Addressing Healthcare Barriers in Residents of a Subsidized Housing Community

Introduction. Despite expansion of healthcare programs for low income and elderly individuals, vision, hearing, and dental services have limited coverage. Community services are often called upon to fill these gaps. We surveyed staff and residents in Burlington Housing Authority (BHA), Burlington, Vermont, subsidized housing. Residents ranged from 18 to 91, were disabled and/or elderly. Our goal was to (1) identify gaps in healthcare coverage and (2) assess barriers to accessing those services.

Methods. Surveys were distributed to the first 50 residents to attend an event at the BHA office. BHA staff were also surveyed to assess staff perception of residents’ healthcare utilization and barriers to access. We also consulted the Champlain Valley Agency on Aging to discuss healthcare coverage under Medicare. A 1-hour workshop was held with residents at the BHA to present our findings and circulate a packet of community resources.

Results. A total of 45 surveys were returned. 93% of residents reported being enrolled in Medicare, Medicaid, or both. Services that residents most often reported being unable to access were acquiring dentures (18%) and eyeglasses (7%). The most common barriers were identified as healthcare cost (47%), transportation (21%), and inadequate insurance coverage (21%).

Conclusion. Our results demonstrate a population that is well-covered by health insurance but with persistent healthcare needs. Such barriers serve to undermine the preventive goals of Medicare and Medicaid. Although charities and community programs can cover shortages, it is obvious that without additional state or federal aid, these needs will continue to go largely unmet.