Barriers to Diabetes Management in the Homeless Population

There are few studies assessing outcomes for homeless patients with diagnosed diabetes, despite evidence that homeless patients suffer from diabetes at about the same rate as the general public, which as of 2018 is approximately 10.5% of the U.S. population. Diabetes is a chronic disease that usually does not present with acute symptoms until late into the course of disease progression. Due to social vulnerability, homeless patients often present a particular set of challenges that require different approaches from healthcare providers. These challenges include unstable housing, limited food choices, behavioral health problems, lack of access to stable care and transportation, and chronic stress. These challenges build barriers that prevent homeless patients from managing their chronic diseases effectively. There are very few studies looking at which particular barriers are the most challenging for patients, so we believe a survey quantifying the barriers will be useful for the field of diabetes management and for chronic disease management in the homeless population as a whole. We expect that by identifying specific barriers we could impact both better patient outcomes and lower healthcare costs for unhoused patients by targeting the specific issues that they struggle with. In our study, we will be operating out of the True Worth Clinic, which is a JPS clinic that primarily serves homeless patients. There is a robust diabetes education team that works to provide care to homeless patients with diabetes mellitus. Our aim is to work with the diabetes education team to create and implement a survey that will be administered to patients coming into the clinic over the next 6 months. The survey will focus on barriers to care that are unique for homeless patients managing chronic conditions, such as diabetes. Having data on patient's barriers to care will allow the True Worth Clinic to more effectively address the unique barriers that their patients face.