Homelessness & Health Care: Access to Medical Services

by: Richard Bicknell | 2023.10.03

Unhoused man sitting outside on stone staircase.

Did you know that people who are experiencing homelessness are:

29x more likely to have Hepatitis C
20x more likely to have epilepsy
5x more likely to have heart disease
4x more likely to have cancer
3.5x more likely to have asthma
3x more likely to have arthritis or rheumatism

Many people who are experiencing homelessness rely on walk-in clinics and emergency rooms for their health care, which is a very expensive means of obtaining treatment. While it may not cost a dollar upfront, taxpayers have spent $4.5 billion over a decade of inaction on the homelessness cause.

Unhoused individuals do not have different illnesses than the general population. However, their living circumstances and poverty affect their ability to cope with these health problems.

These individuals are at a significantly higher risk of physical and mental health issues compared to the housed population. Exposure to the elements, inadequate nutrition, substance use, and the stress of homelessness contribute to a higher chance of chronic illnesses, infectious diseases, and mental health disorders.

Access to medical services can be a lifeline for people who are experiencing homelessness, providing them with much-needed preventive care, treatment for acute and chronic conditions, mental health support, and addiction treatment services.

So, how do we, as a community, ensure medical care for these individuals? Keep reading this blog post to find out.

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The Health Care Challenges Faced by Unhoused Individuals

Unhoused individuals often experience many health issues, both physical and mental, due to their living conditions and the challenges they face.

Common physical health issues include malnutrition, exposure-related illnesses (e.g., hypothermia), infectious diseases (e.g., tuberculosis, HIV), and chronic conditions (e.g., diabetes, hypertension).

Mental health challenges are common among the homeless, especially depression, anxiety, post-traumatic stress disorder (PTSD), and substance use.

Barriers to Accessing Medical Care

Transportation Challenges: Unhoused individuals may not have access to reliable transportation to reach healthcare facilities. Even when healthcare services are available, the distance and lack of transportation options can prevent them from seeking care.
Stigmatization: Stigma and discrimination can discourage houseless individuals from seeking medical care. Negative stereotypes and biases held by some healthcare providers can create an unwelcoming environment for this population.
Lack of Documentation: Unhoused individuals may not have the necessary identification or documentation to access healthcare services. Lack of a permanent address or identification can lead to administrative barriers when attempting to enroll in health programs or access medical care.

What Happens When Unhoused People Don’t Have Access to Healthcare?

Healthcare disparities refer to differences in health outcomes and access to healthcare services among different population groups. People who are experiencing homelessness are negatively affected by healthcare disparities, resulting in:

Delayed diagnosis and treatment of illnesses, leading to more severe health conditions
Higher rates of preventable hospitalizations and emergency room visits
Reduced life expectancy compared to the housed population
Increased burden on healthcare systems and resources due to unmet healthcare needs

The Role of Homeless Healthcare Programs

After learning about the health-related hardships that affect unhoused individuals, we can more clearly understand the role and importance of homeless healthcare programs.

Homeless healthcare programs are specialized initiatives designed to provide medical and related services to people who are experiencing homelessness. These programs recognize the unique needs and challenges faced by the unhoused population and aim to deliver healthcare in a more accessible and targeted manner.

They often operate in collaboration with shelters, outreach teams, and community organizations to reach those in need.

Some examples of successful homeless healthcare programs include:

Healthcare for the Homeless (HCH) Clinics: These clinics are dedicated to serving unhoused individuals and offer a wide range of services, including primary care, mental health, substance abuse treatment, and case management.
Street Medicine Programs: These programs take healthcare services directly to unhoused individuals on the streets, providing immediate care where they reside.
Mobile Healthcare Units: These are equipped vehicles that bring medical services, vaccinations, and screenings to homeless encampments, shelters, and community locations.
Homeless Outreach Teams: Teams of healthcare professionals and social workers engage with unhoused individuals in their environments, building trust and providing care.

How Do These Programs Operate?

Homeless healthcare programs are designed to overcome the specific barriers that unhoused individuals face in accessing medical care. They do so through various strategies:

Low-Barrier Access

Programs often have low or no-cost services and do not require proof of insurance or identification.

Culturally Competent Care

Healthcare providers in these programs are trained to address the unique needs and challenges faced by unhoused individuals with empathy and cultural sensitivity.

Coordinated Care

They facilitate coordination between medical, mental health, and social services to provide holistic care.

Outreach and Engagement

Programs actively seek out unhoused individuals, build relationships, and encourage them to seek care.

Addressing Social Determinants

They may assist with housing, employment, and other social determinants of health that contribute to homelessness.

Benefits of Homeless Healthcare Initiatives

Homeless healthcare programs offer numerous benefits, including:

Improved Health Outcomes: By addressing health issues proactively, these programs contribute to better health outcomes for unhoused individuals.
Reduction in Emergency Care: Timely access to healthcare reduces the need for costly emergency room visits.
Enhanced Quality of Life: Medical care and support services help individuals stabilize their lives and work towards housing stability.
Cost Savings: By preventing and managing health issues, these programs can lead to cost savings for the healthcare system.
Community Health: Addressing healthcare needs among the unhoused population can have a positive impact on public health by reducing the spread of infectious diseases.

Strategies for Improving Access to Medical Services

You might’ve heard the saying “it takes a village”. We believe that any tangible and lasting change truly takes a village. It takes people who care, to come together to provide solutions.

Nurses in homeless shelter doing check-ups.

Here are some strategies we can implement to provide medical access to the homeless community:

Collaborations Between Shelters and Healthcare Providers

Coordinated Care: Shelters can partner with local healthcare providers to offer on-site or nearby healthcare services for unhoused residents. This ensures that individuals have easier access to medical care.
Regular Health Clinics: Some shelters host regular health clinics staffed by medical professionals who can provide primary care, vaccinations, and health screenings.
Case Management: Collaborative efforts often include case management services to help people who are experiencing homelessness navigate the healthcare system and connect with appropriate services.

Mobile Healthcare Units

On-the-Go Care: Mobile healthcare units, often equipped with medical professionals, travel to locations frequented by homeless populations, such as shelters, food distribution sites, and encampments.
Immediate Care: They offer immediate medical attention, preventive services, vaccinations, and referrals for more comprehensive care when needed.
Access to Vulnerable Populations: These units can reach individuals who may not visit traditional healthcare facilities due to barriers like transportation or stigma.

Telemedicine for Homeless Populations

Virtual Consultations: Telemedicine involves providing healthcare services remotely through video calls, phone calls, or online platforms.
Accessible Care: Telemedicine can bridge the gap by allowing unhoused individuals to access medical consultations without the need for physical transportation or visits to healthcare facilities.
Mental Health Support: It can also be instrumental in providing mental health counseling and support, addressing one of the critical health needs of the unhoused population.

Outreach and Education Efforts

Engaging Outreach Teams: Outreach workers, often with social work or healthcare backgrounds, engage with unhoused individuals where they are and build trust over time.
Health Education: Outreach teams provide health education, emphasizing the importance of regular check-ups, vaccinations, and preventive care.
Referral Services: They connect unhoused individuals with appropriate healthcare resources, helping them navigate the system effectively.

Final Thoughts

In this blog post, we have explored the challenges faced by homeless individuals in accessing healthcare. By implementing innovative strategies, including homeless healthcare programs and telemedicine, we aim to improve their access to vital medical services.