Abstract
BackgroundThe COVID-19 pandemic laid bare some of the United States’ most devastating health and social inequities faced by people experiencing homelessness. Homeless populations experience disproportionate rates of underlying health conditions, stigma and marginalization that often disenfranchise them from health and social services, and living conditions that potentiate the risk of COVID-19 transmission and adverse outcomes.MethodsGuided by the socio-ecological model, this community-based participatory research study examined the impacts of the COVID-19 public health crisis on people experiencing homelessness in Tippecanoe County, Indiana, and the ways in which homeless service providers prepared for, experienced, and responded to the pandemic. Eighteen (18) semi-structured interviews were conducted with representatives of 15 community-based organizations, including shelters and other homeless service providers.ResultsQualitative content analysis revealed myriad challenges at the individual and interpersonal levels faced by people experiencing homelessness as a result of the pandemic, and multilevel responses for COVID-19 impact mitigation in this community. Many of the emergency measures put in place by homeless service providers in Tippecanoe County, Indiana created opportunities for innovative solutions to longstanding challenges faced by homeless populations that are informing better service delivery moving forward, even beyond the COVID-19 pandemic.ConclusionsCommunity-based organizations, including homeless shelters, are uniquely qualified to inform pandemic response and disaster risk mitigation in order to respond appropriately to the specific needs of people experiencing homelessness. The lessons learned and shared by homeless service providers on the frontline during the COVID-19 pandemic have important implications to improve future disaster response for homeless and other vulnerable populations.
Highlights
The COVID-19 pandemic laid bare some of the United States’ most devastating health and social inequities faced by people experiencing homelessness
people experiencing homelessness (PEH) face disproportionate rates of underlying health conditions and substance use disorders, stigma, and marginalization that often disenfranchise them from health and social services, and social living conditions that lead to a heightened risk of infection and adverse outcomes of COVID-19 [1,2,3]
Academic and grey literature was reviewed to gain insights into the COVID-19 response among communities working with PEH and to identify knowledge gaps that could be addressed by the local Communitybased organizations (CBO) interviews
Summary
The COVID-19 pandemic laid bare some of the United States’ most devastating health and social inequities faced by people experiencing homelessness. Homeless populations experience disproportionate rates of underlying health conditions, stigma and marginalization that often disenfranchise them from health and social services, and living conditions that potentiate the risk of COVID-19 transmission and adverse outcomes. The COVID-19 pandemic has exposed and amplified the rampant health disparities and weaknesses of our public health system that inequitably impact marginalized and underserved populations in the United States (US), including people experiencing homelessness (PEH). PEH face disproportionate rates of underlying health conditions and substance use disorders, stigma, and marginalization that often disenfranchise them from health and social services, and social living conditions that lead to a heightened risk of infection and adverse outcomes of COVID-19 [1,2,3]. Standard COVID-19 prevention guidelines, such as practicing social distancing, maintaining regular personal hygiene, and mask wearing can be difficult in congregate settings, placing homeless shelter guests, staff, and everyone they interact with at increased risk of infection
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