Transcript Homelessness and Health University of Michigan Project H Lunch Talk, April 26 2004

Homelessness and Health
University of Michigan Project H
Lunch Talk, April 26th 2004
Who Is Homeless?

“Chronic Homeless”
– What we generally think of when we think of
homelessness

Families
– Families with children are the fastest growing segment of
the homeless
– More than 600,000 American kids will sleep in a shelter
tonight
– The average age of a homeless person: 9 years old.
Why are families homeless?
They don’t have enough money to afford
housing!!
 There is an affordable housing shortage
throughout the United States.
 The housing that does exist is very expensive.

The High Cost of Housing
An example: Washtenaw County
 To afford a two-bedroom apartment in
Washtenaw County, a family head must:

– Earn $32,600 per year
– Make $15.67 an hour at 40 hours/week
– Work 122 hours/week at minimum wage!
The reality…

12% of all people in the United States live
below the official poverty level
– Including 17% of children – more than 12
MILLION kids!

The poverty level is $15,260 for a family of
three – even at incomes significantly higher
than this level, housing is not affordable
Other factors contributing to
homelessness in some cases…
Substance Abuse
 Mental Illness
 Domestic Violence
 Family Strife
 Unemployment
 Disability

Health and Homelessness
The link between poverty and poorer health
is well-established. There are also specific
risks faced by homeless people.
 Homeless people are less likely to have a
regular source of healthcare.

Health and Homelessness:
Infectious Disease
Crowded living arrangements with many
other families means more bug sharing
 Homeless are at increased risk of:

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Upper respiratory infections
Acute otitis media
Lice
Scabies
Others
Homelessness and Health:
Mental Health & Development
Estimates of percent of homeless people
with mental illnesses are as high as 80-95%
 Homeless and marginally housed kids may
have higher rates of depression and behavior
problems
 Homeless children are more likely to have
developmental delays than their housed peers

Homelessness and Health:
Nutrition
Income is associated with obesity for all age
groups
 Homeless face additional problems in access
to nutritious food
 Homeless children and those in unaffordable
housing situations have actually been shown
to exhibit growth stunting due to
malnutrition

Homelessness and Health:
Dental Care
Access to dental care is a huge problem –
Medicaid does not cover dental care for
adults
 Nearly 50% of school-aged children have not
seen a dentist in the previous year in one
study
 36% of homeless children have dental
problems according to family surveys

Homelessness and Health:
Child Asthma
Asthma rates are increased for children living in
poverty in general, including homeless children
 Associated with poor housing conditions:
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Dust mites
Cockroaches
Molds
Rodents
URI’s as a trigger (increased due to crowding)
Conclusion
Homelessness is extremely prevalent
 Homeless people face unique challenges to
their health
 What does this mean for you?

– Be aware of people’s housing status and
associated risk factors
– Alter your plan of care to be realistic given
people’s living situation
For more information…
This presentation and citations are available
at: www.umich.edu/~projectH
 You can also find links to other resources
there!

Citations



Who is Homeless?
– Homes for the Homeless and the Institute for Children and Poverty.
“Facts About Homelessness.” www.homesforthehomeless.org
– www.alphahouse-ihn.org
The High Cost of Housing
– Affordable rent set by U.S. HUD. Calculations compiled by National
Low Income Housing Coalition, “Out of Reach” 2003
Poverty statistics
– U.S. Census, 2002

Health and Homelessness
– Karr, Catherine. “Homeless Children: What Every Health Care
Provider Should Know.” Compilation of many various studies.
Available at www.nhchc.org/children