I would like discuss about the most public concern health challenge, that is homelessness. It is the most experiencing challenge in India. It is also a social issue. Homelessness is defined as living in housing that doesn’t meet the minimum criteria or not even minimum secure. It is security of occupancy, services acceptability and so on. The major health challenge which I have found is homelessness in India. It is not referring to only the people who doesn’t have minimum requirements but also to people who live in public places such as platforms, temples, roadside, under the flyovers, open spaces, staircases, pipes and streets. Being in such places, they get infected to many diseases and they can lose their health.
Burden due to this health challenge
Based on 52% of city areas, it is estimated that around 1.8 million people in India are suffering with this health challenge. According to 2011 census, Delhi in India has a range of 150,000 to 200,000. Most of the people in this community are facing this problem. Due to this challenge whole population are affected and diseased in conjunction with this homelessness population. Due to this people get habituated to substances and offences. It can also lead to other diseases due to unavailability of facilities, lack of nutrition, hygiene and also by crowding in public places. In an article it was found that due to homelessness, there is increased risk in chronic diseases, respiratory infections, sexually transmitted infections and stroke of death. Due to this condition, along with physical and mental health problems, substance addiction and behavioural problems are also seen. Due to this, there is also chance of respiratory infections by inhaling toxic fumes and construction dust. Due to this condition, normal illness leads into a severe disease by increasing the burden. Many other linked conditions like malnutrition, dental diseases, joint disorders, venereal diseases are also observed. By being homeless they get easily receptive to many ranges of diseases. Mental illness is the main aspect and to control this many governmental and non-governmental schemes are introduced because as they have poor access to health care. With this population, mental illness is caused 20 times more than normal people. They also conducted a trail taking 140 people in India, they found vast people about 90% were from India when compared to others in this burden due to homelessness.
There are many factors for this condition, they are like poverty, addiction to drugs, unhealthy relations between children and parents, violence, natural calamities, disturbance between people. One of article says that not only due to poverty but also expecting high amount, they rent it and get money. Even due to cheating, it is observed and also if crop is failure by farming, it also leads to homelessness. Also due to lack of education, people will be unaware of risk factors of homeless and causing factors. In adequate income, disputes and un healthy relationships, overcrowding in major cities, urbanization and so on are observed.
- Poverty: Both the poverty and homelessness are inter connected to each other as it was found that when housing people are compared to homeless people, they are under the poverty line and around 50% of people are found with this connection.
- Violence and war: In some places in India other than Delhi like Uttar Pradesh, Muzaffarnagar, Assam and bode tribes, there were riots and in that many of them lost their houses. It is a surprised factor observed. When compared to normal this is community violence, where many are affected.
- Joblessness: It is one of major causes in Delhi observing at present situation due to higher competition in jobs. So, that people are unable to spare the price of a house in addition. It is how they are unable to meet minimum housing or lack of houses.
- Natural calamities: Many of the natural disasters like tsunami, cyclones, thoofan are leading to destroying of houses. Recently, there are many cyclones observed in Uttarakhand in addition to Delhi where most of houses were destroyed.
- Drug and alcohol addiction: People due to addiction to alcohol, substance usage, tobacco smoking is of the most people in homeless condition. These addictions are mainly observed among homeless persons than persons containing home. When they are addicted and habituated to those all, they will be no balance between income, spending and savings. So, they can’t buy or rent a proper house as houses are more costly in Delhi and major cities.
- Disputes between children and parents: This is also important factor as children may mis behave and are irresponsible, their parents don’t give their property and children get evacuated from house. As they can’t earn money as much to afford house and so homelessness increases. If the relation between them is healthy, then this condition can be reduced.
- Family disputes like divorce: Then people in a family get separated and move to separate places and live separately. Then is there is risk for this parent with depending children.
