Homelessness and health care

Homelessness describes the condition of people without a regular dwelling. People who are homeless are most often unable to acquire and maintain regular, safe, secure, and adequate housing, or lack ” fixed, regular, and adequate night-time residence.” Causes:  Unavailability of employment opportunities.  Poverty, caused by many factors including unemployment and underemployment.  Lack of accessible healthcare. People who have some kind of chronic and weakening disease but cannot get healthcare either because they don’t have money to afford it or because the government will not give it to them are simply too weak to go and work every day.  Abuse by government or by other people with power.  War or armed conflict.  Natural disasters  Mental disorder, where mental health services are unavailable or difficult to access. A United States Federal survey done in 2005 indicated that at least one-third of homeless men and women have serious psychiatric disorders or problems.  Disability, especially where disability services are non-existent or poor performing.  Social exclusion, including because of sexual orientation and gender identity  Domestic violence.  Relationship breakdown, particularly in relation to young people and their parents.  Prison release and re-entry into society.  Disasters, including but not limited to earthquakes and hurricanes.  . The basic problem of homelessness is the need for personal shelter, warmth and safety. Other difficulties include:  personal security, quiet, and privacy, especially for sleeping  safekeeping of bedding, clothing and possessions, which may have to be carried at all times  hygiene and sanitary facilities  cleaning and drying of clothes  obtaining, preparing and storing food in quantities  keeping contacts, without a permanent location or mailing address  hostility and legal powers against urban vagrancy. Homeless people face many problems beyond the lack of a safe and suitable home. They are often faced with many social disadvantages also, reduced access to private and public services, gaps in their personal infrastructures, and reduced access to vital necessities.  Reduced access to health care and dental services.  Limited access to education.  Increased risk of suffering from violence and abuse.  General rejection or discrimination from other people.  Loss of usual relationships with the mainstream  Not being seen as suitable for employment. Most countries provide a variety of services to assist homeless people. They often provide food, shelter and clothing and may be organized and run by community organizations (often with the help of volunteers) or by government departments. These programs may be supported by government, charities, churches and individual donors. Social supports While some homeless people are known to have community with one another providing each other various types of support people who are not homeless also may provide them friendship, food, relational care, and other forms of assistance. Such social supports may be done through a formal process, such as under the auspices of a non-governmental organization, religious organization, or homeless ministry, or may be done on an individual basis. Income sources Many non-profit organizations such as Goodwill Industries maintain a mission to ” provide skill development and work opportunities to people with barriers to employment”, though most of these organizations are not primarily geared toward homeless individuals. Many cities also have street newspapers or magazines: publications designed to provide employment opportunity to homeless people or others in need by street sale. While some homeless have paying jobs, some must seek other methods to make money. Begging or panhandling is one option, but is becoming increasingly illegal in many cities. Despite the stereotype, not all homeless people panhandle, and not all panhandlers are homeless. Another option is busking: performing tricks, playing music, drawing on the sidewalk, or offering some other form of entertainment in exchange for donations. In cities where plasmapheresis centers still exist, homeless people may generate income through frequent visits to these centers. Homeless people have been known to commit crimes just to be sent to jail or prison for food and shelter. In police slang, this is called ” three hots and a cot” referring to the three hot daily meals and a cot to sleep on given to prisoners. Health care for homeless people is a major public health challenge. Homeless people are more likely to suffer injuries and medical problems from their lifestyle on the street, which includes poor nutrition, exposure to the severe elements of weather, and a higher exposure to violence (robberies, beatings, and so on). Yet at the same time, they have little access to public medical services or clinics. There are significant challenges in treating homeless people who have psychiatric disorders, because clinical appointments may not be kept, their continuing whereabouts are unknown, their medicines are not taken and monitored, medical and psychiatric histories are not accurate, and for other reasons. Because many homeless people have mental illnesses, this has presented a crisis in care. Homeless persons often find it difficult to document their date of birth or their address. Because homeless people usually have no place to store possessions, they often lose their belongings, including their identification and other documents, or find them destroyed by police or others. Without a photo ID, homeless persons cannot get a job or access many social services. They can be denied access to even the most basic assistance: clothing closets, food pantries, certain public benefits, and in some cases, emergency shelters. Obtaining replacement identification is difficult. Without an address, birth certificates cannot be mailed. Fees may be cost-prohibitive for impoverished persons. And some states will not issue birth certificates unless the person has photo identification, creating a Catch-22.