Sample Annotated Bibliography Paper on Homelessness

Homelessness

On average, more than 600,000 Americans spend their night out in the cold on a single night. The U.S. Department of Housing and Urban Development reported in its 2012 Annual Homeless Assessment Report that 633,782 people were homeless during a single night count in January 2012 (p. 4). The majority (62%) of the homeless were individuals while the rest were family people. More than half of the homeless people spent the night in transitional housing and other forms of temporary shelters while more than one-third were on the streets and other unsheltered sites. Homelessness is highest in California where more than 20% of all homeless persons in the United States are residents. About half of the homeless population in America comes from California, Florida, New York, Georgia, and Texas (Annual Homeless Assessment Report, 2012, p. 4). Homelessness has been increasing significantly in Florida, Ohio, New York, Missouri, and Massachusetts since 2007.  Children comprise a significant percentage of homeless persons in the United States. For example, over 1 million children in public schools were homeless in the 2010/2011 academic year (Grant et al., 2013, p. 3). In addition, about 1.6 million children in the United States were homeless in 2011. According to Bassuk (2010, p. 496), the number of homeless children as a fraction of homeless persons grew from less than 1% in the 1980s to more than 30% in 2009.

Families headed by single parents (mostly single mothers) are most vulnerable to homelessness. According to Bassuk (2010, p. 498), over 80 percent of homeless families consist of single mothers with their children aged less than 6 years. Most of the homeless families belong to minority groups, and lack skills and basic education to obtain reasonable employment. Domestic violence contributes significantly to homelessness among women and children.  Homeless people have poorer health than their housed counterparts do in many measures including mental health, medical conditions, and substance abuse. Trauma and depression are the most common effects of homelessness due to the daily high risk of violence, sexual abuse, and harsh living conditions. More than 90 percent of homeless women including minors experience sexual abuse and over 60 percent of adult women are victims of intimate partner violence (Bassuk, 2010, p. 498). These harsh conditions explain the high rate of posttraumatic stress disorder and chronic depression among homeless women.

Federal and State Policies

Government policies to address homelessness in the United States have evolved significantly since the 1980s with the gradual increase in the awareness of homelessness as a public health problem. Prior to 1980, the United States health care system lacked a specialized strategy for the homeless. The homeless simply received healthcare as any other citizen but were underserved because of lack of insurance and other access limitations (Zlotnick et al., 2012, p. 199). Community-inspired specialized response to homelessness began in the 1980s with the establishment of the Pew Charitable Trust and Robert Wood Johnson Foundations that began sponsoring service delivery to this population. In 1987, the federal government passed the McKinney-Vento Homeless Assistance Act and this became its first significant step to address homelessness. Since then, the government has continued to provide specialized care to the homeless under the Health Resources and Services Administration. More than 208 specialized care centers for the homeless have been established throughout the United States.

Exclusion of “Homelessness” from Healthy People 2020 Objectives

The response to homelessness through specialized health care programs has significantly improved access to healthcare services for many homeless people in many states through outreach and community collaborations. However, the problem is still unsolved with more than half a million Americans sleeping in the cold every night (Annual Homeless Assessment Report, 2012, p. 4). The main problem is that the government has lagged behind the community in recognizing and responding to homelessness. For example, the government has not included homelessness in its list of topics for the healthy people 2020 initiative. In fact, the only objective relevant to homelessness in the healthy people 2020 list is “increase the proportion of homeless adults with mental health problems who receive mental health services” (healthpeople.gov, 2013, MHMD-12). This object is good but not sufficient to address the problem of homelessness. Instead, it focuses on mental illness as a cause of homelessness. Even so, addressing mental illness alone is insufficient because homeless people need medical attention, food, and shelter to improve their health.

Role of Nurses

Nurses occupy a central position in the fight against homelessness. As the government develops plans to improve housing and socio-economic causes of homelessness, nurses can help by providing healthcare services to the homeless to improve their physical and mental health. Some of the medical conditions nurses can address include skin infections, respiratory disorders, sexually transmitted infections, and TB (Tansley, 2008, p. 17). In addition, nurses are needed to treat mental illnesses such as depression and trauma. Nurses can participate by offering counseling, psychiatric services, and other specialized services. Nurses have many opportunities to meet and attend to homeless people including specialized care centers for the homeless, outreach programs in which the nurse visits the homeless, and community programs for the homeless.

In conclusion, state and federal governments should view homelessness as a cause of poor health in homeless people instead of viewing mental illness as the main cause of homelessness. This attitude change is necessary to stir up the action required to eliminate the social, environmental, and economic conditions that cause homelessness. The government should include homelessness in its healthy people 2020 topics and objectives to achieve the level of prioritization needed to address the problem adequately. In addition, the government should train nurses and other healthcare professionals on handling the unique health problems of the homeless.

References

Annual Homeless Assessment Report (2012). The 2012 point-in-time estimates of homelessness. Retrieved April 25, 2014 from https://www.onecpd.info/resources/documents/2012AHAR_PITestimates.pdf

Bassuk, E. L. (2010). Ending child homelessness in America. American Journal Of Orthopsychiatry (Wiley-Blackwell), 80(4), 496-504. doi:10.1111/j.1939-0025.2010.01052.x

Grant, R., Gracy, D., Goldsmith, G., Shapiro, A., & Redlener, I. E. (2013). Twenty-five years of child and family homelessness: Where are we now?. American Journal Of Public Health, 103(S2), e1-e10. doi:10.2105/AJPH. 2013.301618

Healthypeople.gov (2013). Mental health status improvement. Retrieved April 25, 2014 http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=28

Tansley, K. (2008). Homelessness: a way forward for nurses. Primary Health Care, 18(1), 16-18.

Zlotnick, C., Zerger, S., & Wolfe, P. B. (2013). Health care for the homeless: What we have learned in the past 30 years and what’s next. American Journal Of Public Health, 103(S2), S199-S205. doi:10. 2105/AJPH.2013.301586