Objective:

The Zone7 Beyond Health project sought to improve the health outcomes of individuals experiencing homelessness in downtown Phoenix by leveraging Zeihan Prohealth’s expertise in community navigation. The primary goal was to enhance access to health screenings and supportive services through effective trust-building and navigation strategies.

Solution:

Zeihan Prohealth contributed to the initiative by:

• Health Navigation and Community Engagement:
  • Utilizing its experience to serve as navigators, building connections and trust with individuals experiencing homelessness.
  • Conducting personalized outreach and support to facilitate access to health resources and services.
• Comprehensive Health Screenings:
  • Collaborating with Zone7 Beyond Health to provide on-site health screenings, including assessments for chronic conditions and general wellness checks.
• Mobile Health Units:
  • Deploying mobile health units to offer health services directly to the homeless population, ensuring accessibility without requiring transportation to traditional healthcare facilities.
• Resource Coordination:
  • Facilitating referrals to primary care services, mental health support, and social services to address a broad range of needs.

Outcome:

The Zone7 Beyond Health initiative achieved the following:

1. Enhanced Health Services Access:
   • Provided critical health screenings directly to individuals experiencing homelessness, improving access to essential services.
2. Effective Navigation:
   • Built trust and rapport with the homeless community, aiding in the effective navigation of health services and resources.
3. Increased Participation:
   • Engaged a significant number of participants through tailored outreach, leading to comprehensive health assessments and interventions.
4. Improved Resource Connections:
   • Successfully connected individuals to a network of resources, addressing both health and social needs.
5. Valuable Data Insights:
   • Collected and analyzed data to inform future outreach strategies and improve service delivery.

Impact:

The initiative had a profound impact on the homeless community:

1. Improved Health Outcomes:
   • Enhanced early detection and management of health conditions among the homeless population.
2. Strengthened Community Trust:
   • Fostered positive relationships with the community, leading to more effective engagement and support.
3. Integrated Support Network:
   • Created a holistic support network by connecting individuals to a range of services beyond immediate healthcare.
4. Guided Public Health Strategies:
   • Provided insights into the specific health needs of the homeless population, guiding targeted public health interventions.
5. Scalable Outreach Model:
   • Developed a model for effective health outreach and navigation that can be applied in other urban settings.

Research Component:

Background: Homelessness significantly impacts overall health, with increased morbidity and mortality linked to cardiovascular disease (CVD) due to risk factors such as smoking, diabetes, and hypertension.

Objectives:

• Primary Objective: Measure CVD risk factors, including blood pressure, cholesterol levels, diabetes, and smoking, in individuals experiencing homelessness and compare these metrics to normative values from the housed population.
• Secondary Objective: Assess future CVD risk using validated risk score models in the homeless population.

Methods:

• Study Design: Prospective cohort study with participants from Phoenix, Arizona.
• Data Collection: Lipids and glucose levels were obtained via fingerstick blood samples. Measurements included blood pressure, BMI, and mean upper arm circumference (MUAC). A survey collected demographic data, cardiac history, smoking status, and medication use.
• Risk Assessment: Data were analyzed using the Framingham Risk Score for Hard Coronary Heart Disease and the ASCVD 2013 Risk Calculator. Comparisons were made to NHANES 2017-2020 population data using a one-sample t-test (two-sided).

Results:

• Participants: 150 individuals, primarily male (63%), 45 years or older (64%), and current smokers (76%).
• Diabetes: Higher self-reported rates (23%) compared to the housed population (10%).
• Cholesterol Levels: Significantly lower total, HDL, and LDL cholesterol compared to the housed population (p < 0.005).
• BMI and Measurements: Similar BMI, but higher MUAC and systolic/diastolic blood pressure (p < 0.005).
• Risk Scores: Framingham risk scores for 10-year heart attack or coronary death were similar to the general population; ASCVD risk score trended higher.

Conclusions: The study highlighted elevated CVD risk factors among the homeless population, including higher rates of diabetes, hypertension, low HDL cholesterol, and smoking. While hyperlipidemia was not prevalent, the findings underscore the need for interventions targeting modifiable behaviors and chronic disease management to reduce CVD risk.