Introduction
Social protection of vulnerable populations is essential to reduce inequality and poverty, promote economic growth and labor productivity, and ensure community stability. In particular, health education programs aim to empower citizens and improve their physical health and mental well-being by increasing knowledge and influencing attitudes towards care. Homelessness is one of the factors aggravating people’s security which indicates the need to address this problem. According to Stanhope and Lancaster (2016), “poor health is both a cause and an outcome of homelessness” (p. 741). Hence, the purpose of this research is to explore the background of the homelessness issue in Los Angeles County, California, and provide a specific health education program for the identified vulnerable population.
Main Points to be Covered
To achieve the goal of this research, the following points will be covered in this presentation. To begin with, the vulnerable population, namely homeless people in Los Angeles County, will be discussed with regard to current demographics, history, and cultural background. The background of the problem will be studied, and specific concerns and risk factors will be established, as well as methods of prevention and control. In addition, the role of the public health nurse and the core functions of public health will be examined. Finally, three local agencies and facilities delivering services to homeless people in LA will be identified, along with additional resources needed in the community.
Vulnerable Population
The vulnerable population chosen for this research is homeless people in Los Angeles County. As defined by the Substance Abuse and Mental Health Services Administration (SAMHSA) SOAR TA Center (n.d.), those experiencing homelessness are “an individual or family who lacks a fixed, regular, and adequate nighttime residence” (para. 4). For instance, it includes people living in emergency shelters, welfare hotels, transitional housing, and places not ordinarily used for habitation. Furthermore, people with low income and social security are at risk of homelessness and require special attention and support to address the issue.
Current Population Demographics
It is essential to discuss the current population demographics to evaluate the importance of health education programs for improving social stability. As reported by Los Angeles Homeless Services Authority (2020), the homeless count in Southern California has grown by 3% to 20% in different counties in 2020, except for San Diego, with a 6% decrease (p. 5). The number of homeless in Los Angeles County increased by 13% in 2020. The primary reasons for one’s first episode of homelessness include economic hardship, weakened social network, disabling health conditions, system discharge, domestic and intimate partner violence, and others. The black population is 4x more likely to stay without housing, while 2/3 of homeless people identify as male (Los Angeles Homeless Services Authority, 2020). As can be seen, there is a need to support vulnerable groups experiencing homelessness.
Background of the Problem and Effect on Public Health
The rationale for choosing this subject for research is the need for supporting the homeless as a vulnerable population affected by numerous factors, including lack of affordable housing, unemployment, physical disabilities or mental illnesses, and substance abuse. Moreover, the phenomenon of unsheltered homelessness can be observed in Los Angeles, as compared to New York City. According to Kuhn et al. (2020), despite the similar poverty and homelessness rates and shares of cost-burdened and severely cost-burdened households, 75% of homeless in LA are unsheltered, compared to 6% in NYC (p. 7). Furthermore, the problem of homelessness is related to public health threats. Mental illnesses, substance abuse rates, as well as infectious and chronic diseases are higher in the homeless population. Furthermore, other consequences include violence, unintentional injury, reproductive health, pregnancy, and child health complications.
Cultural Background and Relevant History of Homeless
The history of homelessness in Los Angeles County reveals the lack of coordination among agencies that hindered structural changes and led to a crisis. It can be traced back to insufficient housing development after World War II and exclusionary zoning that aggravated racial disparities that remain a problem nowadays. As stated by Wolf (2021), “a focus on criminalizing people who live on the street … intensified nationally since the 1970s” (para. 11). Currently, the COVID-19 pandemic forced more low-income households to experience housing insecurity (Wolf, 2021). The homeless culture comprises characteristics of this vulnerable population and various causes that contribute to their social insecurity, such as economic and social factors.
Psychosocial Concerns of Homeless People
Due to numerous factors aggravating the health and well-being of homeless people, they often suffer from psychosocial issues. For instance, as reported by Kuhn et al. (2020), individuals struggling with housing security often face family problems, low perceived social support, anxiety, depression, anger, hopelessness, sexual abuse, substance abuse, and violence. Another significant problem is the social stigma around the concept of homelessness that worsens other social inequalities in the community.
Economic Concerns of Homeless People
Homelessness can be considered an economic and structural problem affecting the population. Low-income families and individuals with chronic financial struggles are more vulnerable to external factors and more likely to face a lack of housing. Income inequality aggravates the situation and forces more people to live on the streets or seek help from support networks. According to SAMHSA SOAR TA Center (n.d.), people with “an annual income below 30 percent of median family income for the area,” are considered at risk of homelessness (para. 9). Furthermore, homeless students face additional challenges for succeeding academically. High unemployment rates prevent many individuals from affording adequate housing.
