Homelessness in Minnesota: Health and illness

Who uses Minnesota’s busiest emergency room? At Hennepin County Medical Center, about one-third of ER patients have private insurance, one-third have Medicare or Medicaid, and one-third are self-pay patients – many of whom have no money at all.

This is one of a series of four short articles about homelessness in Minnesota, based on the Wilder Foundation report and on a May 25 Wilder conference on homelessness. The articles in the series are:
Homelessness in Minnesota: Women and children first
Homelessness in Minnesota: Race matters
Homelessness in Minnesota: Health and illness
Homelessness in Minnesota: Greater Minnesota’s growing homeless population

According to Dr. Michelle Biros, a professor at the University of Minnesota medical school and an emergency room doctor at Hennepin County, people covered by Medicare or Medicaid are just as sick as those who come in with private insurance. That means that public-pay patients are not overusng the ER for trivial problems.

Biros was one of the panelists at a May 25 Wilder forum on homelessness. She noted that patients without stable housing have predictable problems, such as exposure – to sunlight, to tobacco and other fumes. They need targeted care – treating their eyes, teeth, and feet makes a big difference in their daily life.

Over past 18 months, said Biros, HCMC has seen lots of people who opt to buy food instead of medicine, or who have lost jobs and insurance, and so can’t afford to pay for their meds and get sick enough so they need emergency services.

Wilder’s every-three-years survey of homeless Minnesotans found that:

• 41% of homeless adults report conditions that limit the kind or amount of work they can do

• 33% of homeless adults report cognitive disabilities 

• 32% of homeless adults report likely traumatic brain injuries

• 44% of the 669 homeless veterans in the study report a service-related health problem 

In addition, three out of four homeless adults have one or more of three major health issues: mental illness, substance abuse disorder, or a chronic physical health condition.