Homelessness is a common social problem affecting most Americans across the U.S 50 states. The federal department of housing and urban development conducts an annual tally of homeless people in January every year but reports data on March the following year. Homelessness rose higher during the pandemic because of economic hardships like job losses brought by the pandemic. Among the fifty states, California and New York rank the highest in the rate of homelessness, accounting for almost forty percent of unhoused people. In Vallejo, California, there are 275.5 homelessness cases per 100,000 people. This is higher than the national rate, which stands at 174 homelessness cases per 100,000 people. This study seeks to identify the target population and needs assessment, evidence-based intervention mechanisms, collaborations and coordinate care with service organizations, and the role of a nurse as a change agent.
Target Population and Needs Assessment
Homelessness leads to poor health outcomes among the affected people who suffer higher morbidity rates, including hypertension, tuberculosis, diabetes, asthma, and HIV/AIDS. According to Lee (2021), the National Healthcare for the Homeless reported that homeless people die twelve years sooner than the average life expectancy in the U.S.. Homelessness is divided into sheltered and unsheltered homeless, whereby sheltered refers to people who are staying in emergency shelters, while sheltered means people who visit in places unfavorable for human habitation, like cars and abandoned buildings. Both groups experience poor health outcomes, especially those living in the streets get exposed to adverse weather changes, communicable diseases, drug abuse, malnutrition, and violence. Ultimately, the intensity of these issues increases due to the mental and emotional stress brought by homelessness. ‘Patient dumping’, which is a situation whereby homeless patients are discharged without a proper plan, further aggravates poor health outcomes. According to health literature, this issue was first addressed by the Senate Bill of California (Bill 1152 of 2018). The legislation required hospitals to provide transportation, clothing, and meals to the homeless sick (Lee, 2021). The noble effort of the bill was to address the homeless patients’ unmet needs.
Evidence-Based Interventions and Measurable Goals
Even though the legislation addresses the plight of the homeless patients, it did not solve the actual underlying problem of these patients; that is a consistent source of income that can guarantee a safe place for residence. Ideally, housing provides a solution for the health disparities among the homeless. In other words, I expect a change in the support system for the homeless. According to Lee (2021), the Housing First Initiative, which was introduced in 1988, emphasized allocating permanent houses to the homeless without requiring them to resolve or address some problems. In essence, it holds on to the idea that providing housing to these groups without demanding any prerequisite is the beginning of great well-being and self-driven improvement. In other words, I will advocate for improved health through support systems.
Three evidence-based interventions from ‘healthy people 2030’ include the general call by a surgeon to promote healthy homes, healthy homes for everyone, and childhood blood lead among children under five years. The surgeon’s call identifies various steps people individuals can observe to protect themselves against disability, injury, or disease, resulting from hazards in their houses (Office of the Surgeon General US., 2009). The steps in this call have been proven scientifically on their effect in reducing health problems leading to injury or disease. Also, healthy homes point out that unhealthy homes lead to poor health outcomes and vice versa. For instance, homes built long before 1978 are characterized by peeling paint and secondhand smoke. Peeling paint affects children’s IQ and learning ability while smoking asthma and other respiratory conditions like lung cancer (CDC Environmental Health, n.d.). Finally, a report on childhood lead levels in blood among children less than five years in the U.S from 2009 to 2014 showed the adverse health effects caused by lead poisoning. In essence, lead brought about the permanent behavioral disorder and neurologic damage, and some neurologic disorders include comas, seizures, or death (Raymond & Brown, 2017). Children below the age of five are vulnerable because they can touch any object, which can be contaminated by lead, and end up putting their hands in their mouth, thus ingesting lead.
Smart goals include providing affordable houses to people experiencing economic hardships like job losses, providing permanent homes to end chronic homelessness, and ensuring stability in advanced housing programs meant for the youth. The significant barrier preventing my patients from achieving the above goals includes drug and substance addiction. Homelessness is closely associated with drug abuse because these people have a tendency of self-medicating to handle trauma. Even in most supportive environments, it is difficult to deal with addiction (Foundationhousing, 2017). In other words, giving home and other comforts to the homeless may not necessarily end addiction.
Collaborations and Care Coordinations with Service Organizations
In order to assist the vulnerable population, the nurse can partner with other agencies providing support to the homeless. For instance, the Salvation Army church in Australia embarked on a mission to eradicate street sleeping and rough sleeping across the country. The church has partnered with other mission organizations to provide services like ‘safe night space,’ which has reduced vast numbers of people sleeping in gardens, parks, and the street (Gangemi, 2020). Solano Health Services is a perfect example of care coordination. Primarily, it provides health care services for the homeless population, and it is comprised of a team of care support members who are health care experts. Solano health services is funded and run by the local government in Solano County. The department has employed 1262 employees in 22 offices throughout the county.
Role of Nurse in Advocating for Change
As a nurse, it is essential to understand what matters for him/her and what matters to other people. Understanding what matters for the nurse promotes a health care service that addresses patients’ holistic needs besides promoting hope and quality of life (Hofmeyer, 2020). Similarly, while mindful of other people’s interests, a nurse will align with sustainable development goals. For instance, goal three of the SDGs talks about well-being and good health, which depends on the advancement of goals to build inclusive and just civil societies that develop sustainable environmental and social resources. In order to embrace advocacy, nurses should employ 3 evidence-based measures: developing expertise in advocacy, engaging self in advocacy, and fostering partnerships meant to boost advocacy.
Conclusion
This study has successfully identified the target population. It needs assessment, evidence-based intervention mechanisms, collaborations and coordination care with service organizations, and the role of a nurse as a change agent. The target population is homelessness, leading to poor health outcomes among the affected people who suffer higher morbidity rates, including hypertension, tuberculosis, diabetes, asthma, and HIV/AIDS. Three evidence-based interventions from ‘healthy people 2030’ include the general call to promote healthy homes, healthy homes for everyone, and childhood blood lead among children under five years. In order to assist the vulnerable population, the nurse can partner with other agencies providing support to the homeless. As a nurse, it is essential to understand what matters for him/her and what matters to other people.
