Homeless, Pregnant, and in need of Help

Homelessness Statistics

By: FaceMePLS
  • Women represent 80% of homeless adults (Liveright, 2018)
  • Homeless women have an increased risk of chronic illnesses, infectious diseases, substance abuse problems, mental illness, and being a victim of sexual and/or domestic violence
  • Homeless women are less likely to have insurance, social support, income, and access to preventative health care

Pregnant, Homeless Statistics

By: LSE Library
  • Typically younger than nonpregnant homeless women
  • 4% of the homeless population, roughly 1 in every 26 women of reproductive age (Liveright, 2018)
  • Strong history of family disruption likely
  • Higher rates of cigarette smoking
  • Lower rates of unemployment, less formal education received
  • Associated with Black and Hispanic races, those who are unmarried, uninsured, and not taking vitamin supplements prior to pregnancy
  • More likely to be an unplanned pregnancy

Pregnancy and Child Outcomes

  • Increased risk of adverse outcomes due to poor access to health care, poor nutrition, lack of housing, substance abuse, exposure to violence, high rate of infections, and co-occurring medical conditions
  • Increased risk for preterm delivery and low birth weight
  • Increased rates of acute and chronic health conditions for child after birth

In the Media

This media clip sheds light on an unfortunately all too common scenario. The pregnant, homeless population tends to fall through the cracks of and be failed by the health care system. Current research supports this, however the amount of help these women are willing to accept depends largely on their past. If a pregnant, homeless woman has been failed by the system multiple times, and has had a tougher life, the less likely it is that she will accept help. It also becomes more difficult to teach and ensure this population will understand and follow-through with care.  Those who become homeless after say losing a job, and who have had a formal education are more likely to accept help. (Amauri dos Santos et al., 2017).

The woman in this news clip became homeless late in her pregnancy after experiencing a job loss and running out of money. This woman was preparing to stay with family but their house was destroyed by Hurricane Harvey leaving her with no where to live. She stayed in shelters until hearing about a new program in her area called In My Shoes. This program provides a safe-place for the pregnant homeless population. The program provides therapy, education, and resources and allows the women to stay until their child in nine months old. Programs such as this have been popping up all over the country. Current research shows that emergency housing such as this improves birth outcomes and reduces unnecessary hospital visits (Clark et al., 2018).

This clip shows the story of a pregnant, homeless woman named Amanda. Amanda is pregnant with twins and is living on the streets of Philadelphia. She has lost five children through Department of Human Services (DHS) due to substance abuse issues and lack of stable housing. Amanda’s family wants nothing to do with her. She is now in a methadone program, and she lives off of food stamps, begging, and stealing when necessary. Amanda states she is getting assistance with getting into a Mommy and Me program. She is not unique in her situation, as current research shows many homeless, pregnant women have been turned away by their families. Roughly 35% of this population has a substance use disorder (Liveright, 2018).  Resources are limited in terms of housing accommodations and generally no social services assessment occurs until 28 weeks of pregnancy (Fordham, 2015). Healthcare providers need to advocate for this population and assist in ensuring that basic human needs are met for this population.

Massachusetts Community Resources

Women, Infant, and Children (WIC)                                                         1-800-942-1007                                                  https://www.fns.usda.gov/wic/women-infants-and-children-wic

Emergency Housing Assistance Resource                                                1-617-573-1106                                                                       https://www.mass.gov/how-to/find-emergency-family-shelter

Local House Authority Transition Housing Program (LHATHP)            1-671-573-1100                                                                 https://blog.mass.gov/blog/living-in-massachusetts/housing-resources-for-massachusetts-homeless/

Boston Health Care for Homeless Program                                            1-875-654-1000                                                                                 https://www.bhchp.org/



Amauri dos Santos, A., Amuzza Aylla Pereira dos, S., Ingrid Martins Leite, L., Clodis Maria, T., & Elainy Priscila Bezerra, F. (2017). The context of the pregnant woman in the situation of street and vulnerability: its look at the pre-natal. Journal of Nursing UFPE / Revista De Enfermagem UFPE, 11(10), 4103-4110. doi:10.5205/reuol.10712-95194-3-SM.1110sup201713

Clark, R. E., Weinreb, L., Flahive, J. M., & Seifert, R. W. (2018). Health care utilization and expenditures of homeless family members before and after emergency housing. American Journal of Public Health, 108(6), 808-814. doi:10.2105/AJPH.2018.304370

Cutts, D., Coleman, S., Black, M., Chilton, M., Cook, J., Cuba, S., & … Frank, D. (2015). Homelessness during pregnancy: a unique, time-dependent risk factor of birth outcomes. Maternal & Child Health Journal, 19(6), 1276-1283. doi:10.1007/s10995-014-1633-6

Fordham, M. (2015). The lived experience of homeless women: insights gained as a specialist practitioner. Community Practitioner, 88(4), 32-37.

