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Housing is Healthcare

People who are homeless experience a myriad of health problems that are either exacerbated by or are a direct result of their homelessness. These individuals require acute care and frequent visits to the emergency room but often find themselves without safe places to recover from injuries or illness after discharge from the hospital. Resultantly, their health complications become either permanent or long-lasting, and they move into a cycle of consistently entering and exiting hospitals. This scenario is both physically and financially detrimental to those experiencing homelessness. 

I recently interviewed Laura Leahy, RN-BSN, a former San Francisco resident. Before receiving her nursing degree, Leahy worked for a catering company in the city and visited homeless encampments to deliver food leftover from events. She met individuals who had to stay in low-paying jobs for the health insurance benefits but couldn’t afford to lose or leave their jobs because they would be without needed coverage for severe health issues. “They were business people who went to work every day and lived in tents,” she said. Their health problems and low income left them in a predicament, forcing them into homelessness.

Now, Leahy often cares for patients who are homeless and listed heart conditions, diabetes – often accompanied by diabetic ketoacidosis – skin infections, sepsis, HIV, and liver cirrhosis as typical health conditions patients who are homeless receive treatment for at the hospital. However, Leahy emphasized that complications caused by sleep deprivation were the most prevalent. Sleep deprivation puts individuals at risk of heart disease, heart attack, heart failure, irregular heartbeat, high blood pressure, strokes, and diabetes.

According to a fact sheet released by COHSF, “homelessness is an independent risk factor for a number of illnesses, and homeless people themselves are susceptible to increased health problems due to high stress, sleep deprivation, unsanitary surroundings, lack of access to hygiene facilities, and a myriad of other symptoms inherent to living without stable housing.” It makes sense, then, why people who are homeless find themselves constantly in need of the acute care offered by hospitals and cycling in and out of emergency rooms. 

The apparent solution to ending this cycle is providing safe and stable housing as a form of healthcare. Treatment of illnesses and injuries is more effective when paired with stable housing and thus should be considered a form of healthcare, especially among individuals experiencing severe health problems in conjunction with homelessness. Unfortunately, obstructions to securing housing exacerbate this goal.  For example, housing prices continue to rise in San Francisco, and the wage-income gap grows larger as tech companies continue to enter the Bay Area and displace low-income earners. 

References:

https://www.sfccc.org/health-care-homeless 

https://www.ncbi.nlm.nih.gov/books/NBK218236/ 

https://www.nature.com/articles/d41586-019-01573-0 

https://www.cohsf.org/wp-content/uploads/2019/10/Fact-Sheet-on-Homelessness-2019.pdf 

https://nhchc.org/wp-content/uploads/2019/08/homelessness-and-health.pdf

https://www.longwoods.com/content/26294/healthcare-policy/hospital-discharge-planning-for-people-experiencing-homelessness-leaving-acute-care-a-neglected-iss

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