Lillian Gelberg
Biographic Data
| ID | 79740 |
|---|---|
| NAME | Lillian Gelberg |
| GIVEN NAMES | Lillian |
| FAMILY NAME | Gelberg |
| SIGNATURE | GELBERG L |
| AFFILIATIONS | University of California, Los Angeles |
| ORCID | 0000-0001-9772-0116 |
| VERIFIED | Yes |
| TOTAL WORKS | 67 |
| TOTAL CITATIONS | 184 |
| AUTHOR COUNT | 67 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1993 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 6 |
Health Care Outcomes of Homelessness Prevention Programs in Veterans Experiencing Housing Instability
In this study, federal prevention solutions to homelessness were associated with improved health outcomes and lower inpatient costs, which should inform national policy debates within and beyond the VA
Material hardship, forced displacement, and negative health outcomes among unhoused people who use drugs in Los Angeles, California and Denver, Colorado
This LCA indicates that among PWUD experiencing homelessness there exist distinct differences in resource access and material hardship, and that these differences are linked with political, social, substance use, and other health outcomes. We add to the literature on the relationship between poverty and health among PWUD. Policies which increase difficulty accessing necessary material resources may negatively impact health in this population
Addressing racial and ethnic disparities in premature exits from permanent supportive housing among residents with substance use disorders
These findings suggest relationships between SUDs and negative PSH exits differ between racial/ethnic groups and suggest there may be value in culturally specific tailoring and implementation of SUD services for these subgroups
The use of hotels/motels to address homelessness among veterans during the Covid-19 pandemic
The objective of this exploratory mixed methods study is to assess the use of hotels/motels among Veterans experiencing housing instability during the COVID-19 pandemic to inform policy and programmatic responses to homelessness during such emergencies. We analyzed qualitative interviews conducted with national-level homeless services leadership and Supportive Services for Veteran Families (SSVF) program providers during October 2020–May 2021 and…
Pilot trial results of D-Homes
https://clinicaltrials.gov/study/NCT05258630?term=D-HOMES&rank=1, identifier NCT05258630
Determinants to Tele-Mental Health Services Utilization Among California Adults
To investigate the relationship of predisposing, enabling, need, and immigration-related factors to tele-mental health services utilization among California adults, we conducted a secondary analysis of two waves of the California Health Interview Survey (CHIS) collected between 2015 and 2018 (N = 78,345). A series of logistic regression models were conducted to examine correlates and predictors to tele-mental health services use. Approximately 1.…
Nativity and the risk of opioid use disorder among Hispanic/Latinx women in primary care in Los Angeles, CA
Among low-income Hispanic/Latinx women presenting to primary care, one in twenty patients is at-risk for OUD. The odds of moderate-high risk of OUD were three times as high in US-born compared to foreign-born women, and higher among those with chronic medical conditions and those at risk of other substance use disorders. Gender-specific and culturally-tailored screening for OUD may inform overdose prevention interventions for US-born Hispanic/Lat…
Service Provider Perspectives on the Differences between Place‐Based and Scattered‐Site Permanent Supportive Housing in Los Angeles County after the Onset of the Covid‐19 Pandemic
PB can be advantageous for clients with higher levels of acuity, whereas SS could be more appropriate for clients who are more stable and independent. PB programs are seen to have practical and logistical advantages, but some providers prefer SS services. Clients and providers should be matched to PSH configurations that best match their needs and preferences, and providers should be aware that public health emergencies may impact PB and SS setti…
Insights for conducting large-scale surveys with veterans who have experienced homelessness
001). Compared to non-respondents, respondents were older, less likely to have mental health, drug, or alcohol conditions, and had fewer VA housing and emergency service visits. Collectively, our results indicated a national mailed survey approach is feasible and successful for reaching VA patients who have recently experienced homelessness. These findings offer insight into how health systems can obtain perspectives of socially disadvantaged gro…
Which veterans in the Supportive Services for Veteran Families program receive temporary financial assistance and why
