"Step Up For Foot Care" - Addressing podiatric care needs for the homeless in San Francisco, CA

INTRODUCTION – Studies have shown that homeless people are at high risk for lower extremity limb and life-threatening pathologies. These conditions can increase the spread of infection and burden health care costs. In order to identify these concerns and their extent, a needs assessment along with a service project was conducted for the homeless in San Francisco, CA.

METHODS – Service project and study was performed at two San Francisco homeless shelters. Educational sessions were conducted on proper foot care practices. Donated shoes, socks, and insoles were distributed to the homeless. Adult homeless subjects who met study criteria were invited to complete a survey regarding demographics, health status, hygiene practices, and self-reported foot conditions.

RESULTS – Among 299 surveryed, 74% of subjects stated total time on feet daily was at least 5 hours per day, and 31% related they had seen a health professional for a foot problem. As much as about 1 in 8 subjects stated they had chronic foot pain. Most common self-reported pathologies include fungal nails, calluses, and tinea pedis. 27% reported previous foot injury.

CONCLUSION – Most of homeless subjects were quite aware of proper foot care. However, there was notable lack of resources and high incidence of self-reported pathologies that have potentially dangerous sequelae. This project revealed considerable foot care needs for a vulnerable population and thus emphasizes lower extremity health as a pressing public health concern.