Off-campus WSU users: To download campus access dissertations, please use the following link to log into our proxy server with your WSU access ID and password, then click the "Off-campus Download" button below.
Non-WSU users: Please talk to your librarian about requesting this dissertation through interlibrary loan.
Access Type
WSU Access
Date of Award
January 2025
Degree Type
Dissertation
Degree Name
Ph.D.
Department
Psychology
First Advisor
Paul Toro
Abstract
This study examined the composition, service access, and physical and mental health of three cohorts of homeless individuals in Wayne County, Michigan, U.S.A., over a 23-year period. This research project aimed to examine (1) the perceived importance and ease of access to a range of community services; (2) changes in psychological distress and mental health diagnoses over time; (3) the impact of the COVID-19 pandemic on physical health and psychological distress. This study also explored potential profiles of homeless individuals based on the intersection of sociodemographic factors, service accessibility, and psychological distress. The central hypothesis guiding this research posited that limited access to critical community services would be associated with poor outcomes. Across all aims, findings consistently demonstrated that affordable permanent housing remained the most critically needed yet persistently inaccessible service across cohorts. Although access to medical and dental care improved pre-pandemic, it sharply declined following COVID-19. Psychologicaldistress and mental health diagnoses increased over time, with later cohorts showing higher rates of affective disorders and schizophrenia. Higher psychological distress more than doubled the odds of contracting COVID-19, independent of age, education, sex, or race. Finally, latent profile analysis identified two distinct subgroups: one marked by younger age, lower education, and greater barriers to employment services, and another characterized by elevated psychological distress and later data collection time points.
Recommended Citation
Jennings, Matthew, "Examining Risk Factors, Needed Services, And Barriers To Care For Homeless Adults: A Community Study Examining Wayne County, Michigan Over 20 Years" (2025). Wayne State University Dissertations. 4284.
https://digitalcommons.wayne.edu/oa_dissertations/4284