The VA Supportive Services for Veteran Families (SSVF) program is one of the largest housing assistance programs in the US. One of the key components of this program is temporary financial assistance (TFA) which can be used for rent, security deposits, utilities, and other housing-related expenses. The objective of this paper was to identify characteristics of SSVF enrollees that are associated with receiving any TFA and the amount of TFA receive…
Provider Perspectives on Sleep as a Determinant of Health and Housing Outcomes among Veterans Experiencing Homelessness
Sleep problems are common among United States (U.S.) veterans and are associated with poor health, mental health, and functioning. Yet, little is known about insufficient sleep and factors contributing to sleep disparities among veterans experiencing homelessness. We conducted semi-structured interviews to better understand the clinical, environmental, and structural factors contributing to insufficient sleep among veterans and to improve care fo…
Ancestral recipes”
This study brought together patients and key stakeholders committed to addressing the social determinants of health and it mobilized the community to develop culturally vetted health education materials. The findings indicate the need for increased access to evidence-based nutrition education and to culturally appropriate food products that can be easily incorporated into daily food preparation
Bringing Lived Experience to Research on Health and Homelessness
Perceived unmet substance use and mental health care needs of acute care patients who use drugs
Perceptions of Homeless Adults and Their Providers on Coping With the Impact of Covid-19 Pandemic on Mental Health, Substance Use, and Harm Reduction Services
Adults experiencing homelessness experience a disproportionate burden of health disparities which has further exacerbated mental health, substance use, and coping during the COVID-19 pandemic. As limited data is available to understand the experience of adults experiencing homelessness and their health during this time, the purpose of this study was to explore how COVID-19 may have impacted their mental health, substance use, and ways of coping i…
What do Veterans with homeless experience want us to know that we are not asking? A qualitative content analysis of comments from a national survey of healthcare experience
Surveys of people who experience homelessness can portray their life and healthcare experiences with a level of statistical precision; however, few have explored how the very same surveys can deliver qualitative insights as well. In responding to surveys, people experiencing homelessness can use the margins to highlight health and social concerns that investigators failed to anticipate that standard question batteries miss. This study describes t…
Harm Reduction and Adaptations Among PWUD in Rural Oregon During Covid-19
Health-Related Social Needs Among Emergency Department Patients with HIV
Experiences and Perceived Benefits of a Youth Skateboarding Program in South Africa
This study aimed to assess the mental health needs and risk behaviors of adolescents attending an afterschool life-skills skateboarding program, to evaluate the perceived benefits of the program, and to identify potential modifications required to meet the identified needs. Program participants were from three gang- and poverty-affected urban communities in Cape Town, South Africa. Seventy-six adolescents aged between 10 and 19 years old (83% mal…
Perceptions of Care Coordination Among Homeless Veterans Receiving Medical Care in the Veterans Health Administration and Community Care Settings
BACKGROUND: Initiatives to expand Veterans' access to purchased health care outside Veterans Health Administration (VHA) facilities ("community care") present care coordination challenges for Veterans experiencing homelessness. OBJECTIVE: Among Veterans with homeless experiences, to evaluate community care use and satisfaction, and compare perceptions of care coordination among Veterans using VHA services and community care to those using VHA ser…
Comparison of Patient Experience Between Primary Care Settings Tailored for Homeless Clientele and Mainstream Care Settings
BACKGROUND: More than 1 million Americans receive primary care from federal homeless health care programs yearly. Vulnerabilities that can make care challenging include pain, addiction, psychological distress, and a lack of shelter. Research on the effectiveness of tailoring services for this population is limited. OBJECTIVE: The aim was to examine whether homeless-tailored primary care programs offer a superior patient experience compared with n…
Trends in Trimorbidity Among Adults Experiencing Homelessness in Minnesota, 2000–2018
