Chapter 30: The Homeless and Populations in Poverty

NUR 436: Comm & Population Health; MCUSON; Dr. Hall and Dr. Watts

People living in _____ are more likely to suffer from higher rates of chronic disease, increased hospitalizations, and shorter life expectancy

poverty

one factor influencing the growing numbers of poorer persons in the U.S is the changes in the _____

workforce

There are other reasons influencing the growing numbers of poorer persons in the U.S., but the lack of _____ is a major factor

jobs

the primary cause of the growing numbers of poorer persons in the U.S. is _____

vulnerability

_____ _____ _____ _____ are linked to exposure and level of susceptibility, severity and outcome of disease resulting in infections, metabolic or genetic disorder, degenerative process or malignancy

social determinants of health (SDOH)

If you live in _____, you are less likely to have access to healthy foods and safe neighborhoods and are more likely to have lower levels of education, decreased access to healthcare and engage in unhealthy behaviors and suffer worse health outcomes

poverty

Historically, _____ was defined as measuring household income, the number of individuals living in the home and a specified income poverty line

poverty

The Federal Poverty level guides eligibility for _____ assistance

federal

list the 4 federal assistance programs

• Supplemental Nutrition Assistance Program (SNAP)

• marketplace insurance

• Medicaid

• Children’s Health Insurance Program (Chip)

_____ populations have worse health outcomes and an increased sensitivity to risks factors than the general population

vulnerable

_____ _____ _____ _____: less likely to have access to healthy foods, safe neighborhoods & more likely to have lower levels of education, reduced access to care & lower quality health à higher rates of chronic disease -> worse health outcomes  and are more susceptible to risk factors than the general population

Social context —→ linked to risk for exposure & level of susceptibility, severity & outcome of disease resulting from infection, metabolic or genetic disorder, degenerative process or malignancy

social determinants of health (SDOH)

the _____ _____ _____ guides eligibility for federal assistance such as the Supplemental Nutrition Assistance program (SNP); which is food assistance,  marketplace health insurance, Medicaid and the Children’s Health Insurance program (CHIPs)

Federal Poverty Level

_____ _____ are families that live at twice (200%) of the Federal poverty level ($55,500 for a familiy of four)

low incomes

_____ _____ are those living at ½ (50%) of the Federal Poverty level ($13,875.00 for a family of four)

deep poverty

_____ _____ _____ _____ was developed in 2010 to evaluate poverty and outcomes adjusting for geographic differences in the cost of living and medical care

supplemental measure of poverty (SMP)

_____ _____ _____ looks at poverty across the domains of health, education and standard of living

multidimensional poverty index (MPI)

_____ _____ _____ are federal social programs that reduce the population living in poverty

safety net programs

During COVID-19, safety net programs were evident by providing additional money to those who were unemployed and extended unemployment by _____ weeks

13

For the self employed, a new type of _____ insurance was provided

unemployment

The safety net programs helped many families from experiencing downward _____

mobility

Nurses need to know about the safety net programs and how to _____ for policies which strengthen the safety net program

advocate

_____ adults have the highest poverty rate

older

_____ mothers, women, and children are more likely to live in poverty than men. (wage gaps, have lower rates of social security and retirement) — contributes to the older population living in poverty (largest group)

single

***there is a strong relationship between poverty and health which creates a cycle: poorer health status —→ decreased ability to work

_____ _____ have a higher incidence of diabetes, hypertension, overweight, obesity, asthma, HIV/AIDS, sexually transmitted infections (STIs)

minority women

_____ _____ generally have less income, education, and socioeconomic status; lower access to care

rural women

Of families living in poverty in the United States, those led by a _____ _____ make up the largest group. Most vulnerable group is single moms with _____ _____ _____.

single mother; substance abuse disorder

Population of those over _____ has grown by 33% over the past 10 years —→ “graying of America”

65

Gender & ethnic disparities —→ increased _____

poverty

_____ reasons —→ geographic, race/ethnicity, gender, debt, lack of retirement savings & serious illness

multifaceted

Enrollment in government safety programs can be a _____

lifeline

*** No uniform approach

Of those living in poverty, _____ relied on social security as their primary source of cash income

90%

Toxic _____ leads to increased obesity & hypertension in children, Type 2 diabetes, cardiovascular disease, COPD, depression, autoimmune disease

stress

high stress can affect a child’s _____

brain

Poor _____ control and self regulating behaviors – may lead to an increase in smoking and substance abuse which leads to an increase in mortality and morbidity

impulse

_____ is a significant cause of death and disability

trauma

when dealing with the homeless population, the nurse should have an understanding of _____ prior to dealing with this population

homelessness

The nurse will need to create a _____ environment and establish a therapeutic relationship

trusting

_____ ill persons are the least likely to receive community assistance

mentally

_____ _____ _____: an individual who lacks housing, whose primary residence during the night is supervised, shelters, temporary living conditions, people who are in transzonal housing

persons experiencing homelessness (PEH)

list some vulnerable populations experiencing homelessness

• Women, Children & Adult Youth

• LGBTQ+ youth

• Transgender & Gender Non-Conforming Adults

• The Mentally Ill

• Veterans

what is an example of a vulnerable individual: pregnant _____ with a substance abuse disorder (SUD) and is homeless

teen

Concept: _____ _____ _____ according to HRDS: an incarcerated individual, three families living in the same residence, and living in tents/tent cities

persons experiencing homelessness (PEH)

list some impacts of homelessness on health across the lifespan

• Numerous areas ranging from physical to emotional spheres

• Infectious diseases are more prevalent

• Life-threatening hypothermia

• Gender perspective

• Age perspective

• Health complexities

a person experiencing homelessness (PEH) according to US Health Resources and Service Administration (HRSA) are persons that lack housing even if it is overnight in a public or private facility (_____, living on the street in a tent or multiple families living in one house)

incarcerated

_____: supplemental nutrition program that provides free healthy foods, breastfeeding support, nutrition education and referrals to other services

Women, Infant, and Children (WIC)

_____ housing: homeless shelters on cold nights

emergency

What is the primary cause of vulnerability?

poverty

unique role of the nurse:

• Be aware of your biases. Evaluate your own personal, beliefs, values and knowledge about poverty. Example: Making home visits and the home is unkempt

• Nursing care disparities

• Create a trusting environment

• Do not make assumptions

• Develop a network of services & providers

• Advocate for affordable & accessible care

• Focus on prevention

• Know when to encourage

• Develop a personal network of support & provide self-care