Using Community Health Workers to Improve the Health of Homeless Individuals

Abstract

Chronic homelessness is a major public health issue that decreases life expectancy by approximately 30 years (Vázquez et al. 2005, 35-56). This decrease is due, in part, to inadequate access and use of preventative health services and a five-fold increase in reliance on emergency medical services over housed individuals (Aspinall, 2014). Our organization, Up and Running Healthcare Solutions, partnered with the Bethesda project, a Philadelphia-based nonprofit homeless care provider, to implement an innovative solution to address this social issue. The Bethesda Project actively houses 2,000 chronically homeless individuals in Philadelphia yearly; 60 percent of the residents served have mental illnesses identified by staff, 65 percent have serious medical conditions, and 45 percent have a history of addiction-related factors that increase their risk for poor health outcomes. The national and local statistics of homelessness are alarming and we sought to address this major issue (Zlotnick and Zerger 2009, 18-26; Kushel, Vittinghoff, and Haas 2001, 200- 206; Bernstein et al. 2015, e60; Koegel et al. 1999, 306- 317; Jones et al. 2009, 69-77; Henwood et al. 2017, 1-4; Levitt et al. 2009, 978-981) . Homeless individuals are among the most vulnerable experiencing a myriad of health disparities and inequities that adversely impact quality of life.