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. 2020 Jul 23;37(3):418-423.
doi: 10.1093/fampra/cmz085.

Clinical management of Type II Diabetes among the unstably housed: a qualitative study of primary care physicians

Mariana L Henry  1 , Judith H Lichtman  1 , Kendra Hanlon  2 , Danya E Keene  2
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Clinical management of Type II Diabetes among the unstably housed: a qualitative study of primary care physicians

Mariana L Henry et al. Fam Pract. .

Abstract

Background: Housing is a growing challenge for US adults in an increasingly unaffordable housing market. These housing challenges can create barriers to effective management and control of Type II Diabetes. However, little is known about how housing challenges are perceived and navigated by clinicians who care for patients with Type II Diabetes.

Objective: To examine how primary care clinicians perceive and navigate their patients' housing challenges in the context of Type II Diabetes management.

Methods: We conducted semi-structured interviews with 18 primary care clinicians practising in four clinical settings in New Haven, Connecticut. Two investigators systematically coded the interviews. Analysis of coded data was used to determine themes.

Results: Participants considered housing as significant to their patients' health and a potential barrier to optimal diabetes management. Participants sought to improve their patients' housing through advocacy, referrals and interdisciplinary collaborations. They also adjusted clinical decisions to adapt to patients' housing challenges. In making clinical adjustments, participants struggled to find a balance between what they perceived to be feasible for unstably housed patients and maintaining a standard of care. Some participants navigated this balanced by employing creative strategies and individualized care.

Conclusion: In highlighting the challenges that clinicians face in maintaining a standard of care for unstably housed diabetes patients, our findings speak to the need for more guidance, resources and support to address housing in a clinical setting.

Keywords: diabetes; housing; medical education; physicians; primary care; vulnerable populations.

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References

    1. Tilburg WC. Policy approaches to improving housing and health. J Law Med Ethics 2017; 45(1_suppl): 90–3. - PubMed
    1. Benfer EA, Gold AE. There’s no place like home: reshaping community interventions and policies to eliminate environmental hazards and improve population health for low-income and minority communities. Harvard Law Policy Rev 2017; 11.
    1. Burgard SA, Seefeldt KS, Zelner S. Housing instability and health: findings from the Michigan Recession and Recovery Study. Soc Sci Med 2012; 75: 2215–24. - PubMed
    1. Pollack CE, Griffin BA, Lynch J. Housing affordability and health among homeowners and renters. Am J Prev Med 2010; 39: 515–21. - PubMed
    1. Newman SJ, Holupka CS. Housing affordability and child well-being. Housing Pol Debate 2014; 25(1): 116–51.

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