It is situational and is greatly affected by personal perception. There are various terms to describe these populations, such as “underserved populations,” “ medically underserved,” “ medically disadvantaged,” “underprivileged,” and “American underclasses” (Shi & Singh, 2010, p. 255). From the factors mentioned above, socio-economic, health, and geographic locations attribute the most to their vulnerability. Identifying, who is vulnerable can be extensive as there are no specific guidelines to define vulnerability thereby leaving it open to interpretation.
Many groups embody this category such as the poor, mentally ill, drug dependents, undocumented immigrants, the veterans, people with disabilities, women, the young, and the eldery. The determination who belongs in these category is difficult as there are no standards what makes a person vulnerable thereby making the list boundless. This paper will focus on the homeless, as one identified vulnerable population and its effect on the health care delivery system. Demographics The term homelessness has a comprehensive definition.
The National Coalition for the Homeless (2011) website A homeless person is someone who does not have a fixed, regular, and sufficient night-time residence. According to Shi and Singh (2010) “Approximately 3. 5 million people experience homelessness each year on a national level” (p. 264). Determining the number of homeless in the streets or shelters is a challenge because of the different methods use to yield the information, thus resulting in underestimates of homelessness.
Standardized reporting of data on homelessness was initiated in 2007 by the Department of Housing and Urban Development via the Annual Homeless Assessment Report to Congress, which is released in June of each year National Coalition for the Homeless, 2011). Different factors and trends attribute to the rise in number of the homeless. Poverty and unaffordable housing increase the likelihood of homelessness for certain demographic groups. It is believed that the young, the elderly, and women are the most vulnerable of the groups but homelessness appreciates no boundaries.
It can affect people of all ages, regardless of gender, race or ethnicity, income, or educational level. Studies show that children account a large portion of the homeless population at 39%. ; of this number, more than 40% were under the age of five. Numbers can vary in different cities, especially in rural areas. In 2004, 25% of the homeless were ages 25 to 34; the same study found percentages of homeless person aged 55 to 64 at 6% (National Coalition for the Homeless, 2011).
The number of homeless families with children is also increasing in number and make up 30% of this population and is the fastest growing segment (Shi & Singh, 2010). Males are bound to be more exposed to homelessness than women. In 2007, a survey by the United States Conference of Mayors found that of the population surveyed 35% of the homeless people are members of households with children are male whereas 65% of these people are females. However, 67. % of the single homeless population is male, and it is this population that makes up 76% of the homeless population surveyed (National Coalition for the Homeless, 2011).
The United States Conference of Mayors surveyed 25 cities and found the African American homeless population to be the highest at 42%, 38% white, 20% Hispanic, four percent Native American, and two percent Asian (National Coalition for the Homeless, 2011). Tough economic conditions also resulted on declining wages for many workers. Most of the states, making minimum wage makes impossible to afford a decent dwelling.
The federal definition of affordable housing for a minimum-wage worker is working more than 80 hours a week to sustain a two-bed unit (National Coalition for the Homeless, 2011) . Educational level is also a determinant for homelessness. According to Blisard and Harris (2002) “Approximately 22% of the total United States population has never received a high school diploma” (p. 9). It is believed that education has some bearing on the issue because those who lack education has no bargaining power in the job market resulting in unemployment.
Statistics on the homeless population education level shows 38% have less than a high school diploma, 34% with GED, and 28% have more than high school education (National Coalition for the Homeless, 2011). Mental health, violence, marital status, addictive disorders, and chronic medical conditions, are other factors that can make this population at an even greater risk for becoming homeless. It is clear that there is no one description to represent what makes up a homeless person as individual needs may vary, depending on the circumstances that pre-dispose the individual.
