Transcript Exploring Health through the Lens of Homelessness

By: Faith Tolulope Adewusi
Faculty Sponsor: Kathleen Gorman
(Director, Feinstein Center for Hunger Free America)
 Purpose
 Goals
 Methods
 Introduction
 Results
 Conclusion
to Homelessness
To learn about the current conditions of the
homeless in Providence, RI and try to
understand the obstacles they face in terms
of housing, health and nutritional conditions.
 Learn
about the conditions of the
homeless in Providence, RI
 Identify obstacles they have with their
living and health conditions
 Learn about communities that have
implemented strategies to work with
homeless to keep them healthy
 Review clinical histories of some homeless
 Interview people who work with the
homeless
 Library
research
 Secondary data analysis
 Participate in Health Fairs
 Conduct Interviews with:
Director of WARM Shelter
 Administrator for SNAP (Food Stamp Program)
 Social Worker

 Observations
including:

at community meal sites
St. Patrick’s meal kitchen, WARM
shelter, Grace Church and St. Charles
 Homelessness
is a process
that often stems from
vulnerability to poverty
exacerbated by a
combination of traumatic
life events such as family
deaths, abuse, illness,
substance misuse, natural
disasters, job loss etc.
and results in the loss of
permanent shelter.
 Foreclosures
 Poverty
 Decline
in Public assistance
 Lack of affordable housing
 Mental illness
 Addiction disorders
 Domestic violence
 Unemployment
 Poor
health
 Malnutrition
 Stress
 Low self-esteem
 Reduced social integration
 Powerlessness

According to National Alliance to end
Homelessness, Rhode Island is one of the 10
states with the highest rates of homelessness

There was a 64% increase between October
2008 and October 2009 in people accessing
emergency shelters. (RICH)

In November 2009, the state’s shelters were
beyond capacity and nearly 80 people slept
outside (Projo)

In March 2010, up to 1283 men, women and
children sought shelter (Projo)

Two shelters with more than 60 beds closed
on March 31. Two more, with more than 35
beds, will close in April and June (Projo)

For Emergency Shelter:






For Food:





Crossroads Family Shelter– Providence, RI
People to end homelessness – Providence, RI
WARM shelter – Westerly RI
New Hope Shelter of Pawtucket/Central Falls
Interim House – Providence, RI
RI Community Food Bank
Amos House
Providence Rescue Mission
Salvation Army, St. Patrick's ,St. Johns,
Assembly of God, St. Charles…
For Healthcare




Amos House
Hope Clinic
Providence Community Health Center
Providence Rescue Mission/Good Shepard
Dental Clinic

W.A.R.M – Westerly Area Rest and Meals

30 days stay

13 males, 9 females (all adults)

Two dorm rooms (bunk beds), two
bathrooms (1 men, 1 women)

Meal kitchen feeds twice a day

Lunch at noon

Dinner at 5:30pm

They are required to assist in cleaning,
maintenance of the shelter and must be
looking for employment, training or
education

Reasons for non-admittance:

Untreated mental illness

Active substance use

Breaking the rules






“I eat whatever I can get”
“Why would I want to get my blood pressure checked (at a
health screening outreach program)…it’s not like they’ll
give me medicines for my high blood pressure anyways”
“I don’t want that (H1N1) vaccine in my body…”
“Can I have one of the toiletries? I don’t really need it and
I’m not one of those people, I came here with umm… my
stepfather, you know what I mean, like I can afford this, I
just want one for the sake of having it...”
“I’m not sitting with those people, I’ll eat whenever
they’re done eating”
“I take classes at CCRI… my boyfriend and I broke up so I
needed to come here and have a meal”
HYPERTENSION
 SEIZURE
 HIGH BLOOD PRESSURE
 HEPATITIS
 DEPRESSION
 CIRRHOSIS
 DIABETES
 HEART PROBLEMS
 AMPUTATION
 ARTHRITIS
 ASTHMA

CANCER
 GASTROESOPHAGEAL
REFLUX DISEASE
 BODY PAIN
 CONGESTIVE
OBSTRUCTIVE
PULMONARY DISORDER
 CONJUCTIVITIS (PINK
EYE)
 EPILEPSY
 SORE TEETH AND GUMS

About 97 million adults in the United states are
overweight or obese
 Overweight and obesity are common among the
homeless population since they are unable to
access healthy foods.
 This condition increases their risk of morbidity
from hypertension, diabetes, stroke, gallbladder
disease, osteoarthritis, sleep apnea, respiratory
problems and cancer
 Below is the percentages of overweight and
obesity among the homeless in Providence, RI

35.00%
30.00%
25.00%
20.00%
15.00%
10.00%
5.00%
0.00%
25/114
29/114
38/114
21/114
1/114
NORMAL
OVERWEIGHT
OBESITY
EXTREME
OBESITY
UNDERWEIGHT

