Name
Capella University
NURS-FPX 4060 Practicing in the Community to Improve Population Health
Prof. Name
Date
In January 2020, approximately 580,466 individuals in the United States increased from the previous year, with more than 226k of them living in unsheltered conditions. The rise in homelessness has persisted for four years, significantly impacting families with children, veterans, and people of color (Sleet & Francescutti, 2021). The goal of this report is to analyze how the national organization, National Alliance to End Homelessness (NAEH), improves public health and safety, fosters equal opportunities, and enhances the standard of life for affected individuals and communities. By evaluating its mission, vision, and the influence of policies and funding, this assessment will showcase the organization’s impact on homelessness and its contributions to community well-being.
The NAEH operates with a mission to prevent and ultimately end homelessness through a combination of research, policy advocacy, and education. Its vision focuses on making sure that every person and family have access to secure, reliable housing which is a critical factor in improving public health and safety (NAEH, 2024c). By addressing homelessness, the organization works to reduce health risks associated with unstable living conditions, such as increased exposure to communicable diseases, limited access to healthcare, and mental health challenges (Bensken et al., 2021).
A key initiative that supports the organization’s mission is the Rapid Re-Housing program, which provides temporary rental support and services designed to help individuals and families swiftly move out of homelessness. The data for any given night in 2023 shows that 31% have serious mental health issues, 24% face drug abuse of a chronic nature, and 11k individuals have HIV/AIDS, showcasing the impact of homelessness (NAEH, 2023a).This initiative promotes public health and safety by reducing the time people spend in vulnerable environments, such as shelters or on the streets, associated with higher rates of injury, illness, and substance abuse, hence fulfilling NAEH’s mission. Through the initiative, promoting long-term well-being by stable housing which serves as a foundation for better access to healthcare and other essential services. Hence, it leads to NAEH’s vision of improved medical outcomes and standard of life for all individuals who were previously homeless ensuring equity (Nourazari et al., 2021).
The NAEH shows a dedicated effort to advancing equal opportunities and enhancing standard of life for populations by addressing the root causes and consequences of homelessness. Homelessness disproportionately affects marginalized groups, including people of color, LGBTQ+ individuals, and those living in poverty. For instance, a study conducted highlights that homeless individuals had the highest rates of depression, anxiety, hypertension, cardiovascular disease, and hepatitis compared to non-homeless groups (Sleet & Francescutti, 2021). The US citizens spend 50% of the population more than 30% on housing, and a quarter spend above 50% of their earnings on housing (Mehdipanah, 2023).
The Alliance works to dismantle social and economic barriers such as lack of reliable housing, unemployment, poverty, limited access and discrimination. It does so by advocating for policies that increase access to reliable housing, mental care, and employment opportunities, which are essential for long-term stability. For instance, it advocates for the Housing First policy, which prioritizes providing swift, stable housing with no prior conditions, followed by availability of supportive services such as mental health assistance and job training (Leifheit et al., 2022).
Cultural barriers, such as stigma and discrimination, often prevent individuals from seeking help or receiving equitable services. The Alliance actively addresses these barriers by promoting inclusive policies and creating programs that are accessible to all, regardless of background. For example, the organization’s advocacy efforts for affordable housing initiatives aim to reduce economic barriers by increasing housing supply and lowering costs, particularly in high-demand urban areas where low-income populations are disproportionately affected (Mehdipanah, 2023). Physical barriers, such as disabilities or chronic health conditions, also pose challenges to securing stable housing. The Alliance supports programs that provide tailored resources for individuals with physical limitations, including accessible housing and healthcare services.
For instance, the organization supports programs that integrate healthcare services into housing support, such as on-site medical care and home-based health services, to assist individuals with chronic conditions like diabetes or hypertension. Their efforts has substantially reduced homelessness cases through education and advocacy especially for veterans who have been provided homes and ended homelessness among 83 communities in three different states (NAEH, 2023b). Moreover, the organization funds case management programs to help individuals with physical disabilities navigate the housing system, apply for benefits, and access necessary adaptive equipment and home modifications (Nourazari et al., 2021).Altogether, the efforts have positive impact on the organization evident in bipartisan support which enable it to achieve its mission and provide shelters.
