Medical Non-Compliance

Medical non-compliance in the Homeless: Methods of Improving Medical Adherence
Medical adherence is an important factor of health in the homeless population. Failure to adhere in the way prescribed by a health provider not only exacerbates existing and additional medical conditions, but it increases the overall cost of healthcare due to additional emergency hospital visits (Hong, Reed, Novick, Haro, & Aguado, 2011). The New England Healthcare Institute (NEHI) estimated that an annual medical cost of up to $290 billion is a result of medical nonadherence (Coe et al., 2015). Besides medical costs, not only is the homeless population negatively impacted by medical nonadherence, but the general population is also affected due to the higher possibility

Within their social circle, the life expectancy differs greatly from the general population, dying at much younger ages. While the life expectancy is 80 years for women and 74 years for men in the housed population, that is changed to 43 and 47 years in the homeless population, respectively (Parker-Radford, 2016). Within the homeless youth, many are escaping circumstances or living environments where they were subject to physical or sexual abuse. They may even exchange sex for food, clothing, and shelter, which increase the risk of sexually transmitted diseases or unintended pregnancy. Many homeless youth also are at increased risk of physical or sexual assault after leaving their homes, which in turn is not limited to only poor households, but is also inclusive of socioeconomic backgrounds. Among the homeless youth population is also a higher risk for depression and thoughts of suicide, which can be contributing factors to nonadherence. Another reason for nonadherence is that homeless individuals may feel a sense of achievement and an extreme self-reliance due to their methods of survival that mainstream society would more than likely be unable to accept or get used

In one survey, 36% of people stated that they would not want to work closely with an individual who has an acute mental illness (McGinty, Webster & Barry, 2013). This survey can also shed insight on the problems that nurses face and the toll it takes on them over time when dealing with homeless patients, who have many mental disabilities in addition to physical ailments. The standards and lifestyles and quality of life between nurses and the homeless population are very much culturally different. Outside of the medical arena, these different groups of people rarely intermingle within society. There is a lack in the full understanding that the homeless population does not live in, or have direct access to clinics, hospitals, shelters, or any other medical establishment where advice and/or medical instructions or diagnoses are held. Healthcare for the homeless is generally facilitated in shelters, store-front clinics, mobile medical vehicles, hospital EDs, and churches, where appointments are often mistakenly required. This limits the amount of homeless patients that can even be seen for a regular checkup. A concern of nurses who work independently is personal safety due to the possibility of a homeless person acting in an unpredictable