Journal Article

Unmet health needs and barriers to health care among people experiencing homelessness in San Francisco’s Mission District: a qualitative study

Jeffrys, Mason, Rowe, Michael, Thorndike, Anna L., Yetman, Hailey E., Thorndike, Anne N.

2022

Overview

Background People experiencing homelessness have unique health needs and barriers to medical and behavioral health care (mental health, substance use disorder, and overall well-being) compared to housed people. It remains unclear why many people experiencing homelessness do not access care when community-based homeless health care resources are available at low or no cost. This qualitative study examined perspectives of people experiencing homelessness and staff members at community-based homeless health and service organizations in San Francisco’s Mission District on unmet medical and behavioral health needs and barriers to accessing care. Methods We conducted 34 interviews between September and November 2020: 23 with people experiencing homelessness and 11 with staff at community-based homeless health and service organizations in the Mission District. Qualitative interviews were transcribed, coded, and analyzed using the Framework Method on NVivo Qualitative Data Analysis Software. Results Both staff and homeless participants reported unmet and common health needs of mental illness, physical injury and disability, food and nutrition insecurity, and substance use disorder. Barriers to care included negative prior health care experiences, competing priorities, and provider turnover. Recommendations for improving services included building more trust with people experiencing homelessness by training clinic staff to treat patients with respect and patience and expanding clinical outreach and health education programs. Conclusions People experiencing homelessness face many different health needs and barriers to care, some of which community-based organizations have the ability to address. These findings can help inform future strategies for homeless health care programs to identify and target the specific unmet health needs and barriers to care of people experiencing homelessness in their communities.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Access to health care / Barriers / Biostatistics / Community / Community organizations / Community-based programs / Consent / Coronaviruses / COVID-19 / Data analysis / Drug use / Educational programs / Emergency medical care / Environmental aspects / Environmental Health / Epidemiology / Health aspects / Health behavior / Health care / Health care access / Health care disparities / Health care expenditures / Health care policy / Health education / Health needs / Health needs assessment / Health planning / Healthy food / Homeless people / Homelessness / Hospital costs / Injuries / Insecurity / Interviews / Medical research / Medicine / Medicine & Public Health / Mental disorders / Mental health / Mental health care / Mental health services / Neighborhoods / Nutrition / Organizations / Pandemics / Patient perspectives / Patients / Personal health / Physical disabilities / Physical training / Public Health / Qualitative analysis / Qualitative research / Review boards / Social aspects / Software / Substance abuse / Substance use / Substance use disorder / Target recognition / Vaccine / Well being