California Hospitals See Increase in Homeless Patients


August 22, 2019

More than 100,000 visits to California hospitals were by homeless people in 2017, up 28 percent from the two years prior. According to the Office of Statewide Health Planning and Development, over a third involved a diagnosis of mental health, although only 6 percent of hospital discharges included a mental health diagnosis.

The homeless population in California has increased since 2015. Estimates are that the homeless population increased in the state by about 16 percent based on point-in-time reports compiled by the U.S. Department of Housing and Urban Development. Because these reports reflect just one single day, advocates claim that there are far more homeless in the state over the course of a year. Skyrocketing housing costs are one reason given for the increased homeless population, but experts say that many who live on the street are dealing with mental illness.

In addition to mental illness, common reasons for visits to the hospital among the homeless population include drug and alcohol abuse, HIV infections, skin disorders, burns, overdoses and traumatic injuries. Experts say that living on the street is both dangerous and unhealthy, with many suffering from more serious illnesses than the average population. Alcohol and drug addiction typically co-occur with injury and trauma.

Los Angeles reported the most homeless patients seeking care with over 35,000. San Diego, Sacramento, Orange and San Francisco followed close behind. Los Angeles County had the largest growth in patients with an increase of 7,500 but this may be due to the large population in the county rather than the percentage of homeless overall. 

Providers say they are not surprised at the number of homeless in the hospital. This population faces more unique challenges due to extreme living conditions. 

When people are forced to live outside with no shelter, the trauma can be more than just mentally unsettling. The homeless often do not seek medical attention until problems turn into something serious. Because they tend not to avoid preventive care as well, hospital stays are longer and living on the streets presents challenges when it comes to following post-discharge instructions. It’s also difficult for homeless people to undergo rehabilitation, which can impact recovery time and lead to a host of other problems.

Recovery is also a bigger challenge for people without homes in which to convalesce. Hospitals throughout California are attempting to provide any homeless individual who seeks treatment with the proper follow-up care. With so many diagnoses, including mental health disorders, however, it is growing increasingly difficult to provide those individuals with consistent treatment.