At A Glance
When people have one place to coordinate care for their health problems, they have better health outcomes and health care costs are reduced. With that in mind, The Wellness Coalition took steps to offer homeless people in Montgomery, Alabama, increased access to community health workers (CHWs) at the coalition’s Friendship Mission West and North homeless shelters. During 2015–2016, the nonprofit trained four CHWs, who linked 170 homeless people to primary care, free or low-cost medicines, and education on self-managing chronic diseases.
Public Health Challenge
About 1,733 homeless people, including women and children, visited shelters across Montgomery at least one night during 2015–2016. Another 144 were living on the streets, according to the Mid-Alabama Coalition for the Homeless. Being homeless can lead to serious health problems because of lack of proper nutrition, shelter, financial resources, and basic self-care skills. The Centers for Disease Control and Prevention (CDC) notes that homeless people are more likely to develop infectious diseases and chronic illnesses than the general population. Problems can include tuberculosis, HIV/AIDS, heart and lung disease, diabetes, poor mental health, and addiction. Homeless people often turn to the emergency room (ER) for medical needs because ERs do not require upfront payment. Lack of health insurance and an inability to pay medical bills contributes to rising national health care costs.
The Wellness Coalition in Montgomery set up CHW training in 2011 to reduce the use of ERs for routine medical problems and to link local residents in need with primary care and referrals to community resources. With funding from CDC, the nonprofit expanded the program in 2015 and trained four CHWs at Friendship Mission West and North homeless shelters. CHWs learned how to help people living in the shelters set up and get to appointments with primary care doctors, get free or low-cost medicines, enroll in health insurance, and keep their chronic conditions under control.