216474 "Step Up For Foot Care" - Addressing podiatric care needs for the homeless in San Francisco, CA

Tuesday, November 9, 2010 : 12:30 PM - 1:10 PM

Bright Chen, DPM , Podiatric Medicine & Surgery, West Houston Medical Center, Houston, TX
Analiza Mitchell, DPM , Podiatric Medicine & Surgery, St. Barnabas Hospital, Bronx, NY
David Tran, DPM, MS , California School of Podiatric Medicine, Samuel Merritt University, Oakland, 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.

Learning Areas:
Administer health education strategies, interventions and programs
Advocacy for health and health education
Assessment of individual and community needs for health education
Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Public health or related research

Learning Objectives:
1. Describe the public health implications of lower extremity pathologies in vulnerable populations. 2. List the pressing podiatric health needs of the homeless in San Francisco, CA. 3. Formulate an action plan to address the podiatric health needs of indigent populations.

Keywords: Homeless Health Care, Survey

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I completed the research that is to be presented and am a specialist in lower extremity health as a resident podiatric physician.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.