The impact of globalization on populations experiencing homelessness

The impact of globalization has taken hold of American communities as homelessness permeates in the life in major cities. By 2010, half of the world’s population lived in cities [1], affecting the housing markets and affordability. The United States experienced a recent rise in homelessness after years of apparent decline [2]. Families with deep roots in their communities became casualties of gentrification. For example, a quarter of homeless Americans reside in California. Santa Clara County, known for Silicon Valley’s 76,000 millionaires and billionaires, has the nation’s highest income gap and one of the largest population of individuals facing homelessness ([2, para 3]. In addition to urbanization, migration is a widespread issue influencing homelessness internationally. In 2017, 68.5 million people were forced to leave their homes, half of which were women and children [3]. Migration secondary to natural disasters costed the United States 1.3 trillion dollars over the last 12 years and is projected to grow [4]. Though the last global survey was attempted in 2005, it revealed 100 million people as homeless and 1.6 billion people without adequate housing [5]. Globalization impacts the migration (caused by both political circumstances and natural disasters) and the urbanization of human beings, contributing to the proliferation of populations experiencing homelessness.

Individuals who are homeless confront human rights issues, such as the right to a standard of living, including shelter [6]. Further, the World Federation of Occupational Therapists [WFOT] claims occupation as a human right [7]. This right is jeopardized by poverty and other global conditions that can trigger homelessness. Occupational justice is “the right of every individual to be able to meet basic needs and to have equal opportunities and life chances to reach toward her or his potential but specific to the individual’s engagement in diverse and meaningful occupation” [8, p. 193]. Individuals who are homeless encounter occupational injustices, such as facing barriers to employment, education and resources [9].

Occupational therapy practitioners address human rights issues, occupational injustices and promote health and well-being through meaningful, client-centered activities. They possess a distinct collection of skills to support populations experiencing homelessness, addressing needs such as employment, education, money management, coping skills and leisure activities [10] through assessment, treatment, research, case management, outreach and advocacy work [11]. Occupational therapists can promote social inclusion for populations experiencing homelessness by utilizing the Participatory Occupational Justice Framework [12] and have potential to help homeless populations enhance their well-being and promote occupational justice [13].

However occupational therapists face challenges in the realm of education that hinder the pursuit of initiatives working with populations experiencing homelessness [11]. “The paucity of occupational therapy academic training relevant to this clientele will need to be addressed before occupational therapy services for those who are homeless become commonplace” [11, p. 496]. Occupational therapy professionals are not adequately prepared to address the issue.

Are occupational therapy students encouraged in their education to expand the boundaries of their practice? Although body-centered, individual, reimbursement-based interventions remain necessary to promote the health of human beings, it is only addresses one small dimension in the kaleidoscope of one’s well-being. Our unique profession produces waves in the collective of humanity as we respond to issues roused by globalization.

The globalization of our world is complex and ubiquitous, affecting the health and wellness of human beings, for better or for worse. We must expand our professional boundaries and use our exclusive skill set to address the injustices that individuals who are homeless encounter. Occupational therapy education must develop to ensure our future clinicians are proficient global citizens and agents of change. This is an enormous undertaking, but an opportunity for the progression of our profession

Author note

Elisabeth Bahr, OTD, MS, OTR/L is an occupational therapist residing and practicing in New York City. She is a graduate from NYU’s Master of Science Program (MSOT, ’17) and Boston University’s Doctor of Occupational Therapy Program (PP-OTD, ’18). She created a program implemented in the Summer of 2018 at Boston University’s online post-professional doctoral program titled “The Occupational Therapist as a Global Citizen” which teaches and inspires students to use their OT skill set to become agents of global change. Under the guidance of Dr. Kit Sinclair, she compiled and wrote the recently released Manual for Occupational Therapists working with Displaced Populations (2019).

Conflict of interest

None to report.