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1. Health care for homeless, why is it so costly?
They typically have to stay in the hospital for a longer amount of time because they have a lot more co-morbidities that need to be treated. Being brought to the ED is extremely expensive. Critical interventions are very costly, and so are all the diagnostic tests that must be done. They usually don’t have insurance. High mental heath issues in the homeless population. High risk for infections, trauma, violence. Don’t age very well.
Where do they seek health care services? (pg. 425, Effects of Homeless on Health)
Health care is usually crisis oriented and sought in emergency departments.
Those who access health care have a hard time following prescribed regimens.
Insulin-dependent diabetic man who lives on the street may sleep in a shelter. His ability to get adequate rest, exercise, take insulin on a schedule, eat regular meals, or follow a prescribed diet is virtually impossible.
How does someone purchase an antibiotic without money?
How is a child treated for scabies and lice when there are no bathing facilities?
How does an older adult with peripheral vascular disease elevate his legs when he must be out of the shelter at 7am and on the streets all day?
Do they practice preventative health care? (pg. 425, Effects of Homelessness on Health)
Health problems are often directly related to poor access to preventive health care.
Homeless people devote a large portion of their time trying to survive.
Health promotion activities are a luxury for them, not part of their daily lives.
Healthy People 2010 has goals to increase awareness and use of preventive heath services, but it’s very hard for the homeless. *See Healthy People 2010 box on pg. 426*
2. What is mental health? (pg. 433)
Mental health: being able to engage in productive activities and