Sung-Wook Hwang
Biographic Data
| ID | 190771 |
|---|---|
| NAME | Sung-Wook Hwang |
| GIVEN NAMES | Sung-Wook |
| FAMILY NAME | Hwang |
| SIGNATURE | HWANG S |
| AFFILIATIONS | St. Michael's Hospital |
| ORCID | 0000-0002-1276-1101 |
| VERIFIED | Yes |
| TOTAL WORKS | 125 |
| TOTAL CITATIONS | 355 |
| AUTHOR COUNT | 125 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2000 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 10 |
“They were just a person who was curious”: Exploring the impact of supportive coaching on the psychosocial well-being of youth transitioning out of homelessness
Most conversations about the homelessness crisis in high income countries tend to center around the importance of meeting tangible needs like housing; however, there is strong evidence to support that housing is crucial but not sufficient. The psychological challenges associated with experiencing homelessness and their impact on psychosocial well-being—the ability to engage in society with a sense of purpose and meaning—need more attention, espec…
Time to move on: Exploring the journey from supportive housing to independent living for people with past homelessness experience
Supportive housing, which provides subsidized housing with on-site support, is an integral part of the housing continuum. Moving on Initiatives (MOIs) assist people living in supportive housing who no longer require on-site support to access housing in the private market, thereby increasing system capacity while offering individuals choice and control over their housing. The objective of this study was to understand the experiences of adults with…
Complexity among people experiencing homelessness: A scoping review of definitions and measurement approaches
People experiencing homelessness are often described as having "complex needs" for whom various health and housing interventions have been developed. However, there is no consensus on how this and similar terms are defined or measured. A prospectively registered scoping review was conducted to examine how "complexity" is defined and measured with people experiencing homelessness. Six academic databases were searched, along with several techniques…
Ethno-Racial Differences in the Effectiveness of Housing First on Healthcare Utilization Among Homeless Adults with Mental Illness: At Home Chez-Soi, a Pragmatic Randomized Trial
This study evaluates the impact of the Housing First (HF) intervention on healthcare utilization among homeless adults with mental illness, comparing ethno-racial (ER) and non-ER groups with moderate mental health support needs. We linked data from the At Home/Chez-Soi (AH/CS) randomized controlled trial with health administrative data from Ontario, including the Ontario Health Insurance Plan and several healthcare databases (e.g., Discharge Abst…
Addressing housing insecurity as a social determinant of health: A systematic review of interventions in healthcare settings
Mortality among individuals living in permanent supportive housing: A retrospective cohort study
Structural violence as a driver of Covid-19 vaccine hesitancy and low vaccine uptake among people experiencing homelessness in Toronto, Canada: A qualitative study
Multiple pathways of structural violence experienced prior to and during the COVID-19 pandemic influenced vaccine decision-making and represent critical mechanisms by which health inequity becomes embodied by people experiencing homelessness
Disparities in all-cause mortality among people experiencing homelessness in Toronto, Canada during the Covid-19 pandemic: A cohort study
People experiencing homelessness have historically had high mortality rates compared to housed individuals in Canada, a trend believed to have become exacerbated during the COVID-19 pandemic. In this matched cohort study conducted in Toronto, Canada, we investigated all-cause mortality over a one-year period by following a random sample of people experiencing homelessness ( n = 640) alongside matched housed ( n = 6,400) and low-income housed ( n …
Uptake of Covid-19 vaccination among community-dwelling individuals receiving healthcare for substance use disorder and major mental illness: A matched retrospective cohort study
Introduction Patients with major mental illness (MMI) and substance use disorders (SUD) face barriers in accessing healthcare. In this population-based retrospective cohort study, we investigated the uptake of COVID-19 vaccination in Ontario, Canada among community-dwelling individuals receiving healthcare for major mental illness (MMI) and/or substance use disorders (SUD), comparing them to matched general population controls. Methods Using link…
Predictors of housing instability and stability among Housing First participants: A 24-month study
This study examined the characteristics of people who experienced housing instability and stability after 24 months of being enrolled in Housing First (HF). A companion study addresses the same objective using qualitative methods. A sequential logistic regression was conducted to determine predictors of unstable and stable housing at 24 months of enrollment in HF in a randomized trial. We applied the Gelberg-Andersen. Behavioral Model for Vulnera…
Effect of a housing intervention on major cardiovascular events among homeless adults with mental illness
