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1. NURS FPX 4015 Assessment 4 Caring for Special Populations
Teaching Presentation
Capella University
NURS-FPX4015
Instructor Name
Date
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NURS FPX 4015 Assessment 4

2. Caring for Special Populations: Teaching Presentation
Hello, I am (Student Name). The focus of this presentation is on addressing the special
healthcare needs of homeless and housing-insecure individuals. Homelessness continues to rise
as a critical public health concern across the United States, affecting not only individuals but also
families and entire communities. Those without stable housing face profound physical, mental,
and social challenges that compromise their overall well-being (Vineet Punia et al., 2024). To
address these disparities, nurses must develop an understanding of the unique needs, cultural
values, and barriers experienced by this vulnerable population. Through culturally competent and
equitable care, nurses can help enhance the quality of life for individuals affected by
homelessness. This assessment explores the characteristics, healthcare disparities, and nursing
practices essential to caring for homeless and housing-insecure populations.
Characteristics of Homeless and Housing-Insecure Individuals and Their Healthcare Needs
Homeless and housing-insecure individuals represent one of society’s most vulnerable groups,
defined by the absence of safe, stable, and adequate housing. Many reside in shelters, abandoned
buildings, vehicles, or temporary accommodations. As of 2025, over 771,480 people in the
United States experience homelessness on any given day (USAFacts, 2025). These individuals
face exposure to extreme weather, unsafe environments, violence, and poor nutrition, all of
which significantly heighten their risk of illness and mortality. Research indicates that this
population carries a heavy disease burden, often suffering from chronic conditions such as
diabetes, hypertension, HIV/AIDS, and respiratory illnesses (Lutchmun et al., 2022). Because of
barriers such as lack of insurance and limited access to primary care, many rely on emergency
departments as their primary healthcare resource. Additionally, mental illness and substance use
disorders are highly prevalent, with approximately one-third of homeless adults experiencing
serious mental illness and nearly half living with co-occurring substance use disorders (Mosel,
2025). The combination of poor access, limited preventive care, and social instability contributes
to increased hospitalization and reduced life expectancy—by as much as 20 to 30 years
compared to the general population (Richards & Kuhn, 2022). Addressing these challenges
requires evidence-based, trauma-informed, and culturally appropriate interventions that target
both health and social determinants.
Cultural Values and Beliefs Relevant to Healthcare
Homelessness often shapes unique cultural values and coping behaviors rooted in survival and
prior negative experiences. Individuals facing homelessness frequently value self-reliance and
independence, often avoiding medical attention until health conditions become severe (Lachaud
et al., 2024). Strong peer networks within homeless communities often serve as surrogate
families, providing mutual support and influence over decisions regarding healthcare.
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3. However, experiences of stigmatization, discrimination, and perceived mistreatment in medical
institutions foster deep mistrust toward healthcare providers. Many individuals may also use
substances as coping mechanisms for trauma, stress, or mental illness, further complicating
healthcare interactions. Understanding and respecting these cultural values is essential for nurses,
as it informs how care is offered, how trust is established, and how interventions are accepted.
Healthcare Disparities Faced by the Homeless Population
Homeless and housing-insecure populations experience disproportionate health disparities and a
higher burden of disease. Chronic illnesses such as diabetes, cardiovascular disease, and
respiratory infections are common and often poorly managed due to unstable living
environments (Volkow & Blanco, 2023). Mental health conditions—including depression,
schizophrenia, and bipolar disorder—are prevalent, frequently compounded by substance use
disorders. These challenges are intensified by systemic barriers such as lack of insurance,
transportation issues, and limited access to preventive services (Jiang et al., 2023). Consequently,
individuals are more likely to depend on emergency rooms, leading to higher rates of
hospitalization and premature mortality. Stigma within healthcare settings further discourages
engagement, perpetuating cycles of poor health and mistrust.
Strategies for Providing Culturally Competent Nursing Care
Culturally competent, trauma-informed, and evidence-based strategies can significantly reduce
disparities in care for the homeless population. Building trust is foundational—achieved through
consistent, nonjudgmental, and empathetic interactions. For instance, nurses who regularly visit
encampments or shelters with outreach teams demonstrate reliability and respect, encouraging
individuals to seek and maintain care. Mobility and flexibility in healthcare delivery are equally
vital. Programs such as street medicine initiatives and shelter-based clinics overcome logistical
barriers related to transportation and scheduling (Canham et al., 2023). Integrated care models
that combine medical, mental health, and addiction services within a single facility address co-
occurring conditions effectively and reduce the complexity of navigating fragmented systems.
Additionally, advocating for long-term policy changes—such as permanent supportive housing
programs—can address the root causes of health inequities. By aligning care approaches with the
lived experiences and values of homeless individuals, nurses promote autonomy, reduce stigma,
and improve access to essential health services.
