Public health encompasses a range of social, economic, and environmental issues and homelessness is no exception. In order to understand how homelessness is related to public health, we must first define what public health is. According to the World Health Organization (WHO), public health can be defined as “the science and art of preventing disease, prolonging life, and promoting health through organized efforts of society” (WHO, 2022). The homeless community is influenced by these factors by constantly being criminalized, being affected by housing instability, and experiencing the lack of access to healthcare.
The COVID-19 pandemic has affected so many people including the homeless community so much so that “due to funding cuts and social distancing restrictions, massive congregate shelters had to downsize their occupancy” (National Coalition for the Homeless, 2020). During this time, encampment sweeps have occurred, going against CDC guidelines. There have been reported ‘quality of life crimes’ that have targeted homeless individuals cited for pandemic related violations. Additionally, criminalization measures that focus on people experiencing homeless are “not only ineffective in reducing homelessness and costly to enforce but serve as a barrier to income and housing stability” (APHA, 2017). Continuing homeless services is important during the pandemic so that this vulnerable population has resources and guidelines for safety for themselves and the community. For instance, providing overflow sites to meet high demands, isolation/quarantine sites to test for COVID-19, and protective housing for those inflicted by the illness.
Moreover, finding housing solutions for the homeless population is an effective strategy to improve public health. “However, the lack of affordable housing and high rent costs are barriers to achieving housing stability” (APHA, 2017). Individuals experiencing homelessness with health needs often have difficulty in obtaining affordable housing. In addition, increasing income stability by providing supportive employment services for this vulnerable population is essential to aid in housing stability. “Key supportive housing services include medical and psychiatric treatment, case management, and resources designed to support independent living, which are often funded through Medicaid” (APHA, 2017). It is also imperative to identify which populations should be targeted in order to provide the appropriate prevention program. For instance, resources to help youths, families, and veterans differ and depend on their circumstances. A strategy for individuals to achieve and maintain permanent housing includes intervention through the “Housing First model” (CDC, 2020) in which can improve the quality of life and assists access to supportive services and health care. The lack of housing can also result in an increase in preventative health conditions as well as worsening of chronic health conditions.
Furthermore, the lack of access to healthcare is another factor to consider when discussing homelessness as a public health issue. In fact, “the access to primary care is lacking. Homelessness, poverty, and socioeconomic status have been associated with inadequate primary and preventative health care” (Fotoula, 2015). Disparities in care, demographics, and environmental issues have consequences when it comes to health care for the homeless population. Research findings show that “higher mortality rates and chronic disease loads among individuals experiencing homelessness than among those who are housed” (APHA, 2017). This can explain the reason that homeless individuals use emergency services extensively which leads to higher cost for treatment. This also proves extremely difficult, especially those going through chronic mental and physical health conditions, and substance abuse are unable to access care such as prescribed medications when necessary.
All in all, homelessness is a public health issue and a few factors affecting the homeless population include criminalization of homelessness, housing instability, and lack of access to healthcare. It is important to consider and recognize that each homeless individual is different as well as their situations. Therefore, there is not one solution that fixes everything. Additionally, finding housing services that include medical and psychiatric treatment and increasing access to employment for income stability is just one step to help the homeless community.