The 'sizable' homeless population: a growing challenge for medicine

Currently, I see approximately 1,000 to 1,500 patients a year. They suffer from a variety of medical conditions and diseases—in particular, hypothermia due to accidental exposure. The consequences range from severe irreparable brain damage, renal failure, pneumonia, and cardiac arrest to untimely death. Many are victims of gunshot wounds, knife wounds, and trauma associated with secondary contusions from baseball bats, tire irons, or bottles." This is a much abbreviated description of some of the medical conditions seen in the emergency room at California Hospital Medical Center, Los Angeles. It is given by Gary Rapaport, MD, a staff physician. The patients Rapaport is describing form a particular group: the homeless. By even the most conservative estimates, they form a sizable, and growing, underbelly of American society. On an average night a couple of winters ago, between 250,000 and 350,000 persons were homeless, according to the Department of Housing and Urban Development (HUD)