Page 25 - Layout 1

MENTAL HEALTH MENTAL HEALTH

Results
Demographics: Fifty five percent of patients were male and 45% Of the patients with hypertension, 16% were on medication and
were female. There was a nearly even distribution of age among our the average systolic blood pressure reading was 136 mmHg. Nine per-
patients; the majority ranged from 18-60. Nearly half listed a home cent of patients were on diabetic medications and the average glu-
address and twenty percent reported living at a shelter. Less than a cometer reading was 132 mg/dL. Nearly three quarters of our patient
third of patients reported having a primary care physician and 1/3 of population were overweight, obese or severely obese. Figure 3 displays
patients had been hospitalized in the preceding 3 years. body mass indices of homeless patients. Fifty six percent had a BMI
greater than or equal to 30 and thirty percent with a BMI greater than
Figure 1 or equal to 35 (classified as extremely obese).

Figure 3

A Closer Look at the Medical Needs Figure 1 describes the distribution of health needs during the clinics.

of San Antonio’s Homeless Population On the dental side of the clinic, the most common intervention was Figure 3: Visual representation of homeless patients’ BMI. Only 3% of our
patients were underweight.

extractions (46%), followed by dental hygiene (30%) and 16% of pa-
tients had dental restorative procedures. On the medical side of the
By Kaleigh Longcrier, OMS IV, Taylor Sullivan, DO and Hans Bruntmyer, DO, MPH clinic, the most common chief complaint was musculoskeletal, includ- Discussion
ing knee, shoulder, neck, back, and foot pain, and tendonitis. Follow- Table 1 displays a comparison of 2016 Bexar County prevalence
I The motivation behind caring for San Antonio’s homeless popula- ing musculoskeletal complaints, the rest of the patients did not have a rates of various health conditions to the homeless patients in our free
n January 2020, there were approximately 2,932 people experienc-
clinics. As seen, these numbers are significantly higher amongst
8,9
specific complaint, but rather requested a physical exam (i.e., a check-
tion can be multifactorial. It can be argued that helping the homeless
ing homelessness in the San Antonio area, which is a 2% increase
up) or needed a refill for a known medical condition. Several patients homeless patients than the general population. Lack of health educa-
1
from 2019. In the state of Texas, 27,229 people are living either shel- in Bexar County can improve overall health outcomes of the city and
had chronic medical conditions needing attention, exhibited below tion, financial support and access to primary care could be some of the
tered or unsheltered on a single night, which is a 5% increase from can decrease the financial burden of disease. Restoring the health of
in Figure 2. main reasons why homeless patients’ rates are higher than county rates.
2
2019. A growing homeless population comes with an increase in de- the homeless could create opportunities for labor intensive or physi-

mand of health needs. Lack of primary care establishment can lead cally demanding work, and thus theoretically decrease the incidence
Figure 2 Table 1

5
to progression of chronic diseases, such as diabetes or hypertension, of homelessness itself. It can also be argued that in general, taking care
leading to a downward spiral of complications. This often leads to ER of those less fortunate is an altruistic duty of society and a sacred ideal
3
visits and hospital admissions. These visits ultimately contribute to held in many religions.
the overall financial burden that plagues the American health care Christian Medical and Dental Association (CMDA) and Church
4
6,7
system today. Under the Bridge (CUB) are two of several organizations in San An-
The first step in decreasing the burden of disease and creating a tonio that have this layered and multifactorial motivation behind caring
holistically healthy and more cost-effective health care system begins for the homeless population. The authors of this paper have conducted
by identifying the types and prevalence of diseases in the homeless a retrospective review (University of the Incarnate Word Institutional
population. Helping our community can take many forms and facets, Review Board Approval Number 21-02-004) from four free clinics pro-
but if the needs are unknown, our attempts would be futile. Knowing vided to homeless patients by CMDA and CUB during March 2019 to Table 1: Comparison of the most common medical conditions seen in the

homeless patients compared to local rates. As seen, the prevalence is dra-
the most pressing and prevalent health conditions among the homeless January 2020. The following results were obtained on an intake form matically increased in the San Antonio homeless population than the gen-
in a particular region is a springboard to create programs or protocols completed by patients and from history & physical elicited by students Figure 2: The most common medical problems seen at our free clinics. Hyperten- eral population.
sion, Arthritis and diabetes were the most prominent conditions seen.
to address these issues. (with oversight by physicians and dentists) during the free clinics.
continued on page 26
24 SAN ANTONIO MEDICINE • October 2021 Visit us at www.bcms.org 25