Liveright, E. (2018). Prenatal care for homeless women. In V. Barss (Ed.), UpToDate. Retrieved August 22, 2018, from https://www.uptodate.com/contents/prenatal-care-for-homeless-women


What is Hypertension?

Also known as high blood pressure, hypertension is a condition in which the force of the blood against the artery walls is too high. Blood pressure is the force of blood pushing against the walls of the arteries, which carry blood from the heart to other parts of the body. Blood pressure normally rises and falls throughout the day. But if it stays high for a long time, it can damage the heart and lead to health problems. High blood pressure increases the risk for heart disease and stroke, which are leading causes of death in the United States.

Risk Factors

A number of risk factors increase the chances of having hypertension.

  • Age– Hypertension is more common in people over the age of 60 years.
  • Ethnicity– Some ethnic groups, such as African Americans are prone to hypertension.
  • Weight– Being overweight or obese is a key risk factor.
  • Alcohol & tobacco use– consuming alcohol regularly and smoking tobacco can increase a persons blood pressure.
  • Preexisting conditions– Cardiovascular disease, diabetes, chronic kidney disease and high cholesterol can lead to hypertension.

Lifestyle Changes

Hypertension can be managed through lifestyle & dietary changes.

  • Reduce the amount of salt- Average salt intake is between 9 grams and 12 grams; to help decrease the risk of hypertension, reducing intake to under 5 grams a day is recommended.
  • Moderating alcohol consumption-limiting alcohol consumption to two drinks/day for males and one drink/day for females can reduce the risk of hypertension.
  • More fruits and vegetables and less fats– avoiding saturated fats and total fat can reduce a persons risk for developing hypertension.
  • Exercise- Doctors recommend that people with hypertension or have significant risk factors for hypertension engage in 30 minutes of moderate-intensity, dynamic, aerobic exercise. This can include: walking, jogging, cycling, and swimming on 5 to 7 days of the week.
  • Stress Reduction- Avoiding stress or developing strategies for managing stress can help with blood pressure control. Avoiding the use of alcohol, drugs and tobacco to cope with stress will add to hypertensive problems. These should be avoided. Smoking can raise the blood pressure. Smoking cessation reduces the risk of hypertension, heart disease and other health issues.

Common Myths about Hypertension

High blood pressure myths vs facts

Myth: High blood pressure runs in my family. There is nothing I can do to prevent it.

Fact: High blood pressure can be hereditary. If your parents or family members have had high blood pressure, you are more likely to develop it, too.

Myth: I feel fine. I don’t have to worry about high blood pressure.

Fact: About 85 million U.S. adults have high blood pressure — and many of them don’t know it or don’t experience typical symptoms. High blood pressure is also a major risk factor for stroke. If uncontrolled, high blood pressure can lead to serious and severe health problems.

Myth: I read that wine is good for the heart, which means I can drink as much as I want.

Fact: If you drink alcohol, including red wine, do so in moderation. Heavy and regular use of alcohol can increase blood pressure dramatically. It can also cause heart failure, lead to stroke and produce irregular heartbeats.  If you drink, limit consumption to no more than two drinks per day for men and one drink per day for women. Generally, one drink equals a 12-ounce beer, a four-ounce glass of wine, 1.5 ounces of 80-proof liquor, or one ounce of hard liquor (100 proof).

Myth: I have high blood pressure and my doctor checks it for me. This means I don’t need to check it at home.

Fact: Because blood pressure can fluctuate, monitoring your blood pressure at home can provide your healthcare provider with valuable information to determine whether you really have high blood pressure and, if you do, whether your treatment plan is working.

Myth: I was diagnosed with high blood pressure, but I have been maintaining lower readings, so I can stop taking my medication.

