WMJ Vol 124 Issue 1: Exploring Health Care Barriers for the Unhoused: Insights from a Rural Midwestern Community
ABSTRACT
Introduction: People experiencing homelessness are more likely than the general population to have chronic health conditions and often encounter significant barriers to health care access. Many of these barriers can be affected by community-based factors, such as availability of reliable transportation, past experiences with health care systems, and community attitudes toward the unhoused population. This project aims to assess the needs and barriers to health care identified by people experiencing homelessness in a rural Midwestern city.
Methods: The survey used was adapted from a survey previously conducted to assess the needs of the homeless population in Milwaukee, Wisconsin. Surveys were distributed during outreach around the city of Wausau, Wisconsin. Data were transcribed and reviewed, and descriptive statistics were calculated.
Results: A total of 45 surveys were completed. Most participants identified as White, non-Hispanic males (n = 24, 53%) and were 46 to 55 years old (n = 14, 31%). Barriers to health care included lack of housing, cost, transportation, lack of a mailing address, inadequate hours, and disrespectful care. Eighty-six percent of participants (n = 38) reported having a mental health diagnosis, yet only 27% (n = 12) stated that they see a mental health professional.
Conclusions: Individuals experiencing homelessness in a rural community have broad and complex barriers to accessing health care. Given limited resources in smaller communities, innovative and holistic solutions should be considered when aiming to make care more equitable.
Intended Audience
The intended audience for this continuing education activity is healthcare professionals caring for the people of Wisconsin and beyond.
Learning Objectives
As a result of participating in this journal-based activity, healthcare team members will be able to:
- Describe the unique health care access barriers faced by individuals experiencing homelessness in rural communities.
- Interpret survey findings from a rural Wisconsin community regarding the prevalence of mental health diagnoses, substance use, and underutilization of health services despite existing insurance coverage.
- Discuss providing care to unhoused individuals in the learner practice and strategies for improving health care access for this population.
FACULTY DISCLOSURE
It is the policy of the University of Wisconsin–Madison Interprofessional Continuing Education Partnership (ICEP) to identify, mitigate and disclose all relevant financial relationships with ineligible companies* held by the speakers/presenters, authors, planners, and other persons who may influence the content of this accredited continuing education (CE). In addition, speakers, presenters and authors must disclose any planned discussion of unlabeled/unapproved uses of drugs or devices during their presentation.
For this accredited continuing education activity all relevant financial relationships have been mitigated and detailed disclosures are listed below.
| Name of Individual | Individual's Role in Activity | Financial Relationship Disclosure | Discussion of Unlabeled/Unapproved Uses of Drugs/Devices |
| Marianna Shershneva, MD, PhD | Accreditation Specialist | No relevant relationships with ineligible companies to disclose | No |
| James Eberhard, MFA | Accreditation Specialist | No relevant relationships with ineligible companies to disclose | No |
| Reilly Anne Coombs MS | Author | No relevant relationships with ineligible companies to disclose | No |
| Payton Jorgenson, BS | Author | No relevant relationships with ineligible companies to disclose | No |
| Corina Norrbom, MD | Author | No relevant relationships with ineligible companies to disclose | No |
| Amy Prunuske, PhD | Author | No relevant relationships with ineligible companies to disclose | No |
| Maria C Mora Pinzon, MD | Reviewer | No relevant relationships with ineligible companies to disclose | No |
| Lisa Quinn-Lee, PhD, MSSW, LICSW | Reviewer | No relevant relationships with ineligible companies to disclose | No |
| Fahad Aziz, MD | Editor | No relevant relationships with ineligible companies to disclose | No |
| Katie Gillespie, DNP, RN, CPH, FAAN | Reviewer | No relevant relationships with ineligible companies to disclose | No |
| Jessica Leiberg, DNP, ACNP | Reviewer | No relevant relationships with ineligible companies to disclose | No |
| David Dwyer, PhD, RN, NEBC | Reviewer | No relevant relationships with ineligible companies to disclose | No |
*Ineligible companies are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on, patients. The ACCME does not consider providers of clinical services directly to patients to be ineligible companies.
Accreditation and Credit Designation Statements
Accreditation Logos | Accreditation Statements |
![]() | In support of improving patient care, this activity has been planned and implemented by the University of Wisconsin–Madison ICEP and the Wisconsin Medical Journal. The University of Wisconsin–Madison ICEP is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. |
Credit Designation Statements | |
American Medical Association (AMA) The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 0.75 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. | |
American Nurses Credentialing Center (ANCC) The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 0.75 ANCC contact hour. | |
![]() | American Academy of Physician Assistants (AAPA) The University of Wisconsin–Madison ICEP has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 0.75 AAPA Category 1 CME credits. Approval is valid until 03/09/2027. PAs should only claim credit commensurate with the extent of their participation. |
Continuing Education Units The University of Wisconsin–Madison ICEP, as a member of the University Professional & Continuing Education Association (UPCEA), authorizes this program for 0.75 continuing education units (CEUs) or 0.075 hours. | |
Available Credit
- 0.75 AAPA Category 1 CME
- 0.75 AMA PRA Category 1 Credit™
- 0.75 ANCC Contact Hours
- 0.75 University of Wisconsin–Madison Continuing Education Hours
- 0.75 Approved for AMA PRA Category 1 Credit™
Accessibility
If you need anything to participate in this program, please contact [email protected].
Required Hardware/software
Free, current version of Chrome, Firefox, Safari, or Edge. Some older browsers and Microsoft Internet Explorer could produce error messages or not display the content correctly.
Free, current version of Adobe Acrobat Reader or other .pdf reader.

Facebook
X
LinkedIn
Forward
