Background
Homelessness can often cause or be caused by serious health problems. Illnesses that are closely associated with homelessness and poverty include tuberculosis, AIDS, malnutrition, and severe dental problems. Other health problems in society such alcoholism, mental illnesses, and physical disabilities are even more debilitating for the homeless, since they may have no shelter or money to manage the problem. People without shelter could easily get frostbite, get infections, or be victims of violence, even in public shelters. They are also more likely to cohabitate with drug addicts, alcoholics, and/or others with disease.

Each year millions of homeless people in the United States need important health care services but most do not have health insurance or cash to pay for medical care. Finding health care is an enormous challenge for the homeless.

Uninsured individuals have higher out-of-pocket costs compared to the insured, and more often have higher medical bills. People weigh the costs of health insurance and medical care against essential needs such as rent, food, and utilities. Even relatively minor health care expenses add up quickly and the financial impact can be quite serious.

Most uninsured come from working families and are low-income, making less than the poverty level. Most uninsured adults have gone without coverage for at least two years. Workers from low income families have less access to job-based insurance. For low wage workers, employee contributions to premiums are unaffordable. Adults, minorities, and American citizens are the most likely to be uninsured.

Research & Links

“Disproportionate Impact of Diabetes in a Puerto Rican Community of Chicago,” Journal of Community Health 

“Improving Community Health Survey,” Sinai Health System

"Outreach to People Experiencing Homelessness: A Curriculum for Training Health Care for the Homeless Outreach Workers"

“Spirituality as a Clinical Tool: Care for the Homeless Mentally Ill”  

“Surgeon General's Call to Action to Promote Sexual Health and Responsible Sexual Behavior,” United States Department of Health & Human Services 

“Uninsurance Facts and Figures,” The Institute of Medicine of the National Academy

"Uninsured and Overcharge," Service Employees International Union

Center for Studying Health System Change

Trends in U.S. Health Insurance Coverage, 2001-2003: Results from the Community Tracking Study, Robert Wood Johnson Foundation 

Income, Poverty, and Health Insurance Coverage in the United States: 2004

Kaiser Commission on Medicaid and the Uninsured

National Health Care for the Homeless Council

U.S. Census Bureau/Health Insurance  

U.S. Department of Health & Human Services Health Resources and Services Administration Bureau of Primary Health Care