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1 Week 4 Summative Assessment: Health Inequity among the Homeless Population in California Name Tutor Institution Course Date

2 Health Inequity among the Homeless Population in California An overview of the vulnerable population and health concern California is one of the states in the United States with high rates of homelessness. The main causes of such a condition in the state include the inability to access affordable housing, lack of enough income as well as health experiences and supports of discrimination and shifts in the economy all of which leave the population incapable of paying their bills hence lack of access to healthcare. Past studies show that of the total number of Americans who live on the streets, half of them are found in California which shows that the state is adding more homeless people each year compared to other states in the nation (Quigley, Raphael, and Smolensky, 2021). Because of their low living standards coupled with a lack of basic needs including healthcare, the homeless population faces many challenges including health inequity. According to the World Health Organization (WHO), health inequity refers to the differences in health status and distribution of health resources between different groups of the population whose root causes include social conditions, in which individuals are born, grow, work, live and age. Problems that come with lack of access to healthcare in addition to other social services usually exacerbate the underlying risks that are linked to the homelessness situation thereby increasing the probability of the adverse health results and outcomes. Past studies on the issue indicate that the homeless population experiences challenges when accessing preventive care and treatment because of lack of insurance, high cost to access care and lack of transportation (Stafford and Wood, 2017). Therefore, these barriers among others result in greater utilization of emergency services besides higher rates of medical hospitalizations for serious health conditions. Again, the homeless happen to be mainly discharged with inadequate resources into settings that

3 are inappropriate for full recovery, resulting in higher re-admittance rates as well as adverse health outcomes. A granular description of the population In describing the population and the picture of the environment they inhabit in society, it is worth noting that such people do not have a place to call home where they can reside and hence find themselves roaming in the streets of California in this case and other cities of the United States and the world in general. Therefore, their environment can be described as those full of water and soil contamination, noise and air pollution as well as exposure to severe weather events (Stafford and Wood, 2017). Moreover, the homeless happen to be prone to fire risks, mildew and mould and exposure to rodents, pests and landslides together with threats and risks that come along with vigilante and police violence. All these risks in their environment together with a lack of resources and capital result in health inequity and hence a great need to address such concerns to ensure they have better health outcomes. A detailed description with supporting evidence and data of the SDOH involved in the selected population’s health concern In describing the social determinants of health (SDOH) involved in the issue of health inequity among the homeless, research shows that such issues cluster with and are exacerbated by others including poverty, psychological trauma, unemployment, social disconnection and domestic violence. It is important to note that unstable housing and homelessness is one of the significant social determinants of health where the victims are predisposed to worse health outcomes because of food insecurity and adverse living conditions (Quigley, Raphael, and Smolensky, 2021). Furthermore, these people also have limited access to self-care resources and

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4 mainly reside in hard-to-reach areas that are remotely situated and very transient with no transportation means, which worsens their health condition. Identification and description of at least 1policy that is contributing to the existence of the health inequity It is worth noting that homelessness results from deliberate policy decisions and hence to end the problem of health inequity among the population, it is important for the involved agencies to realize the human right to housing and health care for all citizens in the United States to achieve economic, social and racial justice. One policy that contributes to the existence of health inequity among the homeless is the insurance policy in the United States where people experiencing the issue are discriminated against based on their housing status and lack of official address, which affects their social, economic and political rights particularly the right to access health care and other social benefits in the country (Quigley, Raphael, and Smolensky, 2021). Again, it is important to understand that only a few states have laws that permit the homeless to claim access to adequate, affordable housing that ensures privacy. Furthermore, only a few courts in the United States have shown interest in taking the courage to oblige public authorities including healthcare facilities to take all reasonable steps to eliminate the homelessness issue founded on constitutional, national and international human rights obligations. Full analysis of the policy’s contribution to the inequity Universal health insurance policy greatly contributes to the lack of access to healthcare health inequity among the homeless in the United States, specifically in California. Such is because the implemented insurance policies in the country do not include options for the marginalized groups in the nation such as the LGBTQ, homeless, people with disabilities and other populations facing challenges to health care access in the United States (Falter, 2019).

5 These insurance plans fail to find means of addressing conditions that pose huge risks to the homeless such as hypertension, substance abuse, mental illnesses and epilepsy among others, which leave such populations vulnerable, despite their status including poverty. Due to the lack of such appropriate health care for the population, there is deterioration in their health status, prolonged homelessness and eventually death. Background or history of the policy When it comes to the history and background of the policy, it is worth noting that the first insurance programs in the United States which were part and parcel of the Universal Health Insurance were enacted through the Social Security Act which others followed. Medicare ensures a universal right to healthcare for people aged 65 years and above and the eligible participants that were covered gradually expanded (Falter, 2019). Additionally, later amends were made which included adding a new title XXI implying National Health Insurance to establish a national single-payer health insurance program under which every citizen was eligible for enrollment. Such amendments implied that the homeless due to their social status were negatively impacted hence the need to review such implementations for better health outcomes for the group. Evidence and data that establish the link between the policy and the health outcomes Data and evidence that establish a strong connection between health outcomes and the policy are that many homeless people in the United States cannot register for such health insurance policies, rendering them helpless as the government and other healthcare agencies watch. Furthermore, the homeless are mainly found on the streets, where they lack programs that could help them in accessing the services they so much need (Stafford and Wood, 2017). The government remains laid back in educating the population on appropriate measures that they

6 could take to ensure health inequities that exist in their settings are addressed, as such people suffer from a wide range of healthcare conditions including drug and substance abuse. Because of widespread discrimination, these people usually shy away from seeking such services in the available health centres, augmenting their health conditions due to the lack of support and help they dearly need. Advocacy plan to address the disparity In addressing the problem of health inequity among the homeless which is lack of access to healthcare, the government, involved stakeholders and healthcare organizations should collaboratively work together to ensure the homeless are included in the policy measures. Such includes educating them on the need to seek healthcare services in the nearby facilities, creating awareness of the dangers that come along with lack of healthcare and establishing programs that ensure their inclusivity in treatment and preventive care (McFarland and MacDonald, 2019). It is important to understand that access to healthcare is a vital step towards better outcomes hence the need for the State of California and the United States in general to address such concerns for streamlined care for all. References Falter, E. B. (2019). Policy & Politics in Nursing and Health Care. McFarland, A., & MacDonald, E. (2019). Role of the nurse in identifying and addressing health inequalities. Nursing Standard, 34(4). Quigley, J. M., Raphael, S., & Smolensky, E. (2021). Homeless in America, homeless in California. Review of Economics and Statistics, 83(1), 37-51.

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7 Stafford, A., & Wood, L. (2017). Tackling health disparities for people who are homeless? Start with social determinants. International journal of environmental research and public health, 14(12), 1535.

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