Developing creative solutions to improve health care access for homeless women


Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

3138.3: Monday, December 12, 2005 - 12:30 PM

Abstract #110287

Roseanna H. Means, MD, MSc and Ayse A. Atasoylu, MD, MPH. Medicine, Harvard Medical School, Women of Means, Inc., 148 Linden Street, Suite 104A, Wellesley, MA 02482, 781-239-0290, RMeans@womenofmeans.org

Traditional health care delivery systems do not serve homeless women well. Homeless women live in a chaotic world of unpredictability. Each day they face the challenges of securing food, warmth and safety. Survival needs take precedence over planned and preventive care. Exhaustion, fear, cognitive and mental impairment get in the way of access to care, even when the women have Medicaid. Many women are fleeing abusive relationships and the fear of being discovered limits their access of traditional medical care systems. Fear of losing their children prevents them from seeking rehabilitation for substance abuse disorders. Many shelters have limited stays, requiring the women to move frequently hindering follow-up from external sources such as doctor's offices. Access to telephones to make appointments, transportation to the clinic, getting back to the shelter to secure a bed on time are just a few examples of barriers the women have to overcome. The cultural context of homelessness, and barriers to health care access, need to be considered in developing creative solutions to improve health care for homeless women. We describe one such model of care. Women of Means addresses these barriers by providing direct care in homeless women's shelters. Volunteer physicians and staff nurses provide free episodic medical care in safe, accessible settings, with clinical communication and education about the cultural context of homelessness to mainstream medical practices. Educating providers in emergency rooms, mainstream practices, and physicians-in-training further improves the care of homeless women by developing appropriate discharge planning and follow-up care.

Learning Objectives:

At the conclusion of this session participants will

1)Articulate the cultural context of homelessness and how it affects homeless women and their access to medical care 2)Identify the multiple barriers to successful outpatient medical care and inpatient discharge planning for homeless women 3)Recognize that apparently “well-designed” health care delivery systems don’t always work for people whose lives are in chaos and therefore creative solutions must be explored 4)Define the components of one such creative solution, Women of Means, a successful model of medical care that addresses these barriers by providing direct care in homeless women’s shelters

Keywords: Homeless Health Care, Women's Health

Related Web page: www.womenofmeans.org/

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Critical Issues Affecting Women's Health and Innovative Strategies Preserving Women's Health

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA