SRF002: A Medical Snapshot of a Homeless Population Based on Health Fair Outcomes

Daniel Howard, BA; Lakshmi Menon, BA; Thanos Rossopoulos, MD


Context: Homeless populations often experience a variety of barriers to care that make awareness and management of chronic medical disease difficult to attain. Many such individuals may seek care at shelters and clinics; therefore, it is important that personnel at these facilities be aware of medical issues prevalent amongst their clients. A group of medical students and community partners organized a health fair at a shelter for men experiencing homelessness, during which health information was gathered and various screenings and services were provided. Objective: Assess prevalence of common chronic medical conditions amongst shelter clients and inform community partners about areas for future intervention. Study Design: Cross-sectional survey. Setting: 335-bed shelter for men experiencing homelessness in Dallas, TX. Population Studied: 65 men experiencing homelessness and accessing shelter resources who participated in a health fair. Intervention: Health survey and medical screening, including point-in-time measurements of glucose, creatinine, blood pressure, and BMI. Outcome Measures: Primary outcomes include participant-reported insurance status, last emergency department use, and medical conditions including smoking. Secondary outcomes include speculative diagnoses of diabetes, kidney disease, and hypertension based on measured data and participation rates for each screening service. Results: Only preliminary outcomes are reported here; complete analysis is still underway. Average age 49 years; African American 41.5% and White 36.9%; 72% uninsured. Average BMI 31. Self-reported history: 37% Hypertension; 12% Diabetes. Per diabetes screening: 14% of participants met diagnostic criteria, with 3 individuals who did not report a previous diagnosis. CKD prevalence: Stage 3: 9.3%; Stage 4: 1.5%; Stage 5: 1.5%. Hypertension prevalence: Elevated 6.2%; Stage 1: 16.9%. Stage 2: 44.6%. Additional outcome measures are being reviewed, including between-groups differences based on race, age group, insurance access, and self-health rating. Conclusions: Preliminary results appear to be similar to national prevalence rates for hypertension and diabetes but higher for CKD. Additional data is still being analyzed and these outcomes will inform onsite student-run clinic services to prioritize care in preventative and active management of these diseases, particularly in a transient population with poor insurance coverage and healthcare access.
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Jack 11/21/2020

terrific work. thanks for bringing this to NAPCRG

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