The Many Faces of

Homelessness
The Department of
Housing and Urban
Development defines chronic
homelessness as an individual
who has been homeless at
least four times in the last
three years and has a
disability, or someone who has
experienced homelessness for
a year or longer (National
Alliance to End Homelessness,
2015).

Homelessness
affects a magnitude of
individuals without
regard to gender,
religion, ethnicity, or
background.
Homelessness affects
individuals in urban,
suburban, and rural
settings and
communities (LebrunHarris, 2013).
Homeless individuals
make up a large
vulnerable population in
our country and

Homeless individuals are at a great risk for multiple diseases, injuries, morbidity, and
mortality. Most individuals do not have a primary care individual that follows their state of
health and manages their chronic illnesses so more often than not they are primarily seen in
an emergency room for acute needs or exacerbations of chronic illnesses. Homeless
individuals frequently wait to seek medical attention until it is absolutely necessary and their
lives are at risk. Reasons for not obtaining proper medical care that increase vulnerability
include:

Financial instability
Lack of insurance
Approximately 30% of
Fear of bias and
judgement
from healthcare workers
homeless
individuals
Lack of transportation
have a serious mental
Mental health issues
illness and at least 50%
Alcohol and substance addiction issues
of individuals have
substance abuse and
addiction illness,
Nurses and other
medical personnel often
have a bias towards
homeless individuals and a
lack of cultural sensitivity
and knowledge of the
specialized care they
require, (Stanley, 2013). It is
important to deliver care that is
compassionate, non-judgmental,
and takes special regards to the
homeless individuals personal
needs. Barriers to compliance must
be overcome and resources are
required for issues such as
transportation, ability to pay for
medications, preventing
medications and supplies from
being stolen, and obtaining clean
food and water. An abundance of
education must be provided to
homeless individuals about their
increased risks, health promotion,
and how to decrease chances for

Our current system of only treating the acute issues at hand and not
addressing the long term issues is simply not working. Homelessness is
a growing issue is our country and represents a large source of health
spending in the United States, (Evans, 2012).

Actions must be taken to

combat homelessness and start to
rectify the problems faced by this
vulnerable population and alleviate
the financial strain put on the
healthcare system. Every hospital
should employ a team of educated
staff members specialized in
working with homeless individuals.
The team must consist of doctors,
nurses, social workers, discharge
planning, drug and addiction
specialist, and therapist that are
knowledgeable about the
environments that homeless
individuals live in, their specific
needs, and the resources available
in the community. The healthcare
needs of the homeless population
must be approached differently
than the general population.
Healthcare providers must be aware
of the unique needs and
understand how to facilitate and
improve the care for homeless
individuals (Seiler & Moss, 2012).

Conclusion
The homeless population in our country is very vulnerable and need our help. They are
at a great risk and have increased morbidity and mortality. Homelessness puts a great
financial strain on healthcare and the current trends is only getting worse. Actions must be
taken to create resolutions to these problems. Providing a collaborative care team, along
with community resources and housing options is the basis for the necessary change.

References

vans, M. (2012). Residential therapy; Hospitals take on finding housing for homes patients, hoping
to reduce readmissions, lower costs. Modern Healthcare, 42(39), p.0006. Retrieved from
http://0-go.galegroup.com.libcat.ferris.edu/ps/i.do?&id=GALE|
A303531763&v=2.1&u=lom_ferrissu&it=r&p=ITOF&sw=w#

ebrun-Harris, L.A., Baggett, T.P., Jenkings, D.M., Sripipatana, A., Shama, R., Hayashi, A.S., Daly,
C.A., Ngo-Metzger, Q. (2013). Health Services Research, 48(3), p.992-1017. Doi:
10.1111/1475-6773.12009

eiler, A. J. and Moss, V. A. (2012). The experiences of nurse practitioners providing health care to
the homeless. Journal of the American Academy of Nurse Practitioners, 24: 303312. doi:
10.1111/j.1745-7599.2011.00672.x

tanley, M.J. (2010). Teaching about vulnerable populations: Nursing students experience in a
homeless center. Journal of Nursing Education, 52(10), p.585-588. Doi: 10.3928/0148483420130913-03