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Saturday, March 9, 2019

Health care for the homeless

More on that logo art in a moment. Love it.

First, as part of my customary early morning online news review workflow, I ran across this at The Atlantic:
Medieval Diseases Are Infecting California’s Homeless
Typhus, tuberculosis, and other illnesses are spreading quickly through camps and shelters.

…“Our homeless crisis is increasingly becoming a public-health crisis,” California Governor Gavin Newsom said in his State of the State speech in February, citing outbreaks of hepatitis A in San Diego County, syphilis in Sonoma County, and typhus in Los Angeles County.
“Typhus,” he said. “A medieval disease. In California. In 2019.”

The diseases have flared as the nation’s homeless population has grown in the past two years: About 553,000 people were homeless at the end of 2018, and nearly one-quarter of homeless people live in California.

The diseases spread quickly and widely among people living outside or in shelters, helped along by sidewalks contaminated with human feces, crowded living conditions, weakened immune systems, and limited access to health care.

“The hygiene situation is just horrendous” for people living on the streets, says Glenn Lopez, a physician with St. John’s Well Child & Family Center, who treats homeless patients in Los Angeles County. “It becomes just like a Third World environment, where their human feces contaminate the areas where they are eating and sleeping.”

Those infectious diseases are not limited to homeless populations, Lopez warns: “Even someone who believes they are protected from these infections [is] not.”…
Shit. Literally and metaphorically.

I have never been homeless (came close once, in 1967, in the wake of an extended period of illness). I can't imagine.

More recently, before my younger (now late) daughter was dx'd with Stage IV pancreatic cancer, I was a weekly volunteer with the San Francisco "" senior dog rescue center. The nation's most highly overeducated dog rescue shelter laundromat attendant. My parents never let us have pets. I've been a stray magnet ever since. "Senior dog rescue?" I'm there.

The seven or so blocks between the 16th and Mission BART station and Muttville burst at the sidewalk / curbside seams with the shopping carts, blue tarps, tents, and raggedy deitrus of the homeless.

Nasty. Sad. Pungent odors in the air. Watch where you step.

I try to imagine. And I am so grateful for our relative good fortune. As I write, Cheryl and I are doing the final paperwork to close on our 3rd (and likely final) home purchase, in Baltimore, to be close to our son, who happily lives there with his (Baltimore native and state environmental engineer) Eileen in Pigtown.

He has now lost both of his elder sisters to cancer and is the last kid standing. We have to be nearby.

In light of our lovely over-the-ingoing-budget-cap price tag on this place we settled upon, I feel a coming-out-of-retirement stint looming in my future (Cheryl has certainly earned her slack). With my new aortic valve firmly pounding away, I'm loaded for Bear. (There's always Busking, LOL.)

So, just out of curiosity I started putzing around on Talk about a target-rich environment in Baltimore-DC area: "writer," "analyst," "policy analyst," "ethicist," "ASQ," "quality engineer,"... tons.

"Lean health care?" Yes!

Which led me to "Health Care for the Homeless" of Baltimore (and Maryland more broadly). They're soliciting for a (Lean) "Performance Improvement Specialist."

We need to talk. These folks are doing important work.

to wit, apropos of the above Atlantic article, see their page "Homelessness makes you sick."


Their national affiliation:

Wow. Just wow.

Below, is this cool, or what?

Again, The Atlantic:
"People living on the streets or in homeless shelters are vulnerable to such ['medieval' disease] outbreaks because their weakened immune systems are worsened by stress, malnutrition, and sleep deprivation. Many also have mental illness and substance-abuse disorders, which can make it harder for them to stay healthy or get health care."

In 2012 while covering one of my many conferences I met and immediately befriended techie internal med physician Jan "Doc" Gurley, a well-known authority on the medical plights of the homeless. She'd long been with the San Francisco Department of Public Health.

A couple of years ago, she just seemed to fall off the planet. No one among my Health 2.0 crowd knows what has become of her. The last time we spoke she told me of her new effort to address the medical plights of parolees (who overwhelmingly become homeless--if not reincarcerated--in short order). I told her I'd love to help with that. She told me she was taking CCTV classes at Berkeley to learn how to do video documentary episodes.

Then, "poof." Vanished.

Disconcerting. Anybody?


Amazon's "AI" has certainly "got my number."

I expect this book will cohere nicely with my prior post "Can medicine be cured?"

"Polypharmacy?" "Overdo$ed America?"

More to come...

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