Addressing barriers to healthcare that exist for homeless communities in Seattle

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

2. Addressing barriers to healthcare that exist for homeless communities in Seattle Jacqui Hermer Co-founder and Director, Education Transforming Community Health

3. 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.

4. 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

5. 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

6. Why are folks homeless?

7. Why are folks homeless? • High cost and shortage of housing • Poverty, joblessness, education, and literacy • Domestic violence • 44% of youth report as reason for leaving home • Effects of mental illness and chemical addiction • Institutional discharge to homelessness • Legal Issues • Access to healthcare • 2007, 45.7 US citizens (15.3% of pop) did not have health insurance • Institutional Racism • Lack of Community Supports

8. 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%.

9. Systemic barriers to healthcare Poor health is both a cause and effect of homelessness Lack of access to housing Under/Unemployment Lack of mental health services Medicaid restrictions ID requirements Cost of transportation FORMS • 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

10. Common Health Complaints • Foot Problems • Mental Health and Stress relief • Diabetes • Blood Pressure Checks • Vision • Dental • Where can I get care?

11. What conditions you’ll see most commonly diagnosed in a hospital • Heart disease • Cancer • Liver disease • Kidney disease • Skin infections • Diabetes • Hypertension • Frostbite • HIV/AIDS • Pneumonia, • Tuberculosis • Hepatitis

12. 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

13. 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

14. Solidarity

15. 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

16. 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

17. 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/

18. Questions and Conversation Let’s talk.