The NAEH relies on a mix of federal funding, private donations, and grants to support its initiatives, with government programs like the Continuum of Care (CoC) and the Emergency Solutions Grants (ESG) playing a significant role in funding homelessness aversion and rapid re-housing programs (Augustine & Kushel, 2022). The U.S. Department of Housing and Urban Development (HUD) has announced a $2.8 billion for CoC program and sets a target of decreasing homelessness by twenty-five percent till 2025 (HUD, 2023). The allocation of these funds directly impacts the organization’s ability to deliver essential services, as increased funding allows for the expansion of housing assistance and support services, while budget cuts could result in reduced capacity and longer wait times for individuals seeking help.
Policies like The Rapid Re-Housing guidelines significantly influence homelessness programs by shaping housing eligibility and funding priorities. Changes in these policies can directly affect the availability of services for vulnerable populations, impacting their chances of securing stable housing. Increased funding through programs like CoC and ESG helps individuals access housing and support services more quickly, preventing homelessness and reducing negative outcomes such as poor health and disrupted education (NAEH, 2024b). Legislation such as the McKinney-Vento Homeless Assistance Act, which created the CoC program, plays a crucial role in homelessness services by defining legislative support and funding mechanisms.
Changes in legislation can affect the scope and effectiveness of assistance programs, influencing resources available for homelessness. Strong legislative backing contributes to reduced homelessness, better public health, and enhanced community stability by aligning resources with the needs of vulnerable populations (Grattan et al., 2021). Both funding and legislative support are essential in shaping the effectiveness of homelessness programs, with robust financial resources in reducing homelessness and enhancing community well-being.
The NAEH directly impacts community health and safety by stabilizing housing, which is fundamental to accessing healthcare and maintaining mental well-being. By securing permanent housing for individuals, the Alliance mitigates the increased vulnerability to chronic diseases and mental health issues often associated with homelessness. The supportive services provided through the Rapid Re-Housing program, such as short-term residence, substance abuse treatment and mental health counseling, further enhance individual health outcomes and promote long-term recovery. Moreover, reducing street homelessness lessens public safety concerns, such as the potential for increased crime and public health hazards, leading to a healthier and more stable community overall (Watts, 2021).
Nurses can significantly contribute to the NAEH by leveraging their expertise to enhance health outcomes for homeless individuals. They can engage in outreach programs to deliver essential health screenings, immunizations, and preventive care, thereby addressing immediate health needs and connecting individuals to necessary healthcare services. Nurses can also collaborate in developing and implementing holistic care plans that integrate medical, mental health, and social support services, ensuring that individuals receiving housing support receive comprehensive care tailored to their specific needs (McWilliams et al., 2022).
Moreover, nurses can play a pivotal role in advocating for public policies that align with the Housing First approach. By supporting legislation that prioritizes stable housing and integrates supportive services, nurses can help address the wider social factors affecting health, such as availability of mental health services, addiction treatment, and job opportunities (McWilliams et al., 2022). For instance, a nurse can help better accessibility through a partnership with NAEH for immediate care like screening; it can advocate for homeless people through assistance in application for Medicaid or other social services. Most importantly, it can educate homeless people on health topics like the importance of hygiene, nutrition, or disease prevention measures. Their involvement in policy advocacy and community education can drive systemic change, promoting equitable access to resources and improving overall health and safety within the community (Bell et al., 2022).
In conclusion, the NAEH is enhancing health and safety by facilitating secure housing and comprehensive support through education and advocacy services. Its commitment to promoting equal opportunity and addressing systemic barriers significantly improves the quality of life for vulnerable populations. Sustained financial and legislative support is vital for the organization.. Nurses have valuable opportunities to contribute by engaging in direct care, advocacy, and policy development to advance the Alliance’s mission and impact further.