BACKGROUND: Earlier and more severe onset of chronic health conditions contributes to the increased risk of premature death among adults experiencing homelessness. Trimorbidity, a subset of multimorbidity representing overlap of physical health, mental health, and substance use conditions, disproportionately impacts adults experiencing homelessness. We know of no longitudinal data comparing trimorbidity trends among adults experiencing homelessne…
Preventing Suicide Among Homeless Veterans
Rates of death by suicide among Veterans remain high, with age- and sex-adjusted rates 1.5 times higher for Veterans than non-Veteran adults.1 This risk is especially pronounced among Veterans experiencing homelessness, who have particularly high rates of suicidal ideation and suicidal self-directed violence.2 This likely relates to the presence of multiple risk factors, including extreme poverty and lack of housing; loneliness and limited social…
Engaging the Community in Designing a Hepatitis C Virus Treatment Program for Adults Experiencing Homelessness
Despite the availability of cure for hepatitis C virus (HCV), people experiencing homelessness (PEH) are challenged with initiating and completing HCV treatment. The design of culturally sensitive HCV treatment programs is lacking. The objective was to employ community-based participatory research methods to understand perceptions of HCV-positive PEH, and providers, on the design and delivery of a culturally sensitive, nurse-led community health …
Substance Use among Women Attending Primary Healthcare Community Centers
Competing priorities as a barrier to medical care among homeless adults in Los Angeles
OBJECTIVES: The role of competing priorities as a barrier to the utilization of physical health services was assessed in a subset (n = 363) of a probability sample of homeless adults in Los Angeles. METHODS: Unadjusted odds of four measures of health services utilization were calculated for those with frequent difficulty in meeting their subsistence needs. These odds were then adjusted for a range of characteristics assumed to affect the utilizat…
Antecedents of Physical and Sexual Victimization Among Homeless Women
Homeless women experience extensive health risks including physical and sexual victimization. Few studies that have gathered information on homeless persons have reported results separately for women or have compared them directly with men. Research that both investigates antecedents of victimization among homeless women and compares them to those for men is necessary to determine whether prevention efforts must be different for each group. We in…
Applying the Gelberg-Andersen Behavioral Model for Vulnerable Populations to Health Services Utilization in Homeless Women
We applied the Gelberg-Andersen Behavioral Model for Vulnerable Populations to predict health services utilization (HSU) in 875 homeless US women. Structural models assessed the impact of predisposing (demographics, psychological distress, alcohol/drug problems, homelessness severity), enabling (health insurance, source of care, barriers) and need (illness) variables on HSU (preventive care, outpatient visits, hospitalizations). Homelessness seve…
Condom Use and High-Risk Sexual Acts in Adult Films
Objectives. We compared the prevalence of condom use during a variety of sexual acts portrayed in adult films produced for heterosexual and homosexual audiences to assess compliance with state Occupational Health and Safety Administration regulations. Methods. We analyzed 50 heterosexual and 50 male homosexual films released between August 1, 2005, and July 31, 2006, randomly selected from the distributor of 85% of the heterosexual adult films re…
Delays and Unmet Need for Health Care Among Adult Primary Care Patients in a Restructured Urban Public Health System
Objectives. We estimated the prevalence and determinants of delayed and unmet needs for medical care among patients in a restructured public health system. Methods. We conducted a stratified cross-sectional probability sample of primary care patients in the Los Angeles County Department of Health Services. Face-to-face interviews were conducted with 1819 adult patients in 6 languages. The response rate was 80%. The study sample was racially/ethni…
Association between homelessness and opioid overdose and opioid-related hospital admissions/emergency department visits
Exploring Quality of Primary Care for Patients Who Experience Homelessness and the Clinicians Who Serve Them
To develop and evaluate an effective model of patient-centered, high-quality, homeless-focused primary care, our team explored key domains of primary care that may be important to patients. We anchored our conceptual framework in two reports from the Institute of Medicine (IOM) that defined components of primary care and quality of care. Using questions developed from this framework, we conducted semistructured interviews with 36 homeless-experie…
