A new report released last week by the City Club of Portland outlines the challenges and opportunities our community faces concerning homelessness and health care reform.
The report found what many advocates have argued for years, that one of the greatest social determinants of health is housing.
According to the report, national surveys have found that homeless individuals are three to six times more likely to become sick than those who are housed, and Multnomah County is no exception. More than half (53 percent) of the homeless population in Multnomah County were found to suffer from potentially life threatening disabling conditions, with 17 percent of the unsheltered population reporting a chronic health condition.
The annual report, produced by the local government, the medical examiner’s office and Street Roots, found that from 2011 to 2013 more than 135 people experiencing homelessness died in Multnomah County. This only includes individuals who actually died outside and doesn’t include individuals who were homeless but died in a hospital or other such shelter. We know the number to be much higher. The average age of death for all three years was in the mid 40s — well below the average life expectancy of 71 years in Multnomah County.
The City Club report concludes that despite issues with the Cover Oregon website, new Medicaid enrollments of the homeless population are high. Participants were enrolled in OHP by social-service providers, housing and health care workers, the police and others in law enforcement. Street Roots has seen this first hand. Partnering with Central City Concern and others we were able to enroll more than 90 percent of our vendors.
We also know that maintaining this kind of effort will require the support of local and state government to ensure that people experiencing homelessness are engaging the health care system in a timely manner. Even with an address and resources, it’s not easy navigating America’s health care system. Our community must remain diligent in not only providing, but helping facilitate access to our health care system.
Some of the report’s other recommendations include:
-By 2016 all health care providers should be trained to address the special needs of homeless populations;
-Anyone on the streets discharged from a hospital should have a housing or shelter plan; and
-Multnomah County and the city of Portland should look at increasing housing resources for people experiencing homelessness.
The final recommendation, which may in the end be the most important one, is to have health care and housing advocates, government officials and others who work in the interest of the homeless, to strongly advocate for the social determinacy of housing. “It will further strengthen applications to receive funding for housing from public and private foundations, granting entities and private philanthropy sources.”
In November, hospitals in Orlando, Fla., pledged $6 million specifically for rent assistance to assist individuals and families. There’s no reason that local hospitals and health foundations in the region shouldn’t be making the same investment.
Street Roots believes that with the emergence of health care reform we can significantly decrease the number of people experiencing homelessness in our community. The pieces are in place. All it takes is the leadership to make it happen.