How Has The COVID-19 Pandemic Affected Homeless Peoples’ Access To Medical Care in New York City?

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by Lorea 

Overview:

Homelessness has always been an issue in New York City and there has always been a relatively large homeless population. Naturally, they need medical care sometimes and since it is not universal in the US, they have to pay for it. Most of the times, they can’t afford it which makes getting medical care much harder. Doctors in hospitals, emergency rooms, etc. are required to treat the patient, but in New York there is a law that states that all homeless patients must be discharged with a plan from their doctor or physician. This plan must be doable and it involves where the patient can go (preferably to the next of kin, but also a shelter), weather appropriate clothing, prescription for their medications that will last at least a month, and a meal. Naturally some of these protocols must have changes with the pandemic and with so many people going to the hospital. My project looks into how the pandemic affected homeless peoples’ access to medical care. 

BeInformedNYC | Visual.ly
This infographic shows the amount of homeless people in New York City before the pandemic.

Before The COVID-19 Pandemic:

new york city homelessness
Moustafa
IMG_1561
The rectangular slab of concrete, the same size of a shelter room.

Housing is health care. This basically means that housing is the basis for being healthy and well, not having that makes being medically well very hard. Many homeless people before the pandemic preferred living in the streets than in shelters. For instance, Moustafa, a homeless man in his 50s says that he lived in a homeless shelter for a month but had to leave because he needed, “his own space to breathe”. He added that the shelter rooms were the size of the rectangular slab of concrete (seen above) and that he was treated “like an animal”. Each person is only allowed to have two bags and Moustafa had more possessions than he could fit in two bags. The health of those staying there was also not checked to the point that Moustafa felt safer on the streets, and many other homeless New Yorkers would agree. Housing options for homeless people in New York City are shelters, living on the streets, or getting housing from The New York City Housing Authority. The issue with the New York City Housing Authority is that it has a waiting list of 260,000 families with a less than 3% turnover rate. Thus, most homeless people resort to shelters or living in the streets. Both of these options make it easier for them to get sick because neither of them are good housing options, which is also why most homeless people have some sort of condition or illness. This also means that they need medical care, and typically it would need to be routine checkups multiple times a year to see how everything is going and for medication prescriptions. Homeless people can’t afford this so, a lot of the time, their conditions simply just get worse. While there are free clinics in New York City, there aren’t many and they tend to provide basic care. They are also usually medical professionals who volunteer, meaning that there aren’t always that many doctors and physicians.

12 homeless people died in Berkeley in 2019. 137 died in Alameda County

Why The Homeless Are More At Risk for Catching Coronavirus:

COVID-19 Graphics | National Health Care for the Homeless Council

Because of the reasons outlined on the infographic above, homeless people are more at risk for getting COVID-19. Being at a higher risk for COVID-19 makes housing even more complicated, which is the basis of being healthy and medically well, because if they catch it, they wouldn’t have anywhere to go but the street. If one knowingly has COVID-19, they can’t go to a shelter, they can’t stay at a hospital because the hospital is already short on beds, they can no longer stay in the subway because it stopped being open 24 hours a day, so the street was really their only option. Many also have underlying medical conditions, which naturally, make them more at risk for catching the virus.

The Impact that The COVID-19 Pandemic has had:

Prior to the pandemic, New York City was facing record homelessness and the pandemic only made it worse. For starters, one of the main reasons for homelessness is people needing to choose between housing and medical bills since they are so expensive. Needing to go to the hospital and stay there on a ventilator because of COVID-19 led to medical bills being very very high. Thus, people chose between their medical bills and housing and chose to pay their bills, leaving them homeless. Lack of access to private space has exacerbated transmission, hospitalization, and deaths amongst this group of people and those living in shelters are particularly at high risk because of the small space and not knowing others’ health conditions. With the COVID-19 pandemic making homeless people more at risk for getting sick, their access to medical care didn’t change and just got worse. Not only could they not go to the hospital or doctor’s office if they were sick, they also wouldn’t be able to afford it making matters even worse.

