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Structural violence as a driver of COVID-19 vaccine hesitancy and low vaccine uptake among people experiencing homelessness in Toronto, Canada: A qualitative study

Author

Listed:
  • Jenkinson, J.I.R.
  • Wigle, J.
  • Richard, L.
  • Tibebu, T.
  • Orkin, A.M.
  • Thulien, N.S.
  • Kiran, T.
  • Gogosis, E.
  • Crichlow, F.
  • Dyer, A.P.
  • Gabriel, M.D.
  • Hwang, S.W.

Abstract

People experiencing homelessness are at increased risk of contracting SARS-CoV-2 and of severe complications of COVID-19. Vaccination is promoted as a key strategy to protect against severe illness from SARS-CoV-2 infection, but rates of vaccination among people experiencing homelessness are lower than the general population. Studies suggest lower uptake is a result of vaccine hesitancy, but few theoretically engage with the structural drivers of vaccine hesitancy. We explore the role of structural violence in shaping COVID-19 vaccine decision-making among people experiencing homelessness.

Suggested Citation

  • Jenkinson, J.I.R. & Wigle, J. & Richard, L. & Tibebu, T. & Orkin, A.M. & Thulien, N.S. & Kiran, T. & Gogosis, E. & Crichlow, F. & Dyer, A.P. & Gabriel, M.D. & Hwang, S.W., 2025. "Structural violence as a driver of COVID-19 vaccine hesitancy and low vaccine uptake among people experiencing homelessness in Toronto, Canada: A qualitative study," Social Science & Medicine, Elsevier, vol. 365(C).
    • Handle: RePEc:eee:socmed:v:365:y:2025:i:c:s0277953624010426
    DOI: 10.1016/j.socscimed.2024.117588
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    References listed on IDEAS

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    1. Enrico Bentivegna & Silvia Di Meo & Anita Carriero & Nadia Capriotti & Alberto Barbieri & Paolo Martelletti, 2022. "Access to COVID-19 Vaccination during the Pandemic in the Informal Settlements of Rome," IJERPH, MDPI, vol. 19(2), pages 1-11, January.
    2. Elizabeth J. Williamson & Alex J. Walker & Krishnan Bhaskaran & Seb Bacon & Chris Bates & Caroline E. Morton & Helen J. Curtis & Amir Mehrkar & David Evans & Peter Inglesby & Jonathan Cockburn & Helen, 2020. "Factors associated with COVID-19-related death using OpenSAFELY," Nature, Nature, vol. 584(7821), pages 430-436, August.
    3. Tan, Si Ying & Foo, Chuan De & Verma, Monica & Hanvoravongchai, Piya & Cheh, Paul Li Jen & Pholpark, Aungsumalee & Marthias, Tiara & Hafidz, Firdaus & Prawidya Putri, Likke & Mahendradhata, Yodi & Gia, 2023. "Mitigating the impacts of the COVID-19 pandemic on vulnerable populations: Lessons for improving health and social equity," Social Science & Medicine, Elsevier, vol. 328(C).
    4. Julia Corey & James Lyons & Austin O’Carroll & Richie Stafford & Jo-Hanna Ivers, 2022. "A Scoping Review of the Health Impact of the COVID-19 Pandemic on Persons Experiencing Homelessness in North America and Europe," IJERPH, MDPI, vol. 19(6), pages 1-30, March.
    5. repec:plo:pmed00:0050225 is not listed on IDEAS
    6. Paul E Farmer & Bruce Nizeye & Sara Stulac & Salmaan Keshavjee, 2006. "Structural Violence and Clinical Medicine," PLOS Medicine, Public Library of Science, vol. 3(10), pages 1-6, October.
    7. Krieger, N., 2012. "Methods for the scientific study of discrimination and health: An ecosocial approach," American Journal of Public Health, American Public Health Association, vol. 102(5), pages 936-945.
    8. McNeil, Ryan & Small, Will & Wood, Evan & Kerr, Thomas, 2014. "Hospitals as a ‘risk environment’: An ethno-epidemiological study of voluntary and involuntary discharge from hospital against medical advice among people who inject drugs," Social Science & Medicine, Elsevier, vol. 105(C), pages 59-66.
    9. Whittle, Henry J. & Palar, Kartika & Hufstedler, Lee Lemus & Seligman, Hilary K. & Frongillo, Edward A. & Weiser, Sheri D., 2015. "Food insecurity, chronic illness, and gentrification in the San Francisco Bay Area: An example of structural violence in United States public policy," Social Science & Medicine, Elsevier, vol. 143(C), pages 154-161.
    10. Krieger, N., 2008. "Proximal, distal, and the politics of causation: What's level got to do with it?," American Journal of Public Health, American Public Health Association, vol. 98(2), pages 221-230.
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