First Responders and Homelessness

In Burbank, a portion of the homeless population is comprised of older adults, with 3% of the homeless individuals in the 2020 Point-in-Time count being over 55. Additionally, there's a significant number of homeless families in the broader Service Planning Area 2 (which includes Burbank), with about 2,300 family members experiencing homelessness. This includes households with children under 18. 

Here's a more detailed breakdown:

Older Adults:

In 2020, Burbank had 9 individuals over 55 experiencing homelessness, representing 3% of the total homeless population in the city. Across Service Planning Area 2 (which includes Burbank), there were 1,651 older adults experiencing homelessness in 2021. 

Families with Children:

Within Service Planning Area 2, there are about 2,300 homeless individuals who are part of families, which are defined as having at least one child under 18. 

Youth:

While specific data for Burbank isn't available in the provided context, it's worth noting that across Service Planning Area 2, there's a noticeable impact of homelessness on children and youth. 

Age Range:

A study in California indicates that nearly half (48%) of single homeless adults are 50 or older, with a median age of 58. Additionally, 41% of older adults became homeless for the first time after the age of 50. 

Gender:

Men tend to be more represented in the homeless population overall, but women and gender-diverse individuals face unique challenges and vulnerabilities. 

Women experiencing homelessness often face specific risks related to domestic violence, sexual assault, and the challenges of parenting while unhoused. 

Common chronic illnesses:

Homeless individuals face a higher prevalence of various chronic illnesses compared to the general population, including mental health conditions, substance use disorders, respiratory illnesses, and cardiovascular diseases. 

Specific examples include COPD, liver disease, asthma, heart disease, HIV/AIDS, and diabetes. These conditions are often exacerbated by the challenges of homelessness, such as lack of access to healthcare, poor nutrition, and exposure to harsh living conditions. 

Here's a more detailed breakdown:

Mental Health and Substance Use:

Mental Illness:

Homeless individuals are significantly more likely to experience mental health conditions like depression, anxiety, and schizophrenia. 

Substance Use Disorders:

Alcohol and drug dependency are also highly prevalent, often complicating the management of other health conditions. 

Respiratory Illnesses:

COPD:

Chronic Obstructive Pulmonary Disease is more common due to factors like smoking and exposure to environmental irritants. 

Asthma:

Homeless individuals often experience higher rates of asthma, potentially linked to poor living conditions and lack of access to preventative care. 

Tuberculosis (TB):

Increased risk of TB due to crowded shelter conditions and compromised immune systems. 

Cardiovascular and Other Diseases:

Heart Disease:

Higher rates of heart disease and related conditions are observed. 

Liver Disease:

Hepatitis C and other liver conditions are more common, often linked to substance use and risky behaviors. 

Diabetes:

While the prevalence may be similar to the general population, management of diabetes can be more challenging without consistent access to healthcare and proper nutrition. 

HIV/AIDS:

Increased risk due to various factors, including intravenous drug use and lack of access to preventative care. 

Other Health Issues:

Skin and Blood Vessel Disorders:

Conditions like cellulitis, skin ulcers, and edema are more prevalent due to exposure, poor hygiene, and limited access to wound care. 

Dental Problems:

Poor oral hygiene and lack of access to dental care lead to increased rates of tooth decay and other oral health issues. 

Seizures:

Homeless individuals are at higher risk of seizures, potentially due to various factors including substance withdrawal and underlying medical conditions. 

Addictions/Weather:

Alcohol: Know your 647(f)s

Excaberbate these dangers. Alcohol can impair judgment, leading to risky behaviors like staying outside during extreme temperatures or making poor decisions about seeking shelter.

Additionally, alcohol can interfere with the body's ability to regulate temperature, making individuals more susceptible to hypothermia in the cold and heatstroke in the heat. 

Heat:

People experiencing homelessness lack access to resources like air conditioning and cool water, making them vulnerable to heat-related illnesses. 

Alcohol consumption can worsen dehydration and heatstroke, as it impairs the body's ability to regulate temperature. 

Heat can also lead to increased substance use as a coping mechanism. 

Extreme heat can cause displacement and loss of belongings, further impacting mental health. 

Outreach services and access to cool spaces are crucial during heatwaves. 

Cold:

Alcohol consumption can lead to a false sense of warmth, causing individuals to underestimate the dangers of cold exposure and stay outside longer. 

Hypothermia is a serious risk, especially when combined with alcohol's effects on temperature regulation. (Loretta 😪).

Frostbite and other cold-related injuries are more likely to occur in vulnerable populations, including those experiencing homelessness. 

Winter weather also increases the risk of respiratory and cardiovascular issues. 

Providing warm shelters, resources, and education about the dangers of alcohol and cold is essential. 

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Opiates:

Opioid addiction and increased risks

Substance use as a coping mechanism: The harsh realities of homelessness and exposure to extreme weather can drive individuals to use substances like opioids as a way to cope with their circumstances, according to the Christian Reformed Church.

Impact on thermoregulation: Opioids can affect the body's ability to regulate temperature, potentially increasing the risk of heatstroke in hot weather and hypothermia or frostbite in cold weather.

Drug interactions: Medications used to treat opioid use disorder or co-occurring physical and mental health conditions can also increase vulnerability to extreme weather. For example, some antidepressants and antipsychotics can interfere with the body's natural cooling mechanisms, potentially increasing the risk of dehydration and heat-related illnesses.

Increased overdose risk: Research suggests a correlation between colder temperatures and a higher risk of fatal opioid overdose. Additionally, substance use, particularly methamphetamine use, has been linked to an increased risk of heat-related illnesses and deaths, says the Public Health Institute.

Disruptions in treatment access: Climate change and extreme weather events can disrupt access to vital addiction treatment services, such as opioid treatment programs, further endangering individuals struggling with opioid use disorder, notes the National Institutes of Health (NIH). 

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Natural disasters can leave homeless without their drug(s) of choice leading to seizures.

Recreational drugs can cause seizures by indirect mechanisms, including cerebral trauma, CNS infection, and metabolic derangement. 

Some substances cause seizures more directly, either by direct toxicity or as a withdrawal phenomenan. 

Opiates (e.g., heroin) lower seizure threshold, but seizures are an unusual feature of heroin overdose. Except in newborns, heroin withdrawal does not cause seizures. 

Psychostimulants, especially cocaine, can cause seizures without other evidence of toxicity. 

Sedative drugs (e.g., barbiturates) cause seizures during withdrawal.

Marijuana use may decrease the risk of seizures. Seizures are often the result of ethanol withdrawal, but they can also occur in alcoholics outside the withdrawal period, perhaps a consequence of long-term neurotoxicity. 

Clinicians should consider drug abuse in patients with unexplained seizures.

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Alcoholics are usually always warm.

Amphetamine users are usually cold.

Notes:

Who are the alcohol users.

Who are the drug users.

Who has drug or food allergies.

Many drugs are being mixed with fentynal.

Who are the Diabetics or at risk for. (Hyperglycemic or Hypoglycemic)

Who suffers with mental illness ... perhaps not able to cope with stress or a natural disaster.

Who's homeless but has nothing to drink, eat, no change of clothing, or sleep gear. Walking around with nothing.

These are all red flags for 1st responders to be aware of. Know your homeless population for a better outcome.

@BFD @BPD