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my prose and edits: bold = Homeless women in the United States = From Wikipedia, the free encyclopedia

Main article: Homelessness

Out of 10,000 female individuals 13 are homeless . Although studies reflect that there are many differences among women suffering homelessness and there is no universal experience, the average homeless woman is 35 years old, has children, is a member of a minority community, and has experienced homelessness more than once in their lifetime.

The experience of homelessness is a gendered one, with pathways into homelessness differing on the basis of gender. One of the primary causes of homelessness among American women include domestic violence, with research finding that around 80% of homeless women have previously experienced domestic violence. Women and families represent the fastest growing groups of the homeless population in the United States. Approximately 34% of the homeless population are families with children. With '''65% of homeless women with children under 18 live with their children, while this number is only 7% for homeless men. These statistics suggest that homeless women are more likely to take care of their minor children than homeless men are. For this reason, information of homeless women is often linked to that of homeless families.'''

Historical background
'''Housing insecurity has been recorded in the US ever since the first colonial movements when unhoused individuals were called vagabonds. Around the 1930s, the Depression unhoused millions of individuals and families. The modern origins of homelessness are placed during the 1960s. After President John F. Kennedy signed the community mental health act in 1962 the process of deinstitutionalization began, at which point there was an increase in the unhoused population.'''

'''Women’s and family homelessness has been prevalent in American society, however, it has been marginalized and neglected by the public and the government. Most homelessness experienced by women is “hidden” in that women are not explicitly visible on the streets. Instead, a woman being homeless may manifest as residential instability, sex work, and/or insecure housing – conditions that are usually not visible by the public'''.

Health and healthcare[edit]
Homeless women are one of the most rapidly growing groups in the homeless community. In the 1960s, homeless women totaled around 3% of the entire homeless population, however, as of 2016, they comprised nearly 40%. While all homeless people are at an increased risk of poor health outcomes, homeless women are less likely to benefit from routine medical assistance, health insurance, cancer screening, adequate prenatal care, appropriate ambulatory care, and specialty care. Women have distinct health needs from men, homeless women face increased obstacles in meeting their most basic health needs. Specifically, unhoused women suffering from substance abuse, depression, or domestic violence have the greatest health care need. Homeless women face health challenges such as arthritis, mental illness, substance abuse, victimization, and Sexually Transmitted Infections (STIs).

Homeless women are more at risk of injuries and illnesses but receive a disproportionately lower amount of health services compared to housed women, 57% of this group do not have a regular care provider. Often, unhoused women avoid doctors until it is an emergency, or they are forced to use unconventional resources – such as being participants in a study in order to receive healthcare – which are very risky. Health care providers characterize homeless women as their most vulnerable patients, with past experiences of trauma being prevalent among these patients. Healthcare providers can play a role in improving health outcomes of unhoused women by identifying their unhoused or at-risk patients. Many factors intensify homeless women's lack of needed health care, like expensive health insurance, expensive medications, long wait times at clinics, lack of transportation, and more.

Women and mothers who experience housing insecurity live in a high stress state which is associated with multiple health problems such as hypertension, chronic pain, and asthma. Compared to women with housing stability, homeless women are at higher risk of mental illness, higher mortality rates, and poor birth outcomes. The specific experience of unhoused women is often ignored in health care and community resources. To serve clients appropriately, case workers and doctors should be required to address an individual's background and lived experiences holistically. Without asking extensive questions, women cannot get all of the help and information they need.

There has been little research conducted on the accessibility of health care for victimized women, which likely means that many women do not get the sufficient care that they need. Male caseworkers can be a particular trigger for victimized women during their recovery period. If homeless women are only treated for being homeless, other underlying issues like sexual or drug abuse can be overlooked, and they cannot be fully helped. A study of the physical health problems of homeless men and women found that on average men had eighth physical health issues, while women had an average of nine issues.

Nutrition
Malnourishment has been identified as a factor that impacts the health of the overall homeless population. '''Research has found that homeless women have higher nutritional deficits than homeless men. While most unhoused women, 81%, have reported satisfaction with their meals, they often lack adequate nutrition. Up to 96.4% of homeless women have a deficient diet, lacking in vegetables, fruits, milk, cereals, and meat. On average, unhoused women eat 2.25 meals a day, which likely results in a caloric deficit. Studies have also found that unhoused children are at higher risk for iron deficiency, which may indicate the presence of more nutritional deficiencies.'''

