Homelessness and Health

Homelessness and Health

In 2020, we launched a community-academic partnership with LTHC Homeless Services and a growing network of local organizations to understand and address the health disparities facing people experiencing homelessness in Indiana. What began as an urgent response to COVID-19 has grown into a sustained, multidisciplinary research program guided by the priorities of the community itself. Our work spans pandemic response, women’s health, menstrual equity, cervical cancer screening, and infectious disease prevention — all grounded in community-based participatory research methods and a commitment to centering the voices of people with lived experience of homelessness. This partnership has generated a robust evidence base, trained community health workers, and informed local and state policy.

Projects

Pandemic Response and Infectious Disease Preparedness in Homeless Shelters

The COVID-19 pandemic highlighted and exacerbated health disparities among people experiencing homelessness. Among some were access to healthcare and accurate health information, health literacy, and mistrust. Community health workers have close relationships with the communities they serve.

We developed a CHW-led COVID education program within a homeless shelter in Indiana. We’re examining the impact of this program on COVID knowledge and willingness to be vaccinated and tested for COVID. We’re also examining the impact of rapid testing in this shelter on its operations and guests. What we learn can inform infectious disease preparedness efforts.

Addressing Cervical Cancer Disparities Among People Experiencing Homelessness

People experiencing homelessness are up to 4 times more likely to be diagnosed with or to die from cervical cancer than housed individuals. Yet, cervical cancer screening strategies in homeless communities are scarce.

We’re exploring if HPV self-sampling — in a shelter and delivered by a community health worker — is a good strategy. People experiencing homelessness are sharing their thoughts and experiences with us. With this, we will co-design cervical cancer screening strategies in homeless shelters in Lafayette and Indianapolis.

Ziolkowski, R. A., Balian, L., Sridhar, S., & Rodriguez, N. M. (2024). Improving uptake of COVID-19 testing and vaccination in a homeless population: mixed-methods evaluation of community health worker-led education in a shelter. BMJ open, 14(12), e087134. https://doi.org/10.1136/bmjopen-2024-087134

Rodriguez, N.M., Ziolkowski, R., Hicks, J., Dearing, M., Layton, J., Balser, A., … Loomis, G. (2024). Infectious Disease Preparedness for Homeless Populations: Recommendations from a Community–Academic Partnership. Progress in Community Health Partnerships: Research, Education, and Action 18(1), 113-119. https://dx.doi.org/10.1353/cpr.2024.a922335.

Rodriguez, N. M., Martinez, R. G., Ziolkowski, R., Tolliver, C., Young, H., & Ruiz, Y. (2022). “COVID knocked me straight into the dirt”: perspectives from people experiencing homelessness on the impacts of the COVID-19 pandemic. BMC public health, 22(1), 1327. https://doi.org/10.1186/s12889-022-13748-y

Rodriguez, N. M., Cromer, R., Martinez, R. G., & Ruiz, Y. (2022). Impact of COVID-19 on People Experiencing Homelessness: A Call for Critical Accountability. American journal of public health, 112(6), 828–831. https://doi.org/10.2105/AJPH.2022.306768

Rodriguez, N. M., Lahey, A. M., MacNeill, J. J., Martinez, R. G., Teo, N. E., & Ruiz, Y. (2021). Homelessness during COVID-19: challenges, responses, and lessons learned from homeless service providers in Tippecanoe County, Indiana. BMC public health, 21(1), 1657. https://doi.org/10.1186/s12889-021-11687-8