Homelessness and Health University of Michigan Project H Lunch Talk, April 26 th 2004

Who Is Homeless? “Chronic Homeless” –What we generally think of when we think of homelessness Families –Families with children are the fastest growing segment of the homeless –More than 600,000 American kids will sleep in a shelter tonight –The average age of a homeless person: 9 years old.

Why are families homeless? They don’t have enough money to afford housing!! There is an affordable housing shortage throughout the United States. The housing that does exist is very expensive.

The High Cost of Housing An example: Washtenaw County To afford a two-bedroom apartment in Washtenaw County, a family head must: –Earn $32,600 per year –Make $15.67 an hour at 40 hours/week –Work 122 hours/week at minimum wage!

The reality… 12% of all people in the United States live below the official poverty level –Including 17% of children – more than 12 MILLION kids! The poverty level is $15,260 for a family of three – even at incomes significantly higher than this level, housing is not affordable

Other factors contributing to homelessness in some cases… Substance Abuse Mental Illness Domestic Violence Family Strife Unemployment Disability

Health and Homelessness The link between poverty and poorer health is well-established. There are also specific risks faced by homeless people. Homeless people are less likely to have a regular source of healthcare.

Health and Homelessness: Infectious Disease Crowded living arrangements with many other families means more bug sharing Homeless are at increased risk of: –Upper respiratory infections –Acute otitis media –Lice –Scabies –Others

Homelessness and Health: Mental Health & Development Estimates of percent of homeless people with mental illnesses are as high as 80-95% Homeless and marginally housed kids may have higher rates of depression and behavior problems Homeless children are more likely to have developmental delays than their housed peers

Homelessness and Health: Nutrition Income is associated with obesity for all age groups Homeless face additional problems in access to nutritious food Homeless children and those in unaffordable housing situations have actually been shown to exhibit growth stunting due to malnutrition

Homelessness and Health: Dental Care Access to dental care is a huge problem – Medicaid does not cover dental care for adults Nearly 50% of school-aged children have not seen a dentist in the previous year in one study 36% of homeless children have dental problems according to family surveys

Homelessness and Health: Child Asthma Asthma rates are increased for children living in poverty in general, including homeless children Associated with poor housing conditions: –Dust mites –Cockroaches –Molds –Rodents –URI’s as a trigger (increased due to crowding)

Conclusion Homelessness is extremely prevalent Homeless people face unique challenges to their health What does this mean for you? –Be aware of people’s housing status and associated risk factors –Alter your plan of care to be realistic given people’s living situation

For more information… This presentation and citations are available at: You can also find links to other resources there!

Citations Who is Homeless? –Homes for the Homeless and the Institute for Children and Poverty. “Facts About Homelessness.” – The High Cost of Housing –Affordable rent set by U.S. HUD. Calculations compiled by National Low Income Housing Coalition, “Out of Reach” 2003 Poverty statistics –U.S. Census, 2002 Health and Homelessness –Karr, Catherine. “Homeless Children: What Every Health Care Provider Should Know.” Compilation of many various studies. Available at