In preparation for the 2020 Conscious Cities Festival Denver event, Shaping Health, Conscious Denver will be featuring the work of our event speakers to share how they are impacting change in Denver and beyond. In this segment, we are excited to introduce Cathy Alderman, the Chief Communications & Public Policy Officer for the Colorado Coalition for the Homeless.
What struck me most about my conversation with Cathy was the interconnectedness of health and housing. Health, both physical and mental, is dependent upon access to stable housing, while stable housing is directly contingent upon health status. Cathy’s work and the mission of the Colorado Coalition for the Homeless (CCH) is to provide integrated health care, housing, and supportive services to address these systemic relationships in an effort to find solutions for homelessness. The Coalition has developed an extensive network of various housing options, vocational assistance, and health care clinics that support primary care, mental health, vision, dental, and pharmaceutical needs. This effort requires great agility and creativity, especially in the era of Covid19.
Homeless shelters are often large, warehouse-like buildings that do not afford privacy or personal safety in the face of a highly contagious aerosolized illness such as Covid19. The Coalition responded by placing people needing shelter in hotels or motels, allowing for appropriate physical distancing. Screening processes were instituted for people entering their shelter and CCH health care facilities to decrease the spread of the virus. At many sites, hand washing stations were established outdoors and hand sanitizer was distributed. In a remarkable effort, six hundred cell phones were distributed to homeless individuals to increase access to telehealth with mental health and primary care providers. These phones have allowed case managers to maintain contact with their patients, alerting clients to housing options that may become available, while also managing medication checks and symptom tracking.
An often under-appreciated aspect of health care for the homeless population is dental care. Dental hygiene is often challenging without access to restrooms and dental health is directly correlated with general health. Dental problems can have long term impacts on physical health, social wellbeing, and the ability to find a job. The anxiety and realities of homelessness can lead to dental conditions that cause significant pain, requiring prescribed medication or when not possible self-medicating, both of which can have profound impacts on individuals who struggle with substance abuse. While dental services were initially suspended during the COVID-19 crisis response, CCH worked quickly to get these services back up and running as soon as allowable. This is a strong example of the complex nature of homelessness and its ability to impact all aspects of health and wellbeing.
One long-term CCH initiative that Cathy is particularly proud of is the Denver Social Impact Bond. This program was initially established to provide preventive services and stable housing for 250 homeless individuals in Denver. In addition to benefiting the individuals themselves, this program benefits the taxpayers of Denver by directly reducing criminal justice costs. It is yet another example of the interconnected and systemic nature of homelessness and its impact on our wider community.
While Denver is innovating its approach to homelessness, Cathy would like to see an increase in street-medicine programs that assist people where they are located, whether on the street or in a shelter. Individuals in this population will be dealing with the trauma of homelessness along with the potentially traumatic events that led them to become homeless. It’s important that health care and mental health providers have specific trauma training that is person-centered to work with this population. In addition, Denver would benefit from moving more people into housing that could alleviate the amount of street camping. While Covid19 prevalence has not been high within these camps, there are other serious risks such as exposure to the elements, violence, lack of access to restrooms, and other illnesses such as hepatitis and shigella (a highly contagious intestinal disease).
As Cathy described it, homelessness is a complex, systemic issue that requires thoughtfulness and creativity to balance a reduction of harm in one area while avoiding the creation of harm in another. An example of this is the widespread dispersal of hand sanitizer to help fight Covid19. On the one hand it is a critical tool for increasing public health, while at the same time it is a product high in alcohol content and can be abused by individuals experiencing substance abuse. This kind of balancing act requires an agile and creative team to fight for the health of the state’s most vulnerable population. Cathy and the Colorado Coalition for the Homeless are on the front-lines fighting for the profoundly interconnected needs of health and housing access in Colorado.
Join Cathy on October 22, 2020 to learn more about how she and others are Shaping Health in Denver!