James Plumb, MD, MPH¹, Rickie Brawer, MPH¹, and Lara Weinstein, MD². (1) Office to Advance Population Health, Thomas Jefferson University Hospital, 1015 Chestnut St, Suite 715, Philadelphia, PA 19107, 215-955-6340, james.plumb@jefferson.edu, (2) Family Medicine, Thomas Jefferson University, 1015 Walnut, Suite 401, Philadelphia, PA 19107

The homeless in Philadelphia are a growing population with preventable disease, progressive morbidity and premature death. In Philadelphia, the median age of death for homeless men is 45. Heart disease and cancer are the leading causes of death in the homeless aged 45-65. Most homeless receive poorly coordinated acute care in emergency rooms and clinics. Preventive services, screening and health education programs have not been a component of this care “system”. In 2003, Thomas Jefferson University faculty and medical students, through the Jeff H.O.P.E. (Health, Opportunities, Prevention and Education) Urban Health Initiative, instituted a screening and educational project in two men’s shelters. The goals of the project were to 1) provide educational materials related to cardiovascular disease and prostate cancer; 2) assess the prevalence of risk factors, and 3) develop and assess a system of care to provide follow-up of abnormalities. At two shelters, 341 men presented for screening (mean age 42.3); 314 were screened for cholesterol, HDL, blood sugar, blood pressure and smoking status. The results included: 204 (64%) had never had cholesterol or sugar checked; 27% had elevated cholesterol levels; 220 (69%) had low HDL levels; 67 (22%) had elevated blood pressure; 24 (7.6%) were newly diagnosed with diabetes; and 240 (76%) smoked. Using a shared decision technique, 261 were offered screening for prostate cancer; 133 (50%)declined any further screening and 123 elected a PSA; two PSA’s were elevated with cancer eventually confirmed. All men received educational material, nutritional counseling and were offered a smoking cessation program.

Learning Objectives: At the conclusion of the session, participants will be able to

• Recognize the prevalence of cardiovascular and prostate cancer risk in a sheltered male population
• Analyze risk factors for cardiovascular and prostate cancer in a sheltered male population
• Describe a system of care to identify and manage cardiovascular and prostate cancer risk

Keywords: Homeless Health Care, Screening

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.