Counting the Homeless, Case Study Example

For a patient who has been admitted to the hospital with active tuberculosis, a number of factors must be considered in the short term, including the risk of the disease for the patient in question, as well as those with whom he has come into contact in order to prevent further risk and disease development. It is known that in some communities where the homeless congregate, there is a high risk of active tuberculosis; therefore, additional precautions must be taken, particularly if there is a high risk of exposure to other persons. This process requires an effective understanding of the different elements that support the growth of the practice environment and will encourage local communities to recognize the risk of exposure within the homeless community. Public health officials must be cognizant of the different needs that have a significant impact on local residents and how tuberculosis might impact vulnerable populations and those who are at risk of contracting the disease, particularly those who are homeless.

Most importantly, those who have been exposed to the patient must be notified as best as possible, including those who have visited the same shelters and other areas where the homeless person had come into contact in recent days and weeks. Most importantly, these efforts require an organized and detailed public health response in order to prevent complications and to be effective in sharing the knowledge and resources that are required to meet the needs of the affected population groups and the creation of new protocols to improve the response effort. Most importantly, these factors must be considered as part of a larger protocol to ensure that those at risk are aware of this risk and take the necessary precautions accordingly.

It is known that “US-born homeless persons share many risk factors for TB dissemination with individuals who live in the 22 countries the World Health Organization has identified as having a high TB burden. Similar risk factors among these geographically distinct groups are a history of poverty, immune-deregulating substance abuse and poor nutrition, challenged sleep patterns, and increased exposure to public places through their reliance on communal travel and

living. These populations live under the stress of the unknown, with limited access to basic necessities” (Feske, Teeter, Musser, & Graviss, 2013, p. 839). Under these conditions, it is important to identify the specific factors that pose a threat to the homeless population and that demonstrate the importance of developing protocols to reduce the risk and spread of tuberculosis as effectively as possible. These efforts will demonstrate the value of creating new strategies to encourage public health officials and those who work with homeless persons in an effort to reduce these risks over time (Feske et.al, 2013).

The prevention and spread of tuberculosis to other members of the homeless population requires an effective understanding of the challenges and limitations of the disease, along with other factors that will have a lasting impact on local residents who live in close communal quarters, such as homeless shelters. These factors support the continued growth and development of an investigatory protocol to notify those who might be at risk of the disease as soon as possible. Preventing the further spread of the disease requires a high level of expert knowledge and support from the local community in an effort to be proactive in meeting the needs of the local population as effectively as possible. These efforts must support the demand for services that will have a lasting impact on prevention within the homeless community and in the surrounding areas. This process also demonstrates the importance of developing new ideas that will encourage the growth of the public health response to the infection and the potential risks associated with the disease and its impact on local residents.

One issue to consider with the notification process is that it could contribute to unnecessary risk or harm for some patients, particularly those who are at the highest level of risk. Most importantly, it should be noted that “The ethical question for the physician or other health worker is whether or not to warn close contacts of a patient diagnosed with XDR-TB—or a patient suspected to have active illness, while diagnostic confirmation is awaited—especially if there is reason to believe the patient has not warned close contacts of the danger of contagion and/or is failing to take sufficient precautionary measures” (Selgelid, 2008). In this context, notifying the surrounding community is likely to override any particular need to keep this information confidential, particularly when other members of the homeless population and the general public may be at risk as a result of the disease and its lasting impact on the health of the most vulnerable populations. The response, therefore, must be immediate and must remain a critical component of the public health protocol in order to manage the tuberculosis case effectively.

References

Feske, M. L., Teeter, L. D., Musser, J. M., & Graviss, E. A. (2013). Counting the homeless: a previously incalculable tuberculosis risk and its social determinants. American journal of public health, 103(5), 839-848.

Selgelid, M.J. (2008). Ethics, tuberculosis and globalization. Public Health Ethics, 1(1), 10-20.