Health Problems and Health Service Issues that are Associated with Homelessness - Essay Example

Health problems and health service issues that are associated with homelessness al affiliation Health problems and health service issues that are associated with homelessness Introduction Homelessness is an integral public health issue that affects every sphere of human ecology and development. Rough sleepers are present in every state and all regions of the world. Even though the problems faced by rough sleepers seem to be similar in different regions, specific issues are associated with certain countries (Bhugra, 2007). The definition of homeless persons vary from one state to another and hence the methods of determining their existence over time. The UK region, in its constituent states, has different connotations for the term homeless persons. These differences make it difficult to harmonize the statistics (Engelkirk & Duben-Engelkirk, 2008). A common definition of the term homelessness is ‘people who sleep rough (Glover-Thomas, 2002). This definition, however, has to meet certain criteria to qualify one as a rough sleeper. People who qualify for this classification have to be between the ages of 16-20 and above. Besides, they must have been previously under certain care or some custody, or were prior to being rendered a hard sleeper was a member of the HM forces, or was forced out of their former abodes due to family feuds, violence, threats of violence, etc. (Henderson, 2014). This paper will rely on estimates made by the different states to illustrate the magnitude of the problems within. Some factors determine the health factors that are faced by rough sleepers in different nations. These factors as Oliver (2013) notes are different and severe in the developing worlds compared to the developed regions. Rough sleepers in the UK experience a wide array of health problems owing to the increasing number of new entrants who stream into the streets and hostels every year due to homelessness and associated factors. This paper centers in focusing on the health issues facing the homeless persons in the UK. The 21st century has seen the increasing demands for healthcare attention for the homeless persons in the UK. As Baggott (2011) denotes, disease manifestation and occurrence have increased in the wake of global environmental change and disease proliferation through time. The homeless people are more exposed to various health dangers than the other populace. Besides, the increasing number of homeless persons in the UK, a lot of whom are victims of circumstances such as asylum seekers, jobless immigrants, and other related persons makes policy formulations to curb homelessness in the region a terrible nightmare. The paper discusses some of these health related issues in relevance to public health and policy making approaches towards curbing homelessness and its related health issues. Causes of homelessness The causes of homelessness vary from one person to another. The number of homeless people is currently on the rise in every part of the world with the young people becoming more homeless compared to the rest of the age groups. Figure 1 shows the disparities in homelessness among different age groups in the UK between 2010 and 2015. Figure 1: homelessness among the UK residents according to age Source: Department of Communities and Local Government (2015, p 8) Even though the causes of homelessness are deemed different among different persons, there are some factors that seem uniform among the different age-groups. The UK is a characteristic of these different manifestations with various rough sleepers driven into the situation due to a variety of factors. Figure 2 below shows the causes of homelessness as recorded by the UK authorities between 2010 and 2015. Figure 2: Causes of homelessness among the UK rough sleepers between 2010 and 2015 Source: Department of Communities and Local Government (2015, p 6) Many UK residents become homeless due to inability to pay housing rent of lease price. The majority of the rough sleepers in this category are the youths who are also jobless and unable to pay for their accommodation (Naidoo & Wills, 2008). Besides tough economic times, in Europe have rendered most of the people homeless and unable to pay their rents and mortgages hence dismissal by the property owners. Other causes of homelessness in the UK region include dismissal after the expiry of free hostage period offered by parents, relatives and friends, violent relationships and breakdowns in various relationships thus leading to one partner being expelled from the house they formerly occupied. Statistics of homeless persons in the UK It is not easy to provide an estimate the exact number of homeless persons in the UK owing to the differences in strategies used to record the number of homeless persons in various states making the UK region. Moreover, many homeless persons do not always appear on the official governments’ statistics. However, rough estimates have been used for policies formulations to address the effects of homelessness on various individuals. According to Homeless Link (2014), up to 111,965 (26% increase from 2009/10 statistics) households applied for homeless assistance to local authorities in the UK in 2013/14. Also, more than 15,000 households in Wales made similar applications to their local authorities for homelessness assistances. This was found to represent a 7 percent rise from the previous year reports (2010/2011). Scotland on the other hands reported up to 35,000 households applying for homelessness assistances making it one of the lowest periods in its history by registering up to 4 percent decrease in the number of households seeking homelessness assistance (Homeless Link, 2014). The UK region has experienced an increasing number of people seeking homelessness assistance through time and space. England is the largest affected by the number of people sleeping rough or seeking homeless assistances. Figure 1 shows the statistics of the number of people who have been sleeping rough in the UK region over the years from 2010 to 2015; Figure 3: Number of households accepted by the UK local authorities as owed a main duty following the loss of their last settled homes in the financial years 2010/11 to 2014/15 Source: Department of Communities and Local Government (2015, p 6) Health issues relating to homelessness A wide array of health issues has been associated with homelessness. This section will present a discussion of the various health issues commonly experienced by the rough sleepers in the UK region. The factors discussed in this section range from mental to physical health issues created and augmented by the physical and nutritional conditions to which the mentally ill patients are exposed. Mental illness Various studies have reported the association between homelessness and the occurrence of mental disorders in various individuals who are considered as homeless. Acute physical morbidities such as the prevalence of HIV, TB, and other related diseases have also been reported in some writings. These conditions have successfully contributed into augmenting the serious age-specific mortality rates in the UK among the homeless persons in the region. Clinical diagnoses of psychotic disorders have shown the prevalence of the condition ranging from 2% (Baggott, 2007) to 37% (Anderson & Sim, 2011) among the homeless individuals. Cases of depression, on the other hand, have been found to have a prevalence rate of between 4% (Baggott, 2007) to 41% (Anderson & Sim, 2011) while personality disorders range from 3% (Baggott, 2007) to 71% (Anderson & Sim, 2011). A wide variation of factors has been associated with the occurrence of mental incapacitation among the homeless individuals. Various researches have been conducted among various individuals to determine the relationship between homelessness and mental statuses. For instance, Crisis, (2011) research into he same issue included up to 400 homeless persons in England. Mental conditions and statuses were surveyed using the scorecards to determine the IQ levels of the individuals. Some propagating factors such as drugs use and abuse, nutritional and dietary conditions, and trauma were used to correlate mental retardation to homelessness. Besides, the survey also made a comparison between mental illnesses prevalence and other diseases and health conditions that are associated with homelessness. The survey which took one and a half year to generate conclusions revealed that mental illness is the most prevalent health issue that affects homeless persons in the United Kingdom. This was especially common among the young people. These findings are concurrent with those of Department of Health (2010) who records that poor mental conditions and development is a commonality among the young generation who have often fell victims of circumstances such drugs use and abuse, violence and depression. Besides, trauma is as well a common cause of poor mental condition among the young generations who are homeless. Department of Health (2010) attributes this to past experiences that were still fresh in the minds of the various persons interviewed. Mental illnesses are a function of various issues that are socially and psychologically instigated. Department of Health (2010) in his survey of the cases of depression recorded factors such as the inability to wake up in the morning or just get out of bed after long hours of sleep. Gillam, Yates, & Badrinath (2012) record that sometimes, rough sleepers are unable to sleep properly due to constant harassment of external conditions that interfere their sleep, a factor that renders them completely demotivated and stressed. Other factors that were reported in the survey included getting harassed and stressed which makes homeless persons occasionally hungry and angry, sad and even depressed. Studies on the propagation of mental illnesses in rough young sleepers