Homelessness is associated with excess cardiovascular morbidity and mortality. This study reports on the long-term effects of a Canadian housing first initiative, compared to treatment as usual, on major cardiovascular events among adults experiencing homelessness and mental illness. Over the 7-year follow-up period, 34 of 527 participants (6.5%) experienced at least one cardiovascular event. There was no significant difference in the incidence o…
The effect of cash transfers on health in high-income countries: A scoping review
High-income countries use cash transfer programs to mitigate poverty, in part to improve the health of low-income populations and potentially reduce their use of public health care. This review synthesizes evidence from studies that employed experimental or quasi-experimental designs to evaluate the effect of cash transfer interventions on health outcomes or health care utilization in high-income countries. We excluded interventions if they requi…
The role of housing stability in predicting social capital: Exploring social support and psychological integration as mediators for individuals with histories of homelessness and vulnerable housing
Social capital is a collective asset important for individual and population well‐being. Individuals who experience homelessness may face barriers in accessing social capital due to health challenges, small social networks, and social exclusion. Data from a 4‐year longitudinal study was used to determine if housing stability predicted greater social capital and if this relationship was mediated by social support and psychological integration for …
Service restrictions from emergency shelters among people experiencing homelessness: Uncovering pathways into unsheltered homelessness and institutional circuitry
Service restrictions refer to temporary or permanent bans of individuals from a program or an organization's services, and are widely used in emergency shelter systems. Limited research exists on how service restrictions unfold and their impacts on people experiencing homelessness. This qualitative study used in-depth interviews with timeline mapping to examine the antecedents and consequences of service restrictions from emergency shelters among…
Does receipt of social housing impact mental health? Results of a quasi-experimental study in the Greater Toronto Area
Using healthcare encounter data to identify high-cost users among adults with a history of homelessness: A validation study
People experiencing homelessness are often considered frequent healthcare users. Although their service use is not uniform, it can be difficult to identify the highest-cost users without access to comprehensive cost data. This study validated a set of algorithms that apply healthcare encounter data to identify high-cost users among adults with a history of homelessness. Administrative healthcare cost data were compared across common frequent user…
Effect of Free Medicine Distribution on Health Care Costs in Canada Over 3 Years: A Secondary Analysis of the CLEAN Meds Randomized Clinical Trial
ClinicalTrials.gov Identifier: NCT02744963
Exploring the Lived Experience of Aging among Chronically Homeless Older Adults
Introduction/background summary: Twenty-four percent of Canada’s homeless shelter users are over the age of 50 years, a number that is predicted to rise [1]. Homeless older adults experience chronic health issues. They encounter barriers to accessing and utilizing healthcare and social services, such as stigma and misalignment between their needs and available services. Why did you do it? Designing healthcare and social services to address the ne…
When I think about my future, I just see darkness”: How youth exiting homelessness navigate the hazy, liminal space between socioeconomic exclusion and inclusion
A holistic approach integrating coaching and attention to identity capital alongside economic supports may be key to helping youth exiting homelessness achieve socioeconomic inclusion
Coordinated Access and Coordinated Entry System Processes in the Housing and Homelessness Sector: A Critical Commentary on Current Practices
Coordinated access and coordinated entry systems have become central features in community responses to homelessness in Canada and the United States. Coordinated systems assess individuals and families experiencing homelessness on their needs, prioritize them based upon these needs, and then match them to appropriate housing. Despite the widespread implementation of coordinated systems, there have been few evaluations of the effectiveness of thes…
“We don't have a good system for people who don't have a home and don't need a hospital”: Contextualizing the hospital discharge process for people experiencing homelessness in Toronto, Canada
Hospital discharge is a key transition in a patient's care pathway, providing an effective point of intervention to address a patient's ongoing health and social care needs. Addressing these needs may prevent hospital readmissions. The hospital discharge process for people experiencing homelessness who have been admitted for medical conditions has not been well-characterized. To address this gap in knowledge, we interviewed hospital and shelter w…
Using Concept Mapping to Define Indigenous Housing First in Hamilton, Ontario
Concept mapping draws from local knowledge, elicits strong engagement, and captured the holistic and client-centred approach of an Indigenous Housing First Model
Co-Designing Relational Continuity Interventions for Urban Underserved Patients Experiencing Hospital-Primary Care Transitions
The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)The IJIC 20th Anniversary Issue was published in 2021