Pathways to Health Risk Exposure in Adult Film Performers
Utilization of Birth Control Services among Homeless Women
Although homeless women appear to be at notable risk of unintended pregnancy, insufficient attention has been paid to understanding their access to birth control services and the characteristics of homeless women who want birth control services. To address these research gaps, the authors analyzed data from a probability sample of 974 homeless women who were interviewed in shelters and meal programs in Los Angeles County. Multivariate logistic re…
Bringing Lived Experience to Research on Health and Homelessness
Health care service use among vulnerable adolescents
This article describes the patterns of health care service use among a cohort of vulnerable adolescents with a history of homelessness and uses the Expanded Behavioral Model for Vulnerable Populations to examine factors associated with use of ambulatory and emergent care. We incorporated a health care interview into an existing longitudinal study of newly homeless adolescents, at their 24-month assessment (n = 183) and assessed their sociodemogra…
Chronically Homeless Women's Perceived Deterrents to Contraception
Homeless women report substantial deterrents that reduce their contraceptive use. The multiplicity and heterogeneity of their perceived deterrents suggest a need for reproductive health services that are more integrated and culturally competent than those currently offered
Service Provider Perspectives on the Differences between Place‐Based and Scattered‐Site Permanent Supportive Housing in Los Angeles County after the Onset of the Covid‐19 Pandemic
PB can be advantageous for clients with higher levels of acuity, whereas SS could be more appropriate for clients who are more stable and independent. PB programs are seen to have practical and logistical advantages, but some providers prefer SS services. Clients and providers should be matched to PSH configurations that best match their needs and preferences, and providers should be aware that public health emergencies may impact PB and SS setti…
Experiences and Perceived Benefits of a Youth Skateboarding Program in South Africa
This study aimed to assess the mental health needs and risk behaviors of adolescents attending an afterschool life-skills skateboarding program, to evaluate the perceived benefits of the program, and to identify potential modifications required to meet the identified needs. Program participants were from three gang- and poverty-affected urban communities in Cape Town, South Africa. Seventy-six adolescents aged between 10 and 19 years old (83% mal…
Engaging the Community in Designing a Hepatitis C Virus Treatment Program for Adults Experiencing Homelessness
Despite the availability of cure for hepatitis C virus (HCV), people experiencing homelessness (PEH) are challenged with initiating and completing HCV treatment. The design of culturally sensitive HCV treatment programs is lacking. The objective was to employ community-based participatory research methods to understand perceptions of HCV-positive PEH, and providers, on the design and delivery of a culturally sensitive, nurse-led community health …
Convincing New Providers to Offer Medical Abortion
Continuing to rely on the perspectives of abortion providers to predict the fate of medical abortion in the United States is problematic. First these providers precisely because of their familiarity with an alternative technique must overcome biases and in some cases preconceived notions about a new option. In fact a review of the experience of medical abortion in France Great Britain and Sweden concluded that “it can take a decade or longer for …
Convincing New Providers to Offer Medical Abortion
Weighting for Period Perspective in Samples of the Homeless
For some sample-based studies of the homeless, it may be relevant to adopt a period perspective, in which analyses focus on the mix of persons who experience homelessness at least once during some period of time, not just the mix of persons at a point in time. Period perspective presumably can be enhanced by weights that account for the intermittent nature of homelessness, but such weighting invites implementation problems related to calculation,…
Substance Use Among Impoverished Medical Patients
Four hundred forty-three impoverished medical patients, many of whom were homeless, were studied to determine whether homelessness is an independent predictor of current substance use. Twenty-four percent of the sample of patients were frequent alcohol users (i.e., daily or almost daily), and 18% had recently used illegal drugs (cocaine, heroin, PCP, LSD). Marijuana use was not included in the drug use variable. Bivariate analyses revealed that f…
