“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” Martin Luther

King, Jr.

Addressing barriers to healthcare that exist for homeless communities in Seattle

Jacqui HermerCo-founder and Director, Education Transforming Community Health

Education Transforming Community Health

(ETCH)

Political education program for health science students

Health education program for homeless communities

Create hour-long health classes that focus on prevention and harm-reduction.

ETCH

Founded in 2008

Project of Al Shifa Health Resource Center and Students in the Community, UW

Group of health science students and graduates that have partnered with community organizations

Operate out of Urban Rest Stop and Compass Center’s Adult Day Center

Provide weekly classes, alternating at each site

Scope of Homelessness in King County

(One Night Count, Jan 2010)

8,937: People counted homeless in KC in Jan 2010

2,759: Found sleeping outside without shelter

34% of those in shelter: Children aged 0-17

11% in shelters: Young Adults aged 18-25

80% in the shelters: Reported last permanent address within the KC

Why are folks homeless?

Why are folks homeless?

High cost and shortage of housingPoverty, joblessness, education, and literacyDomestic violence

44% of youth report as reason for leaving home

Effects of mental illness and chemical addiction

Institutional discharge to homelessnessLegal IssuesAccess to healthcare

2007, 45.7 US citizens (15.3% of pop) did not have health insurance

Institutional RacismLack of Community Supports

For people under 65 in WA, insurance covered by employers declined by 3.6% from 66.6% to 63%During the same period, state-supported public health insurance programs increased usage by 2.3% from 13.2% to 15.5%.

Systemic barriers to healthcare

Poor health is both a cause and effect of homelessness

Budget Cuts

Lack of prevention services

Lack of health insurance

Nutrient content in affordable/available foods

Lack of distributive care

Attitudes/assumptions of HC providers

Lack of access to housing

Under/Unemployment

Lack of mental health services

Medicaid restrictions

ID requirements

Cost of transportation

FORMS

Common Health Complaints

Foot Problems

Mental Health and Stress relief

Diabetes

Blood Pressure Checks

Vision

Dental

Where can I get care?

What conditions you’ll see most commonly diagnosed in

a hospitalHeart disease

Cancer

Liver disease

Kidney disease

Skin infections

Diabetes

Hypertension

Frostbite

HIV/AIDS

Pneumonia,

Tuberculosis

Hepatitis

Some ways to break down barriers

Listen and respond to what someone identifies as their needs

Someone who fits the category of “vulnerable population” is not worthless or knowledge-less

Person-first language

Prioritize relationships

Take time and be flexible

Meet folks where they are at

Some more ways…

Continue to learn about your herstory and that of the communities you work with

Be an advocate on a local and national level

Focus on harm reduction and prevention

Prioritize collaboration with community members and respected community programs

Work towards universal access to quality and comprehensive health care

Solidarity

Solidarity

[Ultimately] this work is not about you, or me, or any one of us.  It’s about building a world where all of the structures that keep people down don’t exist anymore, and where any human being among us has the power to decide, for real, how they will live their own life. Right? And for that to even begin to happen in a legitimate way, we need to own up to our role in that whole process. How we help it along, and how we stand in its way.

Catherine Jones, MD

Co-founder, Latino Health Outreach Project

Collective Liberation"If you have come to help me, you are wasting your time; but if you are here because your liberation is bound up with mine, then let us work together." Lilla Watson, Aboriginal artist, activist, and academic

References

http://budgetandpolicy.org/schmudget/new-census-data-show-importance-of-public-health-insurance-programs

http://www.cehkc.org/

http://www.urbanreststop.org/

http://www.kingcounty.gov/healthservices/health/budget.aspx

http://www.nationalhomeless.org/factsheets/health.html

http://www.homelessinfo.org/

Questions and ConversationLet’s talk.