{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T03:23:20Z","timestamp":1791084200573,"version":"4.1.0"},"reference-count":47,"publisher":"SAGE Publications","issue":"5-6","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Homelessness increased by 31% from 2022 to 2023 in Denver, Colorado. We surveyed people experiencing homelessness in Denver to evaluate their health conditions and service needs and to identify factors associated with new or worsening health conditions after housing loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>From October 28 through November 15, 2023, we surveyed 356 people experiencing homelessness in Denver. We fit multivariable logistic regression models using backward-fitting procedures to identify factors associated with reporting new or worsening health conditions after housing loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The mean (SD) age of participants was 46.0 (13.7) years, 227 (63.7%) reported physical health conditions, and 207 (58.1%) reported mental health conditions that were new or worsening after experiencing homelessness. Chronic pain (n\u2009=\u200961; 17.1%) and depression (n\u2009=\u2009123; 34.6%) were the most reported conditions. Eye care (n\u2009=\u2009131; 36.8%), dental care (n\u2009=\u200995; 26.7%), and pain management (n\u2009=\u200954; 15.2%) were among the top service needs. Self-rated health declined by 22% after housing loss, from 3.4 (good or very good) before experiencing homelessness to 2.7 (fair or good) at the time of the survey, with a larger decline among those experiencing unsheltered homelessness than among those who were sheltered (0.95 vs 0.57;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.006). As compared with men, women had higher odds of reporting new or worsening health conditions, whether physical (adjusted odds ratio [AOR]\u2009=\u20091.93; 95% CI, 1.14-3.29) or mental (AOR\u2009=\u20092.14; 95% CI, 1.23-3.81). Experiencing violence was associated with reporting new or worsening mental health conditions (AOR\u2009=\u20092.01; 95% CI, 1.20-3.37) after housing loss.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Targeted interventions are needed to address the unique needs of unhoused women and those experiencing unsheltered homelessness in Denver.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00333549251351541","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T10:40:08Z","timestamp":1754476808000},"page":"551-561","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["A Survey of Physical and Mental Health Among People Experiencing Homelessness in Denver, Colorado, 2023"],"prefix":"10.1177","volume":"140","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1409-1017","authenticated-orcid":false,"given":"Jessica P.","family":"Sherman","sequence":"first","affiliation":[{"name":"Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA"},{"name":"Office of Readiness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA"},{"name":"College of Nursing, The Ohio State University, Columbus, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara C.","family":"Drehoff","sequence":"additional","affiliation":[{"name":"Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA"},{"name":"Colorado Department of Public Health and Environment, Denver, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5615-4920","authenticated-orcid":false,"given":"Caroline J.","family":"Waddell","sequence":"additional","affiliation":[{"name":"Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5135-0698","authenticated-orcid":false,"given":"Perri C.","family":"Callaway","sequence":"additional","affiliation":[{"name":"Laboratory Leadership Service, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4484-7011","authenticated-orcid":false,"given":"Kristen E.","family":"Marshall","sequence":"additional","affiliation":[{"name":"Office of Readiness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA"},{"name":"Colorado Department of Public Health and Environment, Denver, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4696-664X","authenticated-orcid":false,"given":"Alexis","family":"Burakoff","sequence":"additional","affiliation":[{"name":"Colorado Department of Public Health and Environment, Denver, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Herlihy","sequence":"additional","affiliation":[{"name":"Colorado Department of Public Health and Environment, Denver, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ella","family":"Keenan","sequence":"additional","affiliation":[{"name":"Denver Department of Public Health and Environment, Denver, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Loth Hill","sequence":"additional","affiliation":[{"name":"Denver Department of Public Health and Environment, Denver, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5599-2727","authenticated-orcid":false,"given":"Nicholas","family":"Laramee","sequence":"additional","affiliation":[{"name":"Colorado Department of Public Health and Environment, Denver, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiszha","family":"Cooley","sequence":"additional","affiliation":[{"name":"Colorado Department of Public Health and Environment, Denver, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Briana","family":"Sprague","sequence":"additional","affiliation":[{"name":"Colorado Department of Public Health and Environment, Denver, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5466-6893","authenticated-orcid":false,"given":"Liesl M.","family":"Hagan","sequence":"additional","affiliation":[{"name":"Office of Readiness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"de Sousa T Andrichik A Prestera E Rush K Tano C Wheeler M. The Annual Homelessness Assessment Report (AHAR) to Congress: Part 1\u2014Point-in-Time Estimates of Homelessness. US Department of Housing and Urban Development; 2023. Accessed May 1 