A recent article on Housing as Health Care for the Homeless helped me focus on a deeper issue behind many things I already knew. It became clear to me that homelessness is “a pre-existing condition” for the vulnerable homeless population. It became clear to me that housing is health care. This insight … even if not surprising… raises a challenging question.
Homelessness as a “pre-existing condition”
First, I reflected on the mantras we have had drilled into us during this pandemic.
Health authorities have released lists of pre-existing medical conditions that put people at high risk for severe illness from COVID-19. But few recognize the pre-existing condition of Homelessness.
Homeless people are disproportionately impacted by COVID-19. They have poor health to begin with. To that, we add exposure to potentially dangerous living conditions.
Why do homeless people have so many pre-existing conditions?
Vicious cycle
Homeless people suffer a greater number and more severe health challenges than their housed counterparts. Poor health can contribute to homelessness, and experiencing homelessness can contribute to poor health.
Unsurprisingly, homeless people recover slower than their housed counterparts. Applying the time-tested adage of “getting plenty of bedrest” becomes nearly impossible when a person doesn’t have one.
What are homeless people told to do?
Social distancing?
“Social distancing is one of the main protections that health authorities have recommended. But for homeless people, this is simply not possible
“Stay apart, stay safe.” Social distancing protects people from all sorts of contagions.
That is precisely what’s so frustrating about homeless people being unable to social distance. … in shelter rooms filled with up to 50 sleepers: “If someone in a shelter dorm gets sick, you’re all getting sick.”
There is also a “Catch22” for social distancing. More stringent social distancing requirements have limited shelter capacity, which means they are better helping fewer people.
Wash your hands?
“Wash your hands for 20 seconds” is a mantra that’s been drilled into our collective consciousness of late. How many times have you washed your hands with soap and water since you woke up today?
Now put yourself in the well-worn shoes of homeless people. Finding a clean spot to maintain proper hygiene was challenging enough pre-COVID-19. But many of the facilities that people used to rely on – washrooms in public spaces, community centers, drop-in centers, YMCAs – have closed due to the pandemic. Even shelter washrooms can be hit-and-miss.
Eat right?
People relying on food banks don’t know what to expect from one day to the next in the current climate. Meal providers have had to modify or cancel services to protect staff and clients. Understandable. But with some food banks closing for several weeks before reopening on adjusted or staggered service leads to inconsistent nutrition at best among an already vulnerable population.
Now to the question
The preceding may have read like a whole bunch of “Tell me something I don’t know!”. Homeless people suffering from underlying health issues is not new information.
But that’s the point. At the risk of beating a dead horse, COVID-19 serves as yet another reminder that homeless populations are vulnerable populations. Adequate housing for all is health care.
When will we learn the lesson?
The Vincentian Family is doing what it can in this time of this pandemic. See more information about the world-wide initiative of the Vincentian Family Homeless Alliance.
Fr. Michael Carroll, CM
So true. Maybe the pandemic will help us to see that “housing first” is a key way to help people who are experiencing homelessness.According to the Institute of Global Homelessness, a few communities around the world have effectively ended street homelessness as a result of this pandemic, such as Scotland, England, and parts of Australia. These communities did so through close collaboration between government and NGOs and healthcare, with a singular focus on getting everyone off the street and out of shelters and into individual accommodation (e.g., hotels, motels). As a result, they have seen much lower infection rates among people who are homeless than in other communities that have not used these strategies. Further, these communities are now using this opportunity and increased government funding to move people out of their temporary accommodation and into permanent options with support services including education and employment. These examples show us that even in challenging circumstances, progress is possible. We need the political will.