Chronic Disease

Healing Hands: Meeting the Challenges of Comorbid Mental Illness & Substance-Related Disorders

Comorbid mental illness and substance-related disorders—commonly known as co-occurring disorders (COD) or dual diagnosis—present difficult treatment problems. Clients with COD are extremely heterogeneous with respect to type and severity of illness, personal skills, and available care networks. Those who are homeless may be at increased risk for exacerbated illness due to limited treatment access and […]

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Adapting Your Practice: Treatment Recommendations for Homeless Patients with Hypertension, Hyperlipidemia and Heart Failure

Diseases affecting the heart or blood vessels are highly prevalent among people experiencing homelessness. Among the cardiovascular diseases most commonly seen by primary care providers serving homeless individuals are hypertension (high blood pressure), hyperlipidemia (high cholesterol and triglycerides) and heart failure (impaired cardiac function, which often results from uncontrolled hypertension and/or hyperlipidemia). Metabolic syndrome—including hypertension,

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Cardiovascular Disease Risk Among the Poor and Homeless—What We Know So Far

Homelessness [and poverty] is rapidly escalating across North America and is associated with dire implications for public health and our health care systems. Both are compelling states of existence affecting all ages, ethnicities and both genders. Homelessness frequently evolves through a complex interaction of factors that are both internal and external to the individual themselves.

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Documenting Disability for Persons with Substance Use Disorders & Co-occurring Impairments: A Guide for Clinicians

This guide was written to assure that individuals with substance use disorders and co-occurring impairments that meet Social Security disability criteria receive Federal disability assistance under the Supplemental Security Income (SSI) program or the Social Security Disability Insurance (SSDI) program. The guide focuses on the complex issues involved in documenting impairments that co-occur with substance

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Hypertension & Homelessness: What Interferes with Treatment

Homeless adults are two-to-four times more likely to have hypertension and other cardiovascular diseases, at younger ages, than either the general population or low-income adults with stable housing. Among the factors that increase their risk are poor diet and excessive use of alcohol, nicotine and other drugs that exacerbate elevated blood pressure and damage the

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Healing Hands: Integrating Primary & Behavioral Health Care for Homeless People

Higher incidence, prevalence, and acuity of medical and behavioral problems among people who are homeless warrant the availability of comprehensive medical and behavioral health services. Limited access to mental health specialists, stigma associated with mental illness, and negative health outcomes related to undiagnosed or untreated behavioral disorders make it incumbent on primary care providers to

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Healing Hands: Heart of the Matter: Managing and Preventing Cardiovascular Disease

Heart disease is the number one killer of both men and women in the U.S. Poor diet, insufficient aerobic exercise, excessive use of drugs that elevate blood pressure and pulse rate (including nicotine and alcohol), highly stressful lives, and lack of regular preventive health care increase the risk for life- threatening diseases of the cardiovascular

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Health, Housing and the Heart: Cardiovascular Disparities in Homeless People

The interaction between housing and health is intimate and complex, yet little evidence exists with regard to the healthcare outcomes for people struggling to survive without housing. The study in this issue by Lee and colleagues not only exposes a resounding need for community-wide interventions to improve the cardiovascular health of homeless adults but also

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