Health Concerns of Homeless People
There are numerous health-related concerns specific to the homeless population. In particular, living on the streets increases the risk of infectious diseases, HIV/AIDS, skin infections, tuberculosis, pneumonia, malnutrition, wounds and injuries, and drug and alcohol abuse (Kuhn et al., 2020). Limited resources and access to birth control methods lead to higher pregnancy rates among unsheltered females and adverse birth outcomes. Moreover, mental health problems, as well as heart disease, contribute to a high mortality rate and risk of suicide.
Risk Factors for Homeless People
Several risk factors can be identified contributing to the chances of housing insecurity in people in Los Angeles County. In particular, income inequality and lack of housing affordability are considered the primary factors causing the problem (Kuhn et al., 2020). Individual financial difficulties and economic hardship can jeopardize the housing situation for some people. Kuhn et al. (2020) report violence, abusive relationships, family problems, mental illnesses, antisocial and aggressive behavior, as well as weakened social networks as contributing factors. Finally, poor academic qualifications and school expulsion can also aggravate the situation for vulnerable populations.
Prevention and Control of Health Concerns and Risk Factors
Prevention and control of health concerns and risk factors for the homeless population can be divided into primary, secondary, and tertiary measures. Typically, primary prevention includes practices aiming to reduce the risk of homelessness in the general population through housing policies and welfare settlement. Secondary prevention identifies and supports people at high risk by providing financial and social aid and monitoring their needs. Tertiary prevention targets people who have already been affected by homelessness and suggests individual interventions facilitated by relevant policies and funding.
Role of Public Health Nurse
Public health nurses play a fundamental role in working with vulnerable populations, including homeless individuals and families. The main goal is primary prevention of health-related issues and well-being promotion. According to Kuhn et al. (2020), public health nurses can identify people at risk and increase awareness about the causes and consequences of homelessness. In this regard, public health has three core functions with regard to care for people experiencing and at risk of homelessness, such as assessment, policy development, and assurance. Using evidence-based practices is essential to address the needs of the vulnerable population in a comprehensive way.
Health Education Program for Homeless in Los Angeles County
As can be seen, a health education program for the homeless could help address the problem in Los Angeles County. In particular, it should target homeless individuals and families, as well as public health care providers, nurses, and volunteer instructors, to spread awareness and knowledge. According to Luquis and Pérez (2021), it is necessary to evaluate and consider the needs of the vulnerable population and racial, ethnic, and cultural demographic factors shaping the community. Mental, physical, social, and emotional health support should be provided, and lectures can be implemented to teach the homeless on safety, hygiene, prevention, mental and physical health aspects.
Local Agencies/Facilities Delivering Services to Homeless
There is a number of local agencies and facilities that deliver services to homeless people in Los Angeles County. For instance, Family Promise of San Gabriel Valley is an organization addressing family homelessness. It provides host services, meals, transportation, and employment and housing location support for families facing a housing crisis within the San Gabriel Valley (“Homelessness statistics for Los Angeles, CA,” n.d.). Jenesse Center supports victims of domestic violence, primarily women and children, through education, public awareness initiatives, and providing competent services. St. Anne’s Service Intensive Transitional Home provides affordable housing, home supportive services, and meals to single male veterans.
Additional Resources Needed in the Community
There is a need for additional resources in the community to address the problem of homelessness as a multifaceted phenomenon. In particular, in addition to the health education program, it is essential to develop policies tackling the problem of affordable housing and income inequalities and providing financial support. Treatment for people with substance use history and policies eliminating racial and gender discrimination are required to address the issue. Furthermore, it is crucial to implement public health initiatives and programs, including ones aiming at youth support and mental health support. Case management, rental or housing subsidies, and legal services are other resources needed in the LA community to eliminate homelessness.
Conclusion
To conclude, the problem of homelessness in Los Angeles County needs to be addressed due to the growing number of people affected. Lack of affordable housing, unemployment, physical disabilities, and mental illnesses, substance abuse, violence, and poverty can be considered the key factors aggravating the issue. A number of psychosocial, economic, and health concerns are associated with homelessness. In turn, a Health Education Program for the homeless suggested in this presentation can help raise awareness and promote health in the vulnerable population.
References
Homelessness statistics for Los Angeles, CA. (n.d.)
Kuhn, R., Richards, J., Roth, S., & Clair, K. (2020). Homelessness and public health in Los Angeles. UCLA: Campuswide Homelessness Initiative.
Los Angeles Homeless Services Authority. (2020). Greater Los Angeles homeless count 2020.
Luquis, R. R., & Pérez, M. A. (Eds.). (2021). Cultural competence in health education and health promotion (3rd ed.). John Wiley & Sons.
SAMHSA SOAR TA Center. (n.d.). Definitions of homelessness. SOAR Works.
Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health care in the community (9th ed.). Mosby Elsevier.
Wolf, J. (2021). The history of homelessness in Los Angeles points to new approaches. UCLA.