Impactos del COVID-19 en la población sin hogar de Belo Horizonte: extracto de un estudio del censo

Resumen

Vulnerable populations are those exposed to potential harm to their physical and mental integrity, including the homeless population. Vulnerability is related to distinct physiological responses to stress, leading to adaptive mechanisms that can be harmful, increasing the individual's vulnerability and susceptibility to chronic diseases and mental disorders. The homeless population is a phenomenon associated with the urbanization process already described in ancient civilizations, describing individuals in a situation of begging, representative of the process of marginalization and social exclusion. With the establishment of the National Policy for the Homeless Population (PNPSR), it was defined that this is a heterogeneous group that has in common extreme poverty, ruptured or fragile family relationships, and the lack of a conventional home. They are, therefore, individuals with broken social ties and in economic vulnerability, with financial hardship resulting in a lack of basic resources, such as food and basic hygiene items. The census of the homeless population in Brazil began in Belo Horizonte and São Paulo, in 1998 and 2000, respectively. The first nationwide survey was conducted in 2007. Counting and understanding the homeless population came shortly after the creation of the Organic Law on Social Assistance (LOAS) in 1993, which establishes social assistance as a public policy. The 4th census of the homeless population in Belo Horizonte aimed to follow up on previous studies, assess the impacts of previous interventions and social programs, highlight changes in profile, and provide information that will enable the development of more effective and sustainable social policies. Furthermore, this dissertation included a selection of data on mental health and the impacts of the COVID-19 pandemic on the homeless population. This census study was carried out through a joint effort by the municipal government, institutions related to social assistance, and a research group at the Federal University of Minas Gerais, NAVES (Research Center on Vulnerability and Health). A total of 5,344 homeless individuals were found, 2,016 men and 387 women, with an average age of 41.9 ± 12.5. The majority of the population self-identified as black (81.4%) and heterosexual (90.2%). In this population, 86.9% declared that they know how to read and write. Of those surveyed, 66.7% are enrolled in the CADÚnico program and 65.5% live or have lived in support institutions such as shelters and hostels. Regarding health, 40.5% have some comorbidity and a prevalence of 57.2% of mental disorders was found in the population, with emphasis on depression (26%) and disorder due to the use of tobacco (53.6%), alcohol (41.7%) and other substances. Among the reasons for being on the streets, family problems (38.7%) and use of alcohol and drugs (23.1%) stand out. The population that became homeless after the pandemic was 33% with a higher proportion of women (18.2%) and literate individuals (91.3%). Furthermore, in this population, there are differences in the reported reasons for being homeless, with a reduction in those who report family problems (36.1%) and alcohol and drug use (18.8%). Among the limitations of the study, the population studied itself stands out, as it is a mobile population with accelerated variability. The increase in the homeless population in the subgroups of women and the elderly and high rates of psychiatric comorbidities are noteworthy. Carrying out the census helps to understand a marginalized population that is invisible, and this is a starting point for transforming social and political interest.