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Keywords:

  • chronic diseases;
  • community health;
  • homeless;
  • service utilization

Abstract

For almost two decades, the US Health Care for the Homeless (HCH) Program has funded clinics across the country for homeless populations. Between October and December 2003, for the first time ever, a nationally representative sample of the almost 200 HCH clinics with a response rate of approximately 71% (the HCH User Visit Survey) was created to examine the health status of its users (n = 1017). This study employed the HCH User Visit Survey's cross-sectional data set to evaluate health indicators of individuals using HCH Services with the US population, and compare individuals who reported they routinely used HCH clinics (‘usual’ HCH users) to those who did not (‘non-usual’ users). HCH users had poorer health status than the US population (44.0% versus 12.3%, respectively). Usual HCH users had similar healthcare status compared to non-usual users, but were more likely to be uninsured, non-English speakers, and walking or taking public transportation to their medical appointments. Usual versus non-usual HCH users were also more apt to have slept in cars, buses or on the streets in the week prior to the survey (14.8% versus 4.3%, respectively). This study shows that the HCH clinics are serving homeless individuals who have a variety of complex health and psychosocial needs, and its most frequent users are those who experience the most barriers accessing care.