Note: please note that this issue overview should (a) contain links to additional information on this topic that is focused either the local, state, national, or global level, and (b) be neutrally presented, based on facts, and include footnotes for each of the items.  See the Research Guide and Information Sources to assist you. 

Goal Statement   one sentence that further defines the topic 

• To provide information that are pertinent to improving the access and quality of health care for the homeless population. 

Policy Options / Model Programs   specific policies or program models, grouped by type, that are profiled 

• Care-A-Van Homeless Outreach - Waikiki, Hawaii

• Health Care for the Homeless - Houston, Texas

• Mount Carmel Community Outreach - Columbus, Ohio

• Outside in Community Medical Outreach, Portland, Oregon

• Street Outreach Services - San Francisco, California 

• West Side Community Health Services - Saint Paul, MN

Local/State/National Information  additional information on this topic at the local, state, national, global level

• Healthcare for the Homeless - USA
• Homelessness and Health Overview

   

Glossary of Terms   key words or phrases that the layperson needs to know to understand this issue 

• Upper Respiratory Tract Infections (URI): is a bacterial or viral infection of the nose, sinuses, or throat. Common symptoms of a URI are a runny or stuffy nose and a cough.

  Examples of URIs include influenza (flu), a cold, and sinusitis.^[1]

   

• Trauma: is a serious injury or shock of the body. It is caused by a physical force such as violence or an accident. The injury may be complicated by psychiatric, behavioral,  and social factors and can cause the disability to be greater than just physical injuries.^[2]

• Female Genitourinary Problems: These are conditions usually caused by infections that can affect the genital area and urinary system. Some infections are caught from another person, usually during sex. Other cases are caused when organisms (bacteria or yeast), which are usually present in small numbers, overgrow and cause symptoms.^[3]
• Hypertension: Blood pressure depends on a combination of two factors: how forcefully the heart pumps blood around the body and how narrowed or relaxed your arteries are. Hypertension occurs when blood is forced through the arteries at an increased pressure. This can cause an artery to rupture or the heart to fail under the strain - in the worst case stopping altogether.^[4]

• Gastrointestinal Diseases: several body parts, including the mouth, esophagus, stomach, small intestine, large intestine, and anus, make up the gastrointestinal (digestive) tract. Gastrointestinal diseases occur when the gastrointestinal (digestive) tract does not function properly. As a result, patients may have difficulty digesting food, absorbing nutrients, or having normal bowel movements.^[5]

• Peripheral Vascular Disease: also known as Peripheral artery disease (PAD) is a condition similar to coronary artery disease and carotid artery disease. In PAD, fatty deposits build up in the inner linings of the artery walls. These blockages restrict blood circulation, mainly in arteries leading to the kidneys, stomach, arms, legs and feet. People with PAD often have fatty buildup in the arteries of the heart and brain. Because of this association, most people with PAD have a higher risk of death from heart attack and stroke.^[6]

• Musculoskeletal Problems: the musculoskeletal system is a type of organ system that allows for movement and stability of the body and consists of bones, muscles, joints, tendons, cartilage, ligaments, and other connective tissue. Musculoskeletal problems can be caused by damage or injury to bones, joints, muscles, tendons, ligaments, or nerves.^[7]

• Mental Illness: is any disease or condition affecting the brain that influences the way a person thinks, feels, behaves, and/or relates to others and to his or her surroundings. Although the exact cause of most mental illnesses is not known, it is becoming clear through research that many of these conditions are caused by a combination of genetic, biological, psychological, and environmental factors. A person with an untreated mental illness often is unable to cope with life's daily routines and demands.^[8]

• Substance Abuse Disorder: substance abuse occurs when individuals use drugs for recreational purposes. Commonly abused drugs include alcohol, central nervous system stimulants (such as nicotine, caffeine, and methamphetamine), cocaine, heroin, and marijuana. Drugs can be taken by mouth, injected into a vein, snorted through the nose, inhaled, or smoked. Over time, individuals begin to develop a tolerance for the drugs. Most substances cause a change in the patient's consciousness, usually a decrease in responsiveness.^[9]

Bibliography    

• Amherst H. Wilder Foundation. “Overview of Homelessness in Minnesota 2006.” http://www.wilder.org/fileadmin/user_upload/research/homelessoverview2006_3-07.pdf
• Badiaga, Sékéné Raoult, Didier, and Philippe Brouqui. “Preventing and Controlling Emerging and Reemerging Transmissible Diseases in the Homeless.” http://www.cdc.gov/EID/content/14/9/pdfs/1353.pdf
• European Federation of National Organisations working with the Homeless. “Meeting the Health Needs of the Homeless People.” http://www.feantsa.org/files/Health%20and%20Social%20Protection/FINAL%20meeting%20the%20health%20needs%20of%20homeless%20people.pdf
• Homes and Communities—US Department of Housing and Urban Development. “McKinney-Vento Act.” http://www.hud.gov/offices/cpd/homeless/lawsandregs/mckv.cfm
• Hwang, Stephen, Orav, John, O’Connell, James, Lebow, Joan, and Brennan Troyen. “Causes of Death in Homeless Adults in Boston.” Annals of Internal Medicine 126 (April): 625-628 http://www.annals.org/content/126/8/625.full.pdf+html
• McMurray-Avila, Marsha, Gelberg, Lillian, and Breakey William. “Balancing Act: clinical Practices that Respond to the Needs of Homeless People.” http://aspe.hhs.gov/homeless/symposium/8-Clinical.htm
• National Coalition for the Homeless. www.nationalhomeless.org
• National Health Care for the Homeless Council. “The Basics of Homelessness.”  http://www.nhchc.org/Publications/basics_of_homelessness.html
• Neibacher, Susan. “Homeless People and Health Care: An Unrelenting Challenge.” United Hospital Fund of New York. http://www.careforthehomeless.org/policy/pdfs/an_unrelenting_challenge.pdf (1990).
• Wright, J. D. “The Health of Homeless People: Evidence from the National Health Care for the Homeless Program.” In Brickner, P.W. et al. (Eds.) Under the Safety Net: The Health and Social Welfare of the Homeless in the United States. New York: W.W. Norton. (1990).