Structural Barriers To Homelessness

Homelessness

Dayna is a 38 year old unemployed homeless woman who has been homeless for 3 years after escaping a violent relationship. She has been living on the streets and in temporary shelters. She has numerous health issues including hepatitis C, persistent respiratory infections, depression and a facial laceration caused by recently being physically assaulted. The facial laceration is red and swollen with some seropurulent ooze. Homelessness is defined as people without permanent housing (Maness & Khan, 2014). Homelessness is categorised into three types, primary, secondary and tertiary homelessness. A person without conventional accommodation describes primary homelessness; these people sleep rough on the streets or in makeshift dwellings

There are multiple barriers which can affect a homeless person’s access to health care. Structural barriers lead to health inequalities in the homeless and create challenges for the homeless in accessing health care services. There are various structural barriers which can restrict access to health care services for the homeless, through the health care service itself or as a consequence of being homeless (John & Law, 2011; McNeil, Guirguis-Younger, Dilley, Turnbull & Hwang, 2013). Structural barriers which can be caused by the health care service include inflexibility of primary health care organisations and appointment times (John & Law, 2011; Rinehart & Borninkhof, 2012), geographical factors such as the location of the health care services (Bungay, 2013; Rinehart & Borninkhof, 2012), health care services lack of resources to manage the complex health care needs of the homeless (Moore, Manias, Gerdtz, 2011), restricted opening hours and lack of after-hours services (Hauff & Secor-Turner, 2014; Moore et al., 2011), shortage of bulk-billing general practitioners, fees that the health care service may charge and general practitioner health care services may be at full capacity and not taking on any new clients (Rinehart & Borninkhof, 2012). Health care service policies can also be a structural barrier for homeless people as there are admission criteria and protocols which the service has to follow (Moore et al., 2011). There are structural barriers which are consequences of being homeless; these include a homeless person’s inability to navigate the health care system, which may be caused by a lack of knowledge of the health care system, financial issues can lead to an inability to pay for the health care services they require (Hauff & Secor-Turner, 2014), lack of appropriate accommodation therefore they are unable to access outreach services (Moore et al., 2011), limited access