An Important Role Of Community Health Nurse in Helping Homeless

Windshield Survey

The Community I did my windshield survey is a city called Snellville, in the state of Georgia. Snellville is located approximately 25 miles northeast of Atlanta and 45 miles west of Athens at the intersection of U.S. Highway 78 and Georgia 124. It has become one of Gwinnett County’s fastest growing cities with a population of 20,000. Snellville was initially a place for early settlers specifically the Creek Indians and has experienced tremendous growth. The current population of Snellville as of 2017 are as follows: Total Population:18242, White:11,122, Black or African American:5,479, Hispanic or Latino:1351, Asian :598, Some Other Race:498, Two or More Races:477.

Snellville is a city that is rapidly growing and with growth comes problems as well. Snellville is a very racially and ethnically diverse community.

The vulnerable population I identified in the city of Snellville is the homeless population. The purpose of this paper is to assess the homeless population in this city and explore various ways to help them.

Vulnerable Population Overview

According to Suburbanstats.org, the average age of people who reside in Snellville are between the ages of 39 and 42. There are also a lot of school aged children, preschoolers and young mothers. The HUD, groups homeless persons into categories and defines them as:

Category 1. Literally Homeless: Individuals and families who lack a fixed, regular, and adequate nighttime residence and includes a subset for an individual who resided in an emergency shelter or a place not meant for human habitation and who is exiting an institution where he or she temporarily resided;

Category 2. Imminent Risk of Homelessness: Individuals and families who will imminently lose their primary nighttime residence;

Category 3. Homeless Under Other Federal Statutes: Unaccompanied youth and families with children and youth who are defined as homeless under other federal statutes who do not otherwise qualify as homeless under this definition; and

Category 4. Fleeing/Attempting to Flee Domestic Violence (DV): Individuals and families who are fleeing, or are attempting to flee, domestic violence, dating violence, sexual assault, stalking, or other dangerous or life-threatening conditions that relate to violence against the individual or a family member. (Nies & McEwen, 2015)

The Atlanta Journal Constitution in 2015 reported Gwinnet County as having the largest homeless population of any metro Atlanta community to which Snellville is inclusive. From an observer standpoint, I never thought of Snellville to have any homeless persons, but while conducting my survey, I found this to not be the case. On any given day, there are what appears to be homeless people hanging around the local neighborhood markets and gas stations. In the midst of the affluence the County possesses there is also poverty.

An economic condition that affects this group of people is the Housing market. The city of Snellville is considered a desirable place to live. However, with the rapid growth of this community, there is not enough housing to go around and the current market prices keep rising and most people who reside here are not able to afford the cost of their homes. Another factor that affects this group of people is the job market. Snellville is expanding and there seems to be new businesses opening up, however these businesses do not pay enough for people to be able to afford the housing. This leaves the residents sometimes working 2 or 3 jobs just to be able to afford a roof over their heads.

Strengths, Risk Factors, and/or Barriers

The risk factors the homeless population faces includes drug and alcohol abuse, increased health problems and malnutrition. A study by the NCBI, shows that a larger proportion of homeless suffered from health problems in 24 of 27 diagnostic categories than the non-homeless. One of the barriers they face includes access to healthcare when needed and failure to comply with prescribed medications because of cost or accessibility/transportation. These barriers further lead to an increase in chronic conditions and even mortality. Living in an unsheltered or temporary location can exacerbate conditions such as diabetes and hepatitis C, which a study in Boston showed to be two times and 12 times, respectively, more prevalent in a cohort experiencing homelessness than in the general population.

Community Resources

The community resources available for people in this area includes shelters. Some of these shelters also provide services such as alcohol and drug rehab treatment with clinics. The Family Promise of Gwinnett County (FPGC) is one of such shelters. The goal of the FPGC is to bring existing local resources together to help homeless children and their family regain their housing and their independence while maintaining their dignity. ("Family promise of gwinnett county," 2018). In addition, they also provide triage services at an emergency shelter, help with family stabilization through homeless recovery and self-sufficiency through aftercare. In general, families are accepted at this shelter for 30days and are able to extend their stay if their goals are not met. The maximum length of stay is usually 90days.

Another community resource that is available to residents in Snellville is the Salvation Army. The Salvation Army not only provides housing and homeless services but also helps with hunger relief, emergency financial assistance, adult rehabilitation and emergency disaster services. The services Salvation Army provides are free to the recipient.

The Gwinnett County Health department also offers several resources for the homeless such as helping with applying for Medicaid or locating organizations in the community that provides free or discounted medical services. These resources I strongly believe are adequate for this population. However, there should be more shelters to help with this. Working in the Emergency department, we often get quite a few patients that come to the ED just for a warm blanket and some food. Upon discharge, when we call the shelters to help with placement of these people, we are told they are at full and at capacity. I am of the opinion that more can be done to have resources for the homeless considering the city is growing at a very fast rate.

Community Health Problem Diagnosis

One priority community health problem I identify with this group is chronic disease prevention and management. Studies have shown that people who are homeless have higher morbidity and mortality and a higher prevalence of substance abuse and mental illness than the general population. Due to this population being homeless, it is difficult to obtain continuity of care. People with chronic diseases such as high blood pressure, diabetes asthma and cardiovascular diseases need constant follow-up to ensure medication compliance. When people unfortunately have to choose between a roof over their heads, food to eat or medications, they will choose a roof over their heads. This is why access to health care is important because it influences a person’s overall physical, social, mental health status and quality of life. A community health nurse can help with this by partnering with the local health departments to set up mobile clinics in the underserved areas or even where there is a huge population of homeless. Doing this is in essence taking the clinic to them.

A healthy People 2020 objective that relates to this problem is AH S-5 which is to increase the proportion of persons of all ages who have a specific source of ongoing care. (US Department of Health and Human Services: Healthy People 2020, 2018, Objectives: Access to Health Services, para 5). People who are homeless face several barriers to obtaining care some of which include accessibility and affordability. In a study published by the Ontario Health technology assessment series, it shows Moderate-quality evidence that indicates orientation to clinic services available either alone or combined with outreach improves access to primary care providers among adults who are homeless, without serious mental illness, and living in urban centers (Jego, Abcaya, & Stefan, 2016, p. 49)

Summary

In conclusion, the vulnerable group I identified was the homeless population in Snellville, Georgia. The key risk factors that this group faces includes drug and alcohol abuse, increased health problems and malnutrition. The priority health problem they face is chronic disease prevention and management. Putting an end to homelessness is not only a state or county issue but also a public health issue because they have a high occurrence of chronic health conditions and barriers to healthcare.

A community health nurse plays an important role in helping this population. One way the community nurse can help is help set up mobile clinics that will provide basic medical care to this population. Doing this will not only help provide this care but improve the health of this population.