Lack of housing is the major
contributor

Poverty which leads to chronic
physical health problems

Emergency shelter predisposes
to infections and anxiety

Inability to obtain healthy
foods

Homeless people’s perceptions
on their own health due to lack
of adequate health education

Physical injuries
 57






year old male (emergency shelter)
Feels like social worker has done nothing for him
No place to prepare meal
Not receiving food stamps
Couldn’t afford to eat balanced meals
Overweight, subdural hematoma
Alcohol addiction; smokes about 3 cigarettes/day
 What

seems to be the problem here?
Although it seems like the food stamp program
will help provide meals for this man, the program
does not benefit him because he has nowhere to
prepare meals even if he receives food stamps
 What’s
the solution?
 Food
Access Project - designed to help
low-income individuals especially the
homeless gain access to prepared healthy
foods in restaurants e.g. Subway
 Beneficial
to people without kitchen and
cooking facilities e.g. homeless, disabled,
elderly

6 healthcare workers completed the questionnaire


How would you define homelessness?

“Not having a home, no consistent, physical structure to return to day after day.” – (Medical
Technologist)

People without a shelter and a place to call home…Unfortunately this can happen to anyone
who has lost their home from natural disasters, foreclosures etc.” – (Pathologist)


(These include pathologist, registered nurse, medical technologist, 4th year student doctor,
dosimetrist, and Hematology lab supervisor)
(Dosimetrist)
What do you think is the main problem that most homeless
face in terms of healthcare?

“Not being able to afford healthcare or able to pay penalty for not having healthcare” –
(Hematology Supervisor)

“Not going to the doctor because they lack confidentiality in doctors, especially those that are
on drugs” – (Student Doctor)

(RN)
 Adequate
health education on how to
maintain their health and succeed in their
treatments.
 Proper medical attention from health care
workers
 A stable and continuous care from a trusted
clinician
 Better nutrition
 Permanent shelter







Majority of common illnesses can be easily transmitted among
the homeless and can become life threatening diseases when
they are left untreated.
Homeless people face a wide variety of diseases and illnesses,
not just one specific type.
The major problem that homeless people face in terms of
healthcare is cost.
Housing should be the first form of treatment for homeless
people with medical problems because this will protect them
against illness and make it easy for the sick to recover.
Many homeless people use emergency rooms as their primary
source of healthcare and this is more expensive for hospitals and
the government.
Many healthcare workers are unable to offer a full range of care
necessary to address the complex needs of people experiencing
homelessness.
The effects of contacting disease by being homeless costs more
on the part of the government and generally affects the society.

Rhode Island Coalition for the
Homeless – assists individuals
to secure permanent housing

Supplemental Nutrition
Assistant Program (SNAP)

Family Resources Community
Action – social services,
education, economic
opportunities

Oasis Advocacy and Social
Center – for mental health

Community action agencies
 Donate
 Take

action
Help save the Neighborhood Opportunities
program(NOP). NOP helps to set rents low for
families and individuals with low income and
people with disabilities.
 Volunteer
 Organizational
membership

Dr. Kathleen Gorman -- Director, Feinstein Center for Hunger Free
America

Gail Faris –-Assistant Director , Women’s Center

Dr. Diane Martins PhD, RN – URI College of Nursing

Leah Murphy RN – URI Alumni

Patricia Stout NP/Professor - URI College of Nursing

Laura Jaworski – Director, Westerly Area Rest Meals

Robert McDonough – Former Administrator, Food Stamp Program

Survey Participants

Aron, Laudan Y. and Janet M. Fitchen. "Rural Homelessness: A Synopsis,” Homelessness in
America, Oryx Press, 1996

Davis, Paul. Number of Homeless People in R.I. Reached Record in March, Housing
Advocates Say. Newspaper Article. Providence: Providence Journal, 2010.

Diaski, Isolde. "Perspectives of Homeless People on Their Health and Health Needs
Priority." Journal of Advanced Nursing (2006): 273-280.

Dujardin, Richard. Tent City Homeless Setup in East Providence. Article. Providence:
Providence Journal, 2009.

Jaworski, Laura. Living in a Shelter: WARM Shelter Faith Tolulope Adewusi. March 2010.

Lang, Jennifer. Clinical Social Work Regarding the Homeless Faith Tolulope Adewusi. April
2010.

Leung, S Cheryl, et al. "Homelessness and the Response to Emerging Infectious Disease
Outbreaks: Lessons from SARS." Journal of Urban Health (2008): 402-410.

McDonough, Robert. Food Access Project Faith Tolulope Adewusi. April 2010.

Milby, Jessy B, et al. "To House or Not to House: The Effects of Providing Housing to
Homeless Substance Abuser in Treatment." American Journal of Public Health (2005):
1259-1264.

National Coalition on Health Care. 2010. 19 April 2010 <http://nchc.org>.