"Homeless Health and Nursing:
Building Community Partnerships for a Healthier Future"
Chronic homelessness is a major public health issue that has serious repercussions on overall health status and life expectancy. In their Annual Report to Congress, the US Department of Housing and Urban Development reported that on a single night there were 549,928 homeless individuals in the Unites Stated. Philadelphia’s similar Point-In-Time Homeless count was 6,112 individuals.
Homeless Individuals have increased rates of chronic and acute illness with 57% reporting fair, poor or very poor health. In the same study 68% of homeless adults reported having at least two chronic physical conditions and 56% reported having at least two chronic mental health conditions. Homeless people 25-44 years old face a 9-fold increase in mortality, those who are 45-64 years old face a 4.5-fold increase. Homeless individuals experience increased cardiovascular disease6, mental health diagnoses and substance use disorder. Rates of diabetes and hypertension are comparable to the general population. However complications of these conditions are increased in the homeless.
These individuals have difficulty accessing primary care, leaving emergency departments as their most accessible source of care. Unmet health care needs have related homeless individuals to this reliance on and utilization of emergency medical services at a higher rate than the general population.
One possible solution to reduce these disparities may be the utilization of community health workers. Community Health Workers (CHW) are specially trained community members who share demographic similarities with the populations they serve. This facilitates the delivery of care consistent with the population’s values and needs. These workers have been used successfully during the transition from the hospital to home environment, in primary care settings, and in chronic illness management. Our program has potential to provide better care and outcomes to homeless individuals.
CHWs will guide residents in navigating the complex health care system and other social services in Philadelphia. This expanded model of care will decrease health disparities and increase access to high-quality, patient-centered healthcare for this underserved population- thereby facilitating an improved quality of life for homeless individuals in the Philadelphia community.
Clients will identify a primary care provider and maintain follow-up for preventative and chronic disease management services.
Clients will seek support from a mental health provider and maintain follow-up to promote a high quality of life.
Clients will obtain, utilize, understand, and maximize the benefits of health insurance to remain healthier and in their community.