Chapter 25: Poverty, Homelessness & Mental Health Risks

Poverty, Homelessness & Mental Health Risks examines how social determinants of health create profound inequities, specifically focusing on the challenges faced by impoverished individuals, the unhoused, pregnant adolescents, and those living with mental health disorders. The discussion clarifies federal poverty benchmarks and distinguishes between long-term persistent poverty and geographically concentrated neighborhood poverty, noting how these conditions trigger physiological stress responses that impair childhood development and lead to chronic adult illnesses. Homelessness is explored through the lens of crisis-driven, transitional, and chronic lack of shelter, highlighting the unique vulnerabilities of veterans, LGBTQ+ youth, and families. Nursing interventions prioritize managing complex health needs such as infectious disease control and the stabilization of chronic ailments like diabetes or hypertension in unsanitary environments. Regarding adolescent pregnancy, the text centers on the social drivers of early childbearing and the critical need for confidential prenatal support and nutritional guidance to prevent low birth weight and developmental delays. Mental health is presented as a vital public health priority, tracing the impacts of deinstitutionalization and the ongoing necessity for accessible community-based services to support those with serious mental illness (SMI). Public health nurses are encouraged to apply primary, secondary, and tertiary prevention strategies, utilizing intensive case management, advocacy, and therapeutic communication to build trust and eliminate systemic barriers to essential healthcare services for these vulnerable populations.