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Straight, No Chaser: Health Concerns of the Homeless

By Jeffrey Sterling, MD September 22, 2018

HomelessVeteran

We tend to take an out-of-sight, out-of-mind approach to a lot of things. The plight of homelessness is certainly one of them. The healthcare needs of the homeless should be of interest to you, because even if you’re not homeless, what’s happening to them can affect your health.

homelessness-estimates-by-state_hud

Let’s start with some interesting facts.

  • The U.S. Department of Housing and Urban Development places homeless estimates at over 610,000, although The National Law Center on Homelessness and Poverty places the number at 1.75 million.
  • An estimated 100 million people worldwide are homeless.
  • Nearly 20 percent of homeless people in the U.S. are either in New York City (11%) or Los Angeles (9%).
  • Approximately 12% of the adult homeless population are veterans; of this population, 40% are either African-American or Hispanic (despite accounting for only 15% of the veteran population).
  • 50% of the homeless population is estimated to be African-American.
  • 36% of the homeless population is estimated to be families with children.

homelessnesspoverty

Regarding health:

  • Approximately 66% of the homeless have problems with alcohol, drug abuse or mental illness.
  • Approximately 22% of the adult homeless population suffer from a severe and persistent mental illness.

Health concerns affecting the homeless disproportionately to the general population include the following:

  • Bronchitis
  • Environmental disorders (e.g. hypothermia, frostbite, heat exposure)
  • Infectious diseases such as pneumonia, wound and skin infections
  • Mental health disorders
  • Physical and sexual abuse
  • Substance abuse

The health risks are fairly straightforward.

  • The preponderance of the homeless and the relative inability for them to access healthcare means any infectious diseases they carry are able to be spread into the general population.
  • The presence of mental health disorders and substance abuse means the risky behaviors that correlate with these disorders are a threat to those exposed.
  • The presence of such a large population of children among the homeless increases the risk for future development of mental health disorders in these individuals.

The plight of the homeless lacks the level of advocacy needed to eradicate this plague on societies around the world. In the U.S., the circumstances of homeless veterans and the chronically homeless have received attention such that the number of homeless dropped 4% between 2012 and 2013. That said, there is a long way to go and much work that still needs to be done. Consider discussing this matter with any or all of your governmental representatives. Just because homelessness may be out-of-sight or out-of-mind doesn’t mean it’s out of reality.
Feel free to ask your SMA personal healthcare consultant any questions you have on this topic.
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