Hjemløse: livsforhold og orale forhold. En litteraturgennemgang med kasuistikker

Oversigtsartikel Dato: 01.08.2006

For at forbedre de hjemløses sundhed, herunder deres orale forhold, er det nødvendigt at skabe et overblik over hvem og hvor mange de hjemløse er samt hvilke faktorer der påvirker deres generelle vilkår. Derfor gennemgås begrebet hjemløshed, de samfundsmæssige og individuelle forhold af betyd ning for hjemløshed, de hjemløses levevilkår under opvæksten og som voksne samt deres fysiske, psykiske og sociale sundhedstilstand. De hjemløse er udsat for en ophobning af dårlige levevilkår og en overdødelighed, hvilke er forhold der øger den so ciale ulighed af sundhed i den danske befolkning, og forhold der kræver sundhedsmæssige løsninger på de hjemløses præmisser. Endelig vurderes de hjemløses orale forhold og De Hjemløses Tandklinik/Bisserne i relation til denne komplekse situation.

Homeless people: Life conditions and oral situation. A literature survey and case reports: In order to improve the health conditions of the homeless people in Denmark, including their oral health, it is necessary to have a clear picture of this heterogeneous group. In this article their living and health conditions are described from relevant literature. As a statement: Homelessness implies some vital necessities which go beyond the absence of secure accommodation. Homelessness is also related to social exclusion, unhealthy lifestyle, lack of a social network and personal resources. The aim of this article is to describe the term homelessness. This includes a description of the individual and the social conditions which are often present in order to become homeless. All relevant aspects are related to their general health state and to the poor oral health conditions which no dental services until 2003 had been taken care of. Individual conditions which are often present in order to become homeless include abusive parents , parents who suffer from a mental disease during the child’s years of growth, or a childhood where one parent has left the home. Such conditions result in child neglect. Neglect in the years of growth is often related to poor schooling and an adult life which lacks education and includes criminal activities such as violence, abuse and theft. The homeless people suffer from an accumulation of health hazards in adulthood. Physically they include problems from constant outdoor living and poor general hygiene, including poor oral hygiene, dental destruction, malnutrition, lack of sleep, and consequently infections, diseases in the pulmonal-blood-heart-system and other vital organs. Psychological problems because of neglects during the years of growth, no self-confidence, no selfesteem, mistrust to public services and stigmatisation in society, paranoia and aggressions. Social problems include loneliness which leads to fear, depression and a shorter life. One of the primary challenges for health promotion is to develop and deliver appropriate initiatives to this heterogeneous population of homeless that is not always easy to categorise, but has a wide range of needs. The aim of The Homeless’ Dental Clinic in Copenhagen, Norrebro, established in 2003 is to provide at least a minimum of oral health and dental services to the homeless people on their premises. This project of The Homeless Dental Clinic has inspired to establishing a nursing clinic in The Homeless’ House, Norrebro from 2006.