Homeless Veteransʼ Utilization of Medical, Psychiatric, and Substance Abuse Services
This study focuses on the association between homeless veterans' prior utilization of medical, psychiatric, and substance abuse services and biopsychosocial characteristics reported at admission into a domiciliary care program. Given the large number of veterans in the US homeless population and their health care needs, understanding factors associated with health service use among homeless veterans is significant. Research participants were 429 …
Access to Substance Abuse Treatment for Homeless Women of Reproductive Age
Homeless women in the United States comprise a subpopulation at high risk for substance abuse, with rates of substance use disorder ranging from 16% to 67%. Despite the need for treatment that such high rates imply, relatively few substance-abusing homeless women avail themselves of formal treatment. The fact that they tend not to utilize formal treatment services is especially problematic among homeless women of reproductive age, who are not onl…
Drug-Abusing Homeless Clients in California's Substance Abuse Treatment System
As many as one-half to three-fourths of homeless persons have diagnoses of alcohol or other drug dependence. Rates of alcohol and other drug use disorders, and the social costs associated with untreated substance disorder, are higher among homeless than nonhomeless persons. Despite the high level of need for treatment, relatively few substance-abusing homeless individuals receive treatment for their drug problems, suggesting difficulties in acces…
Competing priorities as a barrier to medical care among homeless adults in Los Angeles
OBJECTIVES: The role of competing priorities as a barrier to the utilization of physical health services was assessed in a subset (n = 363) of a probability sample of homeless adults in Los Angeles. METHODS: Unadjusted odds of four measures of health services utilization were calculated for those with frequent difficulty in meeting their subsistence needs. These odds were then adjusted for a range of characteristics assumed to affect the utilizat…
Accuracy of Homeless Adults' Self-Reports
From the School of Medicine, Division of Family Medicine, University of California, Los Angeles, California. Supported in part by grant no. R01 HS06696 from the Agency for Health Care Policy and Research to Lillian Gelberg. It was conducted in conjunction with the RAND Course of Homelessness Study, which was funded by the National Institute of Health (R01 M464121). Dr. Gelberg is a Robert Wood Johnson Foundation Generalist Physician Faculty Schol…
Determinants of Regular Source of Care Among Homeless Adults in Los Angeles
OBJECTIVES: The authors explore the determinants of having a regular source of care in a community-based probability sample of homeless adults in Los Angeles. Results from this study should be more representative than those from previous studies of the homeless that are clinic- or shelter-based. In addition to those factors found to be barriers to regular sources of care in the general population, we hypothesized that psychosocial characteristics…
Reliability, Validity, and Composition of a Subset of the Centers for Disease Control and Prevention Acquired Immunodeficiency Syndrome Knowledge Questionnaire in a Sample of Homeless and Impoverished…
OBJECTIVES: Measures of acquired immunodeficiency syndrome (AIDS)-related knowledge that have good psychometric properties are needed to evaluate the impact of educational interventions, particularly among impoverished populations. Few measures that satisfy these requirements are available. The authors describe the psychometric characteristics and composition of a subset of 21 AIDS knowledge items from the questionnaire used by the National Cente…
Antecedents of Physical and Sexual Victimization Among Homeless Women
Homeless women experience extensive health risks including physical and sexual victimization. Few studies that have gathered information on homeless persons have reported results separately for women or have compared them directly with men. Research that both investigates antecedents of victimization among homeless women and compares them to those for men is necessary to determine whether prevention efforts must be different for each group. We in…
Weighting for Period Perspective in Samples of the Homeless
For some sample-based studies of the homeless, it may be relevant to adopt a period perspective, in which analyses focus on the mix of persons who experience homelessness at least once during some period of time, not just the mix of persons at a point in time. Period perspective presumably can be enhanced by weights that account for the intermittent nature of homelessness, but such weighting invites implementation problems related to calculation,…
