Abstract
The purpose of this paper is to discuss current health issues among the homeless population. The paper will also explore the reasons behind homelessness and the society’s perception. According to the National Coalition for the Homeless an individual experiencing homelessness fall into one of the three categories such as, chronic, transitional or episodic homelessness. Medicine or treatment for homeless individuals seeking medical attention, are not as accessible compared to non-homeless individuals due to the culture and rough life style. Neglecting proper housing and health care to underprivileged people is inhumane and increases the homeless population.
Keywords: homelessness, chronic, transitional, episodic
Homelessness and Health Care
Throughout history there has always been a portion of society living in disadvantaged conditions. With the current high cost of living, global issues, unemployment rate on the rise, and low wages, many Americans are finding themselves homeless. One would think that in this advanced century, there would not be individuals living without the basic necessities such as food, water, and shelter. Unfortunately, there are millions of people with nowhere to sleep. Besides the many problems homeless people face daily, one of the leading problems is health care. Being homeless with limited access to health care or shelter in conjunction with mental illness or exposure to harmful diseases can lead to poor health, or
The lack of mental health services available to the mentally-ill and the deinstitutionalization of mental health hospitals have created a public health concern. These issues along with a failed continuum of care plans and a lack of community mental health services have been major contributing factors to homelessness. In addition, the strict guidelines for psychiatric hospitalization are critical when analyzing homelessness. In many cases, only the critically ill are meeting clinical criteria for hospitalization, leaving those who have significant mental health problems to fend for themselves. The link between homelessness and mental health is acknowledged but requires reform.
Homelessness is an issue in American society today that affects anywhere from 800,000 to 3.5 million people. There are a substantial amount of people that are without shelter, food, or employment, and there are numerous other people affected by poverty and homelessness. People living in nearly every city in the United States are affected by homelessness due to the large amounts of homeless individuals living on the streets and begging for money, food, and other necessities. The issue of homelessness has been a constant problem since the conquering of the New World, and soup kitchens and homeless shelters have not been able to fully end homelessness. Especially today, with a lack of affordable housing and high unemployment rates, homelessness is prevalent.
Homelessness is the condition of people without a permanent place to live, such as a house. People who are homeless are unable to acquire and maintain regular, safe, secure housing. It has been a problem for a long time but it has become a social issue from the past few decades. People think about homelessness as one’s personal problem and seek them to face it. Moreover, the majority of the people think that the only reason behind being homelessness is their choice and just laziness to do any work and lead to a better life. But that’s just one incomplete perception about the homelessness.
The homeless are a vulnerable population. They are defined by the U.S. Department of Health and Human Services as “an individual who lacks housing (without regard to whether the individual is a member of a family), including an individual whose primary residence during the night is a supervised public or private facility (e.g., shelters) that provides temporary living accommodations, and an individual who is a resident in transitional housing.” (The National Health Care for the Homeless Council, 2016). They are a social group throughout the US who are susceptible to all of the life’s cruelties. They are much more at risk for adverse illnesses due to their lack of available resources and medical help. Many have predetermined illnesses which need daily treatment but cannot acquire the medication needed. The homeless population lacks the funding for life’s necessities, thus the luxury of insurance and medicine is a dream.
Homelessness has become an evolving epidemic of our time, and the health implications associated with being homeless makes it that much worse. Homeless people are at major risk for premature death and a wide range of health problems such as HIV, skin blemishes, and much more. It is very difficult for homeless people to fix their health issues due to the difficulty of accessing health care possibly because of missing health cards, or simply because of the stigma placed on them when they enter a public facility. Whatever the problem may be that is forcing more people to become homeless, it must be solved, and quickly before our world turns into a travesty.
In the United States the homeless population continues to grow rapidly. Homelessness has been a public health issue for many decades. Often times these individuals feel as though society has turned a blind eye to them. This at risk population is seen by society as lazy or chose to live a life on the streets, but if one would examine this population closely would see that there is more to this at risk population than what society has labeled them as. The forces, which affect homelessness, are multifaceted. Social forces such as family breakdown, addictions, and mental illnesses are in combined with structural forces such as lack of low-cost housing, insufficient health services, and poor economic conditions. Many would
The most recent survey of homeless individuals conducted January 29, 2014 revealed 958 homeless adults with no dependants, 70 of which were completely unsheltered, and an additional 130 homeless adults who also had dependent children with them. 208 of these homeless adults are chronically homeless (HUD’s 2014 Continuum of Care Homeless Assistance Programs, Populations, and Subpopulations, 2014).Wayside Christian Mission reaches approximately 7,000 homeless individuals annually (Wayside Christian Mission, 2007). In the Journal of General Internal Medicine, a majority of homeless individuals surveyed stated that they felt discriminated against or that they received lesser care because of their poverty or homelessness (Wen, Hudak, & Hwang, 2007). Homeless and impoverished individuals suffer from high rates of depression, psychiatric illness, alcohol and or substance abuse, HIV/AIDS, TB, Trauma, preterm birth, COPD, low birth weight, musculoskeletal problems, decreased access to care, foot problems, malnutrition, and high Emergency Room utilization (Stanhope & Lancaster, 2014). Not only do homeless persons have a high rate of illness, but they are also less able to appropriately treat health problems. Many homeless individuals have limited access to care, cannot afford medications or nutritious food, and may have difficulty with managing a strict
There are currently 564,708 homeless individuals in the United States (U.S.), however this is just an estimate as there are probably hundreds that go uncounted, during PIT (point-in-time count) or remain unregistered with non-profit agencies providing services (The National Alliance to End Homelessness, 2016). Before the Affordable Care Act (ACA) most homeless individuals did not have health insurance, as provisions for these individuals as well as the low-income population could only be accepted into the Medi-cal / Medicaid program, if they had children that were eligible. Since ACA was implemented a large percentage of the homeless are insured, but, this does not mean that the preexisting gaps and barriers to access health care do not exist. They do. Being homeless has been found to correlate to a poor health status (Robert Wood Johnson Foundation, 2016). In fact, homeless individuals are at risk and experience more chronic illness than someone who has housing. Additionally, once chronic illness develops in a homeless individual, they are at higher risk for comorbid conditions, new conditions (such as skin disorders and respiratory illness) and an acceleration in the development of their disease(s).
