Summary Post

The aims of my research were to comparatively analyze asthma, diabetes, HIV, mental health issues, obesity, and substance use among four homeless subpopulations. The analysis manifested via a focus on the disease’s process, prevalence, incidence, determinants of the disease which limit health care and social service utilization among the homeless, and other factors specific to the disease’s manifestation in homeless subpopulations. My findings demonstrated a dearth of research for asthma, diabetes, and obesity across all subpopulations with little research among the homeless elderly for all diseases. The determinants and factors investigated spanned across the physical, medical, social, financial, and political domains. Moreover, based on all the disease and cohort specific factors, conclusions, current services, and needs for further research, I classified research and policy implications into six areas for improvement. In order of importance and urgency, they are understanding homeless populations, health care and physical needs, service integration and coordination, health care providers and researchers, settings and shelters, and social networks. All of these areas for improvement call for specified and integrated approaches to understanding the specific burdens of homeless groups. Providing health care is inadequate if the competing needs of shelter and nutrition remain unattended. Furthermore, referrals to secondary care have no value if they are inaccessible to individuals based on geographic, physical, or financial limitations. In conclusion, we must not treat ‘the homeless’ as a homogeneous mass, rather programs, policies, and researchers must be proactive in providing efficient services tailored towards the barriers and determinants experienced by different cohorts.