H1N1 an extra risk for homeless

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CHICAGO — For more than four months, Juan Xique has been
struggling to get his life back in order after becoming homeless. He splits his
time between staying with a friend in Cicero, Ill., and hanging out in Humboldt
Park while trying to get back disability benefits to support himself.

One issue that hasn’t been a priority for him is getting an
H1N1 flu shot. Xique, 50, gets most of his medical care from emergency
facilities for the homeless and has on occasion resorted to calling 911 when he
feels ill.

Xique is one of thousands of homeless men and women who may
be among the most at-risk for serious complications if infected with the swine
flu virus, but who have not gotten vaccinated for a variety of reasons, health
experts say.

Homeless people are more likely to be sick and have higher
rates of chronic illness, placing them at the top of the priority list for
receiving the H1N1 vaccination, experts say. But they are also far less likely
to take such a preventive measure.

They are a population that is hard to reach but at times
congregate in shelters and soup kitchens where the virus can spread easily.

Earlier this year, the National Health Care for the Homeless
Council released a manual to help shelter and service providers plan for and
respond to the flu. The book includes information about both H1N1 and seasonal
flu, methods for decreasing the spread of influenza and caring for clients who
have become ill.

“Folks who have been homeless are generally sick, their
chronic medical conditions are not taken care of, so they’re likely to get very
sick and hospitalized and can even die from the swine flu,” said Dr.
Stephanie Luther, medical director at the Heartland Alliance’s health outreach
clinic.

While some note that many in the homeless population tend to
be older — an age group not as susceptible to swine flu as they are to seasonal
flu — they are more likely to suffer chronic medical conditions, further
complicating matters if they get the H1N1 flu. Heart disease, cancer, liver
disease, kidney disease, skin infections, HIV or AIDS, pneumonia and
tuberculosis are common diseases among the homeless population, a 2005 National
Health Care for the Homeless Council Inc. report said.

According to the National Coalition for the Homeless, people
experiencing homelessness are three to six times more likely to become ill than
others.

The homeless also are far less likely to treat minor
sicknesses, Luther said. The National Coalition for the Homeless said that many
homeless people go to emergency rooms as their primary source of health care.

Luther said there is high demand for the H1N1 vaccine at her
clinic and that people are turned away regularly. “Just as fast as we get
the shot in, we distribute it and have to order more,” Luther said.

Xique said he found himself without a home after he was
released from prison for a conviction related to “fighting.” The
medication he receives to treat his diabetes comes from the non-denominational
Night Ministry’s health outreach bus, which stops at Humboldt Park three times a
week.

Xique often can be found among dozens of others who approach
when the vehicle makes its rounds at the park. The vehicle is customized into a
one-stop clinic, where patients can receive free over-the-counter medication,
seasonal flu shots, HIV testing and private counseling. The clinic has ordered
H1N1 vaccine but has yet to receive its supply.

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The Heartland clinic in Uptown serves between 10,000 and
14,000 homeless people every year, clinic officials said.

Earlier this year, the city estimated that 5,170 people are
on the city’s streets any given night. Homeless advocates say the real number
is closer to 21,000 people, including those doubling up with friends or family.

Another example of how vulnerable the homeless can be to
swine flu is Michael Cassidy, 46, who has diabetes and relies solely on the
Heartland clinic for medical treatment.

Cassidy said his life began to crash all around him last
summer. Complications related to the diabetes and seemingly random bouts of
fainting quickly spiraled into problems at work and depression and before he
knew it, he was homeless.

“Basically, it was a domino effect,” Cassidy said.

Recently, he was vaccinated against the swine flu — among
roughly 600 patients at the clinic to get the shot. But his monthly visits to
the clinic doctor make him among the minority of homeless who get regular
medical treatment.

William “Billy” Carlson, 48, also would be at the
top of the priority list for receiving the vaccination. About 10 years ago, he
became acutely ill with hepatitis C, which is now a chronic condition.

He recently received the H1N1 vaccine at the Heartland
clinic.

“It does kind of scare me,” said Carlson, who had
been homeless for five years but now lives in a studio apartment through a
mental health program. “I could die from it. I want to get (the shot) to
be on the safe side.”

Via McClatchy-Tribune News Service.