Toward Understanding Homelessness: The 2007 National Symposium on Homelessness Research. Rural Homelessness. Physical Health Problems of Homeless Persons in Rural Areas


People who are homeless in rural areas have greater health problems but less access to health care (Center for Family and Community Life, 2005; National Coalition for the Homeless, 2006). For example, in Ohio, higher rates of health problems were found in the purely rural counties (41 percent versus 20 percent in mixed counties and 41 versus 31 percent in urban counties) (Roth et al., 1985; Roth & Bean, 1986). In Montana, diagnoses of hypertension (11 percent), asthma (11 percent) and hepatitis C (9 percent) were the most commonly reported diseases (Montana Council on Homelessness, 2007). In a series of qualitative interviews on the health of rural homeless persons, Post (2002) asked clinicians nationally to identify the medical conditions that seem to distinguish rural from other homeless clients and to identify obstacles that prevent clients from getting the health care and social support they need. Clinicians described the morbidity from chronic medical conditions such as hypertension or diabetes as being greater than in urban settings because rural clients remain untreated longer than their urban counterparts. Infectious diseases (including hepatitis C, which is associated with injection drug use) were reported to be a growing problem among rural homeless clients, as were sequelae of alcohol and drug problems. Tuberculosis was reported to be more prevalent among recent immigrants from Latin America and Southeast Asia who often work in rural areas. HIV is often diagnosed later in rural areas than in urban areas, after the illness has reached more advanced stages, making treatment more difficult. Traumatic injuries and musculoskeletal disabilities secondary to trauma or injuries from manual labor were also reported (Post, 2002). Several studies identified specific health problems such as HIV/AIDS as causes of homelessness in their samples (Montana Council on Homelessness, 2007; Post, 2002; Wilder Research Center, 2007a, b).

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