2024. https:\/\/www.huduser.gov\/portal\/sites\/default\/files\/pdf\/2023-AHAR-Part-1.pdf"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(14)61132-6"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.2021.0153"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003750"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.2022.0035"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0033354916667501"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10597-019-00470-0"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwab051"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-7234-y"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.focus.2022.100043"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/00333549231215850"},{"key":"e_1_3_3_13_2","unstructured":"Wenzler E. Denver\u2019s new mayor declares state of emergency on homelessness sets goal of housing 1 000 unsheltered people by end of 2023. Colorado Sun. July 18 2023. Accessed June 26 2023. https:\/\/coloradosun.com\/2023\/07\/18\/denver-homelessness-state-emergency"},{"key":"e_1_3_3_14_2","unstructured":"Substance Abuse and Mental Health Services Administration. SAMHSA\u2019s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS publication (SMA) 14-4884. Trauma and Justic Strategic Initiative; July 2014. Accessed October 20 2023. https:\/\/library.samhsa.gov\/product\/samhsas-concept-trauma-and-guidance-trauma-informed-approach\/sma14-4884"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfp732"},{"key":"e_1_3_3_16_2","unstructured":"National Archives. Executive order 14168: defending women from gender ideology extremism and restoring biological truth to the federal government. January 20 2025. Accessed April 10 2025. https:\/\/www.federalregister.gov\/documents\/2025\/01\/30\/2025-02090\/defending-women-from-gender-ideology-extremism-and-restoring-biological-truth-to-the-federal"},{"key":"e_1_3_3_17_2","author":"Ware JE","year":"1993","unstructured":"Ware JEJr, Snow KK, Kosinski M, Gandek B. SF-36 Health Survey: Manual and Interpretation Guide. Nimrod Press; 1993.","journal-title":"SF-36 Health Survey: Manual and Interpretation Guide"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2002.00185.x"},{"key":"e_1_3_3_19_2","unstructured":"Metro Denver Homeless Initiative. Metro Denver Homeless Initiative 2023 point in time count. July 21 2023. Accessed January 17 2025. https:\/\/public.tableau.com\/app\/profile\/mdhi\/viz\/MDHI2023PointinTimeCount\/Overview"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph14121535"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1136\/fmch-2019-000262"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/0049124103262065"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.2174\/1874924001003020080"},{"key":"e_1_3_3_24_2","unstructured":"Homeless and Housing Resource Center. Trauma-informed outreach learning community session 1: trauma-informed care\u2014responding to the trauma of homelessness. June 7 2022. Accessed October 15 2023. https:\/\/hhrctraining.org\/events-webinars\/webinar\/2798\/trauma-informed-outreach-session-1"},{"key":"e_1_3_3_25_2","unstructured":"National Health Care for the Homeless Council. Promoting safety in street outreach. January 20 2022. Accessed October 15 2023. https:\/\/nhchc.org\/resource\/promoting-safety-in-street-outreach"},{"key":"e_1_3_3_26_2","unstructured":"Colorado Department of Health Care Policy and Financing. Health First Colorado vision benefit. 2025. Accessed January 17 2025. https:\/\/hcpf.colorado.gov\/vision-benefit"},{"key":"e_1_3_3_27_2","unstructured":"Colorado Department of Health Care Policy and Financing. Adult Health First Colorado dental benefit fact sheet. July 2023. Accessed January 17 2025. https:\/\/hcpf.colorado.gov\/sites\/hcpf\/files\/Health%20First%20Colorado%20Adult%20Dental%20Benefit%20Fact%20Sheet.pdf"},{"key":"e_1_3_3_28_2","unstructured":"National Health Care for the Homeless Council. Homelessness and health: what\u2019s the connection? Fact sheet. February 2019. Accessed April 22 2024. https:\/\/nhchc.org\/wp-content\/uploads\/2019\/08\/homelessness-and-health.pdf"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-023-16012-z"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp.2020.0749"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/s2468-2667(20)30055-4"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1177\/2150132720910289"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19010005"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpain.2023.1020038"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7224a1"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1080\/10926771.2015.1074134"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1093\/hsw\/35.1.39"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1891\/0886-6708.vv-d-12-00069"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1177\/0002764204274200"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.2147\/ndt.s161377"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwu350"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1177\/08862605231179720"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1186\/s10020-024-00782-2"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2017.03.014"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2024.06.016"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2005.00291.x"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnw011"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-016-0242-z1"}],"container-title":["Public Health Reports\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00333549251351541","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00333549251351541","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00333549251351541","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T09:40:25Z","timestamp":1777628425000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00333549251351541"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,6]]},"references-count":47,"journal-issue":{"issue":"5-6","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1177\/00333549251351541"],"URL":"https:\/\/doi.org\/10.1177\/00333549251351541","relation":{},"ISSN":["0033-3549","1468-2877"],"issn-type":[{"value":"0033-3549","type":"print"},{"value":"1468-2877","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,6]]}}}