The clinical issues affecting the homeless individual can range from mental illness to health issues. Several clinical issues affect the homeless population because of lack of health insurance and clinical resources. “The clinical issues affecting homeless people are dental, vision, foot diseases, post-traumatic arthritis, HIV, TB, STD’s respiratory infections, diabetes, hypertension, and nutritional problems are all major clinical issues” (Zevin, 2013). Quite a few people are homeless and suffer from various clinical issues because they have no insurance, housing, support from family/friends, or program resources. It seems when populations such homelessness is so huge some are left behind with no help. Various social service organizations exist that cater to the homeless population, but so many individuals and families are not helped because of mis-direction. Health care is an important factor to many, especially those who do not have access to a health care facility. Social services resources are available as well as the human service
According to the American Journal of Public Health (AJPH), disease was prevalent in the newly homeless. This population accessed health care services at high rates in the year before becoming homeless. Significant improvements in health status were seen over the study period as well as a significant increase in the number who were insured (American Journal of Public Health, 2012). The homeless in Overtown face a variety of risks and barriers to their health. Firstly, a good number of the population suffers from mental illness, they suffer from a range of mental health problems from depression, personality disorders, schizophrenia and many more. Most are unable to treat their mental
Homelessness as a result of deinstitutionalization in the US increased dramatically, tripling in 182 cities over the court of the 1980s (Bagenstos, 2012). In addition, mental health and substance abuse is a major problem in across the country because of homelessness. According to the Substance Abuse and Mental Health Services Administration,20 to 25% of the homeless population in the United States suffers from some form of severe mental illness (DMHAS, 2014). Consequently, mental illnesses disrupt people’s ability to carry out key aspects of daily life, such as self-care and household responsibilities. As a result of these factors and the stresses of living with a mental disorder, people with mentally illnesses are much more likely to become homeless than the general population (Karger, & Stoesz, 2014). Even if homeless individuals with mental illnesses are provided with housing, they are unlikely to achieve residential stability and remain off the streets unless they have access to continued treatment and services. In Connecticut there are a number of housing options that are in place like supportive housing. Research has shown that supported housing is effective for people with mental illnesses (DMHAS, 2014). Unfortunately, in Connecticut, lack of funding is a significant barrier to the successful implementation of supported housing programs. Because of homelessness people cycle between street corner, jail cell and hospital beds, in addition the homeless who are
A review of the article: A Comprehensive Assessment of Health Care Utilization Among Homeless Adults Under a System of Universal Health Insurance
One of the biggest leading social issues around the world is homelessness. In the United States alone, there are more than half a million people experiencing homelessness. There are different factors that led a person to homelessness, economic, social, political issues, and natural disasters. But in the United States, homelessness is often caused by system failure, and people and with related issues. A brief history of homelessness, the issues documented during the early colonial period, back then it was viewed as a character flaw in the person and not outside causes. The Great Depression hits the United States hard and millions lost their jobs result in homelessness. Comes swooping in with the New Deal policy from presidents Franklin D. Roosevelt helps save the economy by providing jobs and helps reduce homeless population (Homelessness). In the early 80’s the economy was losing jobs again due to the decline of manufacturing, causes a high-rise in homelessness. That led to many cutbacks in affordable housing, medical care that makes many mentally ill patients unable to afford housing. With that many Individuals with disabilities or mental health issues that can’t afford proper health can be in danger of homelessness. But for those who are already living on the streets don’t have access to nutrient, personal hygiene, and other serious health conditions. There is some organization across the United States that provides health care service for
The social determinants of health are the conditions in which people are born, grow, live, work, and age (WHO, 2016). This current event relates to the social determinants of health because homelessness has a huge impact on someone’s overall health and quality of life. People who experience homelessness do not have the resources to maintain their health. This can lead to stress, depression, substance abuse, and a number of problems. They are exposed to communicable diseases, malnutrition and many other health issues. Over 500,000 Americans are homeless every night (Kertesz, 2016). This is why we have Health Care for the Homeless programs. The majority of federally funded organizations for the homeless are operated properly. But, there are some
The problems of homelessness and mental illness are inextricably intertwined. One way that mental illness impacts people's lives is that it oftentimes renders them unable to carry out the functions of daily life, such as keeping a job, paying their bills, and managing a household. In addition to disrupting the events of daily life, mental illness "may also prevent people from forming and maintaining stable relationships or cause people to misinterpret others' guidance and react irrationally" (National Coalition for the Homeless, 2009). What this means is that a population that is already vulnerable because of an inability to consistently manage self-care lacks the same safety net as much of the rest of society.