Challenges in identifying and treating chronic illness in the homeless

Purposes/Aims: To characterize the incidence and prevalence of chronic disease in homeless individuals seen in the San Gabriel Valley region of Los Angeles County. Background: Diminished health is a cause and an outcome of homelessness (Health Care and Homelessness, 2009). The presence of chronic medical conditions is known to increase the death risk (Hwang, et al., 1998; Hwang, et al., 2001) and be common among homeless individuals (O'Connell, 2005). However, identifying and securing treatment for chronic health problems of the homeless remains a challenge. Los Angeles has been called the “homeless capital” of the U.S. The San Gabriel region of the county is identified as an area severely lacking in services for its homeless. Methods: For the past 15 years faculty and students of Azusa Pacific University School of Nursing have brought mobile health services to the clients of a local non-profit organization. In efforts to enhance the care and condition of this population, the APU nursing faculty and students are seeking to quantify chronic illness and explore methods to enhance health outcomes of this population. A research instrument was developed for use in retrospective chart review to identify chronic illness. In addition focus group interviews are underway to meet with homeless healthcare providers and emergency department personnel and staff of a local community health organization. The focus group information provides expert input to arrive at new approaches community nurses (and others) can develop to better meet the healthcare needs of our local homeless population who suffer from chronic illness.