Sentinel City
Homeless and families in low-income housing are generally at a higher risk for a broad range of health problems. When cross-examining the relationship between homelessness and health the three typical interactions include health problems that add to homelessness, others are consequences of homelessness, and homelessness complicates the treatment of many illnesses. One specific issue that hinders the health of most homeless individuals is mental health. As mentally ill people's disabilities deteriorate, their ability to cope with their surroundings—or the ability of those around them to cope with their behavior—becomes rigorously strained. In the lack of suitable therapeutic interventions and supportive alternative housing arrangements, many find themselves on the streets. Thomas Dwayne, an army veteran, lives in Industrial Heights in Sentinel city and has been homeless for the past two years, he suffers from PTSD, takes Prozac but has failed to refill his last prescription. When looking at low-income housing family’s health, they are also plagued by the same health issues faced by the homeless population. These poor health conditions may be due to living in substandard housing for extended periods of time. Substandard housing creates an assortment of health risks as well, including an increased risk of chronic disease, injury, poor nutrition, and poor mental health.
The goal of primary prevention is to find the primary cause of the problem to reduce risks, and typically involves universal interventions directed at whole communities, as well as targeted interventions for at-risk communities. With regards to homelessness, this could include information campaigns and educational programs, as well as strategic interventions designed to help address problems that may eventually contribute to homelessness, before they arise (HomelessHub). Poverty reduction strategies, anti-violence campaigns, early childhood supports and anti-discrimination work all can contribute to a reduction in homelessness down the road (HomelessHub). With regards to low-income families including programs such as rent banks or tenant advocacy supports, is an example of primary prevention aimed at a specific population. The rationale for these programs often assist of someone to help them navigate a rental committee or mediate with a landlord, or a loan/grant of a few hundred dollars can keep someone housed. Similarly, energy support programs for low-income households can help people facing energy poverty (HomlessHub).
Secondary prevention involves treating the issue in the early stages to prevent reoccurrence. The mayor of Sentinel city, Franklin Hill, has made a personal goal of reducing homelessness by increasing affordable housing as well as working with businesses to provide more jobs. He also plans on work with the Housing Authority and private business owners to create more job opportunities and affordable housing. He believes this can be accomplished through an incentive program. At the secondary prevention level, cost-effective plans for low-income families should include housing subsidies that have the strongest effect on lowering homelessness rates compared to several other interventions tested. Thus, when used as secondary and tertiary prevention, housing subsidies help 80–85 percent of homeless families or chronically homeless single adults to achieve housing stability (Quigley 2001). Another secondary prevention measure that would decrease the amount of homelessness and reduce strain on low-income families is to provide supportive services paired with permanent housing. For people with serious mental illness, with or without co-occurring substance abuse, permanent supportive housing works to prevent initial homelessness, to rehouse people quickly if they become homeless, and to help chronically homeless people leave the streets (Burt et al., 2004; Shern et al., 1997; Tsemberis and Eisenberg, 2000). Evidence from this study indicated declining rate of homelessness over a 10-year period while expanding on social services.
Tertiary prevention initiatives support individuals and families who have previously experienced homelessness, and the goal is to guarantee that it doesn’t happen again. The Housing First model is a type of tertiary prevention by providing habitually homeless individuals with housing and supports to maintain housing stability. These interventions are critical to assist the homeless and low-income families, but each intervention alone cannot prevent homelessness. Systemic application of these interventions on all levels starting from primary down to the tertiary level needs to be implemented to get the highest success rate.
References
Butler-Jones D. The Chief Public Health Officer's report on the state of public health in Canada.Ottawa: Public Health Agency of Canada; 2008.
Frankish CJ, Hwang SW, Quantz D. Homelessness and health in Canada: research lessons and priorities. Can J Public Health. 2005;96(Suppl 2):S23–29.
Frankish CJ, Hwang SW, Quantz D. The relationship between homelessness and health: An overview of research in Canada. Finding home: Policy options for addressing homelessness in Canada. edn.; 2009. pp. 1–21.
Home The Homeless Hub. (n.d.). Retrieved October 17, 2017, from http://homelesshub.ca/ Homeless and low income
Trypuc B, Robinson J. Homeless in Canada: A funder's primer in understanding the tragedy on Canada's streets. King City, ON; 2009. pp. 1–66.
Appendix A
Subsystem: Economics
Primary Prevention
Actions or interventions used to reduce exposure or vulnerability to a health issue of concern prior to disease onset or diagnosis. Think: health promotion and disease prevention
Secondary Prevention
Actions or interventions used to detect or treat a health issue/concern in early stages to prevent progression or recurrence. Think early and periodic screenings.
Tertiary Prevention
Actions or interventions used limit disability and/or enhance rehabilitation for a disease, condition, or injury. Think rehabilitation, occupational, or physical therapy.
Population group: Homeless and low income families
Disease, Chronic Condition, or Injury- Mental Health, Chronic conditions, Injury, poor nutrition and poor mental health, homelessness
Proposed Action or Intervention:
With regards to homelessness, this could include information campaigns and educational programs, as well as strategic interventions designed to help address problems that may eventually contribute to homelessness, well before they arise. Poverty reduction strategies, anti-violence campaigns, early childhood supports and anti-discrimination work all can contribute to a reduction in homelessness down the road.
With regards to low income families including programs such as rent banks or tenant advocacy supports, is an example of primary prevention aimed at a specific population. Often assistance of someone to help them navigate a rental committee or mediate with a landlord, or a loan/grant of a few hundred dollars can keep someone housed. Similarly, energy support programs for low-income households can help people facing energy poverty.
Proposed Action or Intervention:
Mayor Franklin Hill has proposed ideas with working with the Housing authority and private business owners on the homeless and low income family population to more job opportunities and affordable housing through and incentive program.
Providing social services such as housing subsidies to low income families and provide supportive services paired with permanent housing to homeless people.
Proposed Action or Intervention:
The Housing First model is a type of tertiary prevention by providing chronically homeless individuals with housing and supports to maintain housing stability.
Evidenced –based rationale of how this action or intervention will decrease healthcare costs.
Using these interventions during primary prevention helps inform and educate families and individuals about the resources available before they need to use them. The actions or interventions used to reduce exposure or vulnerability to the health issue prior to disease onset or diagnosis reduces the healthcare cost by treating the problem before it happens by educating the patient.