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cluding back pain, foot pain and neck pain. Additional interventions Healthcare for the Poor. Christian Medical & Dental Associa- Health. https://www.ncbi.nlm.nih.gov/pmc/articles/
included cupping, counseling on ergonomics, home therapy and oc- tions. https://cmda.org/healthcare-for-the-poor/ PMC3531350/
casionally prescribed anti-inflammatories. We encouraged regular at- 7. San Antonio Help for the Homeless. CUB Church Under the
tendance at our clinic for subsequent OMT treatments. bridge. (n.d.). https://cub-sa.org/ Kaleigh Longcrier is a fourth-year medical student at UI-
8. City of San Antonio Metropolitan Health District (2016). Bexar WSOM applying to Family Medicine residency. She is also
Future Considerations County Data Report https://www.sanantonio.gov/Portals/ CMDA’s Texas Student Leader Representative and Student
According to 2020 Point in Time Count, 21% of individuals expe- 0/Files/health/News/Reports/BRFSSReport2016_5-31- Trustee to the Board of National Trustees.
riencing homelessness are suffering from some form of mental illness 18.pdf?ver=2018-06-04-155732-877
in Bexar County. However only 4% of our patients disclosed as much 9. Centers for Disease Control and Prevention. (2020, December Taylor Sullivan, DO is graduate of the inaugural class at UI-
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during the clinics. Including mental health on our intake form could 8). PLACES: Local Data for Better Health. Centers for Disease WSOM, current General Surgery resident at UTHSCSA
prompt the interviewer to elicit a psychological history. Additionally, Control and Prevention. https://www.cdc.gov/places/ and member of Bexar County Medical Society Publications
future collaboration could include psychology and therapy students 10. American Osteopathic Association. (n.d.). OMT: Osteopathic Committee.
from local universities to participate in our clinics and provide coun- Manipulative Treatment. American Osteopathic Association.
seling to this marginalized population. https://osteopathic.org/what-is-osteopathic-medicine/osteo- Hans Bruntmyer, DO, MPH graduated from Texas College
Presenting the most common conditions from our clinics was the pathic-manipulative-treatment/ of Osteopathic Medicine in 1994. After completing residen-
first step in our pursuit to highlight and bring care to San Antonio’s 11. Tsai, J., Rosenheck, R. (2013) Obesity among Chronically home- cies in emergency and aerospace medicine, Dr. Bruntmyer re-
homeless patients. We intend to follow these patients over many clinics less adults: Is it a problem? Public Health Reports. tired from the U.S. Air Force in 2015. His current medical practice
once they start back up again (currently halted due to the COVID- https://pubmed.ncbi.nlm.nih.gov/23277657/ consists of providing Osteopathic Manipulative Medicine (OMM) and
19 pandemic) to determine if our interventions are making a positive 12. Koh, K.A., Hoy, J.S., O’Connell, J.J., Montgomery, P. Hunger- general health care at a free clinic for the marginalized in his community.
benefit to this population. obesity paradox: Obesity in the Homeless. Journal of Urban He is a member of the Bexar County Medical Society.

Acknowledgements
Obesity was frequently encountered. Despite the common associa- The authors would like to thank Scott Philips and Mitzi Roberts of
tion of homelessness with underweight individuals, we found 56% of CMDA San Antonio, Diane Talbert of Church Under the Bridge San
our patients to be obese or extremely obese, and this number increases Antonio and Dr. Arunabh Bhattacharya of UIWSOM for their sup-
to 76% when we include overweight individuals. According to a study port and assistance on this project.
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completed by Tsai, et al. in 2013, 57% of surveyed homeless adults
across the United States were overweight or obese. This statistic is fur- References:
ther demonstrated in another study which cited 67% of the homeless 1. South Alamo Regional Alliance for the Homeless (Ed.). (2020).
12
populations they surveyed were overweight or obese. This raises 2020 Point-in-Time Count Report San Antonio and Bexar
many questions about a hunger-obesity paradox, and what can be done County. SARAH Homeless. https://www.sarahomeless.org/wp-
in clinical settings to educate patients about diet and nutrition. It content/uploads/2020/05/2020-PIT-Report-_5.14.pdf
could also be an area further developed in public health campaigns 2. 2020 Annual Report. Texas Homeless Network. (2020, Decem-
and policy formation to increase the availability of healthy food access ber 17). https://www.thn.org/2020-annual-report/
to this demographic. 3. Garrett, D. G. (2012, January). The business case for ending
The most prevalent chronic diseases we came across during our clin- homelessness: having a home improves health, reduces healthcare
ics were obesity, diabetes and their complications (i.e., self-reported utilization and costs. American health & drug benefits.
nephropathy, neuropathy, Charcot foot). These remain more of a chal- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4046466/
lenge to treat, as medical treatments require pharmacologic interven- 4. Hwang, S. W., Weaver, J., Aubry, T., & Hoch, J. S. (2011). Hos-
tion and necessitate follow up. Having regular, frequent clinics (i.e., pital costs and length of stay among homeless patients admitted
monthly rather than quarterly), even if hosted by other ministries, to medical, surgical, and psychiatric services. Medical care, 49(4),
could provide consistent care. 350–354. https://doi.org/10.1097/MLR.0b013e318206c50d
The most common chief complaint we encountered was muscu- 5. Integrate Health Care. Integrate Health Care | United States In-
loskeletal pain. University of the Incarnate Word School of Osteo- teragency Council on Homelessness (USICH). (n.d.).
pathic Medicine medical students performed osteopathic https://www.usich.gov/solutions/health-care
manipulative treatment on several of the patients’ complaints, in- 6. Christian Medical & Dental Associations. (2020, July 23).
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