General Information

Despite Connecticut's status as one of the most affluent states in the nation, it is estimated that 33,000 of its residents are homeless [3]. There are significant health consequences of being homeless, which include inadequate access to healthcare and treatment, nonadherence to therapy, exposure to communicable diseases in crowded shelters, and poor hygiene [1,4]. As a result, the homeless community experiences higher disease rates (e.g., COPD, tuberculosis, and arthritis) [1], has inadequately controlled chronic disease (e.g., diabetes and hypertension) [5,6], and has mortality rates 3- to 10-fold greater than the general population [7,8,9].

In response to this disparity, the South Park Inn Medical Clinic was established in 1987 to provide healthcare services to Hartford's homeless population. In addition to seeing patients in the clinic, we as UConn medical students have expanded our scope to provide South Park residents with educational presentations on various health topics.

In Healthy People 2010, the U.S. Department of Health and Human Services outlines specific goals to "increase the quality, availability, and effectiveness of educational and community-based programs designed to prevent disease and improve health and quality of life [10]." Within our state borders, the Department of Public Health has addressed this issue as well. During the last major conference for Healthcare and the Homeless, health education was identified as an important component of effective medical evaluation and care. It set out three important goals: (1) take advantage of formal and informal educational opportunities to increase the health of homeless clients; (2) give homeless clients knowledge – not more handouts and pamphlets to carry around; and (3) educate shelter staff to identify true emergencies and respond accordingly [11].

We at South Park believe that knowledge is power, and we hold this philosophy as the basis for the spirit motivating the development of improved health education for homeless persons residing at the South Park Inn.

References:

1. Hwang SW. Homelessness and health. CMAJ 164(2): 229-33, 2001.
2. Healthcare and the homeless. Connecticut DPH. http://www.dph.state.ct.us/Publications/BCH/Family%20Health/CTDPH_HOMELESS_FINAL_REVISED4.pdf
3. CT Coalition to End Homelessness. 2004. www.cceh.org
4. O'Connell JJ. Dying in the shadows: the challenge of providing health care for homeless people. CMAJ 170(8): 1251-2, 2004.
5. Gelberg L, Linn LS. Assessing the physical health of homeless adults. JAMA 262:1973-9, 1989.
6. Hwang SW, Bugeja AL. Barriers to appropriate diabetes management among homeless people in Toronto. CMAJ 163(2):161-5, 2000.
7. Cheung AM, Hwang SW. Risk of death among homeless women: a cohort study and review of the literature. CMAJ 170(8):1243–7, 2004.
8. Hwang SW, Orav EJ, O’Connell JJ, Lebow JM, Brennan TA. Causes of death in homeless adults in Boston. Ann Intern Med 126:625–8, 1997.
9. Hwang SW. Mortality among men using homeless shelters in Toronto, Ontario. JAMA 283:2152–7, 2000.
10. Healthy People 2010, Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services, http://www.healthypeople.gov/Document/HTML/Volume1/07ED.htm#_Toc490550849
11. Matrix Public Health Consultants, CT DPH. Addressing the health needs of homeless persons: Building Strategic Partnerships. Report of Proceedings. April 16, 2004.