Disparities in Homeless People's Health Care in France

Wednesday, July 16, 2014: 12:00 PM
Room: F206
Distributed Paper
Laureline COULOMB , Laboratoire Dynamiques Européennes UMR7367 - Université de Strasbourg, Strasbourg, France
The French healthcare system is reputed to be one of the best in the world. In theory, it guarantees free access to medical care to everyone by offering specific medical security scheme for each social group. However, this nationalised system has increased disparities across social groups and classes. This paper will try to understand the reasons why normal patients and homeless people are treated differently. Homeless people are entitled to Social Security benefits, yet they often have poor health. This can be explained by the fact that homeless people develop particular modes of behaviour resulting from survival needs. Their living conditions adversely affect their health, but they often reject medical care. Homeless people usually refuse to go to the hospital or to see a doctor despite their need for proper medical care. Healthcare workers often encounter difficulties to understand what their demand is: most of the time, homeless people are ashamed to exposing their damaged bodies. They don't want to admit that they can't preserve their health while living in the street. They only have their bodies, and they are not able to take care of it. They may decline the help they are offered, whatever form it takes, in order to avoid the difficulty to show their troubles. In addition, healthcare can be denied to them in doctors’ office or in hospitals, which is often due to their possible lack of hygiene or aggressive behaviour. Doctors or nurses are not used to this kind of patients and may encounter difficulties in taking care of them. Analysing the interactions between homeless people and healthcare workers displays how different their respective logics of action are. Plus, their perceptions of health, illness and body image much differ, which can cause misunderstandings and result in homeless people facing great health inequalities