Student Name
Capella University
NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care
Prof. Name
Date
Caring for Special Populations: Teaching Presentation
Providing care for special populations such as individuals experiencing homelessness or housing insecurity presents unique healthcare challenges. This article explores the healthcare barriers faced by this vulnerable group and offers strategies for delivering culturally competent nursing care to enhance health outcomes. By addressing these challenges, nurses and healthcare providers can contribute to reducing health disparities and improving the overall well-being of individuals facing housing insecurity.
Understanding Housing Insecurity and Its Health Impact
Housing insecurity refers to the lack of stable, safe, and affordable housing. This situation places individuals at high risk for eviction, overcrowding, and homelessness. Many people in housing-insecure conditions may live in temporary shelters, motels, or with friends and family due to financial hardship. Others endure unsafe living conditions that lead to chronic stress and worsen health outcomes (National Low Income Housing Coalition [NLIHC], 2023).
Certain groups, including people with disabilities, low-income families, and marginalized communities, are disproportionately affected by housing insecurity. This exacerbates existing socioeconomic disparities. NLIHC (2023) reports that nearly 11 million households, or one in four renters in the U.S., struggle with housing affordability. These financial constraints make it difficult for individuals to maintain stable housing, contributing to their increased vulnerability to health issues.
One of the primary healthcare challenges for individuals facing housing insecurity is a lack of access to care. Concerns about the cost of healthcare, absence of insurance, and barriers to transportation often result in delayed medical attention. Poor living conditions and limited access to nutritious food also contribute to the development of chronic conditions such as hypertension, diabetes, and respiratory diseases (Fitzpatrick & Willis, 2021). Mental health issues, including depression and anxiety, are also prevalent due to financial instability and uncertainty. Often, individuals in this group struggle to follow prescribed medication regimens and may require emergency services for preventable conditions. Expanding access to community-based healthcare programs and support services is essential to addressing these barriers (Willison et al., 2021).
The Importance of Culturally Competent Nursing Care
To provide effective care, nurses must understand the unique health disparities faced by individuals experiencing housing insecurity. These individuals often prioritize basic survival needs over healthcare, resulting in untreated chronic conditions and delayed treatment for acute illnesses. A key strategy to address this is the implementation of mobile health clinics, which provide services directly to shelters and community centers, thus reducing transportation barriers (Rennert et al., 2024).
Additionally, housing-insecure individuals may have a diminished trust in the healthcare system due to past negative experiences and perceptions of discrimination. Research by Hernandez et al. (2021) highlights the importance of trauma-informed care and nonjudgmental communication in building trust with this population. Culturally competent training for healthcare providers can improve patient engagement and adherence to treatment plans, helping individuals feel more comfortable with healthcare interactions.
Financial instability and the lack of identification documents are other significant barriers to accessing healthcare. Nurses can play a critical role in connecting patients with social workers and community organizations that provide free or low-cost healthcare services. Collaborations with food pantries, housing programs, and other social services can address the broader social determinants of health, supporting long-term well-being (Garcia et al., 2024). By integrating culturally responsive care strategies, healthcare providers can help reduce health disparities and improve patient outcomes.
Healthcare Disparities and the Role of Social Determinants of Health
Healthcare disparities are especially pronounced for individuals experiencing housing insecurity. The financial instability, limited access to healthcare, and social stigma they face make it difficult to maintain consistent care. Many rely on emergency departments for treatment of conditions that could be managed with routine care. This reliance on emergency services results in worsened chronic conditions, higher hospitalization rates, and increased mortality (Garcia et al., 2024). Additionally, limited access to preventative care such as vaccinations and routine screenings makes these individuals more susceptible to infectious diseases.
Different subgroups within the housing-insecure population face unique challenges. Families with children often struggle to access pediatric care, while elderly individuals find it difficult to manage chronic conditions in unstable housing situations. Veterans are at heightened risk for mental health disorders and substance abuse, and LGBTQ+ youth may experience homelessness due to family rejection, increasing their vulnerability to violence and exploitation (Miller, 2021).
NURS FPX 4015 Assessment 4
Addressing these disparities requires a multifaceted approach. Mobile clinics that provide healthcare in shelters and public spaces can help reduce barriers to care. Trauma-informed nursing practices can foster trust and improve patient engagement. Furthermore, social workers and housing programs are essential in connecting individuals with financial assistance and stable housing. A leading example of culturally competent healthcare for the homeless is the Boston Health Care for the Homeless Program (BHCHP), which integrates medical, mental health, and substance use treatment within shelters and community spaces (Boston Health Care for the Homeless Program, 2024).
