The invisible population: providing healthcare for the homeless

A few years ago, a doctor friend from West Virginia was in Boston to make a presentation at a conference. He stayed in a hotel in the Back Bay and was delighted with the easy access he had to Newbury Street, the Commons, and the Public Gardens, as well as the grand restaurants he was exploring every night after the conference sessions ended. My wife Sandy and I met him at an Indian restaurant in Harvard Square the night before he was to go home.

"I've never seen so many homeless people in my life," he said after we were seated and we had asked him how he was enjoying Boston.

"Really?" we responded, surprised to hear that was the first thing that came to mind.

"Really," he said. "From the time I leave the hotel lobby in the morning until I get back later that night, it's almost constant. Someone asking for money. Someone sitting on the steps at the drugstore. Someone talking to himself on a bridge."

It's not that Sandy and I were oblivious to the fact there are homeless in Boston. One of Sandy's former bosses used to make his office as well as the office shower available on the weekends to a man he'd met on the street and bought a meal for. A few years before our doctor friend came to town, On Call had published an article about EMTs who went out at night to find the homeless in ATM booths and under highway overpasses to check on how they were and whether or not they needed medical attention. Our photographer David Stone had ridden with them and was amazed at the way the EMTs not only knew exactly where to go but also knew who they would find when they got there. We had also published an article on a medical clinic for the homeless at the Pine Street Inn.

The thing, though, about the homeless is how invisible they become when you see them every day. According to the CDC, there are 3.5 million homeless people every year in the United States with as many as 26 percent of them reporting acute medical conditions such as tuberculosis, pneumonia, or an STD. In addition, 44 percent of the homeless population have one or more chronic conditions. The rate of asthma alone is four times higher among the homeless than among the general population.

Even more invisible than the homeless we see every day on the street are homeless families. Fifteen percent of the homeless are pregnant and 20 percent are parenting newborns. Twelve percent of homeless preschoolers have emotional problems that require professional help, and 47 percent of school age children have anxiety, depression, or withdrawal.

Fortunately, there are people who don't let the homeless remain invisible. Janet Cromer's article this month describes the efforts of the Boston Health Care for the Homeless Program's Family Team. These professionals work regularly with more than 1,800 homeless families a year in shelters throughout the Greater Boston area to ensure that, although they may be invisible to the population at large, they are not forgotten.

Homelessness is something most of us would rather not see, and many times we cross the street rather than have to see it. Thank goodness there are people who cross the street the other way to see that as many homeless families as possible get the care they need.

Joseph Saling