Equitable and Inclusive Care for Homeless and Housing-Insecure Individuals
Homelessness encompasses a diverse range of individuals and families, including veterans,
youth, older adults, and people from various racial and cultural backgrounds. Causes are equally
diverse, including unemployment, poverty, domestic violence, chronic illness, and mental health
issues (Zhao, 2022). Recognizing this diversity is crucial for delivering equitable care
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4. Dignified, stigma-free communication is at the heart of equitable care—asking about immediate
needs such as food, shelter, and safety demonstrates compassion and builds trust. Inclusive care
also means meeting patients where they are—physically and socially—through outreach
programs, mobile clinics, and shelter-based services that reduce systemic barriers. These
initiatives not only improve physical health but also restore dignity, enhance self-worth, and
rebuild trust in the healthcare system.
Case Study: Applying Culturally Competent Care in a Homeless Outreach Setting
John, a 52-year-old man, has lived on the streets for seven years following job loss and untreated
depression. He suffers from type 2 diabetes and hypertension but avoids hospitals due to mistrust
and fear of stigma. A nurse participating in a mobile outreach program approaches John
respectfully, prioritizing conversation and empathy over clinical questioning. Instead of focusing
solely on his medical conditions, the nurse listens to his concerns about safety and food
insecurity. Through consistent visits, trust gradually develops, and John begins allowing basic
health checks. The nurse provides tools for blood sugar monitoring and connects him with a
shelter-based clinic offering medication and counseling. Over three months, John achieves stable
blood pressure and glucose levels and joins a support group. This case demonstrates how trauma-
informed, culturally competent care—grounded in respect, consistency, and empathy—can
overcome barriers and lead to positive health outcomes in homeless populations.
Resources for Further Learning
Several key organizations support healthcare professionals in improving services for homeless
and housing-insecure populations. The National Health Care for the Homeless Council
(NHCHC) offers comprehensive guidance, research, and policy programs that promote health
equity (National Healthcare for the Homeless Council, 2019). The Substance Abuse and Mental
Health Services Administration (SAMHSA) provides evidence-based tools and training for
integrating mental health and substance use treatment into care plans. Similarly, the Centers for
Disease Control and Prevention (CDC) supplies data, toolkits, and best practices for addressing
homelessness-related health concerns. The Street Medicine Institute also plays a vital role by
providing resources and models for delivering mobile healthcare services to unsheltered
populations. Together, these organizations equip nurses with the knowledge and frameworks
needed to deliver equitable and compassionate care.
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5. Conclusion
Homeless and housing-insecure individuals experience complex health challenges exacerbated
by social inequities, stigma, and systemic barriers. Nurses play an essential role in mitigating
these disparities through culturally competent, trauma-informed, and inclusive care. By fostering
trust, utilizing mobile outreach, and promoting interprofessional collaboration, nurses can bridge
gaps in care and empower this vulnerable population. Integrating physical, mental, and social
support within accessible, respectful frameworks not only improves health outcomes but also
restores dignity and humanity. Through advocacy, empathy, and evidence-based practice, nurses
can transform the health trajectory of homeless individuals, reaffirming the core values of equity
and compassion in nursing.
References
Canham, S. L., Donovan, M., Rose, J., Jones, S., & Garcia, I. (2023). Transportation needs and
mobility patterns of persons experiencing homelessness following shelter decentralization.
Evaluation and Program Planning, 99, 102306.
https://doi.org/10.1016/j.evalprogplan.2023.102306
Jiang, C., Yabroff, R., Deng, L., Wang, Q., Perimbeti, S., Shapiro, C. L., & Han, X. (2023).
Transportation barriers, emergency room use, and mortality risk among US adults by cancer
history. Journal of the National Cancer Institute, 115(7), 815–821.
https://doi.org/10.1093/jnci/djad050
Lachaud, J., Yusuf, A. A., Maelzer, F., Perri, M., Gogosis, E., Ziegler, C., Mejia-Lancheros, C.,
& Hwang, S. W. (2024). Social isolation and loneliness among people living with experience of
homelessness: A scoping review. BMC Public Health, 24(1). https://doi.org/10.1186/s12889-024-
19850-7
Lutchmun, W., Gach, J., Borup, C., & Froeschl, G. (2022). Chronic diseases and multi-morbidity
in persons experiencing homelessness. BMC Public Health, 22(1), 1597.
https://doi.org/10.1186/s12889-022-14023-w
Mosel, S. (2025). Substance Abuse and Homelessness: Statistics and Rehab Treatment.
American Addiction Centers. https://americanaddictioncenters.org/rehab-guide/addiction-
statistics-demographics/homeless
National Healthcare for the Homeless Council. (2019). NHCHC | Quality. Access. Justice.
Community. https://nhchc.org/
Richards, J., & Kuhn, R. (2022). Unsheltered homelessness and health: A literature review.
AJPM Focus, 2(1), 100043. https://doi.org/10.1016/j.focus.2022.100043
USAFacts. (2025). How many homeless people are in the US? https://usafacts.org/articles/how-
many-homeless-people-are-in-the-us-what-does-the-data-miss/
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