Shelter Bans Among People Experiencing Homelessness: An Exploratory Study of Predictors in Two Large Canadian Datasets
Differential impacts of Covid ‐19 and associated responses on the health, social well‐being and food security of users of supportive social and health programs during the Covid ‐19 pandemic: A qualita…
The effects of the coronavirus disease-2019 (COVID-19) pandemic on the lives of underserved populations are underexplored. This study aimed to identify the impacts of the COVID-19 pandemic and associated public health responses on the health and social well-being, and food security of users of Housing First (HF) services in Toronto (Canada) during the first wave of the COVID-19 pandemic. This qualitative descriptive study was conducted from July …
Homelessness and Health in Canada: Research Lessons and Priorities
Multidimensional Social Support and the Health of Homeless Individuals
Identifying the Patterns of Emergency Shelter Stays of Single Individuals in Canadian Cities of Different Sizes
The study analyzed the patterns of emergency shelter stays of single persons in three Canadian cities of different sizes (i.e., Toronto, Ottawa, and Guelph). Similar to findings of previous research conducted in large American cities in the early 1990s, cluster analyses defined three clusters with distinct patterns of shelter stays (temporary, episodic, and long stay). A temporary cluster (88–94 per cent) experienced a small number of homeless ep…
A Comprehensive Assessment of Health Care Utilization Among Homeless Adults Under a System of Universal Health Insurance
Objectives. We comprehensively assessed health care utilization in a population-based sample of homeless adults and matched controls under a universal health insurance system. Methods. We assessed health care utilization by 1165 homeless single men and women and adults in families and their age- and gender-matched low-income controls in Toronto, Ontario, from 2005 to 2009, using repeated-measures general linear models to calculate risk ratios and…
Universal Health Insurance and Health Care Access for Homeless Persons
Objectives. We examined the extent of unmet needs and barriers to accessing health care among homeless people within a universal health insurance system. Methods. We randomly selected a representative sample of 1169 homeless individuals at shelters and meal programs in Toronto, Ontario. We determined the prevalence of self-reported unmet needs for health care in the past 12 months and used regression analyses to identify factors associated with u…
Enriching qualitative research by engaging peer interviewers: A Case Study
Engaging peer-interviewers in qualitative inquiry is becoming more popular. Yet, there are differing opinions as to whether this practice improves the research process or is prohibitively challenging. Benefits noted in the literature are improved awareness/acceptance of disenfranchised groups, improved quality of research, and increased comfort of participants in the research process. Challenges include larger investment in time and money to hire…
Is Homelessness Hazardous to Your Health: Obstacles to the Demonstration of a Causal Relationship
Health Status, Quality of Life, Residential Stability, Substance Use, and Health Care Utilization among Adults Applying to a Supportive Housing Program
Residential Stability Reduces Unmet Health Care Needs and Emergency Department Utilization among a Cohort of Homeless and Vulnerably Housed Persons in Canada
Factors Associated with Poor Mental Health Status Among Homeless Women With and Without Dependent Children
High Utilizers of Emergency Health Services in a Population-Based Cohort of Homeless Adults
Objectives. We identified predictors of emergency department (ED) use among a population-based prospective cohort of homeless adults in Toronto, Ontario. Methods. We assessed ED visit rates using administrative data from the Institute for Clinical Evaluative Sciences (2005–2009). We then used logistic regression to identify predictors of ED use. Frequent users were defined as participants with rates in the top decile (≥ 4.7 visits per person-year…
Longitudinal interrelationships of mental health discrimination and stigma with housing and well-being outcomes in adults with mental illness and recent experience of homelessness
Are resilience and perceived stress related to social support and housing stability among homeless adults with mental illness
Perceived stress has been associated with adverse health outcomes. Although people experiencing homelessness often report multiple acute and chronic stressors, research on resilience and perceived stress on the general homeless population is limited. This longitudinal study examined homeless adults with mental illness who were part of a 24-month trial of Housing First to explore: (a) changes in levels of resilience and perceived stress during the…
The elusive goal of social integration: A critical examination of the socio-economic and psychosocial consequences experienced by homeless young people who obtain housing
The health of homeless immigrants
BACKGROUND: This study examined the association between immigrant status and current health in a representative sample of 1189 homeless people in Toronto, Canada. METHODS: Multivariate regression analyses were performed to examine the relationship between immigrant status and current health status (assessed using the SF-12) among homeless recent immigrants ( 10 years since immigration) and Canadian-born individuals recruited at shelters and meal …