'''Interventions aimed at improving nutrition among unhoused women must address factors that impact food behavior such as mental health and the inability to afford varied and healthy foods. Most effective strategies embed nutritional care into existing services leading to sustained changes in food-related outcomes.'''

Pregnancy
In the United States, homeless women have higher rates of pregnancy than housed women. '''Although it's hard to measure pregnancy rates among homeless women, estimates show that between 6% and 22% of young unhoused females may be pregnant. Studies show that up to 25% of homeless women report being pregnant or having been pregnant in the last year. Pregnancy presents a challenge to the process of finding housing stability due to its physical and mental stresses.'''

'''Women experiencing homelessness during pregnancy are at higher risk for birth complications. Their children are also at higher risk of low birth weight, and nutritional or substance abuse-related physical and neurological effects on newborns. Most unhoused women lack access to prenatal monitoring, with only 33% of pregnant homeless women reporting having one prenatal check.'''

Menstrual health[edit]
'''Menstruation represents an additional challenge faced by unhoused girls, women, and menstruating people. These challenges include stigma, access to toilets, water and menstrual products, and lack of information.''' Homeless women are often forced to use improper, unsafe, and often unsanitary objects in order to manage their menstrual blood flow. The repeated use of makeshift feminine hygiene products and lack of access to working restrooms and showers can lead to many health complications such as toxic shock syndrome, urinary tract infections, yeast infections, and vulvar contact dermatitis which arises when the genitals are not cleaned daily, or at all during menstruation. As early as 1990s, homeless women were identified to be more likely than housed women to suffer from gynecological health problems, with menstrual-related issues accounting for the majority of diagnoses.

Additionally, feminine hygiene products are taxed in 45 of the 50 U.S. states because these items are considered luxury goods. This means that homeless women are even less likely to afford necessary supplies for their periods.  Taxation on sanitary products is considered a discriminatory practice, this impacts the accessibility and affordability of menstrual products for low-income and homeless women.

Mental health[edit]
Poor mental health of women is an important precursor and consequence to homelessness, as well as a consequence of homelessness for both women and their children. Mental illness is reported in 30% of homeless persons, and in 50% to 60% of homeless women. Homeless women without children are more likely than homeless mothers to disclose their admission into a mental institution. Homeless women are especially impacted by certain mental health illnesses including antisocial personality behavior, depression, stress, and post-traumatic stress disorder. Addressing homeless' women trauma is essential for treatment, unacknowledged trauma is known to increase women's and families' housing instability.

Infectious diseases[edit]
Because of their poor access to healthcare, infectious diseases are also common among the homeless population, such as the Herpes Simplex Virus type 2 (HSV-2), Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS), and others (3). In the United States, about 21 to 24% are infected with HSV-2 as compared to 88% among homeless women and an even higher prevalence among HIV positive homeless women. Despite this seroprevalence, homeless women are not considered to be a high-risk population in national guidelines. HSV-2 increases the risk of HIV infection. Most homeless women are unaware of their HSV-2 infection, which renders them more vulnerable to HIV exposure.

Besides financial instability, the contraction of HIV/AIDS has been shown to be more associated with homelessness. Homeless women are more likely than poor, housed women to practice unprotected sexual activity with multiple partners exposing themselves to HIV and other Sexually Transmitted Diseases (STDs).

One study estimated that roughly 64% of homeless women participated in unprotected sex, and 60% are infected by one or more STDs such as chlamydia, herpes, genital warts, gonorrhea, syphilis, or trichomonas, with the most prevalent being Human papillomavirus (HPV). The contraction rate of HIV/AIDS to be three times higher in homeless women than housed women. Unprotected heterosexual sex is also the most common way HIV is spread to homeless women in the United States, with intravenous drug abuse and needle sharing followed (3). Unfortunately, due to their lack of quality health care, the homeless population are also more likely to die from HIV/AIDS.