This is a very interesting 3-4 minute video that explains what was previously mentioned about housing being healthcare. To summarize, it explains how housing is the base and almost a necessity to being healthy and without it, one is more at risk to get sick and in this case, get COVID-19. With the start of the pandemic, people were even more scared to go to shelters not knowing if anyone there had the virus or was sick, on top of the complete lack of privacy that is there. Drug usage is common in shelters as well as getting robbed which is also why people would rather stay on the streets. Another thing mentioned in the video is the systemic problems and how homelessness affects people of color more than it does white people and this is due to multiple reasons, that are outlined in the video, all connecting to deep-rooted systemic racism.

Social Determinants:

Feedback and Questions to Think About:

After reading through my project, i would appreciate any feedback in the comments! Some specific questions to think about are:

  1. Do you think that homelessness is an issue in your city and country as well?
  2. In your country or city do you think that having or not having universal healthcare affects the amount of homeless people there are?
  3. Do you know any medical professional who has had an experience with an uninsured homeless person, specifically in the US? How did they handle it and knowing this information about shelters, what do you think of their outcome or plan?

Works Cited:

Click here to see my works cited

5 Comments

5 comments

  1. Hey Lorea! My name is Alexa Mislow, and I’m from the Abnormal Psychology class! I decided to look through your project since it’s an interesting topic to consider, and I wanted to answer your questions at the end of your project!

    Do you think that homelessness is an issue in your city and country as well? – Personally, not in my city, but surrounding cities, sure. Definitely in my country as well, the USA.
    In your country or city do you think that having or not having universal healthcare affects the number of homeless people there are? – Sure, I think it can anywhere. When people don’t have the proper healthcare to treat themselves, and even recover from addiction, healthcare can help. Although, I feel people don’t need it fully to get back on their feet.
    Do you know any medical professional who has had an experience with an uninsured homeless person, specifically in the US? How did they handle it and knowing this information about shelters, what do you think of their outcome or plan? – I personally do not know a medical professional who has experience with an uninsured homeless person.

    Great project, definitely interesting to read up on this!
    Thank you!
    -Alexa Mislow

  2. 1. Yes there is an issue with homeless people where I live
    2. I do think that not having health care affects the homeless people because they don’t get what they need
    3. I personally do not know a medical professional that has worked with a homeless person

  3. Hey my name is Nate Herndon, I’m from providence day school and really enjoyed your page!

    In response to the ending questions. I do believe homelessness is an issue in my city and state. Homelessness is a huge issue in the United States. It’s really bad and there’s not much being done to resolve it. I believe that universal health care is a great idea. It helped give many people health care that didn’t have any.

    I was wondering what your option was on homelessness in other countries? Do you believe that the U.S is doing better compared to others or not? If there are countries that are doing better, what is it that they are doing to avoid it?

  4. Hi Lorea,

    I found it very interesting how your project scrutinizes the conjunction between the homelessness crisis in New York City and the COVID-19 pandemic. Living in the same city, yes, this is evidently a large issue not only in my community but in the United States itself, though this is a widely known issue, it is oftentimes omitted and disregarded. Being homeless can put one at risk of many serious health problems, the prognosis of which actively worsens due to lack of healthcare and no means to combat it. Therefore, I believe that universal healthcare and providing adequate access healthcare access to the homeless will help save lives. This project brings attention to a very critical issue, really good work 🙂

  5. Hi Lorea! I enjoyed reading your project; it was very informative! To answer your questions: Homelessness is a pressing issue where I live due to a variety of factors, including stark income inequality, not easily accessible housing, barriers to addiction treatment, and more. Healthcare costs are also very high, so I think it is another factor contributing to the crisis. I personally do not know a medical professional who’s had an experience with an uninsured homeless person.

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