Diabetes in homeless persons: Barriers and enablers to health as perceived by patients, Medical, and Social service providers

Nancy C. Elder, Matthew R. Tubb

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

The ways homelessness and diabetes affect each other is not well known. The authors sought to understand barriers and enablers to health for homeless people with diabetes as perceived by homeless persons and providers. The authors performed semistructured interviews with a sample of participants (seven homeless persons, six social service providers, and five medical providers) in an urban Midwest community. Data analysis was performed with the qualitative editing method. Participants described external factors (chaotic lifestyle, diet/food availability, access to care, and medications) and internal factors (competing demands, substance abuse, stress) that directly affect health. Social service providers were seen as peripheral to diabetes care, although all saw their primary functions as valuable. These factors and relationships are appropriately modeled in a complex adaptive chronic care model, where the framework is bottom up and stresses adaptability, self-organization, and empowerment. Adapting the care of homeless persons with diabetes to include involvement of patients and medical and social service providers must be emergent and responsive to changing needs.

Original languageEnglish (US)
Pages (from-to)220-231
Number of pages12
JournalSocial Work in Public Health
Volume29
Issue number3
DOIs
StatePublished - Apr 16 2014
Externally publishedYes

Keywords

  • Homelessness
  • complex adaptive systems
  • diabetes

ASJC Scopus subject areas

  • Health(social science)
  • Health Policy
  • Public Health, Environmental and Occupational Health

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