Street Medicine: A Green Light for Homeless Medical Care

By Julia Borovay, Sara Etemad, Lia K. Jacobson, Sarah Ramirez and Cheyenne Sonntag.

Published by The Global Studies Journal

Format Price
Article: Print $US10.00
Article: Electronic $US5.00

Homelessness is a global occurrence that transcends cultural and geographic bounds, affecting heterogeneous populations in developed and developing countries and in urban and rural settings. Homeless individuals face adversity in many aspects of life, not the least of which involves challenges related to increased burden of disease and barriers to obtaining medical care. Four specific barriers to medical care for homeless persons are the perception of stigma, limited finances and lack of insurance, unreliable transportation, and competing survival priorities. In contrast to hospital and clinic settings, Street Medicine outreach programs attempt to bring services directly to the targeted homeless populations on the streets for their convenience. A review of current literature was performed to select medical outreach programs that are representative of physician-led, emergent and comprehensive care models. Results were evaluated on their ability to address the aforementioned barriers to care. By targeting the prominent barriers to obtaining medical care, Street Medicine models are capable of promoting increased access and ultimately improved health for homeless individuals.

Keywords: Homelessness, Street Medicine, Medical Outreach Models, Homeless Barriers to Care, Access to Care, Stigma, Lack of Insurance, Transportation, Survival Priorities

Global Studies Journal, Volume 3, Issue 3, pp.103-114. Article: Print (Spiral Bound). Article: Electronic (PDF File; 634.792KB).

Dr. Julia Borovay

Lecturer, USC Institute for Health Promotion and Disease Prevention Research, Keck School of Medicine of USC, Los Angeles, California, USA

Julia G. Borovay, Dr.P.H., is a lecturer in the USC Institute for Health Promotion and Disease Prevention Research [HP]. She teaches three HP courses: Cultural Competency; Culture, Lifestyle, and Health; and Eastern Medicine and Modern Health. Her research interests are in the areas of cultural competence in health care; health belief models, and patient compliance with recommended medical treatment plans. She was formerly project director for the Los Angeles County Department of Health Services pediatric HIV/AIDS surveillance project and for the perinatal hepatitis B prevention program. She recently participated for five years as research ethnographer for a CDC-sponsored intervention study of parental efficacy in a recruited population of low-income mothers through the UCLA Department of Pediatrics and Research Triangle Institute (RTI) International. Dr. Borovay received her M.A. in anthropology at CSU, Chico, and a graduate degree in linguistics from the University of California, Davis. She earned her doctorate in public health from the University of California, Los Angeles.

Sara Etemad

Master of Science in Global Medicine Alumni, Master of Science in Global Medicine Program, Keck School of Medicine of USC, Los Angeles, California, USA

Sara is from Los Angeles, California. She completed her undergraduate studies at University of California, Berkeley where she received a Bachelor of Arts in Molecular and Cell Biology. While at UC Berkeley, Sara was involved in the Health Worker Program as a community health educator for her peers. As a health advocate in her community, she led outreach programs to raise health awareness among the Berkeley students. Sara has also volunteered at a community health clinic in Los Angeles where she worked with patients of varying cultural and financial backgrounds. Sara’s interest in community medicine and immigrant health guided her to pursue a Master of Science in Global Medicine at the Keck School of Medicine at the University of Southern California. Sara is currently a first year medical student at Creighton University School of Medicine.

Lia K. Jacobson

Master of Science in Global Medicine Alumni, Master of Science in Global Medicine Program, Keck School of Medicine of USC, Los Angeles, California, USA

Lia Jacobson completed an undergraduate degree in Integrative Biology at the University of California, Berkeley and is currently pursuing a Master of Science in Global Medicine at the University of Southern California. Outside of the classroom, Lia has assisted with research surveys on H1N1 vaccine patient perceptions and with the organization of vaccine clinics targeting underserved communities through the LA County Department of Public Health. She is also involved with Healing Hearts Across Borders, a medical outreach group that offers primary medical and dental care to impoverished communities in Tijuana, MX. During the visits, she organizes toy and clothing drives, shadows physicians and helps with Spanish translation during medical consults. In addition, Lia volunteers regularly at the LA County Emergency department, where she has developed an interest in addressing the need for greater primary care availability to LA’s vast homeless population. Lia will begin medical school in Fall 2010 and plans to continue working for underserved and indigent patient populations as a physician.

Sarah Ramirez

Master of Science in Global Medicine Alumni, Master of Science in Global Medicine Program, Keck School of Medicine of USC, Los Angeles, California, USA

Sarah Ramirez has a B.A. from Yale University where she majored in Art History while completing the basic science requirements for medical school. During a junior term abroad she studied public health in Durban, South Africa where she worked as a research fellow exploring the ethics of microbicide clinical trials in the indigent Zulu population of Kwazulu-Natal. As an undergraduate Sarah worked with Yale AIDS Watch doing community education and advocacy as well as organizing the first AIDS walk in New Haven, Connecticut. Throughout college she was also an interpreter at Fair Haven free clinic serving uninsured Spanish-speaking patients. She has worked at the Institute for the Blind and Deaf, a free clinic benefiting low-income children with handicaps in Colombia, South America. Most recently, Sarah was employed as a research coordinator in the department of Radiology at LA County USC hospital overseeing clinical trials targeting underserved Latino participants. Through her diverse clinical experiences Sarah has become passionate about health care policy and reducing existing health disparities in the U.S. and abroad through research and advocacy. She has a M.S. in Global Medicine from the University of Southern California, and is currently a first year medical school at the Albert Einstein College of Medicine.

Cheyenne Sonntag

Master of Science in Global Medicine Alumni, Master of Science in Global Medicine Program, Keck School of Medicine of USC, Los Angeles, California, USA

Cheyenne Sonntag received her Bachelor of Science from the University of California, Santa Barbara where she majored in Cell and Developmental Biology and minored in Exercise and Health Science. While at UC Santa Barbara, Cheyenne served as president for Street Health Outreach, a student organization dedicated to providing basic care to the homeless communities of Santa Barbara County, and assisting other community organizations in giving medical attention to those living on the streets and in local shelters. In this position she coordinated and volunteered with Doctors Without Walls/Santa Barbara Street Medicine, a local NGO that performs foot-led medical street outreach. Cheyenne has worked as an Emergency Medical Technician-I on an Advanced Life Support/Paramedic Ambulance for the University of California Santa Barbara Police Department. Most recently she was employed as a Health Education Associate with the Santa Barbara County Public Health Department during mass-vaccination clinics for distribution of H1N1 vaccine. As a registered California Disaster Healthcare Volunteer she functions as an EMT-1 with the Santa Barbara County Medical Reserve Corps. She has a Master of Science in Global Medicine from, and is currently a first year medical student at, the Keck School of Medicine of USC.

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