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Health Care for Individuals Experiencing Homelessness

Health Care Problems for Individuals Experiencing Homelessness

Roughly 3.5 million Americans experience homelessness each year. Individuals experiencing homelessness have high rates of acute and chronic medical illnesses and poor access to health care. It is crucial to understand how this vulnerable population is affected by various health care issues in order to create policies for improved medical treatment and prevention of future illnesses. With regards to the current global health issue, the COVID-19 pandemic, people experiencing homelessness are at a higher risk of contracting COVID-19. Around 200,000 adults experiencing homelessness are over the age of 50 and 84% of adults have existing physical health conditions, which means that they are at a higher risk of being affected by the virus. Additionally, it is more difficult for individuals experiencing homelessness to follow the recommendations to prevent COVID-19 such as avoiding certain crowded locations (e.g. shelters). To learn more about homelessness and COVID-19, take a look at this site.

People experiencing homelessness face many healthcare barriers such as barriers with medical or surgical care, prescription medications, mental health care, eyeglasses and dental care. These issues are multidimensional with many contributing factors. For example, they are typically due to poor socioeconomic status and lack of health insurance coverage. Food insufficiency also may have contributed to the unmet needs as expenses could have been directed towards obtaining sustenance, leading to higher rates of medical and mental illnesses. Furthermore, employment may have led individuals to prioritize work over healthcare because when there is only one source of income for those experiencing homelessness or poverty, establishing a stable source of income is the goal. The jobs they engage in are low-wage jobs, which often do not include health care benefits, making it even more difficult to prioritize healthcare. A surprising statistic shows that employed individuals experiencing homelessness are more likely to be uninsured than their unemployed counterparts.

Health Care Services for Individuals Experiencing Homelessness

Various factors, like daily activities, alcohol and drug abuse, social isolation, and distrust, affect how individuals experiencing homelessness receive and/or respond to services aimed specifically at them. Daily activities refers to rough day-to-day living conditions that may prevent individuals from maintaining a supply of medication, steering clear of alcohol, etc... Social isolation may make it more difficult for individuals to develop trusting relationships, which contributes to the lack of cooperation with ;’healthcare providers. However, certain qualities of programs can enhance the ability to provide for this vulnerable population: communication and coordination. Communication refers to effectively delivering information to the people and agencies involved in the health care of people experiencing homelessness. Coordination refers to connecting individuals to a wider range of services provided by other agencies (e.g. housing, social services, etc…).

There are various specialized health care approaches including convalescent care and residential placement. Convalescent care provides a place for individuals experiencing homelessness to recover after being discharged from the hospital. Sometimes, an individual’s condition is not severe enough to stay in the hospital, however, returning to an unsheltered place may delay their recovery. This is where convalescent care will be beneficial. Residential placement provides supportive living places for individuals experiencing homelessness with physical and mental disabilities. For example, the Veterans Administration community placement program secures housing for mentally or physically disabled veterans who are at a high risk of becoming homeless.

In 1985, Robert Wood Johnson Foundation of Princeton, New Jersey and the Pew Memorial Trust of Philadelphia jointly created the Healthcare for the Homeless projects with the mission to address health and related needs for individuals experiencing homelessness. The joint program was created in response to the growth of homelessness in large cities in the United States and existing agencies could not cope with the increasing problem. They had a mission to successfully provide healthcare services for people experiencing homelessness by incorporating certain elements. First, a holistic approach will allow providers to formulate treatment plans by recognizing the interaction between the illness and the state of being homeless. Second, having empathetic staff interact with the vulnerable population will allow the formation of trusting relationships, thereby increasing the effectiveness of treatment delivery and response. Third, offering a broad range of health care services will be beneficial. For example, a program can offer convalescent care, prenatal care, and treatment for alcohol problems.

Several issues were raised by the Johnson-Pew project models including stationary vs. mobile clinics and size of area to be served. Although stationary clinics provided sophisticated technology, it can be viewed as threatening to patients that previously had negative experiences in healthcare settings with similar technology. Mobile teams are less threatening and can help patients overcome any reluctance to reach out for help. However, they are less stable and can not carry more advanced technology. Incorporating components of both stationary and mobile clinics may be a good idea but further studies need to be conducted. With regards to the size of area to be served, this is dependent on the resources available to cover a range of services or geographic size of the area.

How to Help Individuals Experiencing Homelessness

To learn more about helping to end homelessness, visit this site.

In summary, you can do the following: contribute, advocate, reach out, and educate. Here are some things you can contribute: clothing, food, computers, books, job opportunities, and more. In regard to job opportunities, encourage your company or school to hire people experiencing homelessness. Next, advocacy refers to working with those affected and various sectors of the community (e.g. county officials, members of Congress, direct service providers, etc…) to create systemic changes. Here are some ways to advocate: involve the media, join the Housing not Handcuffs Campaign that works towards decriminalizing homelessness, become more aware of your language by avoiding referring to people experiencing homelessness in derogatory ways, and more. You can also reach out by volunteering at a shelter and offering professional skills (such as medical, dentistry, tutoring, etc…). Another way to help is by educating yourself and educating others; learn about the root causes of homelessness and teach others how to get involved in ending homelessness.

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