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Medicine Year 1 - Semester 2 - Part 2 > Health and Homelessness > Flashcards

Health and Homelessness Flashcards

1
Q

Maslow’s Hierarchy of needs

A

TOP to BOTTOM

Self-actualisation
Esteem
Love/Belonging
Safety
Physiological

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2
Q

State the main determinants of health

A

Individual lifestyle factors
Social and Community networks

General socio-economic, cultural and environmental conditions

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3
Q

Key determinant of health

A

Housing
Health-care services

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4
Q

ECG of wellbeing

A

5Rs

  • Rafters (firm foundations)
  • Relationships (firm foundations)
  • Resources
  • Restoration
  • Resilience
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5
Q

Rafters

A

Shelter, Security and Continuity

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6
Q

Resources

A

Income, Wealth, Education, Employment, Opportunity

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7
Q

What is homelessness ?

EXAM TYPE Q

A

Has no accommodation in the UK or elsewhere that they can reasonably occupy.

Cannot gain access to their accommodation or risk domestic violence by living there.

Accommodation which is unreasonable, overcrowded or risk to health.

‘Likely to become homeless’ - within 2 months

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8
Q

State some forms of temporary accommodation

A

Council Housing
Voluntary Sector Hostels
Women’s Refuge
Supported Flats
Bed and Breakfast

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9
Q

Why do people become homeless ?

A

Social issues
Personal factors/ vulnerabilities
Housing Factors

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10
Q

State some social issues

A

Lack of affordable housing
Lack of Jobs

Inadequate levels of welfare & disability payment

Ethical & Racial Discrimination
Economic Downturn / Welfare Reform

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11
Q

State some personal factors (family related)

A

Adverse Childhood experiences
Childhood family environment
History of Institutional living

Relationship breakdowns
Social Isolation
Life-coping skills are overwhelmed

Bereavement

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12
Q

State some personal factors (illness related)

A

Mental illness
Substance misuse
Domestic/ Sexual Abuse

Learning Disabilities
History of anti-social behaviour/ offending

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13
Q

State some personal factors (financial related)

A

Poverty and Debt
Household with no recourse to pubic funds (NRPF)

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14
Q

NRPF

A

No recourse to public funds

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15
Q

State some housing factors

A

Rent or Mortgage arrears
Impending eviction/ repossession

Tenure insecurity - tied tenancy
History of neighbour complaints

Previous homelessness
House unable to be adapted to needs

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16
Q

State some people who are at high risk of homelessness (younger generation)

A

Single young males
Young adults 18-25

Family breakups

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17
Q

State some people who are at a high risk of homelessness (people serving time)

A

Those leaving the HM forces
Leaving prison

Refugees / Those with NRPF

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18
Q

State some people who are at a high risk of homelessness (medical)

A

Victims of domestic abuse
Hospital Discharge
People with addictions/ mental health issues

Looked after young people

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19
Q

Describe some health consequences of homelessness

A

Impact on life expectancy (lowered)
Mental Illness and Substance abuse
Physical Ill health

20
Q

State the life expectancy for rough sleepers

A

Average life expectancy of 41 years, compared with the national average of 79 for men and 83 for women.

21
Q

State the top causes of death amongst the homeless

A

Drugs (20x)
Intentional Self Harm (8x)
Assault (7x)
Chest (6x)
Infections (6x)
Alcohol (5x)

22
Q

What is ‘Housing First’ ?

A

A wrap around support to rebuild connection and wean off support, once a previously homeless individual moves into their new accommodation.

23
Q

Dual Diagnosis

A

Mental Illness
Substance Abuse

24
Q

SII

A

Slope Index of Inequality

25
Q

What is the Slope Index of Inequality ?

A

Epidemiological measure of the difference in life expectancy between the most and least deprived sections of the local population.

26
Q

SMR

A

Standardised Mortality Ratio

27
Q

Cross-Cutting issues of homelessness

A
  • 3rd sector dental care
  • Nutrition
  • Social work
  • Podiatry
  • Substance use
  • Emergency Departments
  • Primary Care
  • Alcohol abuse
  • Mental Health
  • Skin care
28
Q

Why is Emergency department a cross cutting issue of homelessness ?

A

Since some homeless people are not registered with a GP/ have issues trying to access the GP, the ER may tend to be the front door for these people.

29
Q

Why is Nutrition a cross-cutting issue of homelessness ?

A

Malnourished due to not getting enough food.

Diet may not be the best, as donated food may not be the healthiest food choices / they may buy the cheapest food.

30
Q

Barriers to accessing healthcare

A

NHS administration
Staff attitudes
Aggressive behaviour
Location and timing of appointments

Problem of ‘Dual Diagnosis’ referral patients
Temporary accommodation

31
Q

NHS administration barrier

A

Need for a permanent address to register

32
Q

Staff attitudes barrier

A

Hostile reception staff

33
Q

Aggressive behaviour barrier

A

Substance misuse (from the homeless) may cause aggressive behaviour.

34
Q

Temporary accommodation barrier

A

Loss of contact

35
Q

Methods of service delivery

A

Dedicated GP / Dental Practices

Dedicated Health Visitors for homeless families

Specialised mental health, drug and alcohol staff

Mainstreamed service

One-Stop Shop arrangements

36
Q

Mainstreamed Service

A

With bespoke access arrangements (in reach, out reach)

37
Q

One stop shop arrangements

A

At homeless venues with voluntary organisations

38
Q

Range of needs for homeless

A

Physical ill-health
Increased mortality
Increased multiple morbidity
Long term conditions

39
Q

Recovery for homeless

A

Relationships and Resilience
Quality and Quantity

40
Q

What are resilience factors ?

A

Hope generators

41
Q

State some resilience factors (network related)

A

Supportive family / friends
Strong social networks

Appropriate support services
Available advice and advocacy

42
Q

State some resilience factors (work related)

A

In a stable employment
Personal empowerment

Savings or access to financial help

43
Q

Inverse Care Law

A

Those who need healthcare the least, use the services more and more effectively.

Those with the greatest need and those people in the worst healthcare receive the least services.

44
Q

What is the purpose of homelessness prevention ?

A

Rebuild hope, purpose and self-respect

45
Q

State some homelessness prevention strategies (conflict / issue resolution)

A

Family/ relationship conflict resolution
Alcohol and Drug Partnerships

Personal resilience skills
Employment support

Income maximisation

46
Q

State some homelessness prevention strategies (social help)

A

Health outreach services
Education and Skills

Housing support
Social work

47
Q

Homelessness Services function

A

Homelessness is about supportive relationships and communities.

Services need to build networks of supportive relationships

Relationships thrive in strong communities.

Medicine Year 1 - Semester 2 - Part 2 (53 decks)

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