CHSU Discovery

Abstract

Access to healthcare for unhoused individuals remains a significant challenge, with social determinants playing a crucial role in health disparities. Street medicine programs have emerged as an effective solution, bridging the gap between traditional healthcare systems and marginalized populations by providing direct medical care. This study aims to assess whether key demographic factors are associated with housing status at United Health Centers (UHC) Tuolumne located in Fresno, California. This will in turn help provide insights into the specific healthcare needs of the unhoused population and inform the development of targeted interventions. We hypothesize that racial and ethnic minority individuals within the unhoused population experience greater unmet medical needs compared to non-minority groups. A retrospective analysis was conducted using data from the PRAPARE (Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences) survey at UHC Tuolumne from January 2021 to May 2024. Patients who answered “I do not have housing” in the PRAPARE survey were included in the study. Data analysis employed descriptive statistics to summarize patient characteristics and chi-square tests for categorical variables to identify predictors of healthcare access disparities among unhoused individuals. Our data shows that out of 1157, only 83 (7.2%) answered that they did not have housing. Within the unhoused group, 62.7% (n=52) identified as Hispanic/Latino, 36.1% (n=30) did not, and 1.2% (n=1) chose not to answer this question. Comparing participants identifying as Hispanic to non-Hispanic participants, the chi-square analysis reveals χ²=5.72, p=0.017. Among the unhoused participants, 45.8% (n=38) reported that a lack of transportation prevented them from attending both medical and non-medical appointments. Of the unhoused Hispanic patients, 61.1% (n=22) have transportation issues compared to non-Hispanic unhoused patients (n=14, 38.9%). ​There is a statistically significant association between race and housing status, supporting the hypothesis that minority individuals may face greater unmet medical needs within the unhoused community.​ Additionally, transportation barriers emerged as a significant issue. Hispanic unhoused patients, in particular, demonstrated the greatest need in this area.​