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Stanford University School of Medicine

Spotlight on homelessness: What medical providers can do

homeless-813618_1280Is homelessness an intractable problem? Not to San Francisco Bay area journalists, who are teaming up today in an unusual cooperative effort to blitz the media waves with news on homelessness, hoping to push policymakers and philanthropists to make lasting changes.

A New York Times article tells the tale of this project, which originated when the San Francisco Chronicle's editor in chief, Audrey Cooper, had an unpleasant encounter with a homeless couple and their dog while walking with her baby. (Check out the paper's comprehensive coverage and open letter to the City of San Francisco.)

Here at Scope, we wanted to do our part, so I recently reached out to Baldeep Singh, MD, a clinical professor of medicine who co-directs the Pacific Free Clinic, a free, weekly clinic for low-income residents located in San Jose, Calif. and run by Stanford medical students and faculty.

In general, among the uninsured population, homeless people are often much sicker than the working poor and are more likely to use emergency departments to receive medical care, Singh told me:

The biggest issue is the number of co-morbid conditions this population has, including high levels of mental illness, drug and alcohol abuse, and sexual and other forms of violence. Given their day-to-day existence, health care for them is a low priority.

After working with the homeless for several decades, Singh has advice for medical providers hoping to help:

  1. Try and collaborate with organizations already providing services to the homeless, such as shelters, soup kitchens or other areas where homeless people congregate.
  2. Remember to consider co-morbid conditions such as psychiatric illnesses and addiction, and all forms of violence.
  3. Simplify medication regimes when treating this population and become familiar with local resources that offer free or low-cost medications. Harm reduction is a reasonable goal with homeless patients.

He says an increasing body of evidence is highlighting the benefits of one seemingly straightforward step: providing housing. "One study found an 86 percent decrease in shelter use, 57 percent fewer inpatient psychiatric days, 80 percent fewer days spent in municipal hospitals, as well as fewer days spent in prison and jail (74 percent and 40 percent, respectively)," he said. "As interventions go, there is increasing interest that this intervention may among the most valuable we could provide."

The Cardinal Free Clinics — Arbor in Menlo Park and Pacific in San Jose — offer many opportunities to volunteer for medical students and physicians. Donations are also welcome.

Previously: "The need is out there": A look at the new Teen VanLearning from patients by walking in their shoes and Sowing the seeds of change: Medical students pen book on leadership, action and social innovation
Photo by krasznaivmagdolna

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