A homeless individual is a person without a regular, satisfactory, and fixed residence for spending a night. The primary residence of such a person is mostly supervised shelter for providing a temporary accommodation. These shelters include emergency shelters and transitional houses that only provide temporary housing. It is a major concern in the US despite being among the most developed countries in the World. Most of the cities in different states in the US are typically faced with the challenge of homelessness. California is among the states that have high levels of street families. Homeless persons usually experience many problems. For instance, they lack basic needs such as food, good clothing, as well as shelter. Acquisition of good health is also an important issue to these people (Gilmer et al., 2013). The report by US Department of Housing and Urban Development showed that around two-thirds of people in San Francisco usually have no shelter that makes them sleep outside (U.S. Department of Housing and Urban Development, 2015). Furthermore, the article showed that California alone had around 21% of the US homeless individuals that adds to around 116,000 persons. Street families have higher possibilities of acquiring diseases than people living in built houses (Jones, 2015). Besides, whenever a person contracts a particular disease, the chances of his or her condition worsening are typically high. There is increased spending on health services for the people living in streets. Living conditions are positively correlated with the health of an individual. The good housing can significantly reduce health problems faced by homeless individuals. It implies that improvement provision of housing to the street families can substantially reduce the health challenges in most of the cities in the US. Besides, the huge budgets allocated for health facilitation of the homeless families can be used for development activities. California being the state having most of the homeless individuals, it requires a significant implementation of policies that can deal with the problem of homelessness since it is primary element that leads to the deterioration of health conditions of the street community. Through exploring the homeless health concerns in California, the paper will establish the possible solutions to homeless health problems.
Clara’s Case
Clara’s life changed dramatically when her mother passed on 3 years ago. Upon her mother’s death, she lodged a relationship with his stepfather; however, their personal relationship was strained and broke out. Clara says that her life came to a halt, and everything came to a standstill. She had no one to turn to because her mother’s immediate family and extended family could not see eye to eye due to family wrangles and struggle to bequeath property. As such, she resulted to the streets of California begging for help and eating from the dustbins. She spent uncountable nights in the cold, without clean water, sanitation, and basic needs. Unfortunately, due to bereavement caused by loss of her mother, she attempted suicide a number of times and her mental health deteriorated. Her doctor says that after the suicide attempt she went into a coma, luckily, she was collected by a Good Samaritan and taken to a hospital. She would spent a week in a coma and later three months in a mental hospital taking rehabilitation from drugs and psychiatric help to stabilize her mind. Though she has not recovered completely, she represents the plight of homeless people in the streets of California.
Extent of the Problem
In 2014, the US Department of Housing and Urban Development found out that California was the state with the highest homelessness with most of the people being concentrated in the Long Beach. Homeless people are characterized primarily by the debilitating condition that incorporates the substance abuse disorder. Sometimes, these people have a mental illness. Homelessness affects all the people in the state such that both the elderly and the youth are likely to be found on the cities’ corridors at night. According to Edidin et al. (2012), “Homeless experience has several adverse effects on the neurocognitive ability, mental, and the physical health” (p. 360). The other associated health implications include substance abuse and sexually transmitted infections. Chronic stress, as well as deprivation, are likely to have a long-term impact on the homeless functioning and their development. The homeless usually face the challenge of accessing quality health care services. The problem has persisted ever since the Regan’s era. During the Reagan time, the National Institute of Mental Health initiated a plan that targeted at investigating mental illness as well as substance abuse among the homeless people (Jones, 2015). Lack of permanent housing in California is one of the primary factors that deteriorate the health condition of the homeless individuals. The patterns of sleeping are also likely to affect the health of a person. Their medical status is more likely to deteriorate as a result of the absence of appropriate prevention as well as timely intervention that makes the treatment an expensive practice and hence becoming complicated to treat. Homeless people in California suffer from several conditions that encompass:
Neurocognitive development
Mostly, the disorder affects the homeless youth. The growth of the youth is all encompassing. For instance, as a person experiences physical growth, brain development also occurs. A homeless young person is likely to have a slow brain development as opposed to the other youths living in well-constructed permanent houses. At the adolescent stage, a person needs support from both the teachers, parents as well as other significant people to advance the reasoning skills as well as decision-making. On the side of the homeless youth, they have no access to such supportive relationships. The cognitive functioning of the homeless youth is usually lower as compared to that of the others (Edidin et al., 2012). Neurocognitive development is a severe health concern that requires being addressed.
Sexually Transmitted Infections
People living in the streets are prone to being sexually abused that increases the chances of suffering from sexually transmitted diseases. Besides, these people usually engage in high-risk sexual activities. STIs including HIV are more likely to spread among the people living in the streets. Unprotected sex is a common practice among the homeless that has led to an increase in the STIs prevalence rates in the California (Jangho, Bruckner, & Brown, 2013).
Substance Abuse
Most of the people usually turn to drug addiction as a means of comforting themselves from the situation. Drugs affect the normal functioning of an individual. Those in the streets often take them for purposes of enabling them to sleep at a time or to mitigate the adverse environmental conditions on the streets, especially at night. Substance abuse is more likely to deteriorate the health state of a person. Addiction is one of the severe situations that call for rehabilitation that is an expensive project. Besides, hard drugs are usually associated with chronic diseases such as lung cancer and liver cirrhosis amongst others (Gilmer et al., 2013).