Housing Quality in a Randomized Controlled Trial of Housing First for Homeless Individuals with Mental Illness: Correlates and Associations with Outcomes
Housing quality (HQ) is associated with mental health, and may mediate outcomes in housing interventions. However, studies of housing interventions rarely report HQ. The purpose of this study was to describe HQ in a multi-site randomized controlled trial of Housing First (HF) in five Canadian cities and to examine possible differences by treatment group (HF recipients and treatment-as-usual (TAU) participants who were able to find housing through…
Homelessness & Health in Canada
Psychological Services, Centre for Addiction and
Homelessness and the Response to Emerging Infectious Disease Outbreaks: Lessons from Sars
The Relationship Between Housing Conditions and Health Status of Rooming House Residents in Toronto
Socioeconomic Misclassification in Ontario’s Health Care Registry
Housing Trajectories, Risk Factors, and Resources among Individuals Who Are Homeless or Precariously Housed
This study identifies time-patterned trajectories of housing stability among homeless and vulnerably housed individuals who participated in a multisite four-year longitudinal study in Canada. Findings show four distinct trajectories for the homeless and vulnerably housed: high levels of sustained housing stability, improving levels over time leading to high levels of housing stability, decreasing levels of housing stability over time, and low lev…
Patterns and effects of social integration on housing stability, mental health and substance use outcomes among participants in a randomized controlled Housing First trial
Dynamic Sustainability: Practitioners’ Perspectives on Housing First Implementation Challenges and Model Fidelity Over Time
Objectives: Although Housing First (HF) is a popular evidence-based intervention for persons experiencing homelessness and mental illness, research exploring its sustainability over time is scant. This mixed methods study captures practitioners' perspectives on key shifts in implementation of Housing First in a large urban center, and factors affecting fidelity to the model over time. Methods: This study uses fidelity assessments, at baseline and…
Increasing Accessibility for Community Participants at Academic Conferences
The 4th ICUH had a significant impact on community registrants and provided valuable opportunities to bridge academic and community divides. These data support the need for comprehensive strategies for community engagement at health conferences
The Effect of a Housing First Intervention on Acute Health Care Utilization among Homeless Adults with Mental Illness: Long-term Outcomes of the At Home/Chez-Soi Randomized Pragmatic Trial
We assessed the effects of the Toronto Site Housing First (HF) intervention on hospitalizations and emergency department (ED) visits among homeless adults with mental illness over 7 years of follow-up. The Toronto Site is part of an unblinded multi-site randomized pragmatic trial of HF for homeless adults with mental illness in Canada, which followed participants up to 7 years. Five hundred seventy-five participants were recruited and classified …
Mortality Among Men Using Homeless Shelters in Toronto, Ontario
CONTEXT: Homeless persons in US cities have high mortality rates. However, few comparison data exist for death rates among homeless persons in other developed countries. OBJECTIVES: To compare mortality rates among men using homeless shelters and the general population in Toronto, Ontario, and to determine whether mortality rates differ significantly among men using homeless shelters in Canadian and US cities. DESIGN: Cohort study conducted from …
Is Homelessness Hazardous to Your Health: Obstacles to the Demonstration of a Causal Relationship
The Relationship Between Housing Conditions and Health Status of Rooming House Residents in Toronto
Socioeconomic Misclassification in Ontario’s Health Care Registry
Interventions to Improve the Health of the HomelessA Systematic Review
Homelessness and Health in Canada: Research Lessons and Priorities
Le logement en tant que déterminant socio-économique de la santé: Résultats d’une évaluation des besoins, des lacunes et des possibilités (EBLP) de recherche à l’échelle nationale
The Effects of Housing Status on Health-Related Outcomes in People living with HIV: A Systematic Review of the Literature
Homeless People’s Perceptions of Welcomeness and Unwelcomeness in Healthcare Encounters
BACKGROUND: Homeless people face many barriers to obtaining health care, and their attitudes toward seeking health care services may be shaped in part by previous encounters with health care providers. OBJECTIVE: To examine how homeless persons experienced "welcomeness" and "unwelcomeness" in past encounters with health care providers and to characterize their perceptions of these interactions. DESIGN: Qualitative content analysis of 17 in-depth …
Population mortality during the outbreak of Severe Acute Respiratory Syndrome in Toronto
Limitations on access to medical services during the 2003 SARS outbreak in Toronto had no observable impact on short-term population mortality. Effects on morbidity and long-term mortality were not assessed. Efforts to contain future infectious disease outbreaks due to influenza or other agents must consider effects on access to essential health care services
