Healthcare for the Homeless

Elizabeth Brock

Abstract

Low-income families do not always have the same accessibility to receiving medical care, and this is a profound issue when it comes to promoting the United States’ freedom and equality for all. The United States’ healthcare system caves in when it comes to morally adjusting to provide basic needs for those who desperately need it. In regards to the surge of homelessness in the United States, the healthcare system needs to invoke a change in order to prevent the increase and spread of disease and disparity among the low-income community. Ultimately, in order to overcome the higher than average disease and mortality in the homeless community, it is primarily necessary for healthcare systems to provide low-income individuals with homes and jobs instead of monetary values and adopt a universal healthcare model.

Article

The current healthcare system essentially gives rise to homelessness, but the housing model gives rise to a possible solution for healthcare to adopt. Primarily, the majority of homeless individuals are transiently homeless- signifying that they were not born into homelessness, but they are temporarily homeless due to a lost job, crisis, addiction, or due to high medical bills as a result of health complications. In other words, the intense expenses for severe diseases or profound accidents can leave one homeless, and they may not even make it through complete treatment before they are essentially homeless. In fact, homeless individuals are, on average, shown to have a life expectancy that is 12 years lower than the average person. ¹ A multifactorial combination of increased disease and lack of resources to obtain medical care contribute to this disparity. Furthermore, there exists an additional disparity between the homeless population in California and Texas. Houston has adopted the Housing Model in which all homeless individuals, regardless of addiction or mentally ill, are given homes. ² Conversely, California has adopted a belief that homeless people must get off drugs first before they consider housing. However, 58% of the unhoused homeless community has substance abuse issues versus the housed homeless community has only 16%. ³ This data lends support to the fact that the Housing Model is impactful when it comes to decreasing medical disparities.

Additionally, it is significantly difficult to get homeless individuals fully off of drugs before housing them; Maslow’s Hierarchy depicts that basic needs, such as having a home, is necessary before approaching substance abuse therapy. Medical treatment for substance abuse or mental health disorders is often insignificant if the individuals are simply discharged back onto the streets afterwards since they have a high chance of relapse. It is important to note that Houston was able to adopt the Housing Model because they have guaranteed affordable, multi-unit housing with fixed prices. ⁴ In addition, Houston does not have a strict zoning regulation; thus, it allows them to open up homeless and low-income housing quite easily since they do not have a large bureaucracy to go through. On the other hand, California has intense zone laws, so it is significantly more expensive to build homes in California. Furthermore, job applications require a permanent address, so once more homeless individuals are settled into their homes, they are much more likely to obtain a job and eventually build their way out of poverty. Ultimately, healthcare begins with housing. Even if healthcare workers provide assistance to homeless individuals on the streets, it is not as effective simply providing them with the base of Maslow’s Hierarchy: a home.

In addition to adopting the housing model, universal healthcare is a human right that could be catalyzed in the United States to break the low-income correlation to poor health. According to the World Health Organization, only half of the world receives the healthcare services they need. A staggering 100 million people are impoverished due to the medical bills they pay each year (WHO). ⁵ Universal healthcare could solve this issue by allowing all individuals, regardless of income, to obtain high quality medicine and primary care services. There are a multitude of varying approaches to universal healthcare- beginning with the consideration of the primary health care view. This view is imperative to ensure that medical care is centralized on providing specialized treatment for all individuals.

However, there are several challenges in achieving this approach; according to the WHO, 18 million healthcare professionals are required by 2030 to accommodate the need to reach universal healthcare. ⁵ In addition, the majority of doctors aim to work in middle or high income areas instead of low-income, potentially dangerous areas. However, the majority of individuals who need medical support are, in fact, those who live in low-income areas who do not have the expenses to pay for medical care. Thus, a potential step to reaching the goal of 18 million healthcare workers, especially in lower-income regions, would be to have MCAS provide additional funding to support more doctors working in low-income societies. All in all, if universal healthcare is not attainable, the bare minimum that the medical community can achieve is providing an abundance of medical care professionals in the homeless and low-income communities in an attempt to bridge the gap between poor health in these communities to sustainable health in higher-income societies.

At the end of the day, homeless and low-income individuals are just as deserving of medical care as the average and high-come classes. Not only does the medical society need to accept this ideal, but it is imperative that all regions of society believe it. If the California legislature viewed homeless individuals as equally deserving of having basic necessities, such as a home, they may be more inclined to adjust their laws. In the same light, if MCAS, along with the healthcare legislature, viewed homeless individuals in an equitable manner to receive medical care, then MCAS could fund more doctors to specialize in these regions, and thus, the primary step of obtaining enough healthcare workers could catalyze universal healthcare. Homeless, rich; obese, underweight; African American, Caucasian; medicine is designed to treat and support all in the same, justified light.

References

1. National Health Care for the Homeless Council. (2019). National Health Care for the Homeless Council Fact Sheet | May 2018. Homelessness & Health: What’s the Connection? Retrieved from https://nhchc.org/wp-content/uploads/2019/08/suicide-fact-sheet.pdf

2. Kimmelman, M., Tompkins, L., & Lee, C. (2022, June 14). How Houston moved 25,000 people from the streets into homes of their own. The New York Times. Retrieved from https://www.nytimes.com/2022/06/14/headway/houston-homeless-people.html

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