MENTAL HEALTH
A Closer Look at the Medical Needs of San Antonio’s Homeless Population By Kaleigh Longcrier, OMS IV, Taylor Sullivan, DO and Hans Bruntmyer, DO, MPH
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n January 2020, there were approximately 2,932 people experiencing homelessness in the San Antonio area, which is a 2% increase from 2019.1 In the state of Texas, 27,229 people are living either sheltered or unsheltered on a single night, which is a 5% increase from 2019.2 A growing homeless population comes with an increase in demand of health needs. Lack of primary care establishment can lead to progression of chronic diseases, such as diabetes or hypertension, leading to a downward spiral of complications. This often leads to ER visits and hospital admissions.3 These visits ultimately contribute to the overall financial burden that plagues the American health care system today.4 The first step in decreasing the burden of disease and creating a holistically healthy and more cost-effective health care system begins by identifying the types and prevalence of diseases in the homeless population. Helping our community can take many forms and facets, but if the needs are unknown, our attempts would be futile. Knowing the most pressing and prevalent health conditions among the homeless in a particular region is a springboard to create programs or protocols to address these issues. 24
SAN ANTONIO MEDICINE • October 2021
The motivation behind caring for San Antonio’s homeless population can be multifactorial. It can be argued that helping the homeless in Bexar County can improve overall health outcomes of the city and can decrease the financial burden of disease. Restoring the health of the homeless could create opportunities for labor intensive or physically demanding work, and thus theoretically decrease the incidence of homelessness itself.5 It can also be argued that in general, taking care of those less fortunate is an altruistic duty of society and a sacred ideal held in many religions. Christian Medical and Dental Association (CMDA) and Church Under the Bridge (CUB)6,7 are two of several organizations in San Antonio that have this layered and multifactorial motivation behind caring for the homeless population. The authors of this paper have conducted a retrospective review (University of the Incarnate Word Institutional Review Board Approval Number 21-02-004) from four free clinics provided to homeless patients by CMDA and CUB during March 2019 to January 2020. The following results were obtained on an intake form completed by patients and from history & physical elicited by students (with oversight by physicians and dentists) during the free clinics.