Augustine, D., & Kushel, M. (2022). Community supervision, housing insecurity, and homelessness. The ANNALS of the American Academy of Political and Social Science, 701(1), 152–171. https://doi.org/10.1177/00027162221113983
Bell, L., Whelan, M., Fernandez, E., & Lycett, D. (2022). Nurse‐led mental and physical healthcare for the homeless community: A qualitative evaluation. Health & Social Care in the Community, 30(6). https://doi.org/10.1111/hsc.13778
Bensken, W. P., Krieger, N. I., Berg, K. A., Einstadter, D., Dalton, J. E., & Perzynski, A. T. (2021). Health status and chronic disease burden of the homeless population: An analysis of two decades of multi-institutional electronic medical records. Journal of Health Care for the Poor and Underserved, 32(3), 1619–1634. https://doi.org/10.1353/hpu.2021.0153
Carmichael, C., Schiffler, T., Smith, L., Moudatsou, M., Tabaki, I., Doñate-Martínez, A., Alhambra-Borrás, T., Kouvari, M., Karnaki, P., Gil-Salmeron, A., & Grabovac, I. (2023). Barriers and facilitators to health care access for people experiencing homelessness in four European countries: An exploratory qualitative study. International Journal for Equity in Health, 22(1), 206. https://doi.org/10.1186/s12939-023-02011-4
Grattan, R. E., Tryon, V. L., Lara, N., Gabrielian, S. E., Melnikow, J., & Niendam, T. A. (2021). Risk and resilience factors for youth homelessness in western countries: A systematic review. Psychiatric Services, 73(4), appi.ps.2020001. https://doi.org/10.1176/appi.ps.202000133
HUD. (2023, March 28). HUD announces $2.8 billion in annual funding to help people experiencing homelessness. U.S. Department of Housing and Urban Development (HUD). https://www.hud.gov/press/press_releases_media_advisories/HUD_No_23_062
Leifheit, K. M., Schwartz, G. L., Pollack, C. E., & Linton, S. L. (2022). Building health equity through housing policies: Critical reflections and future directions for research. Journal of Epidemiology and Community Health, 76(8), 759–763. https://doi.org/10.1136/jech-2021-216439
McWilliams, L., Paisi, M., Middleton, S., Shawe, J., Thornton, A., Larkin, M., Taylor, J., & Currie, J. (2022). Scoping review: Scope of practice of nurse‐led services and access to care for people experiencing homelessness. Journal of Advanced Nursing, 78(11), 3587–3606. https://doi.org/10.1111/jan.15387
Mehdipanah, R. (2023). Without affordable, accessible, and adequate housing, health has no foundation. The Milbank Quarterly, 101(S1), 419–443. https://doi.org/10.1111/1468-0009.12626
NAEH. (2023a, December). Health. National Alliance to End Homelessness. https://endhomelessness.org/homelessness-in-america/what-causes-homelessness/health/
NAEH. (2023b, December). Veterans. National Alliance to End Homelessness. https://endhomelessness.org/homelessness-in-america/who-experiences-homelessnes/veterans/
NAEH. (2024a). Legislation endorsed by the national Alliance to end homelessness. Endhomelessness.org. https://endhomelessness.org/wp-content/uploads/2024/08/August2024_NAEH-EndorsedLegislation.pdf
NAEH. (2024b). New federal funding boosts unsheltered homelessness response. National Alliance to End Homelessness. https://endhomelessness.org/resource/new-federal-funding-boosts-unsheltered-homelessness-response/
NAEH. (2024c). Our mission and history. National Alliance to End Homelessness. https://endhomelessness.org/who-we-are/our-mission-and-history/#:~:text=The%20National%20Alliance%20to%20End
Nourazari, S., Lovato, K., & Weng, S. S. (2021). Making the case for proactive strategies to alleviate homelessness: A systems approach. International Journal of Environmental Research and Public Health, 18(2), 526. https://doi.org/10.3390/ijerph18020526
Sleet, D. A., & Francescutti, L. H. (2021). Homelessness and public health: A focus on strategies and solutions. International Journal of Environmental Research and Public Health, 18(21), 11660. National Library of Medicine. https://doi.org/10.3390/ijerph182111660
Watts, G. R. (2021). Homelessness is an ethical issue in America. AMA Journal of Ethics, 23(11), 835–839. https://doi.org/10.1001/amajethics.2021.835
