Kate Pocock Talks About How Homelessness Drains Our Healthcare System and How Street Medicine Offers a Solution
According to the latest study from National Health Statistics Reports, homeless people account for 1.4 million emergency department visits annually. This alarming figure underscores the dire consequences of lacking access to essential resources like healthcare and housing.
Published on June 11, 2024, the study was conducted over six years (2016-2021) using data from the National Hospital Ambulatory Medical Care Survey and medical record data showing patient residency status. It reveals that people experiencing unsheltered homelessness are three times more likely to visit the emergency room than those with stable housing.
The findings also show that unhoused individuals not only frequent the ER three times as often, but those who wind up in the ER are also more likely to make multiple return visits. In many cases, return trips can occur multiple times, as chronic conditions present more often within this vulnerable population. This data is further evidence of a vast overrepresentation of homeless people being admitted to the ER, and it barely scratches the surface of the problem.
Frequent and repeat visits to hospital emergency rooms are the norm for homeless people, yet these are visits that could be prevented with better access to housing and healthcare.
The Hidden Toll of Homelessness: How Emergency Room Data Highlights Disparities in Health and Access
The fact that homelessness exists drains much-needed medical resources, taking a toll on unhoused and housed people alike. Glaring trends from the statistics are as follows:
- PEH represented 8.6 million known emergency department visits over the 6-year study period
- Homeless people were more likely to exhibit chronic conditions than housed people
- There was a vast difference in age distribution, with most housed ER patients representing children under the age of 18 and seniors aged 65 and over. In stark contrast, approximately 82% of homeless people visiting the emergency room were between the ages of 26 and 64.
*While the study doesn’t expressly point out this connection, it’s important to note that homeless people’s average life expectancies are three decades shorter than their housed peers, which should be taken into consideration when reviewing the glaring shift in age distribution.
* Findings from this study also show that homeless people spend significantly more time in the emergency room for mental health conditions than their housed peers, which stands as a testament to their lack of access to mental health care. Access to any healthcare is hard to come by for our unhoused neighbors.
Experts Say Access to Housing and Healthcare Is Key
“We’re diving into this trend and looking for answers,” explained Clinical Instructor of Family Medicine Kate Pocock, MHS, PA-C, in a brief interview with Invisible People.
Kate is a member of an LA-based street medicine team who works directly with members of the unhoused community in a medical setting. According to her, many unsheltered individuals view the emergency room as their only access to healthcare, be it mental, physical, or other.
“One of the questions we’ve been asking recently on a survey is, do you have access to healthcare? And everybody says yes. And to them, the ER is their access to all things healthcare,” Kate said. “That is something we need to understand a little more because the ER is designed to be a safety net, and that’s how they’re utilizing it. It is designed to be a place that is open 24 hours a day where folks can go and have their medical needs served.”
“But in the meantime, I think this data is saying that we need to have a better way of ensuring that folks can meet some of their lower acuity issues outside of the ER,” she continued. “It comes down to two things: infrastructure and access.”
As Kate Pocock mentioned, many of the diagnoses featured in this report show that housed people are more likely to arrive at the ER due to low-acuity issues than their housed counterparts. For example, homeless males were less likely to receive a primary diagnosis of respiratory illness or infectious disease, and they were more likely to receive a primary diagnosis related to mental health.
Another aspect of the report that suggests a lack of access is that unhoused people were more likely to arrive at the hospital via ambulance. Lack of access to transportation is a major roadblock to non-emergency healthcare for our unhoused neighbors.
“Increased access to preventative services is crucial because we know that’s what keeps folks out of the ED,” said Kate. “Access to preventative services and general healthcare for lower acuity issues would drastically reduce those numbers. Access to better nutrition and regular care could also help unhoused people stay healthier and keep them out of the ER for those higher acuity events that do happen because we know that people experiencing homelessness have higher rates of disease processes, especially cardiovascular and so forth.”
“Prevention is often the best medicine,” she concluded. “This is why I feel strongly about street medicine being an excellent solution for addressing this issue.”
Talk To Your Legislators About Housing and Healthcare. Your Community Depends Upon It.
If hospitals are inundated with non-emergency visits because a sizeable portion of our population lacks housing and healthcare, the impact on public health is significant. The cost will be borne by all of us, in dollars, pennies, nickels, dimes, and lives. Yes, lives. Talk to your legislators about making housing and healthcare accessible to everyone.