indicate that the condition begins to deteriorate when a person becomes homeless and tends to increase as the person continues to live on the streets. The constant feelings of rejections, the dismissal often results into low self-esteem among the homeless people. Many pieces of research have revealed that many homeless persons feel lonely as a result of their dwelling in the past such as forceful eviction and trauma of losing their abodes. These feelings constantly make them harbor the heinous feelings that affect their psychological standing (Greenfields, Dalrymple, & Fanning, 2012). According to John & Law, (2011), memory losses and constant flashbacks into the past is a primary cause of poor mental development. Group 1 diseases: communicable diseases Diseases are divided into three main groups depending on their epidemiological processes and procedures: group 1, 2 and 3. Group 1 diseases comprise of the communicable diseases and include Cholera, Dysentery, TB, Asthma, Amoeba, typhoid among others (Larkin, 2009). These diseases, owing to their ease of transfer from one person to another, are very common among the rough sleepers. Group 2 diseases, on the other hand, are composed of non-communicable diseases such as cardiovascular diseases, cancer, ulcers, allergies; physical injuries, etc. group 3 diseases are associated with old age (aging diseases). As Patel, Woodwood, Feigin, Queigh and Heggenhoughen (2010) notes many places, where the rough sleepers spend their homage times such as parks, hostels, and streets, are highly crowded and unhygienic. Besides, most of these places have no well-maintained sewerage services or lack such services at all. During the cold seasons when a lot of rainfall trickle down these alleys, a lot of dirty and filth is carried along that often result in a series of diseases affecting the rough sleepers who dwell these areas (Patel, Woodwood, Feigin, Queigh, & Heggenhoughen, 2010). Coupled with poor sanitation, these people are exposed to massive attack from a wide array of communicable diseases mentioned above. Moreover, the summer seasons are not any safer for rough sleepers as they are characterized by flowing dust particles from moving vehicles, people, and the wind. These movements splash dirt particles into various homes in which the rough sleepers dwell and thus feeding dust particles together with disease-causing germs into the dwellings of these persons. As a result, they get infected with various communicable diseases such as coughs, diarrhea, and colds very easily since these diseases are caused by germs that reside in such media. Another very common disease that finds its way easily into the lives of the rough sleepers in the UK is HIV/ AIDS. Several wirings have focused on the proliferation of HIV among the homeless in various parts of the world. As in the US and other countries that experience a growing number of homeless persons, the HIV/AIDS menace among these deprived populations is a serious phenomenon (Tankimovich, 2013). According to, the depriving conditions under which rough sleepers spend their days and lives makes then susceptible to contracting the disease due to abuse and exploitation by other people. This is mainly common among the female gender affected. According the Tankimovich (2013), females are more vulnerable to sexual exploitation compared to the males. Many of the rough female sleepers are also prostitutes thus increasing their vulnerability to contracting sexually transmitted infections such as HIV. Moreover, congestion in the areas and the deplorable conditions under which rough sleepers live makes them, male and females, more vulnerable to external and internal sexual exploitations thus exposing them to HIV infections. Patel, Woodwood, Feigin, Queigh, & Heggenhoughen (2010) survey research on the proliferation of STDs among the rough sleepers conducted in Wales found out that most rough sleepers also abused drugs. Besides, this population, who abuse drugs especially among the youths, was also more sexually active and registered a high partner turnover rate. They were found to exchange frequently exchange sex for money or drugs. The females exchanged sex for money while most of the males exchanged sex for drugs and sometimes for money. Following this, there was a high prevalence of STDs among this population, including HIV/AIDS Group 2 diseases: non-communicable diseases Group 2 diseases are widespread in various categories of rough sleepers in all UK regions. The group 2 diseases are non-communicable diseases and comprise of a wide array of conditions and diseases which vary in effects and ease of contraction. Examples of physical injuries, accidents, cancer, heart diseases, liver diseases, kidney diseases, CNS diseases, tissue related diseases, Pneumonia, Sepsis, dietary diseases, such as malnutrition, etc. These diseases are contracted due to the condition of the places in which the homeless people live. Figure 4 shows a summary of the occurrence