Barriers to Accessing Healthcare for the Homeless

Published By: Majdulina

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Access to healthcare differs among individuals and depends on their circumstances. For instance, barriers to healthcare for the homeless community can vary from lack of transportation to geographic barriers and even financial barriers. It is important to note that understanding the problem is not enough, but rather, we must be actively finding real world solutions that will not only work but have a lasting impact. Identifying these issues can help create solutions while also providing quality health care to these individuals.

According to Purkey and MacKenzie (2019), their qualitative findings discovered that the main themes among people with homelessness experience include the “stigma and shame when accessing healthcare, lack of accountability of the healthcare system, [and the] inflexibility of the healthcare system.” The stigma and stereotyping regarding people living with homelessness is so prominent that individuals “avoid care due to past negative experiences” (Purkey & MacKenzie, 2019), furthering distrust towards healthcare providers and the overall barrier to healthcare. It is also pointed out that the lack of empathy or compassion resulted in individuals reducing their trust in healthcare providers. In order to create solutions and change for the homeless community, we must listen to their needs through “trauma and violence informed care, harm reduction, and cultural safety” (Purkey & MacKenzie, 2019). 


Additionally, financial burdens cause a strain on the homeless populations’ access to healthcare services. Examples of financial barriers include: the lack of health insurance, limited healthcare benefits and restrictive eligibility criteria, and no access to subspecialty care” (Gillis & Singer, 1997). Affording and accessing health insurance is a challenge for homeless individuals because of the high costs and lack of Medicaid benefits. In fact, “nearly one-third of all visits to the emergency room are made by people struggling with chronic homelessness” (Green Doors, 2021). With this in mind, it is revealed that healthcare providers and hospitals do not have the equipment necessary to assist the people living with homelessness and their complex issues. Health issues that arise include higher rates of chronic health problems…such as “high blood pressure, heart disease, lung disease, and HIV disease” (Green Doors, 2021). It is evident that several obstacles occur because of financial burdens and lack of access to healthcare services. A solution could be telehealth technology which is a cost-effective method “especially if transportation or mobility issues are also at play” (Wheel Team, 2019). Although it is not the only solution, it is available to increase awareness for more convenient and affordable options. 


Moreover, another setback that should be considered is the lack of transportation. Homeless individuals are not the only ones a part of this narrative; in fact, “3.6 million Americans do not receive medical care due to transportation issues…and is cited as the third most common barrier to healthcare access” (Wheel Team, 2019). Transportation barriers can lead to missed appointments and delayed care. Not only that, but geographical barriers appear to be an obstacle to rural communities because of physician shortages and long distances between healthcare facilities. Health promotion and disease prevention initiatives prove to be difficult especially because of distance barriers. Low health literacy rates, high poverty rates, and educational disparities are also examples of social determinants that are barriers. A solution that can reduce the transportation disparity could be utilizing telehealth services which deliver “virtual healthcare services directly to the patient, at home, school, or work” (Wheel Team, 2019). This can also alleviate some burdens in the rural communities by providing services such as “chronic care management, home monitoring, ICUs, long-term care, online therapy and counseling” (Wheel Team, 2019) among others.