Homelessness puts individuals at greater risk of certain health issues. Since individuals experiencing homelessness are not sheltered from the elements and may not have reliable access to nutritious food and fresh running water, some conditions are more likely to develop. The lack of safe and comfortable bedding, seating, and shelter also puts individuals at greater risk for injuries. On top of this, limited access to health insurance, makes caring for this population more difficult, as well.

While every individual experiencing homelessness is different, here at Street Medicine Detroit we know it’s important to understand important issues that disproportionately impact our population. This information helps us approach patients with compassion and screen for high risk conditions. Here we’ve listed six of the most common concerns we encounter when on a street run.

Mental Health and Substance Use Disorders

A large portion of the homeless population suffers from mental health conditions. In many cases, individuals become homeless after being released from hospitals or jails without any support or assistance for mental health conditions. Substance abuse among the homeless is a multi-faceted problem. Some individuals become homeless after battling with substance abuse issues, while others develop substance use disorders as a way to cope with chronic pain or the stress of homelessness.

During flu season, Street Medicine Detroit provides flu shots to protect our patients from viral infections

Infectious Diseases

Poor nutrition and compromised immune systems, as well as exposure to many people every day, put individuals experiencing homeless at risk of contracting infectious diseases. Activities more common among the homeless population, such as intravenous drug use and unprotected sex also put these individuals at greater risk for certain illnesses and conditions. Without access to antibiotics or a sterile environment for recovery, these diseases also worsen quicker than in a traditional patient.

Skin and Foot Conditions

Showering and moisturizing the skin regularly is difficult for those without homes; this makes individuals experiencing homeless more susceptible to develop skin conditions. In addition, walking many miles on a typical day, often in worn shoes, puts the homeless population at greater risk for developing foot problems. Furthermore, exposure to moisture in wet seasons intensifies these skin and foot complications.

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Dental Problems

Many individuals experiencing homelessness do not have access to running water and dental hygiene supplies, such as toothbrushes, toothpaste, and floss. This makes regular tooth care difficult, so tooth decay and gum disease are common among homeless. Inadequate access to proper nutrition also has a negative impact on dental health.

Assault and Violence

Individuals experiencing homelessness are often targets of violence. Without shelter to protect against crimes of violence, this population is vulnerable than an individual with housing. Men are much more likely to be attacked and women are often subjected to sexual assault. Lack of health insurance and financial resources also makes these attacks more likely to go untreated and develop into an infection or disability.

Unintentional Injuries

Individuals experiencing homelessness are more often struck by motor vehicles and suffer falls that go untreated more frequently than individuals with homes. Individuals may also suffer burns while trying to stay warm or become injured due to extreme conditions. Severe sunburn or frostbite is more likely to occur because homeless people have limited ways to shield themselves from the elements.

Street Medicine Detroit helps combat some of the health concerns disproportionately impacting the homeless population in the city. After receiving treatment and connecting with primary care physicians, patients have improved quality of life and are better prepared to focus on housing and employment.

Amanda Flowers draws on her studies in Psychology, English Literature, and Public Health to create online content that addresses human needs in a simple way. Flowers is currently a freelance health blogger and writer for Blue Cross Blue Shield of North Carolina.

In the heart of Midtown at the corner of Woodward Avenue and Alexandrine Street lays Midtown Rx Pharmacy. Midtown Rx Pharmacy opened in January of 2016 as Midtown’s newest pharmaceuticals store. Though definitely not the first pharmacy in the area (the business is merely a few blocks from much larger competitors like CVS and Rite Aid), Midtown Rx Pharmacy chose its location in the center of Midtown with a very specific purpose: to provide more personal care. Mike Srour, Pharm.D., is the owner and operating pharmacist of the business; we sat down with Mike to learn more about his mission.

Mike Srour, Pharm.D., owner and operating pharmacist of Midtown Rx Pharmacy, prioritizes affordability

Srour had previously worked for a larger chain corporation with a familiar name and a steady customer influx. However, he felt one-on-one time with his patients often took a backseat to enhance speed of delivery and numbers of prescriptions filled. Srour decided to leave his pharmaceutical job at this larger company in an affluent neighborhood to instead set off on his own in the city of Detroit.

Almost immediately after beginning his business in Midtown, Srour noticed significant differences in his patient demographic. He found that many of his new customers in Detroit often didn’t know which prescriptions they were taking. Formerly, at the suburban pharmacy, most patients understood what each of their drugs were meant for and which drugs could or could not be taken together. In Midtown, Srour discovered that far more of his patients did not have a primary care physician or even insurance and could only describe their maintenance prescriptions as “the red pills.” He also encountered more patients experiencing homelessness than he had previously, many of whom were unsure of how to even administer their own medications.

Srour has recognized, however, that his new position as owner and operator of his own pharmacy affords him the opportunity to prioritize patient education and affordable care. Dedicated to these principles, he works six days a week and provides free home deliveries. On top of this, Srour finds time to sit down with his patients and explain to them what prescriptions they are taking. He employs medication therapy management to help his patients stay on track of all the medications they need. These business practices represent a change in approach from the larger corporate chain that formerly employed Mr. Srour.

Competing with larger corporate chains has not been without its share of difficulties. As a private owner, reimbursements go down, and thus volume must go up. The location of the pharmacy has also proven challenging at times: individuals come in with fake scripts looking for narcotics, and Srour even experienced a break-in earlier this month. However, despite these obstacles, Mike Srour has found a distinct need for affordable pharmaceuticals, and he strives to provide the most personal care he can to his patients.

After recognizing the need for pharmaceuticals here in Detroit, Srour began working with Street Medicine Detroit to help provide our patients with appropriate medications. “Sometimes homeless people will stop taking their maintenance medication because it’s the last thing on their minds of stuff to worry about,” he noted. Srour will often personally deliver the pharmaceuticals to the shelter to make sure everyone is taken care of and fully educated on what their prescription entails.

Though it was difficult to build a patient base in the Midtown area (with several other competing pharmacies nearby, as well as pharmacies operating within the hospitals themselves), Srour has found a loyal following in the area, in part due to his philanthropic nature. Apart from assisting Street Medicine Detroit, Srour works with uninsured individuals on a case-by-case basis to see if he can provide the most cost-effective option for people to acquire their medications. Though he can’t provide a free pharmacy, he works hard to make medication affordable for those who are struggling and focuses heavily on educating all his patients regarding the details of their pharmaceutical regiment.

We asked Mike Srour what made him leave his comfortable suburban corporate pharmacy, open a pharmacy in Midtown Detroit, and take on the challenge of serving a much more impoverished community. “I wanted to do something different. I didn’t just do it for the money; I wanted to have a more direct contact with my patients. There’s a huge difference in the way that you can treat patients when you run things yourself. You can spend that extra time and explain things to them in a way that they will understand,” he said. This quote captures the selfless drive that motivates Srour to help Street Medicine Detroit serve our patients, and more importantly, empower the people of Detroit to improve their health.

Midtown Rx Pharmacy is open Sunday through Monday and is located at 4100 Woodward Avenue, Detroit, MI 48201

Kristy Abraham, MSI, SMD Communications Coordinator

Six Health Concerns That Disproportionately Impact Individuals Experiencing Homelessness

Midtown Rx Pharmacy: Affordable Pharmaceuticals in Midtown