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General Health Issues

The Unique Health Issues of the Homeless  

  • February 14, 2015
  • 5 min read
The Unique Health Issues of the Homeless   

Most people are aware that being homeless is difficult, but they might not realize exactly how difficult it can be. There are a lot of things that people with homes take for granted, especially when it comes to health and personal hygiene.

homeless-health issues

For example, people might understand that the homeless don’t always have access to bathroom facilities, but they don’t really understand what that lack of access means in terms of overall health.

  • Not being able to regularly wash the body or clothing doesn’t just cause dirt and odors to accumulate; it can also make people more prone to skin conditions like scabies, lice, and eczema.
  • Not being able to brush the teeth regularly can make people more prone to tooth decay and gum disease, which can also increase the risk of developing heart disease.
  • Women of child-bearing age don’t have the ability to clean themselves while menstruating, or to even change to fresh pads or tampons. Additionally, the prolonged use of tampons is linked to toxic shock.
  • People can also be more prone to airborne illnesses, like colds and flu, which are often contracted by touching an infected surface and then rubbing the nose or eyes.

However, bathroom facilities are only a small part of the equation. The homeless also don’t have reliable access to kitchens and refrigeration. Even if they live in shelters, they might still be in situations where the kitchen is off-limits, or access is at the discretion of the shelter staff.

For someone with diabetes, who has to keep his insulin cold, those limitations could prevent him from properly storing his medication, or from having access to it when he needs it. Additionally, the shelter might not allow him to have needles or syringes on site, because they can also be used for illicit drugs, so that even if he does have access to a refrigerator, he has no way to administer his medication.

The homeless are also more likely to be the victims of violent crime, such as assault and rape, resulting in serious injuries. Theft is also an issue, not only of any money that the homeless may have, but also of the medications many of them need to survive. Sometimes they are victims of other homeless people, and sometimes they are victims of criminals who see them as easy marks. Jersey City is also an area that I watch closely, as there are always very interesting cases.

Perhaps one of the biggest obstacles the homeless face is in getting adequate treatment for mental illness, substance abuse, and addiction.

Homelessness, Mental Health, and Addiction

When it comes to treatment for mental health issues and addictions, the homeless face a lot of obstacles. In addition to a lack of access to facilities, or even a safe place to keep medications there is also the issue of the strong relationships between homelessness, mental health issues, and addiction.

Approximately 25 percent of people with serious mental illness, such as schizophrenia and bipolar disorder, are chronically homeless; and there are greater instances of mental illness among the chronically homeless and homeless women. Homeless teens, a growing segment of the homeless population, are also showing changes in brain development that can lead to behavioral problems and mental health issues.

For some, homelessness and mental health issues are part of a vicious cycle: the mental health issues contribute to the homelessness, and the homelessness exacerbates the mental health issues.

For others, becoming homeless and having to cope with living on the streets can actually trigger mental illness, such as post-traumatic stress disorder.

Whether the mental illness was pre-existing, or developed as a result of being homeless, it can ultimately making it harder for the homeless mentally ill to find suitable housing.

Substance abuse becomes a factor as people turn to drugs and alcohol to self-medicate, when “real” medication isn’t available, and to deal with the stresses of living on the street. For some, drugs and alcohol are also a means of bonding and forming a sense of community with other people on the street.

Although drugs do exist within homeless communities, alcohol abuse is the most prevalent, with nearly 70 percent of homeless men, and 30 percent of homeless women reporting an alcohol problem.

Although drug, alcohol, and mental health issues are common among the homeless, viable treatment options are not.

Although there are some shelters that cater specifically to individuals with drug and alcohol problems, those are few and far between. Many shelters screen out those with issues. Additionally, many organizations that offer aid to the homeless in the form of housing and other services, also exclude people with drug and alcohol issues.

As a result, many of these people are left to fend for themselves on the street, spend a lot of time in and out of hospital emergency rooms, or end up in the legal system.

Some homeless do get some form of drug or alcohol treatment through residential or outpatient drug treatment programs, including 12-step programs and group counseling. In some cases, those programs also address their other health issues and might even help them find shelter or housing.

Unfortunately, these services only reach about 25 percent of the homeless population, and a large number of people still fall through the cracks.

 Article By Jennifer Smith







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