10.1177/0261018314546311.

[11] Osei Asibey B, Conroy E, Marjadi B. Health problems and healthcare service utilisation amongst homeless adults in Africa- a scoping review. BMC Publ Health 2020;20(1):594. https://doi.org/10.1186/s12889-020-08648-y.

[12] Taber JM, Leyva B, Persoskie A. Why do people avoid medical care? A qualitative study using national data. J Gen Intern Med 2015;30(3):290-7. https://doi.org/10.1007/s11606-014-3089-1.

[13] Mohd-Tahir NA, Paraidathathu T, Li SC. Quality use of medicine in a developing economy: measures to overcome challenges in the Malaysian healthcare system, vol. 3. SAGE Open Med; 2015, 2050312115596864. https://doi.org/10.1177/2050312115596864.

[14] Mat-Baharin NH, Ahmad-Tarmidzi NA, Muhammad EF, Md-Yusuf Nn. Assessment of oral health knowledge and challenges in oral hygiene practices among homeless adults in Jalan Chow Kit. Kuala Lumpur. J Soc Distress Homeless. 2021:1-7. https://doi.org/10.1080/10530789.2021.1897934.

[15] Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. Updating guidance for reporting systematic reviews: development of the PRISMA 2020 statement. J Clin Epidemiol 2021;134:103-12. https://doi.org/10.1016/j.jclinepi.2021.02.003.

[16] Clarke V, Braun V. Teaching thematic analysis: overcoming challenges and developing strategies for effective learning. Psychol 2013;26(2):120-3.

[17] Alhabshi SM, Abdul Manan A. Homelessness in Kuala Lumpur, Malaysia: a case of agenda denial. Int J Soc Sci Tomorrow 2012;1(2):1-9.

[18] Ramli MW, Dawood SRS. Revealing homelessness phenomenon in Malaysia: a case study in George Town, Penang. In: Mat Akhir NS, Sulong J, Wan Harun MA, Muhammad S, Wei Lin AL, Low Abdullah NF, et al., editors. Role(s) and relevance of humanities for sustainable development. European proceedings of social and behavioural sciences, vol. 68. Future Academy; 2019. p. 790-9.

[19] Tarmaraja K, Krishnan GG, Rani H, Saini AR, Mohd-Dom TN. A cross-sectional survey of oral health status and literacy of a sample of homeless adults in Kuala Lumpur City. Journal of Dental Medical Public Health 2021;1(1):8-15.

[20] Yaacob KBK, Mohamad MS, Sarnon N. Isu gelandangan di Malaysia: tahap kesihatan mental & kemahiran hidup. Jurnal Sultan Alauddin Sulaiman Shah 2017:119-31.

[21] Aizuddin AN, Abdul Jabar SW, Idris IB. Factors associated with health services financier among temporary sheltered homeless in urban Malaysia. BMC Publ Health 2019;19(Suppl 4):548. https://doi.org/10.1186/s12889-019-6871-5.

[22] Drani SB, Azman A, Jamir Singh PS. Do homeless people giving up hope? A qualitative study in Penang, Malaysia. Asian Social Work Journal 2021;6(5):1-10. https://doi.org/10.47405/aswj.v6i5.179.

[23] Ignaszewski MJ. The epidemiology of drug abuse. J Clin Pharmacol 2021;61(Suppl 2):S10-7. https://doi.org/10.1002/jcph.1937.

[24] Okafor IP. Causes and consequences of drug abuse among youth in Kwara state, Nigeria. Can J Fam Youth 2020;12(1):147-62. https://doi.org/10.29173/cjfy29495.

[25] Williams PP, Carney T, Parry CDH. Reducing substance use and sexual risk behaviour among men who have sex with men in South Africa. South Afr J Sci 2016;112(9-10):1-5. https://doi.org/10.17159/sajs.2016/20150425.

[26] Berry MS, Johnson MW. Does being drunk or high cause HIV sexual risk behavior? A systematic review of drug administration studies. Pharmacol Biochem Behav 2018;164:125-38. https://doi.org/10.1016/j.pbb.2017.08.009.

[27] Ozbay F, Johnson DC, Dimoulas E, Morgan CA, Charney D, Southwick S. Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry (Edgmont) 2007;4(5):35-40.

[28] Moffa M, Cronk R, Fejfar D, Dancausse S, Padilla LA, Bartram J. A systematic scoping review of environmental health conditions and hygiene behaviors in homeless shelters. Int J Hyg Environ Health 2019;222(3):335-46. https://doi.org/10.1016/j.ijheh.2018.12.004.

[29] Rollinger L. Health, hygiene, and practical interventions, for people who are experiencing homelessness. Boston, MA: Boston University; 2020.

[30] Bawah AT, Abaka-Yawson A, Seini MM, Yeboah FA, Ngala RA. Prevalence of diabetes among homeless and slum dwellers in Accra, Ghana: a survey study. BMC Res Notes 2019;12(1):572. https://doi.org/10.1186/s13104-019-4613-5.

[31] Maslow AH. Toward a psychology of being. Lanham: Start Publishing LLC; 2013.

[32] Ohara L. Changing the stigma of the homeless in nursing students. Hilo, HI: University of Hawai’i Hilo, School of Nursing; 2019.

Share

COinS