Chapter 23: Homeless Populations & Public Health Care

Homeless Populations & Public Health Care begins by contrasting different ways of defining the problem, from international conceptual models that look at the social and legal aspects of a "home" to the specific legal definitions used by American federal agencies to determine program eligibility. Understanding these definitions is vital for accurately counting the population through methods like point-in-time counts and computerized databases, which reveal that homelessness affects a wide range of groups including veterans, unaccompanied youth, and families. The discussion identifies three primary systemic factors that fuel this crisis: a severe lack of affordable housing options, insufficient income to cover basic living expenses, and a scarcity of necessary support services. Health status is a major focus, as individuals experiencing homelessness face significantly higher rates of both acute and chronic illnesses, mental health challenges, and substance use disorders compared to the general public. To combat these issues, the chapter proposes a public health nursing framework rooted in social justice and "upstream" thinking. This perspective encourages healthcare professionals to look beyond immediate clinical treatments and instead focus on the social determinants of health. By utilizing tools like the Public Health Intervention Wheel, nurses can engage in advocacy, policy development, and community organizing to address the root causes of housing instability and improve long-term outcomes for vulnerable communities.