Barriers, Challenges, and Impact on Health Care Homeless are said to be the most vulnerable because of the increased risk for unfavorable health-related outcomes brought about by unsanitary living conditions. They are more susceptible in acquiring communicable diseases because of malnutrition, unsafe health practices, and lack of access to medical care. Aside from the financial aspect, meeting certain eligibility requirements for health coverage provided by the government is unrealistic for them. Transportation to medical facilities is un-accessible to this population.
The homeless population in general has a high incidence of untreated medical condition whether acute or chronic, psychiatric problems, and recreational drug use (National Coalition for the Homeless, 2006). Violence against this population is high because of exposure to rough environmental elements (Shi & Singh, 2008). Furthermore, the society’s perception of the homeless causes prejudice and discrimination leading to disparities in accessing health care services. Delivering medical and emergency services to this population can be a challenge because of lack of permanent dwelling and transportation.
Lack of education, unemployment, limited job skills, substance abuse, medical, and special status in society such as criminal involvement and immigration issues add up to the already challenging face of homelessness. The growing number of the homeless population has resulted in increased need for health services and is impacting the use of emergency services in hospitals all over the country. The homeless population also account for high degree of hospital admissions because of various conditions, notably psychiatric care, and substance abuse.
The demand for emergency food assistance has also risen because of job loss, foreclosures, and other aggravating circumstances (Blisard & Harris, 2002). This crisis has created a huge economic and environmental impact on health care, and there is no apparent resolution in sight. Stakeholders and the Homeless The stakeholders in this case, the government, insurance companies, hospital organizations, nonprofit organizations, and the consumers are directly affected by the problem. Despite of the challenges, efforts to improve the homeless population has been astounding.
The homeless population in the United States is supported in various ways by governmental and nongovernmental organizations. The idea of physical and financial aid is supported by these groups. Another advocate of this population is The National Alliance to End Homelessness who represents the group by coordinating with the different government agencies for the creation of new policies that will help the homeless. Housing programs, whether transitional, permanent, or emergency is provided at an affordable rate (National Coalition for the Homeless, 2006).
Supportive services for substance abuse such as counseling, access to treatment centers, and rehabilitation are part of the programs most agencies provide for the homeless. Currently, there is one federally funded program, Health Care for the Homeless, which is outlined particularly to provide primary health care services for their complex health needs (National Coalition for the Homeless, 2006). Universal access to low-cost, safe, and quality care is vital in the fight to end homelessness.
The development of a standardized and effective health care system is necessary to closed-in the gap of this vulnerable group to the rest of the population. Conclusion Vulnerability is not a representation of one’s personal deficiency but rather a result of an interplay of multiple factors, over many of which individuals have little or no control. Predisposing, enabling, and need characteristics increase the susceptibility of these groups to negative events (Shi & Singh, 2010). This population groups face challenges and barriers in health care access and delivery of service.
Homelessness, as a result of these factors, has become a global problem. As many as 3. 5 million people experience homelessness in a given year, which is one percent of the entire Unites States population (Shi & Singh, 2010). The needs of the homeless population is complex as it requires medical, social, financial, and environmental assistance compared to other population groups. Operating and sustaining homeless support services is a costly undertaking. Funding for these programs greatly affect the stakeholders and consumers in general.
Tax dollars and private donations are a big part of mobilizing the different government programs designed to help this population. As a society, we should continue advocating for changes that will ease the problems brought by homelessness. Job retraining and educating this population to be an active and productive member of the community is a frightening task, but we must persevere. Volunteering in a shelter, organizing events, involving others, and connecting with local housing coalition in the area are ways to help the homeless.
It is foretold that the current recession will worsen the homeless crisis in the years to come but continually educating ourselves, our families, and the community and to contribute to every way we can, we can make a difference. Breaking away and ending homelessness is a tall order. For the time being, helping people enduring the effects of homelessness and supporting the agencies that oversee this population is a strategy we can adapt as a community to serve the homeless better. Furthermore, changing the society’s perception of the homeless and prevent the stereotype but instead treat them with compassion and kindness as humanly possible.