"Step Up for Foot Care": Addressing Podiatric Care Needs in a Sample Homeless Population

J Am Podiatr Med Assoc. 2014 May;104(3):269-76. doi: 10.7547/0003-0538-104.3.269.


Background: Studies have shown that lower-extremity problems in the homeless population have significant public health and economic implications. A combined community service and research project was performed to identify and address the foot and ankle care needs in a sample homeless population in San Francisco, California.

Methods: A 37-question survey regarding general demographic characteristics, foot hygiene practices, associated risk factors, and self-reported lower-extremity pathologic conditions was completed by 299 homeless individuals who met the inclusion criteria. The service project included education on proper foot care and the distribution of footwear.

Results: The participants demonstrated mostly good efforts regarding foot hygiene but had high-risk factors, including smoking, alcohol use, and extended hours on their feet. More than half of the homeless individuals surveyed experienced foot pain. Approximately one in five had edema and neuropathic symptoms. The most commonly reported foot problems were dermatologic, but these conditions could pose serious sequelae in the setting of risk factors. The community service project was well received by the homeless community.

Conclusions: This study demonstrates lack of resources and high-risk factors for lower-extremity complications in the homeless individuals studied. It is important in the realm of public health to keep lower-extremity health in mind because it plays an important role in preventing the spread of infection and lowering the social economic burden.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • California
  • Community Health Services / organization & administration
  • Cross-Sectional Studies
  • Female
  • Foot Diseases / diagnosis
  • Foot Diseases / epidemiology
  • Foot Diseases / therapy*
  • Homeless Persons / statistics & numerical data*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Needs Assessment
  • Podiatry / methods
  • Public Health
  • Risk Assessment
  • Self Report*
  • Skin Care / methods*
  • Surveys and Questionnaires*