Chicago Tribune
(MCT)
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.
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."
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(c) 2009, Chicago Tribune. Distributed by Mclatchy-Tribune News Service.