The impact of social determinants on homelessness cannot be overlooked. Economic barriers such as unemployment, low wages, and rising housing costs contribute significantly to housing insecurity. Environmental factors like exposure to extreme weather and poor living conditions further increase health risks, including hypothermia, respiratory infections, and dehydration (Anthonj et al., 2024). Mental health issues, often aggravated by past trauma, compound these health challenges. Many housing-insecure individuals lack access to mental health services, leading some to cope with substance abuse. Expanding Medicaid eligibility and implementing housing-first initiatives are critical steps toward addressing these issues. Policymakers must focus on decriminalizing homelessness, improving low-barrier healthcare access, and investing in permanent supportive housing to improve long-term stability and health outcomes.
Table: Strategies for Culturally Competent Nursing Care
| Strategy | Description |
|---|---|
| Self-Reflection and Education | Nurses should recognize their biases and understand how cultural values influence health beliefs and behaviors. |
| Cultural Practices Recognition | Acknowledge alternative medicine, dietary restrictions, and spiritual traditions in patient care. |
| Culturally Appropriate Communication | Use interpreters, avoid medical jargon, and incorporate visual aids to bridge language barriers. |
| Collective Decision-Making | Involve family members and community leaders in care planning to align treatment with patients’ values. |
| Addressing Socioeconomic Challenges | Offer flexible appointment scheduling and use mobile health services to improve accessibility. |
| Professional Development in Cultural Competence | Continuous education helps nurses navigate complex healthcare interactions and reduce disparities. |
Conclusion
Addressing the healthcare challenges faced by individuals experiencing housing insecurity requires a comprehensive approach. By delivering culturally competent care, healthcare providers can help reduce health disparities and improve the overall well-being of this vulnerable population. Strategies such as mobile health clinics, trauma-informed care, and social support networks play a vital role in enhancing access to healthcare services for those facing housing insecurity. With a focus on addressing both medical and social determinants of health, healthcare providers can significantly improve outcomes for individuals experiencing homelessness and housing instability.
References
Anthonj, C., Mingoti Poague, K. I. H., Fleming, L., & Stanglow, S. (2024). Invisible struggles: WASH insecurity and implications of extreme weather among urban homeless in high-income countries – A systematic scoping review. International Journal of Hygiene and Environmental Health, 255, 114285. https://doi.org/10.1016/j.ijheh.2023.114285
Boston Health Care for the Homeless Program. (2024). Street team. https://www.bhchp.org/services/street-team/
Deering, M. (2024, May 3). Cultural competence in nursing. NurseJournal. https://nursejournal.org/resources/cultural-competence-in-nursing/
Fitzpatrick, K. M., & Willis, D. E. (2021). Homeless and hungry: Food insecurity in the land of plenty. Food Security, 13(1). https://doi.org/10.1007/s12571-020-01115-x
Garcia, C., Doran, K., & Kushel, M. (2024). Homelessness and health: Factors, evidence, innovations that work, and policy recommendations. Health Affairs, 43(2), 164–171. https://doi.org/10.1377/hlthaff.2023.01049
Hernandez, N. C., Leal, L. M. R., & Brito, M. J. M. (2021). Building culturally competent compassion in nurses caring for vulnerable populations. Journal of Holistic Nursing, 40(4), 089801012110627. https://doi.org/10.1177/08980101211062708
NURS FPX 4015 Assessment 4
Miller, L. (2021). Statistics on veterans and substance abuse. Veteranaddiction.org. https://veteranaddiction.org/resources/veteran-statistics/
National Low Income Housing Coalition. (2023). A shortage of affordable homes. https://nlihc.org/sites/default/files/gap/Gap-Report_2023.pdf
Rennert, L., et al. (2024). Mobile health clinics for vaccinations to underserved communities. Public Health in Practice, 8, 100550. https://doi.org/10.1016/j.puhip.2024.100550
Willison, C. E., et al. (2021). Technically accessible, practically ineligible: Medicaid expansion and chronic homelessness. Journal of Health Politics, Policy and Law, 46(6). https://doi.org/10.1215/03616878-9349142