Health Care Cost Matters for Homeless People: An Example of Costing Mental Health and Addiction Services in Homeless Shelters in Canada
Increasing Accessibility for Community Participants at Academic Conferences
The 4th ICUH had a significant impact on community registrants and provided valuable opportunities to bridge academic and community divides. These data support the need for comprehensive strategies for community engagement at health conferences
Homelessness and the Response to Emerging Infectious Disease Outbreaks: Lessons from Sars
Mortality among residents of shelters, rooming houses, and hotels in Canada: 11 Year Follow-Up Study
OBJECTIVE: To examine mortality in a representative nationwide sample of homeless and marginally housed people living in shelters, rooming houses, and hotels. DESIGN: Follow-up study. SETTING: Canada 1991-2001. PARTICIPANTS: 15 100 homeless and marginally housed people enumerated in 1991 census. MAIN OUTCOME MEASURES: Age specific and age standardised mortality rates, remaining life expectancies at age 25, and probabilities of survival from age 2…
Multidimensional Social Support and the Health of Homeless Individuals
The health of homeless immigrants
BACKGROUND: This study examined the association between immigrant status and current health in a representative sample of 1189 homeless people in Toronto, Canada. METHODS: Multivariate regression analyses were performed to examine the relationship between immigrant status and current health status (assessed using the SF-12) among homeless recent immigrants ( 10 years since immigration) and Canadian-born individuals recruited at shelters and meal …
Drug problems among homeless individuals in Toronto, Canada: Prevalence, drugs of choice, and relation to health status
Drug use is common among homeless individuals in Toronto. Current drug problems are associated with poorer mental health status but not with poorer physical health status
Universal Health Insurance and Health Care Access for Homeless Persons
Objectives. We examined the extent of unmet needs and barriers to accessing health care among homeless people within a universal health insurance system. Methods. We randomly selected a representative sample of 1169 homeless individuals at shelters and meal programs in Toronto, Ontario. We determined the prevalence of self-reported unmet needs for health care in the past 12 months and used regression analyses to identify factors associated with u…
Low Rates of Cervical Cancer Screening Among Urban Immigrants: A Population-Based Study in Ontario, Canada
OBJECTIVE: Women who are immigrants or socioeconomically disadvantaged have been found to have significantly lower cervical cancer screening rates than their peers in Toronto, Ontario, Canada. The objective of this study was to examine rates of appropriate cervical cancer screening among women living in Ontario, Canada, using recent registration with Ontario's universal health insurance plan as an indicator of immigrant status. METHODS: This retr…
The At Home/Chez Soi trial protocol: A pragmatic, multi-site, randomised controlled trial of a Housing First intervention for homeless individuals with mental illness in five Canadian cities
Introduction Housing First is a complex housing and support intervention for homeless individuals with mental health problems. It has a sufficient knowledge base and interest to warrant a test of wide-scale implementation in various settings. This protocol describes the quantitative design of a Canadian five city, $110 million demonstration project and provides the rationale for key scientific decisions. Methods A pragmatic, mixed methods, multi-…
The assessment of food security in homeless individuals: A comparison of the Food Security Survey Module and the Household Food Insecurity Access Scale
Objective To compare the Household Food Insecurity Access Scale (HFIAS), the US Food Security Survey Module (US FSSM) and a modified version of the US FSSM in which references to buying food were changed to references to getting food, in terms of their classification of food security levels among homeless individuals, and to determine which of these instruments was most preferred by homeless individuals. Design A cross-sectional survey. Setting R…
Cognitive Interviewing Methods for Questionnaire Pre-Testing in Homeless Persons with Mental Disorders
Health Status, Quality of Life, Residential Stability, Substance Use, and Health Care Utilization among Adults Applying to a Supportive Housing Program
Hospital Costs and Length of Stay Among Homeless Patients Admitted to Medical, Surgical, and Psychiatric Services
BACKGROUND: Homeless individuals often suffer from serious health conditions and are frequently hospitalized. This study compares hospitalization costs for homeless and housed patients, with and without adjustment for patient and service characteristics. METHODS: Administrative data on 93,426 admissions at an academic teaching hospital in Toronto, Canada, were collected over a 5-year period. These data included an identifier for patients who were…
Inequalities in Determinants of Health Among Aboriginal and Caucasian Persons Living With HIV/Aids in Ontario: Results From the Positive Spaces, Healthy Places Study
Medicine (104 works) · Homelessness and Social Issues (101 works) · Psychiatry (60 works) · Gerontology (58 works) · Mental health (50 works) · Environmental health (48 works) · Psychology (48 works) · Food Security and Health in Diverse Populations (41 works) · Population (35 works) · Sociology (35 works)