Mental Health
Notably, most of the homeless individuals typically suffer from psychiatric disorders these include depression, PTSD, and psychosis. Besides, anxiety and mood disorders are also among the diseases that people face. The prevalence rates of mental health among the homeless populations have led to high levels of suicide attempts as well as completed suicide. Several factors usually induce mental health among the street population such as the pre-existing mental disorder, chronic stress, their demands, and substance abuse. Care for mental health for those living in streets is a challenge due to the costs as well as the low appeal to treatment in the population (Gilmer et al., 2013).
Health Care Access
Most of the homeless individuals in California are reluctant to accessing health care services. Several factors contribute to the poor access to health care services. These include financial inability, structural, and personal reasons. The standard financial barriers to acquiring health care are a lack of finances for subscribing health insurance and lack of transportation funds. The structural inhibitors include the inability to have a permanent address, identification photo, as well as birth certificate. Structural factors inhibit homeless from acquiring free health services. Gilmer et al. (2013) found “homeless people are usually facing the challenge of navigating health care systems” (p. 2252). Besides, there are few clinics; the health providers have a poor coordination, the working hours, and the long waiting times experienced in the medical centers. The personal reasons that hinder individuals constitute of embarrassment and lack of sufficient knowledge. The homeless people also suffer from the stigma that makes them presume that they will be discriminated in health care centers upon seeking medical assistance (Jangho, Bruckner, & Brown, 2013).
Health Care Intervention and Prevention Measures
The health issues in California can be addressed through employing several measures that include:
Establishing permanent supportive housing
The establishment of a housing program for the homeless is one of the essential initiatives towards curbing their worse health conditions. The housing protects individuals from exposure to the element that is likely to increase infection rates. According to Henwood (2013), “Permanent housing is essential to reduce stress associated with homelessness” (p. S189). Housing eliminates all the psychological anxiety and reduces all the hazards that increase the rates of infections (Henwood et al., 2013).
Improved access to quality health care service
The state government of California should initiate programs that target at increasing health facilities for the homeless. Besides, the introduction of the specialized hospital for handling only the homeless can motivate them to attend hospitals since the perception of discrimination will be eliminated (Jones, 2015). More homeless people will be catered for in these health facilities.
Introducing substance abuse as well as mental health services administration centers
The introduction of such units is crucial since it will cater for those suffering from mental illness as well as those addicted to hard drugs and other related substances. In these centers, homeless will undergo counseling sessions, treatment, and assessment of the management progression (Gilmer et al., 2013).
Integrated health care models such as free treatment
The introduction of free treatment services for the homeless is another measure towards treatment and prevention of the health risks associated with homelessness. Moreover, it motivates the homeless to visit health care facilities in an event where one suffers from a disease. The structural barriers such as the requirement required to be met by homeless to acquire free medical services need to be eliminated. For instance, the permanent address requirement and birth certificate should be reduced. Such elimination will be imperative for purposes of encouraging more homeless people to access health care (Edidin et al., 2012).
Initiation of homeless health education policies
Community development policies such as educating homeless on health matters can act as a prevention measure for the diseases that they are likely to suffer (Jangho, Bruckner, & Brown, 2013). For instance, educating them on the dangers of leading promiscuous lives as well as having unprotected sex can serve as a means of preventing the spread of STIs.
Conclusion
Health is a homeless concern in California. In 2014, California was the state with the highest homelessness with most of the people being concentrated in the Long Beach. The health implications include substance abuse and sexually transmitted infections. Chronic stress and deprivation have a long-term impact on the homeless people. Homeless individuals in California are reluctant to accessing health care services. Several factors contribute to the poor access to health care services. These include financial inability, structural, and personal reasons. Establishment of the permanent housing can serve as one of the methods for preventing diseases that affect homeless in California. Others include introducing substance abuse as well as mental health services administration centers and initiation of homeless health education policies amongst others.
References
Edidin, J., Ganim, Z., Hunter, S., & Karnik, N. (2012). The Mental and Physical Health of
Homeless Youth: A Literature Review. Child Psychiatry & Human Development, 43(3), 354-375. doi:10.1007/s10578-011-0270-1
Gilmer, T. P., Katz, M. L., Stefancic, A., & Palinkas, L. A. (2013). Variation in the
Implementation of California's Full Service Partnerships for Persons with Serious Mental Illness. Health Services Research, 48(6), 2245-2267. doi:10.1111/1475-6773.12119
Henwood, B. F., Cabassa, L. J., Craig, C. M., & Padgett, D. K. (2013). Permanent Supportive
Housing: Addressing Homelessness and Health Disparities? American Journal of Public Health, 103(2), 188-192.
Jangho, Y., Bruckner, T. A., & Brown, T. T. (2013). The Association between Client
Characteristics and Recovery in California's Comprehensive Community Mental Health Programs. American Journal of Public Health, 103(10), e89-e95
Jones, M. M. (2015). Creating a Science of Homelessness during the Reagan Era. Milbank
Quarterly, 93(1), 139-178.
U.S. Department of Housing and Urban Development. (2015, November). The 2015 Annual
Homeless Assessment Report (AHAR) to Congress. Retrieved May 7, 2016, from https://www.hudexchange.info/resources/documents/2015-AHAR-Part-1.pdf
