The statistics are staggering
Nationally, Oregon has the fourth highest rate of homelessness and the second highest rate of families without shelter.
In recent years Portland’s chronic homelessness has increased at twice the national rate. According to the 2017 Point In Time Count (a biannual snapshot of the individuals and families experiencing homelessness on a given night in our community), 4,177 people experienced homelessness on a single night in February 2017, a 10% increase from the 2015 count. This includes people sleeping on the streets, in their cars, in emergency shelters and transitional housing, and on the couches of family and friends.
Number of people who experienced homelessness on a single night in Feb
Life expectancy of a homeless person
Portland’s homeless that report a chronic disabling condition
Highest rate in the nation of unsheltered families
The homeless population in Portland is growing older, more disabled, and is on the streets for longer periods. The “chronically homeless” have increased from 6% in 2015 to 13% in 2017. Homeless folks in our community face stigma, social isolation, and loss of relationships. They suffer a disproportionate burden of illness and premature death. The life expectancy of a homeless person is a shockingly low 47 years. 72% of Portland’s homeless report a chronic disabling condition. The daily struggle for food, shelter, clothing, and safety relegates health to a low priority, which in turn increases health risks, exacerbates chronic conditions, and complicates treatment. Infections, injuries, and other acute conditions fester; and communicable diseases such as tuberculosis, AIDS, and viral hepatitis readily spread. Health disparities are exacerbated by mental health issues, substance use problems, and violence on the streets and in crowded shelters.
Portland Street Medicine is based on two proven strategies that can quickly improve the health of people experiencing homelessness: access and continuity. Those without access to healthcare are at increased risk for later-stage diagnosis of disease, poor control of manageable conditions (e.g. hypertension, diabetes), and hospitalization for preventable conditions. And without continuity, the trust that is necessary to make change over time is impossible to gain. The three most common causes of death—drug overdose, cancer, and heart disease—are either preventable or treatable in the traditional health care setting. Addressing the health care issues of homeless people is perhaps the greatest health equity challenge of our time.