Impactos da COVID-19 na população em situação de rua de Belo Horizonte: recorte de um estudo censitário

Abstract

Vulnerable populations are those exposed to potential harm to their physical and mental integrity, among which we find the homeless population. Vulnerability is related to distinct physiological responses to stress leading to adaptive mechanisms that can be deleterious, increasing the individual's vulnerability and their susceptibility to chronic diseases and mental disorders. People experiencing homelessness (PEH) is a phenomenon associated with the urbanization process already described in ancient civilizations, depicting individuals in a state of begging representative of the process of marginalization and social exclusion. With the establishment of the National Policy for the Homeless Population (PNPSR from the portuguese Política Nacional para a População em Situação de Rua), it was defined that this is a heterogeneous group that shares extreme poverty, the breakdown or fragile family relations, and the lack of a conventional home. They are, therefore, individuals with broken social ties and in economic vulnerability, with financial difficulty unfolding into a lack of basic resources, such as food and basic hygiene items. The census of the PEH in Brazil began with Belo Horizonte and São Paulo, in 1998 and 2000, respectively. The first national survey was conducted in 2007. Counting and understanding the homeless population came shortly after the creation of the Organic Law of Social Assistance (LOAS from the Portuguese Lei Orgânica de Assistência Social) dated 1993, which places social assistance as public policy. The IV census of the homeless population in Belo Horizonte aimed to continue previous studies, assess impacts of previous social interventions and programs, highlight changes in profile, and provide information that enables the development of more effective and sustainable social policies. Furthermore, in this dissertation, a segment of mental health data and impacts of the COVID-19 pandemic on the homeless population was made. This census study occurred through a joint effort of the municipal government, institutions related to social assistance, and the research group from the Federal University of Minas Gerais, Research Center on Vulnerability and Health (NAVES from the portuguese Núcleo de Pesquisa em Vulnerabilidade e Saúde). A total of 5344 individuals in a homeless situation were found, with 2016 men and 387 women with an average age of 41.9 ± 12.5. The majority of the population 9 self-identified as black (81.4%) and heterosexual (90.2%). In this population, 86.9% declare 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% present some comorbidity, and a prevalence of 57.2% of mental disorders was found in the population, with emphasis on depression (26%) and disorders due to the use of cigarettes (53.6%), alcohol (41.7%) and other substances. Among the reasons for being on the street, family problems (38.7%) and the use of alcohol and drugs (23.1%) stand out. The population that started living on the streets after the pandemic accounted for 33%, with a higher proportion of women (18.2%) and literate individuals (91.3%). Moreover, in this population, there are differences in the reasons reported for being on the street, with a reduction in those who report family problems (36.1%) and the use of alcohol and drugs (18.8%). The limitations of the study highlight the studied population itself, 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 notable. Conducting the census helps in understanding a marginalized population, being this a starting point to transform social and political interest.