Utilization of Birth Control Services among Homeless Women
Although homeless women appear to be at notable risk of unintended pregnancy, insufficient attention has been paid to understanding their access to birth control services and the characteristics of homeless women who want birth control services. To address these research gaps, the authors analyzed data from a probability sample of 974 homeless women who were interviewed in shelters and meal programs in Los Angeles County. Multivariate logistic re…
Chronically Homeless Women's Perceived Deterrents to Contraception
Homeless women report substantial deterrents that reduce their contraceptive use. The multiplicity and heterogeneity of their perceived deterrents suggest a need for reproductive health services that are more integrated and culturally competent than those currently offered
How Accessible is Medical Care for Homeless Women
BACKGROUND: Women have become a major segment of the homeless population, yet little is known about their access to health care or the relationship between access to care and vulnerability of homelessness. OBJECTIVE: To examine homeless women's access to health care using the Expanded Behavioral Model for Vulnerable Populations. RESEARCH DESIGN: Population-based cross-sectional study using a probability sample of homeless women. SETTING: Seventy-…
Convincing New Providers to Offer Medical Abortion
Continuing to rely on the perspectives of abortion providers to predict the fate of medical abortion in the United States is problematic. First these providers precisely because of their familiarity with an alternative technique must overcome biases and in some cases preconceived notions about a new option. In fact a review of the experience of medical abortion in France Great Britain and Sweden concluded that “it can take a decade or longer for …
Convincing New Providers to Offer Medical Abortion
A Comparison of Hispanic and White Adolescent Females' Use of Family Planning Services in California
Delays and Unmet Need for Health Care Among Adult Primary Care Patients in a Restructured Urban Public Health System
Objectives. We estimated the prevalence and determinants of delayed and unmet needs for medical care among patients in a restructured public health system. Methods. We conducted a stratified cross-sectional probability sample of primary care patients in the Los Angeles County Department of Health Services. Face-to-face interviews were conducted with 1819 adult patients in 6 languages. The response rate was 80%. The study sample was racially/ethni…
Predictors of Sexually Transmitted Infection Testing Among Sexually Active Homeless Youth
Determinants of physician unwillingness to offer medical abortion using mifepristone
Health care service use among vulnerable adolescents
This article describes the patterns of health care service use among a cohort of vulnerable adolescents with a history of homelessness and uses the Expanded Behavioral Model for Vulnerable Populations to examine factors associated with use of ambulatory and emergent care. We incorporated a health care interview into an existing longitudinal study of newly homeless adolescents, at their 24-month assessment (n = 183) and assessed their sociodemogra…
Health Care Access, Use of Services, and Experiences Among Undocumented Mexicans and Other Latinos
BACKGROUND: We compared access to health care, use of services, and health care experiences for Mexicans and other Latinos by citizenship and immigrant authorization status. METHODS: We acquired data from the 2003 California Health Interview Survey, with 42,044 participants representative of noninstitutionalized households. Participants were differentiated by ethnicity/race, national origin, and citizenship/immigration authorization status. Outco…
Homeless Women
Applying the Gelberg-Andersen Behavioral Model for Vulnerable Populations to Health Services Utilization in Homeless Women
We applied the Gelberg-Andersen Behavioral Model for Vulnerable Populations to predict health services utilization (HSU) in 875 homeless US women. Structural models assessed the impact of predisposing (demographics, psychological distress, alcohol/drug problems, homelessness severity), enabling (health insurance, source of care, barriers) and need (illness) variables on HSU (preventive care, outpatient visits, hospitalizations). Homelessness seve…
Ethnic Differences in the Correlates of Mental Distress Among Homeless Women
Pathways to Health Risk Exposure in Adult Film Performers
Medicine (63 works) · Homelessness and Social Issues (46 works) · Psychiatry (37 works) · Psychology (35 works) · Gerontology (32 works) · Environmental health (31 works) · Family medicine (27 works) · Nursing (27 works) · Food Security and Health in Diverse Populations (25 works) · Public health (24 works)