Health equity is attained when all individuals have fair opportunities to realize their total possible health. It involves eliminating the differences that cause inequities, including socioeconomic status, age, and ethnicity. However, vulnerable populations, including homeless individuals, continue to be at a high risk of mental illnesses, Asthma, tuberculosis, and HIV/AIDS, which makes it a public health concern. The population has challenges accessing care, aggravating the likelihood of adverse health outcomes. They also have problems accessing preventive and treatment care due to a lack of insurance and required finances, leading to a high rate of mortality. This paper describes issues faced by homeless individuals with a focus on mental illnesses, the social determinants of health, and an advocacy plan to reduce the disparities.
Homelessness is an issue of global significance, with a 4.2% prevalence of individuals being homeless in the U.S. Every night, over 584,000 individuals are homeless and do not have a place to sleep. Homeless individuals often face mental complications with a high risk of mortality and morbidity (Gutwinski et al., 2021). Research shows that 25% of homeless individuals have severe mental illnesses, while 45% of the individuals have other forms of psychological complications. Most individuals who face homelessness include those with disabilities, veterans, and unaccompanied youths. African Americans are at a high risk of being homeless. High rates of homelessness are disproportionately witnessed in California, New York, and the District of Columbia.
Homeless individuals mainly live on the streets and sleep in places that are unfit for human habitation. 69% of the homeless population live in emergency shelters, while 31% remain unsheltered in the streets and abandoned buildings. They have limited access to health care as they lack health insurance and adequate finances, which worsens their mental complications (Onapa et al., 2022). They also experience traumatic disorders due to violence, rape, and robberies. Homeless people are at a high risk of suicide, substance abuse, and depression.
Homeless individuals come from low socioeconomic backgrounds and lack stable housing. Research shows that individuals in the U.S. spend more than 30% of their income paying rent (Onapa, 2022). Unemployment also impacts homeless individuals despite having a great desire to work due to lack of education. The homeless population has trouble paying rent, which causes eviction and makes them prone to illnesses. They are also impacted by food insecurity, which leads to mental illnesses.
The population also lacks access to health care due to a lack of health insurance, transportation, and limited healthcare resources. They are less likely to seek care and treatment for conditions such as depression and children’s developmental delays, leading to health disparities (Gutwinski et al., 2021). The individuals also lack access to education, which leads to a cycle of low socioeconomic status, which impacts the families’ health outcomes. Moreover, people experiencing homelessness live in neighborhoods with high levels of violence and safety risks. They also face discrimination and stigma as they are perceived to be bothers and dangerous. They have trouble affording basic needs, which impacts their mental health. The children are also exposed to abuse and neglect at an early age, which results in mental complications.
There is a policy enforcing anti-camping ordinances, which affects people experiencing homelessness. Recently, the U.S., particularly in Missouri, passed laws prohibiting people experiencing homelessness from sleeping in public parks and state property (Oppenheimer, 2024). Sleeping on the property attracts a fine, which has led to a further displacement of the population and an escalation of mental health complications. Loitering and storing personal belongings near public facilities is also illegal. The state funding for people experiencing homelessness has also been reduced. Other cities, including Oregon, are also in the process of passing laws targeting people experiencing homelessness. People experiencing homelessness are forced to hide in unsafe locations, which poses mental issues.
There has been a public uproar about the homeless camping in public spaces, which led to the development of the policy. Camping has also been criminalized due to the cited increase in rates of violence and damage to property where the homeless live (Oppenheimer, 2024). The public also perceives homelessness as a threat to safety. The local regulations have also contributed to the implementation of the policy.
The anti-camping laws have led to increased mental complications. Homeless individuals worry about getting arrested by law enforcers. Research shows that individuals sleep in isolated places, which increases the risk of assault and anxiety (Oppenheimer, 2024). The population has trouble sleeping due to depression. The policy also deters individuals from seeking medical and support services.
The plan begins with creating awareness of the root causes of homelessness to reduce stigma and enhance public acceptance. The community outreach programs will enhance sympathy toward homeless individuals, where the public and donors will be ready to help reduce the disparities. There should be advocacy to the legislation to reduce the rate of homelessness by adopting policies that ensure long-term solutions to the problem. The anti-camping laws should be challenged to ensure they are repealed. The efforts should also expand access to healthcare while reducing harm to the homeless population (Kapadia, 2022). It can be done by enabling people experiencing homelessness to acquire health insurance plans at a low cost to improve their health outcomes.
There should be advocacy for implementing the Housing First approach to provide people experiencing homelessness with shelters and improve their quality of life. Affordable housing should also be prioritized to reduce the number of people on the streets (Kapadia, 2022). Policymakers should work to align policies and funding to end homelessness. The efforts should also be aimed at advocating for policies that protect the population’s rights while providing support. Advocacy to ensure the collaboration of healthcare providers and social service organizations should be done to ensure people experiencing homelessness have access to quality care and mental health support while reducing the disparities. Training programs to develop the population’s skills should be advocated for, enhancing their chances of employment.
Homelessness has been an issue of public health concern due to the posed health risks, including mental disorders, which contribute to health disparities. People experiencing homelessness have economic instability and cannot afford housing. The population also has limited access to care and lives in neighborhoods that are prone to different forms of violence. One of the policies promoting the disparities is the anti-camping ordinances, which prohibit people experiencing homelessness from living and sleeping in public places. The policy increases the risk of mental health disorders as individuals live in fear of getting arrested and experiencing assault. The advocacy plan to reduce the disparities includes creating public awareness of the root causes of homelessness and campaigning against the policy to displace people experiencing homelessness. The advocacy efforts should also ensure policy reforms to implement affordable housing and enhanced access to care. Advocating for training programs for the population is also vital to increasing their chances of employment and ending homelessness.
Gutwinski, S., Schreiter, S., Deutscher, K., & Fazel, S. (2021). The prevalence of mental disorders among homeless people in high-income countries: an updated systematic review and meta-regression analysis. PLoS medicine, 18(8), e1003750. https://doi.org/10.1371/journal.pmed.1003750
Onapa, H., Sharpley, C. F., Bitsika, V., McMillan, M. E., MacLure, K., Smith, L., & Agnew, L. L. (2022). The physical and mental health effects of housing homeless people: A systematic review. Health & social care in the community, 30(2), 448-468. https://doi.org/10.1111/hsc.13486
Oppenheimer, P. M. (2024). The Illusion of Public Space: Enforcement of Anti-Camping Ordinances Against Individuals Experiencing Homelessness. In University of Chicago Legal Forum (Vol. 2023, No. 1, p. 18). https://chicagounbound.uchicago.edu/uclf/vol2023/iss1/18/
Kapadia, F. (2022). Ending homelessness and advancing health equity: public health of consequence, March 2022. American journal of public health, 112(3), 372-373. https://doi.org/10.2105/AJPH.2021.306704