Health promotion

Homelessness

Presented by Tedra Estis

• To be without a home. Lacking a fixed, regular, safe and secure place to dwell.

• A state of vulnerability – Health risks due to exposure to the elements – Violence – Harassment – Absence of privacy– Alienation from society

(Homelessness, n.d.)

Homelessness defined

The Problem

• Homeless is everywhere.• Estimated 2-3 million homeless people in the U.S.• Homelessness breaks up families. Some shelters

won’t accept men or children.• Small illnesses become serious health conditions due

to expose to elements and unsanitary conditions.• Depression sets in, the homeless become hopeless.• Violent attacks on the homeless, rape, and cruelty.• Urban slum and blight.

(Homelessness, 1996)

Consequences

The homeless frequently visit hospital emergency rooms. – Each visit costs approximately $3,700– Average of $18,500 in ER stays per year per

homeless person

(The cost, n.d.)

Who are homeless?

(HUD, 2012)

Who lives in Shelters?Statistics • 62% are male• 38% are female• 21.8% are under age 18• 23.5% are 18-30• 37% are 31 to 50• 14.9% are 51 to 61• 2.8% are 62 or older• 41.6% are White, Non-Hispanic• 9.7% are White, Hispanic• 37% are Black/African-American• 4.5% are other single races • 7.2% are multiple races (Current, 2011)

Homelessness MythsMyth-The homeless are lazy.Fact- 45% of homeless work, but do not earn a living wage.

Myth-Homeless people want to be homeless.Fact-Nobody wants to be homeless. They have often lost faith.

Myth-Homeless people are dirty and smelly.Fact-Many homeless find ways care for hygiene; in shelters, in gyms, at truck stops.

Myth- The homeless are uneducated.Fact-Many homeless are educated. Some have Master’s degrees.

Myth-It won’t happen to me.Fact- 1 out of 3 working individuals are 3 paychecks or less away from poverty.

(Homelessness, n.d.)

Vulnerable Populations

• Veterans• Mentally Ill• The Working Poor• Unattached youth• Elderly• Alcoholics• Transients

(At risk, 2011; United, 2012)

Health Determinants

Policy Making– Include the homeless in policy making. Give them a

voice. – Allow everyone to apply for HEARTH ACT

assistance and be flexible – Maintain adequate level of outreach, emergency

housing, transitional housing, and supportive services

– Include rural homeless and let them not be disadvantaged

(Priority, 2011)

Health DeterminantsIndividual Behavior– Substance abuse• About two thirds of homeless people abuse drugs

and/or alcohol

– Domestic Violence• Half of homeless women have left abusive relationships

(At risk, 2011)

Health DeterminantsSocial– Available affordable housing– Safety of environment• Big city

– Crime rates– Gangs

• Rural area– Elements of weather– Lack of assistance

(HUD, 2012)

Health Determinants

Health Services– Barriers to help• Language barriers• Pride

– Unavailable housing or refuge • Transient housing• Shelters• Churches

(U.S., 2012)

Health DeterminantsBiology and Genetics– Mental Health- 20 to 25% of all homeless people

have some type of mental illness • Schizophrenia• Post traumatic stress disorder (especially Veterans)• Bi-polar

– Family history of alcohol abuse

(Current, 2012, United, 2012)

Housing and Urban Development

• HUD’s objectives:– Eliminating slum and blight

– Eliminating conditions which are detrimental to health, safety, and public welfare

– Principally benefiting person of low and moderate income

(HUD, 2012)

HUD Regions in the U. S.

(HUD, 2012)

Health Promotion

Homelessness assistance programs–McKinney-Vento Homeless Assistance Act – Supportive Housing Program– Shelter Plus Care Program– Single Room Occupancy Program– Title V Program– Emergency Solutions Grant Program

(HUD, 2012)

One Solution

Provide affordable housing• Health care costs are reduced by 59%.• Emergency room costs are decreased by 61%.• General inpatient hospitalizations are

decreased by 77%

(The cost, n.d.)

In Springfield, Missouri

One Door (ran out of the Kitchen)– 11,000 phone calls– 577 client assessments– 2,656 requests for shelter– 3,523 requests for utilities assistance • Total spent $74,000

Emergency Rent Assistance62 households assisted• Total spent $22,900

(B. Griesemer, personal communication, December 4, 2012)

In Springfield, Missouri

• Jordan Valley• The Kitchen• Victory Mission• Salvation Army• Missouri Hotel• First Step• New Life Evangelistic• Community Partnership

(Springfield, n.d.)

Get Involved

Become an advocate for the homeless– Be familiar with community assistance– Provide information to the homeless– Refer patients – Provide tools– Follow up

Get Involved…

• In your local government– Attend City Council meetings– Join a council or advisor committee

• In your community– Volunteer at clothing banks, soup kitchens, and

homeless shelters– Donate

Final thought

I am a mental health nurse who deals with homelessness on a daily basis in my job and in our community. I have served on the Citizen’s Advisory Committee to City Council for the last two years. We allocate HUD discretionary fund money to the City of Springfield’s non-for-profit organizations. I have worked in our community and am passionate about our citizens. Homelessness is everyone’s problem. I implore you to get involved! For more information about this committee and others like it, please visit:

http://www.springfieldmo.gov/boards/advisory/members.jsp

http://www.springfieldmo.gov/boards/home.jsp

ReferencesAt risk of becoming homeless. (2011). Destination home. Retrieved from http://www.destination-

home.info/Homelessness/at-risk.htm

Current statistics on the prevalence and characteristics of people experiencing homelessness in the

United States (2011, July). Substance abuse and mental health services administration. Retrieved from

http://homeless.samhsa.gov/ResourceFiles/hrc_factsheet.pdf

Homelessness defined. (n.d.). The suitcase clinic. Retrieved from

http://www.suitcaseclinic.org/homelessness-defined/

Homelessness: Programs and the people they serve. (1996). Urban institute and the national survey of

homeless assistance providers and clients. Retrieved from

http://www.urban.org/publications/310291.html

ReferencesPriority recommendations regarding implementation of the homeless emergency assistance and

rapid transition to housing act(2011). National coalition for the homeless. Retrieved from

http://www.nationalhomeless.org/advocacy/HEARTHrecommendations2011.html

Springfield Missouri homeless shelters and services for the needy. (n.d.). HDS helping the needy.

Retrieved from http://www.homelessshelterdirectory.org/cgi- bin/id/city.cgi?

city=Springfield&state=MO

The cost of homelessness facts. (n.d.). Green doors. Retrieved from http://greendoors.org/facts/cost.php

United states department of veterans affairs. (2012). Retrieved from

http://www.va.gov/health/NewsFeatures/20120220a.asp

U.S. department of housing and urban development. (2012). Retrieved from

http://portal.hud.gov/hudportal/HUD