Health Care for the Homeless

1. Team faculty:

Erik Garcia MD
Medical Director
Homeless Outreach and Advocacy Project
GarciaE@ummhc.org
(508) 860 1052
page: (508) 426 1418

Joyce Landers NP
Family Nurse Practitioner
HOAP
(508) 860 1010

Jane Whelan Banks
Family Nurse Practitioner
HOAP
(508) 860 1051

Annie Parkinson
Substance Abuse Counselor
(508) 860 1060

2. The Clerkship:

The average life expectancy for a homeless adult in Boston is 47 years old. This mirrors the mortality rates seen in the US and is a reflection of both profound health care disparity and the inherent risks of being street homeless.
With increased incidence of mental illness and substance abuse, less access to preventive medicine and poorer management of treatable chronic disease, homeless adults are at a tremendous health disadvantage and it requires specialized services to help meet these needs. The term "homelessness" can reflect a wide spectrum of circumstances, ranging from a family shelter with nutritional and vocational support to a campsite, hidden in the outskirts of an urban park. Moreover, the community itself often dictates the nature of homelessness and how services are accessed. As an example, the majority of Worcester's homeless are concentrated in a fairly limited area, making centralized care a possibility. Contrast this with Fitchburg, where mobile medical vans meet the needs of a more scattered and suburban homeless population.

We will accept 5 students to join us at Homeless Outreach to gain an understanding of health issues faced by Worcester’s homeless adults. We will visit several shelters and outreach sites and observe how the community shapes the barriers and accessibility to healthcare for the underserved through comparison to Boston, (and/or Fitchburg) for contrast.

3. Resources:

www.aafp.org/afp/2006/1001/p1132.html
2006 AAFP article on Adapting medical practice to care for America’s Homeless

http://www.nhchc.org/PrematureMortalityFinal.pdf