Happy Feet: Podiatric Evaluation of the Burlington Vermont Homeless Population

Introduction. Many homeless individuals spend a large portion of their days standing or walking, placing particular importance on lower extremity health in this population. However, few studies have been performed to investigate the podiatric needs of this group.

Objective. We characterize the podiatric needs and concerns of the homeless population of the Burlington metropolitan area.

Methods. Homeless guests residing at the Committee on Temporary Shelter (COTS) Waystation in Burlington, Vermont were offered foot screenings that included musculoskeletal, neurological, circulatory and dermatologic evaluations. Data were also collected regarding the guests’ medical and social history as well as information to gauge their knowledge of proper foot care.

Results. Of the 21 participants, 52% had not had their feet examined within a year. 0% reported the usual state of their feet as “excellent,” 48% reported “good,” 29% reported “fair,” and 24% reported “poor.” 52% reported being on their feet an average of 8 or more hours per day and 86% reported having concerns about their feet. 67% reported having current or past podiatric issues; 62% reported experiencing subjective abnormalities such as numbness, pain, burning, or itching; and 71% were found to have objective abnormalities on exam such as edema, tinea pedis, decreased reflexes, etc.

Conclusions. While subjective and objective podiatric concerns are common within the homeless population, few individuals receive adequate foot care. Foot care education, consistent foot exams, and better care of chronic health conditions are potential areas for public health intervention. This approach may be used in other geographic settings.