Populations experiencing Homelessness

What type of population has experienced the single largest increase in homelessness?

• People in families with children

• Overall though, number of people experiencing homelessness is increasing

Examples of factors that contribute to homelessness

• Poverty

• Lack of affordable housing

• Lack of affordable healthcare

• Lack of employment

• Domestic violence

• Mental illness

• Addiction disorders

• Personal/financial crisis

• Natural disasters 

• Personal choice 

In 2/3 of people who file for bankruptcy, what is often a key contributor?

Medical issues + lack of affordable health care

What factors may contribute to homelessness specifically in youth and young adults?

• Substance misuse

• Mental health problems

• Foster care

• Hx of being in juvenile detention or jail

• LGBTQ

• Lack of high school diploma/GED

What factor is most highly correlated with increased risk of youth homelessness?

Lack of high school diploma/GED

What law/act provides security/resources for youth experiencing homelessness?

• Available to students experiencing housing instability/homelessness

• Helps remove some barriers they might face

• Federal law → meant to protect the education/wellbeing of students experiencing homelessness

  • Access to resources that make education more accessible, less difficult, and more equitable

When providing care to those experiencing homeless, the public health nurse needs to do what 3 things in order to provide the best care?

• Establish trust

  • (they’re already vulnerable, likely distrustful of healthcare. PHN needs to establish a trusting relationship)

• Self-clarification of beliefs and values about homelessness, poverty, addictions, and mental disorders 

  • (can’t provide good care if you don’t treat your clients with respect)

• Comprehensive and holistic approach

  • (need to treat and consider all aspects. Poor health is multifactorial, and homelessness is complex)

Primary levels of prevention for homelessness 

• Advocating for affordable housing, employment opportunities, better access to health care

• Financial counseling 

• Assistance in accessing social services, temp housing, health care to avoid a crisis

• Health education 

  • Parenting skills, violence prevention, anger management, coping skills, healthy eating, hygiene, immunization

Secondary prevention methods in the context of homelessness

• Assessment of client needs for:

  • Housing, health care, education, social services, employment

• Screening for communicable diseases and other health problems

• Assessment of barriers to accessing services

  • Lack of transportation

Tertiary prevention methods in the context of homelessness

• Rehabilitative care 

• Support clients that are already homeless

• Treating complications of advanced disease 

Case management

• Seamless delivery of services as people transition from one level of care to another

• “Managing the case”

Advocacy 

Development of innovative modes for response to homelessness

Advocate at each level of prevention for positive change 

Why do people experiencing homelessness exhibit severe oral health problems?

• Poverty

• Substance use

• Poor nutrition

• Coexisting illnesses

Health issues that homeless populations face

• Acute health problems

  • Straightforward. May experience injury, but also increased risk of acute illnesses

• Chronic health problems

  • TB, HIV/AIDS, diabetes, HTN

  • Addiction and mental disorders

• Trauma and criminal victimization

• Severe oral health problems

• HIGH prevalence of HIV