copyright © 2008 delmar. all rights reserved. chapter 27 the homeless population
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Copyright © 2008 Delmar. All rights reserved.
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Homelessness
• Homeless Assistance Act of 1987 refers to someone: – Who lacks a fixed residence– Lives in shelters– Lacks regular sleeping accommodations– Living in a home and has been asked to leave
within the next month
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Homelessness
• Social condition and usually the result of several factors such as: – Severe and chronic health conditions– Mental illness, substance abuse– Chronic unemployment– Domestic violence– Poverty, war, disease, forces of nature
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Homelessness
• Population is younger, often employed, and involves children
• Vulnerable populations are subgroups sensitive to risk factors because of: – Economic, social, physical, environmental,
biological and lifestyle, chronic disease, health care disparities
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Key Factors in Contributing to Homelessness
• Poverty
• Eroding work opportunities
• Decline in public assistance and government supported housing
• Lack of affordable health care
• Domestic violence, mental illness, addiction
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Health of the Homeless
• Higher rates of substance abuse
• Higher rate of peripheral vascular disease
• Hypertension
• Liver disease
• Communicable disease
• Limited access to health care
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Health of the Homeless
• Chronic versus acute health problems– Diabetes– Tuberculosis
• Policy recommendations for health care of homeless– Universal access, accessible health care– Increase funding
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Health of the Homeless
• Better tracking systems for hate crimes
• Promotion of police training about hate crimes
• Homelessness speakers’ bureaus
• End homelessness
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Mental Illness
• Policy recommendations– Ensure access to accountability of addiction
and health care services– Require health plans
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Mental Illness
• Policy recommendations– Strengthen existing mental and addiction
services– End criminalization of homelessness– Establish policies and programs that are
consistent with evidenced-based practices
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Mental Illness
• Special populations– Homeless youth
• Family, economic, and residential problems• Gay, lesbian, bisexual, transgender • Accessibility of education
– Risk of STDs, depression, substance abuse, suicide attempts
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Mental Illness
• Policy and program recommendations for homeless youth – Substance abuse services– Provide drug free safe place to socialize– Group training in conflict resolution– Anger management, stress reduction, coping
skills
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Homeless Elderly
• Individual over age 50
• Primarily due to: – Lack of affordable housing– Increased poverty– Decreased wages– Lack of adequate retirement
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Homeless Elderly
• Often suffer from the following:– Neurological disorders
• Epilepsy, peripheral neuropathies• Cognitive disorders
– Gastrointestinal problems– Musculoskeletal disorders – Pneumonia, COPD, TB
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Characteristics of Homeless Elderly Men
• African American
• Low levels of education
• Significant psychiatric problems
• Suffer chronic diseases
• Suffer higher rate of social isolation
• Often never employed full time
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Characteristics of Homeless Elderly Women
• Vulnerable to homelessness after death of spouse
• Caucasian
• Receive public assistance
• Suffer psychiatric illnesses
• Chronic health problems
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Characteristicsof Homeless Elderly
• Growing number are veterans– Low income, post-traumatic stress disorder– Poor physical health
• Policy and program recommendations– McKinney-Vento Homeless Assistance Act– Federal Education Rights and Privacy Act– Strong support system, advocacy
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Homeless Veterans
• Lack of affordable housing and poverty
• Decreasing veterans’ benefits
• Post-traumatic stress disorder– Alcohol and substance abuse– Lack of family and social support
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Programs forHomeless Veterans
• VA’s Health Care for the Homeless Veterans Program
• VA’s Domiciliary Care for Homeless Veterans
• Special Outreach and Benefits Assistance
• Veterans Benefits Assistance
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Programs forHomeless Veterans
• Acquired Property Sales for Homeless Providers Programs
• Readjustment Counseling Service Vet Center
• Drop-in centers
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Overall Prevention and Policy Recommendations
• Title V (1983)
• Homeless Persons’ Survival Act (1986)
• Urgent Relief for the Homeless Act (1987)– McKinney-Vento Homeless Assistance Act
• Community Involvement– Resources – Self-improvement
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Overall Prevention and Policy Recommendations
• Ending chronic homelessness
• Strategies for action– Enhance access to services– Foster state and local response
• Geographic Information System
• Community Based Homelessness Prevention Program