How Homeless Trajectories Shape Health Outcomes in Los Angeles

By: Evelyn Silva Rosales

In a research study made by Jessica Richards, researchers found an association between homelessness and poor health outcomes in Los Angeles County. They set up a homeless trajectory conceptual model to indicate that homeless trajectories are rooted in predisposing risk factors. Individuals who fall into homelessness especially vulnerable when they experience financial instability along with the loss of a loved one or other tragic events in their lives. Once homeless, they may be at substantially greater risk of health problems due to exposure of violence, weather, pollution, poor sanitation, and behavioral risk (Richards, 2021).

People who experience unsheltered homelessness have greater mortality rates compared to those who experience sheltered homelessness. Unsheltered adults had the most common causes of death to be noncommunicable chronic diseases, substance use disorders, and chronic liver disease (Richards, 2021). People in the homeless population were also more likely to experience pain, and the use of substances further declined their health status. The spread of diseases such as HIV and tuberculosis is significantly high, and the use of needles to inject drugs further worsens their health. Chronic substance abuse by alcohol also led to grave injuries and chronic liver disease. Studies show that the continuation of homelessness does lead to greater rates of substance use. A cross-sectional study of women in the unsheltered homeless population also showed that unsheltered women were more likely to have sexually transmitted diseases and experience unwanted pregnancy. Other health related problems included problems with walking, vision, teeth, and high blood pressure. 

Mental health is an issue that often accompanies unsheltered homelessness. Descriptive studies have shown that depression and suicidal thoughts are prevalent within the homeless community. In addition to major depression, schizophrenia and mood disorders are common mental health diagnoses among unsheltered populations (Richards, 2021). Substance use and mental health issues are frequent among the homeless community. Individuals who are chronically unsheltered tend to show a dual diagnosis with both disorders. There is evidence that shows mental illness can increase the likelihood of substance use and in turn, substance use can increase the likelihood of poor mental health (Richards, 2021). 

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Unfortunately, there is an association between unsheltered homelessness and decreased rates of health care utilization. Individuals without health insurance are less likely to seek adequate care and far less likely to report the use of hospital, mental health, or substance abuse services. Unsheltered homelessness is strongly associated with chronic homelessness that exacerbates serious mental illness and substance use, which is often co-occurring (Richards, 2021). The correlation shown in these studies highlight the importance in maintaining organizations that help the homeless population receive a little bit of help from the community. Volunteer work that can help bring them comfort and maintain interaction with them can create a notable difference in their lives and enact a change.

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References:
Richards. (2021). Examining homeless trajectories and health outcomes among young adults in           Los Angeles County/by Jessica Richards. University of California, Los Angeles.