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mVET Team part of the Supercourse (www.pitt.edu/~super1/)
WHO Collaborating Centre, University of Pittsburgh, Pittsburgh, PA 15261 USA (WHOcc@pitt.edu)
In 5 years one million troops return from Afghanistan. As a result there will be over 180,000 homeless vets. The limited data predict harrowing health problems. Homeless vets are 4-8 times more likely to die then the general population with an average age of death of 46 http://santabarbarastreetmedicine.org/wordpress/wp-content/uploads/2011/04/PrematureMortalityFinal.pdf .A homeless vet in Washington or Los Angeles is 3 times more likely to be killed than in a soldier in Afghanistan. During the period of the Iraq and Afghanistan wars, 6280 of our troops were killed in action. During the same period over 19,650 homeless vets died. Young homeless women are 20 times more likely to die with a very high chance of being raped. Homeless people die at 46, AIDs patients die at age 69. Johnny comes marching home to die. We need to prevent this from occurring.
The Veterans Administration has done a wonderful job in finding housing for Homeless vets, but it will take years to make this available to all. Even if we obtain housing for the Veterans, it is not clear as to if this can help prevent the primary causes of death, injury, drug abuse, exposure and Murder/Suicide.
Homeless vets are voiceless.
We propose public health approach called mVET and dying with dignity to the homeless to prevent needless death for our homeless vets. mVET will give every veteran homeless person a voice by providing each a smart phone with “life-line” apps. These life line apps are designed to reduce many crises and acute deaths faced by the homeless. The apps could include minutes to call family, to help cope with PTSD, body internet temperature apps to prevent hypothermia and frost-bite amputation, psychological apps to talk with a counselor, Telemedicine apps to monitor ulcers, teeth, and diabetes, 911 apps to call for help, GPS to find shelter and food. In addition, pharmaceutical apps to monitor AIDS treatment regimes, personal care apps for showers, clean clothes, etc.
mVET targets prevention of acute crises which lead to death. A call for help is sent if thugs are roughing one up, or if a homeless friend in unconscious because of drugs, or if the temperature rises to 110 degrees or plummets to -30. Prevention of the magnitude of crises and frequency of crisis is a proven public health way to prevent mortality. We will not attempt to prevent the root causes of homelessness, or drug abuse. The exclusive target is to prevent the very high mortality seen in the homeless vets and an opportunity to die with dignity.
Amazingly about 40% of the homeless have a cell phone (http://www.washingtonpost.com/wp-dyn/content/article/2009/03/22/AR2009032201835.html). They do not lose their phones. Also, if one looks around there are many places to charge phones, in buildings, libraries, McDonalds, or even using batteries.
Once needs to be concerned about the cost of this program in this fiscal climate. Fortunately the FCC has instituted a program call Life Line America (http://www.lifeline.gov/aboutus.html) which is already funded. This program provides cell phones and 250 minutes per month to all needy people in the US. All we need is the political will to move our homeless veterans to the front of the line. The homeless vet needs to have a point of contact should they have a crisis. There already are Homeless, wounded warrior, suicide hotlines from the VA and DOD that could be tapped into, or non-military 911, or even student nurses which could be developed at a marginal cost.
Dying with Dignity: A second major component to mVET is death with Dignity. Currently less than 4% of Veterans die in hospice care, even fewer homeless Vets die in a hospice. A VA benefit is that all Veterans have the right to die with hospice care, but few are availing themselves of this. There are more homeless veterans dying on the streets then are dying in a hospice. We plan to change this.
Our mission is simple, reduce mortality by ½ and Death with Dignity
“When people talk, listen completely. Most people never listen” (Hemingway). We need to listen to the young vets as “The young dead soldiers do not speak.” (MacLeish)
mVET team, Ronald E. LaPorte, Ph.D. WHO Collaborating Center Director, Epidemiology Professor, Uni. Pittsburgh
Richard Fisher, M.D.
Jay Sanders, M.D.
William Reinckens, BA
Faina Linkov, Ph.D.
Posted by Perry Miller, Editor at May 28, 2012 8:46 AM