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There have always been homeless people in the United States, but their plight has only recently stirred widespread public reaction and concern. Part of this new recognition stems from the problem's prevalence: the number of homeless individuals, while hard to pin down exactly, is rising. In light of this, Congress asked the Institute of Medicine to find out whether existing health care programs were ignoring the homeless or delivering care to them inefficiently. This book is the report prepared by a committee of experts who examined these problems through visits to city slums and impoverished rural areas, and through an analysis of papers written by leading scholars in the field.
Dr. O'Connell's collection of stories and essays, written during thirty years of caring for homeless persons in Boston, gently illuminates the humanity and raw courage of those who struggle to survive and find meaning and hope while living on the streets.
Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised citizens. In recent decades, federal agencies, nonprofit organizations, and the philanthropic community have worked hard to develop and implement programs to solve the challenges of homelessness, and progress has been made. However, much more remains to be done. Importantly, the results of various efforts, and especially the efforts to reduce homelessness among veterans in recent years, have shown that the problem of homelessness can be successfully addressed. Although a number of programs have been developed to meet the needs of persons experiencing homelessness, this report focuses on one particular type of intervention: permanent supportive housing (PSH). Permanent Supportive Housing focuses on the impact of PSH on health care outcomes and its cost-effectiveness. The report also addresses policy and program barriers that affect the ability to bring the PSH and other housing models to scale to address housing and health care needs.
This volume highlights the socioeconomic concerns related to medical care for homeless patients and places them at the interface of common psychiatric and medical problems clinicians encounter. Written by experts in psychiatry and other medical specialties, this volume is a concise, yet comprehensive overview of the homeless crisis, its costs, and ultimately, best practices for improved outcomes. The text begins by examining the scope and epidemiology of the problem and discusses its costs. It then examines the best practices for both physical and psychiatric care before concluding with a section on working with special populations that have unique concerns across the country including LGBTQ, women, children, veterans, and aging adults. As the first medical book on homelessness, it is designed to cover a broad range of concerns in a concise, practical fashion for all clinicians working with homeless patients. Clinical Management of the Homeless Patient is written by and for psychiatrists, general internists, geriatricians, pediatricians, addiction medicine physicians, VA physicians, and all others who may encounter this crisis in their work.
Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.
Late in the 1970s, Americans began to notice more people sleeping in public places and wandering the streets. By the late 1980s, the homeless were everywhere--a grim reminder of America's social and economic troubles. Renowned social analyst Jencks discusses the causes and extent of this problem and what can be done about it. Line illustrations and tables.
Considers why U.S. society is believed to be less healthy in spite of disproportionate spending on health care, identifying a lack of social services, outdated care allocations, and a resistance to government programs as the problem.
"Brings together leading and emerging researchers to advance understanding of the complex relationships between homelessness and health. Covering a wide range of topics from youth homelessness to end-of-life care, contributors outline policy and practice recommendations to respond to this public health crisis."--Back cover.