Community-support model for underserved groups during health emergencies

Boston University School of MedicineJun 20 2024

A community-support model for providing health resources and education is a way to continuously engage unhoused people and other underserved groups who are particularly vulnerable during health emergencies like the COVID-19 pandemic.

Having a stable system for bringing health information to unhoused people and connecting them to providers at Boston Health Care for the Homeless Program (BHCHP), is a pathway for addressing a number of health issues they experience. Many of the people we interacted with lacked insurance or a primary care team, meaning their only option was to visit shelter clinics or the Boston Medical Center emergency room."

Kareem King, Jr., research program manager at Boston University's Clinical & Translational Science Institute

King is the corresponding author of the report, "Building Power on Mass&Cass: A Community-Centered Approach to Addressing Health Resource Gaps for Persons Experiencing Homelessness in Boston, MA, 2021" published online in the American Journal of Public Health.

The report outlines the joint work of two organizations, Housing Equals Health, a health justice initiative, and We Got Us, a student-led nonprofit focused on health equity, supported by the Rapid Acceleration of Diagnostics – Underserved Populations Initiative (RADx-UP) with Duke and the National Institute of Health. BHCHP was a consultant.

This initiative started in November 2021. It was created from work that Housing=Health and other advocacy organizations had done earlier on in the pandemic to bring attention to the unique health issues unhoused people experienced. From April 1, 2022 – March 31, 2023, RADx-UP supported them to conduct outreach events on a bi-weekly basis at four rotating Boston locations chosen with guidance from community members and insight from BHCHP.

At the outreach events, persons experiencing homelessness (PEH) received COVID information, testing, and a resource kit which included a number of items provided by nonprofit and industry partners (masks, sanitizer, wipes, water, snacks, etc). In addition to this, they were asked to participate in surveys to share their experience utilizing the programs, and what they would like to see at future events. Longer interviews to discuss healthcare experiences and needs were conducted on a select group. The information was shared with BHCHP, the Boston Public Health Commission and other partners in this initiative.

"We conducted 28 outreach events, passed out 2,558 resource kits, and had over 3,000 interactions," said King. "The events showed that community support and multi-sectoral partnerships are needed to build sustainable health programs. In times of crisis, survival and basic needs come first. Our goal was to meet those needs, through the support of our institutional partners, while engaging people with stable access to vaccinations and health education to promote ongoing public health efforts."

King felt the initiative served as a model for the infrastructure and communication needed for future health emergencies.

"We were able to provide consistent public health resources to unhoused people, break accessibility barriers to COVID-19-related information, and establish a bidirectional pipeline of trusted public health messaging," the report concluded. King felt it also showed that Boston-area students could be an important resource in building and maintaining health programs.

"This program demonstrates the value and impact that community-centered approaches have in driving sustainable public health efforts," said King. Their work with unhoused populations continues.

Co-authors of the report included: Eilien Milien and Melissa Jones of We Got Us, Boston; and Terrance Mensah, MD, MPhil, and Lady Lawrence E.J. Carty, of Housing=Health.

Funding for this report was supported by the National Institutes of Health under Award Number C0437.