Now, More Than Ever, Housing Is Health Care
Coronavirus affects people in vastly different ways. Health authorities have released lists of pre-existing medical conditions that put people at high risk for severe illness from COVID-19. The World Health Organization said that “80 percent of infections are mild or asymptomatic, 15 percent are severe infections requiring oxygen, and 5 percent are critical infections requiring ventilation.” Those underlying, pre-existing conditions can make all the difference.
Advocates for people facing homelessness suggest adding a lack of permanent housing to the list. Homeless people are disproportionately impacted by COVID-19, due to a standing health deficit and exposure to potentially dangerous living conditions.
Why Does a Homeless Health Deficit Exist?
Homelessness does not lend itself to good health. It is well-known that homeless people suffer a greater number and more severe health challenges than their housed counterparts. Poor health can contribute to homelessness, and experiencing homelessness can contribute to poor health.
Here are some health conditions that are common in the homeless community:
- Lung diseases, including bronchitis, tuberculosis, and pneumonia
- Wounds and skin infections
Unsurprisingly, homeless people recover slower than their housed counterparts. Applying the time-tested adage of “getting plenty of bedrest” becomes nearly impossible when a person doesn’t have one.
Why Do Homeless People Struggle to Maintain Good Health?
“Social distancing is one of the main protections that health authorities have recommended. But for homeless people, this is simply not possible [given the current infrastructure],” said Kristy Buccieri of Trent University. Shelters are too densely occupied for effective isolation.
Although catchphrases like social distancing and self-isolating have been cast into the spotlight during the COVID-19 pandemic, it’s hardly a new idea. Some argue the concept has existed since the middle ages. It works, and not just against coronavirus.
Many essential services that have stayed open during the pandemic noticed a drop in sick calls from their employees. Why? “Stay apart, stay safe.” Social distancing protects people from all sorts of contagions.
That is precisely what’s so frustrating about homeless people being unable to social distance. Let’s take Matt Andrews, a homeless Torontonian for example. He has stayed in shelter rooms filled with up to 50 sleepers: “If someone in a shelter dorm gets sick, you’re all getting sick.”
Homeless shelters have reacted in the wake of current events.
The CEO of a mission in Ottawa, Peter Tilley, commented on how they’re adapting to new needs:
“The health of people who are homeless or at risk of homelessness is often compromised, which may leave them more vulnerable to COVID-19. Given this reality, we are adjusting our operating procedures to ensure that the risk to our shelter guests and other populations remains as low as possible.”
Although necessary, these changes have raised new concerns. More stringent social distancing requirements have limited shelter capacity, which means they are better helping less people. The federal government, for their part, has chipped in millions of dollars to help socially distance homeless Canadians, opening isolation centers in hotels and community centers. But what happens after the temporary funding stops and hotels start closing their doors to homeless people?
Another health-related challenge facing homeless people is maintaining good hygiene practices.
Just think of how much time we spend in the shower or in front of a well-lit mirror, washing, exfoliating, cleansing pores, tweezing and plucking. These daily rituals are more than mere pursuits of vanity. Our bodies, like everything else, require upkeep. Neglect takes a toll. Or think about the wash your hands for 20 seconds mantra that’s been drilled into our collective consciousness of late. How many times have you washed your hands with soap and water since you woke up today?
Now put yourself in the well-worn shoes of homeless people. Finding a clean spot to maintain proper hygiene was challenging enough pre-COVID-19. But many of the facilities that people used to rely on – washrooms in public spaces, community centers, drop-in centers, YMCAs – have closed due to the pandemic. Even shelter washrooms can be hit-and-miss.
Proper nutrition raises yet another challenge.
People relying on food banks don’t know what to expect from one day to the next in the current climate. Meal providers have had to modify or cancel services to protect staff and clients. Understandable. But with some food banks closing for several weeks before reopening on adjusted or staggered service leads to inconsistent nutrition at best among an already vulnerable population.
The preceding may have read like a whole bunch of “Tell me something I don’t know!” Homeless people suffering from underlying health issues is not new information. But that’s the point. At the risk of beating a sick horse, COVID-19 serves as yet another reminder that homeless populations are vulnerable populations. Adequate housing for all is health care.
When will we learn the lesson?