Needing primary care but not getting it: The role of trust, stigma and organizational obstacles reported by homeless veterans

Thomas P. O’Toole, Erin E. Johnson, Stephan Redihan, Matthew Borgia, Jennifer Rose

Research output: Contribution to journalArticle

Abstract

We describe data from a multi- center community- based survey of homeless veterans who were not accessing available primary care to identify reasons for not getting this care as well as for not seeking health care when it was needed. Overall, 185 homeless veterans were interviewed: The average age was 48.7 years (SD 10.8), 94.6% were male, 43.2% were from a minority population. The majority identified a recent need for care and interest in having a primary care provider. Reasons for delaying care fell into three domains: 1) trust; 2) stigma; and 3) care processes. Identifying a place for care (OR 3.3; 95% CI: 1.4-7.7), having a medical condition (OR 5.5; 95% CI 1.9-15.4) and having depression (OR 3.4; 95% CI: 1.4-8.7) were associated with receiving care while not being involved in care decisions was associated with no care (OR 0.7; 95% CI 0.5-0.9). Our findings support the importance of considering health access within an expanded framework that includes perceived stigma, inflexible care systems and trust issues.

Original languageEnglish (US)
Pages (from-to)1019-1031
Number of pages13
JournalJournal of Health Care for the Poor and Underserved
Volume26
Issue number3
StatePublished - Aug 1 2015
Externally publishedYes

Keywords

  • Access
  • Attitudes
  • Homeless
  • Veterans

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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