Burden of homelessness
Data collected to represent the burden of homeless is done by professional workers from both government and non-governmental organizations. It was found that in India, around 78 million people are homeless in this developing world money making height. There is more burden of homeless in urban areas about 69,000 than in rural areas. In Delhi in 2010, there were 55,955 people are suffering with homelessness. In 2011, it was found 3,594 children out of total 46,076 people are homeless. There are also some conditions like they struggle due to homeless in particular time but not for longer times. As Delhi is a major city it has people suffering from this, central district about 25% where north district of it has 14.2% and north west side consists of 19.3%.
Critical analysis of new Health approaches
Focus on social support, social capital, behaviour and lifestyles: In this new this new public health approach, there is special support in behaviour wise or financially. While supporting this challenged people with financially can definitely afford a house and can lead a better life. Also guiding them good behaviour and lifestyles can decrease the burden of disease.
Legislation and policy: Under this approach all the public health workers must notify the issue in all policies and should create more awareness among people and also provide health care services. They need to argue about these issues and monitor. So, that homelessness can be reduced.
Philosophy and awareness: Philosophy plays an important in any health challenge. Because of their motivation, many changes in the public can be observed. However, in some articles it is said that, practically it lacks. These public health workers bring awareness and homeless can be decreased by maintaining relations in families and working properly.
Prevention and health promotion: Homelessness can be prevented in some cases like poverty by creating employment, in addiction to alcohol and substances whereas in some cases it cannot be prevented. Health promotion can apply in homelessness people by teaching them causes, risks of it and also burden of disease caused due to homeless.
Equity and social justice: In Delhi, this is the one of the major causes. All the people must be treated equally. There should be bias in gender, race, religion, community etc. due to these conditions people get effected and may not get houses. They remain homeless.
Also, according to Ottawa Charter example in those approaches, he presented two communities naming A and B. one is supportive and the other creative. Definitely, supportive approach community has more change than the community with creative. So, there should be some supportive approaches to avoid homelessness.
New approaches and recommendations
There are many new public health approaches to overcome the health challenge from which Indian community are suffering. It involves many schemes, government policies, non-governmental associations, legislations, easy access to health care services, awareness camps, welfare programmes and services, hosing interventions and so on. In this conditions, mostly mental illness is mostly observed, so to overcome, these must be supported with acts like revised persons with disability act, 2016 & mental health care act, 2017. So that these community population will have right to live in the community and also government should provide support to housing and also other services for their living. Also, guidelines are be developed to access and programmes developing must be comprehensive with all preventive components and immunization. Also, special care must be taken on homeless people by adopting schemes.
Intervention of housing: The main motto of this approach is to avoid disabilities, increased availability of houses, affordable and decrease the burden of diseases in support to homelessness people living, Indian government should introduce policies for their housing and those will be allotted to them. To meet their mandatory complex necessities, housing first is the best intervention as it is proof to talk about housing facilities, security. The National Mental Health Policy of India envisions prevention of disability, promotion of mental health, and facilitating recovery from psychiatric illness.
To support self-development: Homeless people stay far from the city. As they are illiterate, they live far and can’t get any schemes and policies that are provided. So, they are taken to open shelters and provide minimum shelter and motivate them to live better. In order to facilitate the key streaming of homeless people into society, shelters must ensure the design and implementation of different training programs, non-formal education projects and access to affordable services and rights.
Accessing to minimal services: Mostly, it is observed that people invest money for sanitation and water. Due to this, homeless people can’t even get provided with minimum requirements. They are getting exhausted with this. So, if action is taken and people in homes use them in less, homeless people can utilize from shelters and outside.
There are many issues and high burden of diseases due to homelessness. It is not only a single issue but it is a way to many of diseases. This is mostly being observed in Delhi in India. Many people in India are homeless and suffering with this issue. There are many causes, it may be due to poverty, illiteracy etc. Also, there are new public health approaches where those are applied to this community suffering with homelessness health challenge. Finally, homelessness can be decreases to minimum cannot be eradicated due to many factors.