Date

12-16-2025

Department

School of Health Sciences

Degree

Doctor of Philosophy in Health Sciences (PhD)

Chair

Orchid George

Keywords

homelessness, unhoused populations, street medicine

Disciplines

Medicine and Health Sciences

Abstract

The purpose of this phenomenological study was to understand the problem of poor health among unhoused populations based on the perspectives of outreach workers and shelter staff. This study was conducted in Monroe County, Indiana. The theory guiding this study was social ecological theory by Urie Bronfenbrenner. Social ecological theory was used to understand how social ecological layers impact poor health in unhoused populations. Hermeneutic phenomenology was used with purposive maximum variation sampling to gather seven study participants with lived experience of working with unhoused populations. Data collection included one-on-one interviews, observation, and documentation review. After data collection was completed, thematic analysis was conducted by manual coding to reveal emerging themes based on the experiences of outreach workers and shelter staff. Data collection through one-on-one interviews revealed eight themes including systemic barriers and gaps, relational care, capacity, complexity of health needs, survival focused, co-occurring conditions, vulnerability, and access and environment. Observation demonstrated the impact of social determinants of health and continuity of care in addressing poor health in unhoused populations. Documentation review emphasized systemic inequities that contribute to poor health in unhoused populations. Age disparities were identified during documentation review of unhoused populations receiving services in Monroe County, Indiana.

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