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  • Using Informational Murals ...
    Ha, Yoonhee P; McDonald, Nicole; Hersh, Shari; Fenniri, Stephanie R; Hillier, Amy; Cannuscio, Carolyn C

    American journal of public health, 01/2021, Volume: 111, Issue: 1
    Journal Article

    The coronavirus disease 2019 (COVID-19) pandemic has upended every aspect of life in the United States and forced Americans to rethink their daily activities, including how they work, attend school, secure food, obtain health care, and maintain social connections. For vulnerable populations that were already facing significant barriers to health, such as people experiencing homelessness, the pandemic has only generated new hardships and exacerbated existing inequities. Compared with the general population, people experiencing homelessness suffer from poorer health and have higher rates of mental illnesses, infectious and noncommunicable diseases, and premature mortality.1,2 Since the start of the pandemic, this highly vulnerable population has also faced increased risks of being exposed to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-the virus that causes COVID-19. Nightly, many of these individuals must make the difficult decision between lodging in crowded shelters, where the risk of outbreaks is high, and staying outdoors, where they must weather the elements and risk their safety.3 5 Many people experiencing homelessness also have little or no access to personal protective equipment and testing, and even when testing is available, it may be challenging to conduct contact tracing and quarantine individuals in this population because of their lack of housing and limited access to mobile phones and mailing addresses.6 Furthermore, given their preexisting medical conditions and other factors such as poor nutrition and lack of health insurance, people experiencing homelessness are also more likely to have worse outcomes if they develop COVID-19. The COVID-19 pandemic has also affected the nonprofit organizations that provide people experiencing homelessness with basic needs such as food, clothing, and medical care. Across the United States, communities are engaging in a collective effort to shelter in place and practice social distancing to reduce the person-to-person transmission of SARS-CoV-2. Although these measures are essential to "flattening the curve" of active cases of COVID-19, they have dramatically reduced the number of people who are able to volunteer for nonprofit organizations.8 Likewise, the temporary and permanent shuttering of businesses has resulted in sharp declines in the monetary and material donations that sustain these entities.8,9 It is also likely that the high unemployment rate will eventually translate into increased numbers of people experiencing homelessness.