Vulnerability of Homelessness

Vulnerable populations are classified as such due to circumstances or prejudices that stack the deck against their success in relation to the standard in a country, province or region. Many groups may be classified as vulnerable due to ethnicity, religion, infirmity, or any host of other characteristics that may separate them from the pack in their ability to care for themselves or access or utilize assistance in the form of healthcare or social services. Universally, those who are without suitable shelter or a stable place to call home will fall into this category.

Being homeless is in many ways the perfect recipe for failure of health. According to Woolley (2015), homeless people are disproportionately affected by: injuries due to increased risk of being victims of violence; hunger and malnutrition; skin and oral health conditions related to hygiene limitations; sexual health complications attributable to increased risky sexual encounters and practices; a broad range of mental health issues, infectious diseases, respiratory illnesses and chronic conditions such as hypertension, diabetes and seizures; chronic pain due to many of the reasons listed above, as well as an inability to obtain or afford required prescription drugs (Woolley, 2015). Exposure to the elements -both extreme heat and cold- is also a grave health threat to the homeless (Steeves, 2018).

Compounding the challenge for these groups is the fact that the condition of being homeless predisposes people to a greater need for healthcare and social services while simultaneously making them less accessible. These populations -lacking a permanent mailing address- may have no means of collecting social assistance payments or even obtaining proper identification to facilitate access to such services (Cooke, 2019). Lack of appropriate identification may also serve to perpetuate the situation by making it more difficult to obtain work (or medication) that may help them to get back on their feet. This helpless state could heighten anxiety, further magnifying challenges.

A study conducted in New Brunswick three years ago attempted to identify a baseline for the number of homeless people across four major cities in the province (CBC News, 2016). The procedure for this head count made very clear the challenge involved in studying and tracking the health of these people. The transient nature of homelessness makes these individuals difficult to study, and without their individual capacity and initiative to seek appropriate care, impossible to treat. To help this vulnerable group, a holistic approach that addresses homelessness across multiple levels would need to be implemented. In addition to treating the existing acute and chronic health conditions, social determinants (such as providing a safe place to live with protection from the elements and violence; the means to improved hygiene, nutritious diet and positive social interactions) would need to be addressed to make a lasting impact. Providing access to these basic needs would serve as a starting point. Beyond this, career counselling and training would provide the skills to join the workforce and ultimately become self sufficient (for those who manage to achieve the required health and capacity to handle such positions).

Resources

CBC News. (2016). Homeless study counts 200 people in 4 N.B. cities | CBC News. Retrieved July 12, 2019, from CBC News website: https://www.cbc.ca/news/canada/new-brunswick/homeless-count-nb-cities-1.3482952

Cooke, A. (2019). New Brunswick man makes a homeless shelter in garage, gets shut down by bylaw. Retrieved July 12, 2019, from The Star website: https://www.thestar.com/news/canada/2019/01/13/new-brunswick-man-makes-a-homeless-shelter-in-garage-gets-shut-down-by-bylaw.html

Steeves, S. (2018). New Brunswick outreach groups work overtime to help homeless during heat wave. Retrieved July 12, 2019, from Global News website: https://globalnews.ca/news/4320769/new-brunswick-outreach-groups-work-overtime-to-help-homeless-during-heat-wave/

Woolley, E. (2015). What are the top 10 health issues homeless people face? Retrieved from https://athabascaedu-my.sharepoint.com/personal/cchambers4_athabasca_edu/Documents/What are the top 10 health issues homeless people face.pdf