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Housing is Healthcare
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ONC Editorial

Aug 24, 2023

With a safe space to sleep, nutritious food and a way to access and store medication, we can begin to reconnect the homeless with strong physical and mental health. (The opinions expressed in this article are those of the individual author, whose information can be found below.)

Beyond the safety and comfort of our homes, an ongoing public health crisis plagues our cities and neighborhoods. Homelessness impacts hundreds of thousands in the United States and is closely connected to poor physical and mental health. 

The Point-in-Time (PIT) count conducted by the United States Department of Housing and Urban Development (HUD) measured 580,466 homeless Americans on a single night in January 2020. Sixty-one percent of these individuals were in sheltered locations (emergency shelter or transitional housing) for the night, while 39 percent of these homeless individuals were unsheltered, or in abandoned buildings, on the streets or in other inhabitable locations. 

The number of chronically homeless people has increased by 15 percent. For the unsheltered homeless, this number has increased to 21 percent. But, what does homelessness have to do with healthcare? 

The National Health Care for the Homeless Council (NHCHC) describes poor health as a major cause of homelessness. People experiencing a health condition may need to take sick-leave from work, eventually exhausting their sick-pay or not being able to work on a consistent schedule. Too much time away from work can bring one’s employment status into question. 

Without a stable income, people cannot afford basic needs such as healthcare (treatment and medication) and housing. Once one has exhausted possible help from safety nets, such as friends and family, the options to find secure or affordable housing are limited due to a lack of space. This relationship between illness, injury and employment quickly becomes a vicious cycle. 

When an individual is homeless, new health concerns arise and existing conditions can worsen, according to NHCHC. The stress of finding shelter or a safe place to spend the night away from violence and harmful weather takes a toll on the mental and physical health of homeless people. 

Some may begin to rely on drugs and/or alcohol to ease this stress if there's no end in sight. Some may have trouble affording medications for pre-existing conditions such as high-blood pressure and diabetes, or may not have a safe space to store these medications. Maintaining a nutritious diet is also difficult when affordable foods are not as nutritious. Homelessness is a life-altering experience that leads to poor health and high stress.

Providing stable housing is necessary to improve the health of homeless individuals in the United States. With proper access to basic necessities for survival such as a safe space to sleep, nutritious food and a way to access and store medication, we can begin to reconnect the homeless with strong physical and mental health. 

As we assist these people, those who experience homelessness may begin to find employment and a stable future. This can only be done if we consider homelessness as a public health crisis and enact change through policy initiatives and government intervention.

Tatianna Staszkow was a Healthcare intern for ONC during the Spring 2022 semester. 

Sources:

Li, Hillary. “CDC - Homelessness as a Public Health Law Issue - Publications by Topic - Public Health Law.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 2 Mar. 2017, https://www.cdc.gov/phlp/publications/topic/resources/resources-homelessness.html

Henry, Meghan, et al. The 2020 Annual Homeless Assessment Report (AHAR) to Congress, Mar. 2021. 

Homelessness & Health: What's the Connection?. National Health Care for the Homeless Council, Feb. 2019, https://nhchc.org/wp-content/uploads/2019/08/homelessness-and-health.pdf.

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