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Barriers to Medical Care for Homeless Families Compared With Housed Poor Families
David Wood, MD, MPH;
R. Burciaga Valdez, PhD, MHSA
Am J Dis Child. 1991;145(10):1109-1115.
Abstract
• To evaluate health access and health services utilization of homeless families we selected a systematic sample of 194 homeless families from 10 shelters in Los Angeles and 196 housed poor families from the same geographic regions of Los Angeles selected from welfare offices. Both samples relied primarily on Medicaid for their health insurance (61% and 96%). However, more homeless families than housed poor families were currently uninsured (26% vs 2%), had lost health insurance over the past year (50% vs 21%), and had spent a greater percentage of the past year uncovered by health insurance (22% vs 6%). Homeless families were much less likely to report a regular provider for preventive care (81% vs 94%) or for sick care (72% vs 95%). Moreover, of those reporting a regular provider, homeless families were more likely than housed poor families to use emergency departments or clinics rather than private offices for both preventive care (35% vs 15%) and sick care (37% vs 26%). Barriers to health care more frequently prevented homeless families from obtaining care (38% vs 28%). These findings suggest that homeless families have greater problems of access to health care than other poor families, related to lack of insurance, lack of a regular primary care provider, and other barriers. Programs to address these barriers for homeless families are presented.
(AJDC. 1991;145:1109-1115)
Author Affiliations
From the RAND/UCLA Center for Health Policy Study; the Department of Pediatrics, Cedars-Sinai Medical Center; and the Department of Health Services, University of California, Los Angeles.
Footnotes
Accepted for publication June 24, 1991.
The opinions and conclusions expressed herein are solely those of the authors and should not be construed as representing the policies or opinions of The RAND Corp, Cedars-Sinai Medical Center, or the University of California.
Reprint requests to Department of Pediatrics, Room 4428, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048 (Dr Wood).
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