A public health approach to street medicine

In 2012, the city of San Bernardino declared chapter 9 bankruptcy. The homeless population in San Bernardino County rose from 1,736 in 2009 to 2,876 in 2011, an increase of 39.6 %.^1,3 Currently, twenty-six percent of residents live below the poverty line and 46% of residents receive some form of aid such as Cal Fresh or Medi-Cal.² In 2011, a team of medical students from the Loma Linda University School of Medicine began providing basic healthcare services to homeless adults living in and around San Bernardino, CA. Under the supervision of licensed physicians, the students provide general health assessments, vaccinations, dispense medication, and refer patients to other healthcare providers. Students from LLU's School of Public Health have joined the Street Medicine Outreach in a student-to-student effort, bringing a public health approach to better understand the determinants of poor health among the homeless and their access to resources. A comprehensive mixed-method assessment was conducted, including literature reviews, data analysis from secondary sources, knowledge, attitudes and practices (KAPS) survey, windshield survey, focus groups and key informant interviews with homeless individuals, as well as healthcare providers, members of law enforcement, and shelter workers. The assessment results will be shared with the homeless community and LLU Street Medicine Outreach and other service providers to help develop more strategic, focused programs. The SPH team will continue to collect data to extend the reach of Street Medicine program, working to deepen healthcare practitioners' understanding of the challenges faced by San Bernardino's homeless population.