Often the result as well as the cause of poor health, homelessness
contributes to illness through a number of factors such as: the
absence of a home base and supportive network, physical and psychological
stress, exposure to the elements, living in crowded, chaotic,
unhealthy environments, lack of protection from an array of bacteria
and viruses and social problems associated with poverty and the
stigma of being on the streets. "The homeless probably harbor
the largest pool of untreated disease left in American society
today" (Wright and Weber 1987:17).
Among the health problems commonly encountered by homeless people are:
Cold Injury
This is especially important in the northern United States and
Canada and is evidently the result of being without proper protection
from the cold.
Cardio-Respiratory diseases
Many suffer from upper respiratory problems or chronic physical
illnesses such as coronary artery disease or high blood pressure.
Tuberculosis
Between 1987 and 1992, the United States experienced an increase
of 20 per cent in active tuberculosis cases. TB is highly infectious
and common among those in shelters and in the streets. The rate
of TB among homeless people is at least a hundred times greater
than the average for the general population.
Skin diseases
Homeless people are predisposed to skin problems and edema resulting
from malnourishment, poor circulation, ill-fitting shoes, cuts
and dirty clothing.
Nutritional deficiencies
Because of poor nutrition and lack of care, a high percentage
of homeless persons have dental problems and suffer from malnourishment,
which increases the risk of infectious diseases and gastrointestinal
disorders.
Sleep deprivation.
For most people sleeping is difficult in the noisy atmosphere
of shelters. Sleep disorders cause irritability, apathy and behavioral
impairment. Children are especially affected.
Health problems of children and youths
Children in emergency shelters have emotional and developmental
difficulties and most are unable to do well in school. These children
have a rate of chronic disease twice as high as that of their
more stable peers. They can suffer from upper respiratory infections,
traumas and skin disorders, lice infestation, chronic problems
with eyes, ears and teeth, along with malnutrition, gastrointestinal
disorders, genito-urinary difficulties and sexually transmitted
diseases.
Mental Illness
There are evident links among homelessness, mental health and
public policies relating to the care or mentally ill people. It
is generally accepted that about one third of all homeless people
have serious and chronic forms of mental illness. Half of them
experience hopelessness and despair because of their conditions
and one in six attempt suicide.
Physical and sexual assault
Life on the streets is violent. Physical assaults and muggings
are common, and these attacks precipitate health problems. Women
and children are especially vulnerable. The rate of sexual assaults
to homeless women is twenty times higher that for women in general.
Drug dependency
Between 10 and 15% of homeless males abuse drugs and among them
there is a high occurrence of diseases such as HIV/AIDS, venereal
disease, skin ailments, bruises, lacerations and injuries resulting
from violence
Mortality
The death rate for homeless people is about four times greater
than the rate for the general population and among young homeless
men the rate is even higher. On average, homeless adults die twenty
years earlier than their non-homeless counterparts. Over half
of homeless adults die violently and one quarter of those are
murdered.
HIV/AIDS
These represent between 5 and 11 percent of all homeless people.
This is mostly due to drug use or homosexual or heterosexual activity
to earn money.
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