Chronic disease in Homeless population in L.

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Chronic disease in Homeless population in L.A

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Chronic disease in Homeless population in L.A 2

Introduction:

When compared to other major American cities, Los Angeles, California, comes in at number two.

About 3.8 billion of the world's population lives there. Large numbers of experiencing

homelessness and chronically homeless persons make up a significant component of California's

PEH population. People experiencing homelessness (PEH) face a higher risk of contracting

infectious illnesses due to a confluence of circumstances, including increased exposures, co-

occurring problems including drug use disorder and mental illness, and inadequate access to

sanitation and healthcare (Rew, 1998).

There is no universally accepted definition of a "person experiencing homelessness" (PEH), hence

the criteria used by each government body to identify them might vary. The United States

Department of Health and Human Services defines "homelessness" as "lack of housing," which

includes "an ordinary person whose main home during the night is a monitored governmental or

private facility that offers momentary housing arrangements and a person who is a resident in

transitional housing." This term is broadened by the US Department of Housing and Urban

Development (HUD) to cover those who reside in temporary structures like hotels, RVs, and tents.

Inadequate housing, high rent, unemployment, poverty, and poor salaries are all contributing factors

to the problem of homelessness. The difficulty in counting PEH stems from the fact that people's

housing situations change throughout time. An nationwide one-night estimate of people who are

homeless and either have no place to sleep or are sleeping on the streets is one way to quantify this

problem. It is often carried out by local planning agencies in the United States during the final week

of January each year. There were 553 thousand PEH in the US in 2018, with 180 thousand (or 33%)

belonging to households with children. Sixty-five percent were housed (in shelters or hotels) and

sixty percent were men. While the national rate of PEH reduction was 13.2% between 2010 and

2018, the rate in California was 5.3% higher. The magnitude, percentage of unsheltered, and

percentage of chronically homeless among California's PEH population sets it apart (Bensken et al.,
Chronic disease in Homeless population in L.A 3

2021). Twelve percent of the United States' population (40 million) and twenty-four percent of PEH

(129 972; 0.3 percent of California's population) were located in the Golden State in 2018. The

largest county in California, Los Angeles County, is home to 25% of the state's population and 32%

of the state's homeless population (42 079). More than two-thirds (69%) of California's homeless

population lacks shelter, and the state is home to over half (47%) of the nation's unsheltered

homeless population. Last but not least, California is home to 32 668 people who are chronically

homeless, or 25% of the total PEH in the state and 37% of the total chronically homeless population

in the United States(Liu et al., 2020).

Body:

The 2020 Greater Los Angeles Homeless County Survey by the Los Angeles Homeless Services

Authority (LAHSA) found 66,436 homeless persons in Los Angeles County in January 2020.

(2020). These data show a 12.7 percent increase from 2019 and a 14.2 percent increase in Los

Angeles, which is surprising given that Los Angeles County has spent millions of public dollars on

homelessness initiatives. In the last several years, Los Angeles County has methodically planned

and implemented a number of housing aid programs to help the homeless find and keep permanent

homes, but the response has not matched the severity of the problem. Increased housing costs, poor

salaries, and a shortage of affordable housing for the homeless and low-income households at

danger of homelessness worsen an already overwhelming situation. Homelessness is a complicated

social, economic, and administrative issue, especially for unsheltered homeless Veterans, a

vulnerable category that is hard to find, identify, and support. A review of housing policy, the

characteristics and challenges of homeless populations, and housing programs that have helped

homeless Veterans and other populations obtain and maintain permanent stable housing is needed to

determine the best way to help this vulnerable population and reduce, and hopefully eliminate, the

urgent societal problem of homelessness in Greater Los Angeles (Liu et al., 2020).
Chronic disease in Homeless population in L.A 4

Most first-time and chronic homeless people need distinct assistance to find and keep permanent

residence. First-time homelessness was often linked to growing housing costs, post-incarceration,

and self-diagnosis of mental health issues. Clinically verified diagnoses or novel clinical diagnoses

will improve this study's prediction model. A random research in different parts of the country can

also help identify correlations and characteristics of unsheltered homeless Veterans in a larger

model.

A data-gathering study like this one is required to obtain corresponds and characteristics of the

unsheltered homeless Veteran population, but a more comprehensive, qualitative study of their

specific needs and the reason they are not actively seeking VHA services will be needed to better

assist this inhabitants in obtaining and retaining stable and permanent housing. As first-time and

chronically homeless individuals homeless Veterans may have different primary care and mental

health care treatment needs, longitudinal study is needed to characterise group diversity in their

clinical needs. These findings suggest further study to match specialised, supportive, comprehensive

care to unsheltered homeless Veterans' particular requirements (Streeter, 2022).

Conclusion:

PEH numbers are rising in California. PEH in California are mainly houseless and

chronically homeless. These people die early and have more mental health, diabetes mellitus, and

HTN. PEH are more vulnerable because to increasing pathogen exposure, lower immunity, and

limited access to medical care and resources that reduce sickness severity. Housing condition and

mental illness statistics have numerous key limitations. First, PEH population undercounting may

exaggerate illness incidence. Disease incidence is calculated using HUD's yearly juncture counts,

which may not include persons in hard-to-reach locales (riverbeds, distant encampments) and those

who cycle between homelessness and insecure temporary housing. Second, PEH screening may

increase caseloads. Targeted syphilis screening in Sonoma County may explain the higher rate of

PEH among syphilis patients. PEH may sometimes be undiagnosed owing to a lack of medical
Chronic disease in Homeless population in L.A 5

treatment or contact information. Finally, home status is inconsistently captured across illness

categories and much housing data is missing, which might influence disease incidence estimates.

References

Bensken, W. P., Krieger, N. I., Berg, K. A., Einstadter, D., Dalton, J. E., & Perzynski, A. T. (2021).

Health Status and Chronic Disease Burden of the Homeless Population: An Analysis of Two

Decades of Multi-Institutional Electronic Medical Records. Journal of Health Care for the Poor and

Underserved, 32(3), 1619–1634. https://doi.org/10.1353/hpu.2021.0153

Liu, C. Y., Chai, S. J., & Watt, J. P. (2020). Communicable disease among people experiencing

homelessness in California. Epidemiology and Infection, 148.

https://doi.org/10.1017/s0950268820000722

Rew, L. (1998). Perceived health status among homeless youth. Journal of Adolescent Health,

22(2), 136. https://doi.org/10.1016/s1054-139x(97)83187-4

Streeter, J. L. (2022, May). Homelessness in California: Causes and Policy Considerations |

Stanford Institute for Economic Policy Research (SIEPR). Siepr.stanford.edu.

https://siepr.stanford.edu/publications/policy-brief/homelessness-california-causes-and-policy-

considerations