If cities and towns define extreme poverty and homelessness as a public-health issue, the public-policy responses will be quite different than what we are used to today.
Consider that in all cases a homeless person, or someone who lives in extreme poverty, is marginal in most, if not all, categories of health: medical condition, physical and mental disabilities, clothing, personal hygiene, nutrition, shelter/ housing, addiction issues and access to clean drinking water.
Even though many homeless persons tend to live with or carry all their worldly possessions, it is amazing how much trash they generate for example. Yet in many cities and towns throughout the Merrimack Valley, trash pickup is non- existent and thereby a public-health threat is created.
It’s all about attitudes and approach. Many municipal leaders have a bias towards “hiding the problem” in order to defend the image of their community, business investment and property values. But if they understood that those who are marginalized are also a vital part of the fabric of their communities, the scourge of homelessness would be eradicated.
There are many opportunities throughout the fiscal year in most communities to apply line-item transfers to address targeted public-health service costs, such as trash cleanup and outreach for a variety of interventions ranging from nutrition to medical. This is often a good interim step until more robust and permanent budget commitments are made to build outreach components to public health departments.
When this is combined with a coordinated effort through volunteers, service organizations, faith-based groups and advocates who are “ on the ground” we will see results in addressing this issue adequately.