of group 2 diseases among the homeless individuals in the UK between the year 2010 and 2015. Figure 4: Percentage of occurrence of group 2 diseases in the UK between 1989 and 1994 Source: Jonathan, Lawrence, Lawrence, Robert, Irene, & Ann, (1994, p.306) The explanations given about the occurrence of group 2 diseases among the rough sleepers in the UK vary from time to time and from persons to persons. This owes to the differences in exposure conditions in which these people live. Injuries are the most occurring of all the group 2 diseases among the homeless individuals in the region (Henderson, 2014). This as Henderson (2014) observes, owes to the poorly built and poorly protected conditions. Larkin (2009) notes that most of the homeless persons in the UK live in dark alleys with dim or no lightings at all, in parks, and in poorly maintained hostels. These places expose the homeless persons to attacks by wild animals, malicious persons, blunt objects, etc. These challenges expose the homeless dwellers under extreme dangers and accidents. Moreover, self-inflicted dangers are another category of injuries that usually affect the homeless persons with an increasing prevalence rate. Drugs abuse and use and mental incapacitation are the two most common factors that contribute to self-inflicted injuries (Glover-Thomas, 2002). Moreover, violence also contributes to widespread injuries in this category of people. As mentioned above, most homeless persons abuse drugs or suffer from mental incapacitation thus are prone to injuries inflicted as a result of fights (violent reactions e.g. during combats), accidental injuries such as those incurred in dark alleys, external injuries inflicted by malicious persons etc. (Oliver, 2013). Nutritional infections are another group of diseases that have been reported in several pieces of literature among the homeless persons in the various states of the UK. According to Greenfields, Dalrymple, & Fanning (2012), homeless persons live in the streets and other related places due to their inability to afford better living places with better lifestyles. On most occasions, these people depend on food given to them by well-wishers or sometimes scavenged foods from remains thrown away especially from posh urban homes. Occasionally, they go hungry and without food especially when they are not lucky enough. The foods given to the rough sleepers or scavenged are sometimes not safe of just lack adequate nutritional content required to keep sound human health (Glover-Thomas, 2002). As a result, these people are exposed to various nutritionally/dietary based illnesses including marasmus and kwashiorkor among children under the age of 5 years. Cardiovascular diseases, kidney related infections, and cancer on the other hand result due to the poor eating habits and indiscriminate consumption of different types of foods, some of which are unsafe for the body. Cancerous infections occur due to the intake of junk foods. As Tankimovich (2013) notes, homeless persons have little choice on what they consume especially when living under very deplorable conditions where getting food is a great challenge. Junk foods Tankimovich (2013) are the major causes of cancer, cardiovascular diseases, and hypertension. Consumption of such foods, therefore, exposes the victims to a wide array of group 3 diseases as mentioned earlier. Policies to prevent homelessness in the UK The prevention of homelessness requires a multiplicity of policy approaches that would see through the eradication of such lifestyles. Various policies have been implemented in the UK regions to deal with the rising situation of homelessness in all states making up the UK. Even though some progress has been realized, these policies have met serious challenges that have hindered their effective implementation in some areas. For instance, the government of the UK, through the related ministries formulated a policy that would help them eradicate rough sleepers in the region. The policy, entrenched on the governments vision to end rough sleeping and dubbed, No Second Night Out focused on six key priority areas including improving access to mental health care provision and support to the homeless, reduction of drugs proliferation among the homeless populations, building of alternative dwellings from the homeless persons, acts to prevent aggression towards rough sleepers, improving Medicare services to the homeless persons and strategies to minimize the number of new entrants into the rough sleeping community. These policies were, however, marred by the rapid increase in the number of homeless persons who were moving into the streets at a higher rate than the rate at which the government was removing them. This made it easy for these policies to be accomplished. This paper suggests certain alternative policy programs that would be useful in addressing the issue of homelessness in the UK regions. Policies to provide alternative shelter According to Naidoo & Wills (2008), having an alternative shelter that provide most of the needs such as prevention from cold nights and seasons, injuries, invasion by wild animals and other malicious persons can prevent a lot of risks for the homeless persons. The provision of cheap but adequate shelter will help solve problems such as contraction of various illnesses such as injuries, pneumonia, asthma and other related diseases. Besides, this will also prevent the exposure to external attacks from various persons and objects (Baggott, 2007). Moreover, having homes where one can keep their belongings and families would enable the homeless persons to seek employment in various sectors to help them live adequately well. Policies to provide medical services In the UK, people who have no homes or permanent places of residence cannot have registered medical guarantee. By providing alternative residential places for the homeless persons, they will be able to access medical services just like other persons that have homes hence prevent a myriad of illnesses such as those that are communicable, etc. moreover; more mortality will be controlled as a result of such provisions. Conclusion Homelessness is a common phenomenon in various states within the UK region. Over time, the number of homeless people in the region has been increasing consistently. Literature shows that the number of youths who are homeless is higher than the other age groups. Some health issues continue to afflict the health of the homeless persons in the region. The most common health problem that has been identified in various literature materials is mental illness. Such is brought about by instances of drugs abuse, depression and trauma based on the past reflections. Other diseases such as HIV/AIDS, communicable diseases and other Class 3 diseases (non-communicable diseases) have been identified to have a common occurrence among the homeless persons in the UK region. Various policy programs have been chosen to help alleviate these conditions and reduce the number of homeless persons. Such policies involve the reduction of the number of homeless persons through the provision of alternative shelter, provision of healthcare services among others. Bibliography Anderson, I., & Sim, D. 2011. Housing and inequality. Coventry: The Chartered Institute of Housing. Baggott, R. 2011. Public Health Policy and Politics. Basingstoke: Palgrave. Baggott, R. 2007. Understanding Health Policy. Bristol: The Policy Press. Bhugra, D. 2007. Homelessness and Mental Health. Cambridge University Press. Crisis. 2011. Tracking the impacts of policy and economic change in England 2011-2013. London. Retrieved April 28, 2015, from The homelessness monitor: http://www.crisis.org.uk/data/files/publications/TheHomelessnessMonitor_141011.pdf Department for Communities and Local Government. 2015, June 24. Statutory Homelessness: January to March Quarter 2015, England. Housing Statistics Release, 1-26. Department of Health. 2010. Our strategy for public health in England. Retrieved April 28, 2015, from Healthy lives, healthy people: https://www.gov.uk/government/publications/healthy-lives-healthy-people-our-strategy-for-public-health-in-england Engelkirk, P., & Duben-Engelkirk, J. 2008. Laboratory Diagnosis of Infectious Diseases: Essentials of Diagnostic Microbiology. Lippincott Williams & Wilkins. Gillam, S., Yates, J., & Badrinath, P. 2012. Essential Pubic Health: Theory and Practice (2nd ed.). Cambridge: Cambridge University Press. Glover-Thomas, N. 2002. Reconstructing Mental Health Law and Policy. Cambridge University Press. Greenfields, M., Dalrymple, R., & Fanning, A. 2012. Working with Adults at Risk from Harm. Berkshire: Open University Press. Henderson, R. 2014. Homelessness is a public health crisis. Retrieved June 30, 2015, from The Guardian: http://www.theguardian.com/society-professionals/2014/jul/22/homelessness-public-health-crisis Homeless Link. 2014. The Unhealthy state of Homelessness. Health audit results, 1-23. John, W., & Law, K. 2011. Addressing the health needs of the homeless. British Journal of Community Nursing, 16 (3), 134-139. Jonathan, R. H., Lawrence, B., Lawrence, K., Robert, S., Irene, M., & Ann, K. M. 1994. Mortality in the cohort of homeless adults in Philadelphia. The New England Journal of Medicine, 331 (5), 304-309. Larkin, M. 2009. Vulnerable groups in Health and Social Care. London: Sage Publications Limited. Naidoo, J., & Wills, J. 2008. Health Studies: An Introduction (2nd ed.). Basingstoke: Palgrave Macmillan. Oliver, V. 2013. Healing Home: Health and Homelessness in the Life Stories of Young Women. University of Toronto Press. Patel, V., Woodwood, A., Feigin, V., Queigh, S., & Heggenhoughen, K. 2010. Mental and Neurological Public Health: A Global Perspective. Academic Press. Tankimovich, M. 2013. Barriers to and interventions for Improved Tuberculosis Detection and Treatment among Homeless and Immigrant Populations. Journal of Community Health Nursing, 30 (2), 83-95. Read More