Ethnic minorities remain disproportionately over-represented in the homeless population in the United States. Despite accounting for a small portion of the national population, African Americans, Native Americans, and Hispanic/Latinos are the majority of the homeless in the country, representing 40%, 22%, and 3% of the homeless population, respectively (National Alliance to End Homelessness (NAEH), 2020). For instance, 40% of African Americans are homeless despite accounting for only 13% of the national population (NAEH, 2020). In comparison, although the majority of the general population (76%), White Americans have a relatively low rate of homelessness (49%) (NAEH, 2020). Homelessness causes many negative effects on the health and overall well-being of homeless people ranging from health conditions to personal entrapment. This paper reviews existing literature on homelessness to shed more light on how it impacts the homeless in New York City.
Homeless people encounter multiple complex health issues in their lives. Research shows that the majority of this population suffers from intricate health problems such as cancer which remain unrecognized in the United States (Biedrzycki, 2018). In addition, people without permanent housing are very vulnerable to many other acute and chronic illnesses such as cold injury, cardiovascular diseases, tuberculosis, skin conditions, and HIV/AIDS (Stenius-Ayoade et al., 2017; Klop et al., 2018). They also report myriad physical, psychological, and mental health problems such as stress, depression, and sleep deprivation nutritional deficiencies (Stenius-Ayoade et al., 2017; Lippert & Lee, 2015). Besides, this population is disproportionately vulnerable to drug and alcohol dependency, violence (both physical and sexual), and mortality (Stanley et al., 2016; Klop et al., 2018). The research of Stanley et al. (2016) on the experiences of the unsheltered people in Maryland between 2003 and 2011, indicated high number of violence deaths within this population. Roncarati et al. (2018) document a similar trend showing high death rates among unhoused adults in Bolton, Massachusetts. High deaths rates within this population has been attributed to multiple factors including physical and sexual assault, drug and substance addition, and poor health (Stanley et al., 2016; Roncarati et al., 2018). Klop et al. (2018) point out that homeless people often experience negative emotions and feelings such as isolation, loneliness, and alienation which increase the risk of alcohol and substance dependence, multiple health problems (physical and mental), and involvement with criminal behaviors such as theft, murder, and kidnapping. Therefore, homelessness contributes to complex and chronic comorbidities which compromise their health and overall well-being.
Lack of attention to homeless people contributes to the high incidence of the complex physical, psychosocial, and mental health problems within this group. Existing research shows that these health issues are caused and exacerbated by lack of access to adequate quality health services and hospitals (De Veer et al., 2018). Klop et al. (2018) found that both unsheltered people and healthcare providers face many barriers to accessing and providing care that match and fulfill the unique needs and concerns of unsheltered people. Larkin et al. (2019) opine that the homeless do not have access to better care and depend heavily on the sheltered environment. In addition to lack of adequate attention from healthcare providers and their family members, homeless people have limited access to other necessities such as food, shelter, water and security which expose them to multiple physical, psychological, and mental problems (Roncarati et al., 2018). As a result of being unable to meet their basic needs, homeless people become heavily dependent on transitional and long-term housing assistance. Therefore, homelessness compromises their ability to care for themselves, consequently exposing them to many complex health issues.
References
Biedrzycki, B. (2018). Homeless With Cancer: An unrecognized problem in the United States. Clinical Journal of Oncology Nursing, 22(6).
De Veer, A. J., Stringer, B., Van Meijel, B., Verkaik, R., & Francke, A. L. (2018). Access to palliative care for homeless people: complex lives, complex care. BMC palliative care, 17(1), 119.
Klop, H. T., De Veer, A. J., Van Dongen, S. I., Francke, A. L., Rietjens, J. A., & Onwuteaka-Philipsen, B. D. (2018). Palliative care for homeless people: a systematic review of the concerns, care needs and preferences, and the barriers and facilitators for providing palliative care. BMC palliative care, 17(1), 67.
Larkin, H., Aykanian, A., & Streeter, C. L. (2019). Homelessness prevention and intervention in social work. Springer International Publishing.
Lippert, A. M., & Lee, B. A. (2015). Stress, coping, and mental health differences among homeless people. Sociological Inquiry, 85(3), 343-374.
National Alliance to End Homelessness. (2020). The state of homelessness in America. End Homelessness Organization. Web.
Roncarati, J. S., Baggett, T. P., O’Connell, J. J., Hwang, S. W., Cook, E. F., Krieger, N., & Sorensen, G. (2018). Mortality among unsheltered homeless adults in Boston, Massachusetts, 2000-2009. JAMA internal medicine, 178(9), 1242-1248.
Stanley, J. L., Jansson, A. V., Akinyemi, A. A., & Mitchell, C. S. (2016). Characteristics of violent deaths among homeless people in Maryland, 2003–2011. American journal of preventive medicine, 51(5), S260-S266.
Stenius-Ayoade, A., Haaramo, P., Kautiainen, H., Gissler, M., Wahlbeck, K., & Eriksson, J. G. (2017). Mortality and causes of death among homeless in Finland: a 10-year follow-up study. J Epidemiol Community Health, 71(9), 841-848.