healthcare in the spirit of generous excellence
01 United Way of the Midlands-Basic & Material Needs read
02 A Growing Need-Children Living in Homeless Shelters read
03 Local Homeless Challenges and Facts read
04 Homelessness in America Today read
05 National Estimates of Homelessness read
06 People Need Health Care read
07 An Effective Response to the Problem read
Article 04
Homelessness in America Today
Homelessness inevitably causes serious health problems. Illnesses that are closely associated with poverty – tuberculosis, AIDS, malnutrition, severe dental problems – devastate the homeless population. Health problems that exist quietly at other income levels – alcoholism, mental illnesses, diabetes, hypertension, physical disabilities – are prominent on the streets. Human beings without shelter fall prey to parasites, frostbite, infections, and violence.
Each year, millions of people in the United States experience homelessness and are in desperate need of health care services. Most do not have health insurance of any sort, and none have cash to pay for medical care. Homeless people are concentrated in the nation's urban centers and are dispersed throughout rural America, frequently not near the health care facilities that they need. They don't have transportation or real control over their daily lives, since they depend on the routines of shelters, soup kitchens and marginal jobs to meet their most basic survival needs.
Finding health care is tough or impossible. People who are homeless are more concerned with meeting immediate needs for shelter, food, clothing, and safety than with seeking health care. For some, the symptoms of their illnesses or bad experiences with the health care system in their past cause them to actually avoid health care.
Unacceptable costs result from poor access to health care. Because homeless people often are uninsured and lack access to low-cost preventive health care, they go without care until relatively minor problems become urgent medical emergencies. Ultimately, most homeless people do get treated, but it is treatment of the most expensive sort, delivered in hospital emergency rooms and acute care wards. Through taxpayer support of public institutions and through the cost-shifting inherent in the health insurance system, we all pay the high costs of care deferred.
Undetected and untreated communicable diseases threaten the health of other homeless people in particular and of the public in general. These infectious and communicable diseases quickly escalate from personal trials to become costly and deadly public health emergencies. In the long run, perhaps the greatest costs are the moral and social results of neglecting the needs of dispossessed, seriously ill people in our midst.