Physical disability, homelessness, and health

Objective: To understand how the living conditions in homeless shelters affect the health and access to health care and social services among adults with physical disabilities.

Methods: Trained interviewers conducted face-to-face interviews with working-age adults (18-64 years old) who had a physical disability (i.e., requiring use of an assistive device) and lived in a homeless shelter in the District of Columbia. Participants reported the accessibility of the shelter, health status, functional capacities (e.g., bathing, dressing, getting around), and barriers to needed health and social services.

Results: A total of 84 individuals from 12 different homeless shelters participated in an interview. The majority were male (76%), African American or Black (92%), and living in a homeless shelter for less than 5 years (93%). In addition to physical disability, many participants suffered chronic conditions (e.g., high blood pressure, arthritis, and depression). Over 40% participants reported that their health had gotten worse because of substandard and inaccessible living conditions (e.g., poor sanitation, crowdedness, and lack of grab bars and wheelchair accessible showers in the bathroom). Common reasons for delaying or not receiving needed health care (e.g., prescription medication, new medical equipment) and social services (e.g., case management) were due to lack of accessible and reliable transportation, insufficient knowledge of available services, limited insurance coverage, and lack of motivation.

Conclusions: Our findings suggest that barrier-free living environments, accessible public transportation, and information on available services are essential for independent living and maintaining basic health and well-being of adults with physical disabilities.