Fact: High blood pressure can be a lifelong disease. Follow your healthcare professional’s recommendations carefully, even if it means taking medication every day for the rest of your life.



Hales, C. M., Carroll, M. D., Simon, P. A., Kuo, T., & Ogden, C. L. (2017). Hypertension Prevalence, Awareness, Treatment, and Control Among Adults Aged ≥18 Years – Los Angeles County, 1999-2006 and 2007-2014. MMWR: Morbidity & Mortality Weekly Report

Give Your Hypertension Coding a Clean Bill of Health With 7 Tips. (2018). Cardiology Coding Alert, 21(1), 3-5.


Elmore, K. E. (2016). Hypertension: Facts and Forecasts. Med-Surg Matters, 25(3), 4-7.

Childhood Vaccinations – Helpful, NOT Harmful

Children are given shots (vaccines) at a young age because this is when they are at highest risk of getting sick or dying if they get these diseases. Newborn babies are immune to some diseases because they have antibodies they get from their mothers, usually before they are born. However, this immunity lasts a

Image result for childhood vaccinations safefew months.
Most babies do not get protective antibodies against diphtheria, whooping cough, polio, tetanus, hepatitis B, or Hib from their mothers. This is why it’s important to vacci nate a child before she or he is exposed to a disease.


What is a vaccine? Why are they so important?
Vaccines are our best defense against infections that may have serious complications such as pneumonia, meningitis, cancer, and even death.

  • The Center for Disease Control and Prevention (CDC) recommends vaccinations before the age of two years to protect children against 14 infectious diseases: measles, mumps, rubella (German measles), varicella (chickenpox), hepatitis A, hepatitis B, diphtheria, tetanus, pertussis (whooping cough), Haemophilus influenza type B (Hib), polio, influenza (flu), rotavirus, and pneumococcal disease (CDC, 2015).
  • Vaccines contain weakened or killed versions of the germs that cause a disease. These elements of vaccines, and other molecules and micro-organisms that stimulate the immune system, are called “antigens.”
  • Babies are exposed to thousands of germs and other antigens in the environment from the time they are born. When a baby is born, his or her immune system is ready to respond to the many antigens in the environment and the selected antigens in vaccines.

Image result for 2018 CDC recommended immunization schedule

Vaccine Safety – Debunking the Myth

Vaccines are safe, effective and save lives (Knopf, 2017). Because vaccines are given to millions of healthy people,  including children, to prevent serious diseases, they’re held to very high safety standards.

Many parents have common misconceptions about childhood vaccinations and believe they may cause serious side effects – like autism- and choose not to vaccinate their child. Others believe there are too many recommended vaccinations compared to 20, 30 years ago. Claims that vaccines are linked to autism, or are unsafe when administered according to the recommended schedule, have been disproven by a robust body of medical literature (Knopf, 2017).

Vaccinations save thousands of lives every year and have eradicated many diseases such as the measles, mumps, and rubella. However, because parents are choosing not to vaccinate their children, these diseases are making a comeback and claiming the lives of innocent children.

Image result for childhood vaccinations safe

How are vaccines tested for safety?

Every licensed and recommended vaccine goes through years of safety testing including:

  • Testing and evaluation of the vaccine before it’s licensed by the Food and Drug Administration (FDA) and recommended for use by the CDC.
  • Monitoring the vaccine’s safety after it is recommended for infants, children, or adults

Vaccines are tested before they’re given to the public

Before a vaccine is ever available for use, it’s tested in labs and this process can take several years.  The FDA uses the information from these tests to decide whether to test the vaccine with people (Gould, 2017).

During a clinical trial, a vaccine is tested on people who volunteer to get vaccinated. Clinical trials start with 20 to 100 volunteers, but eventually include thousands of volunteers. These tests take several years and answer important questions like:

  • Is the vaccine safe?
  • What dose (amount) works best?
  • How does the immune system react to it?

Throughout the process, FDA works closely with the company producing the vaccine to evaluate the vaccine’s safety and effectiveness. All safety concerns must be addressed before FDA licenses a vaccine.

Every batch of vaccines is tested for quality and safety

Once a vaccine is approved, it continues to be tested. The company that makes the vaccine tests batches to make sure the vaccine is:

  • Potent (It works like it’s supposed to)
  • Pure (Certain ingredients used during production have been removed)
  • Sterile (It doesn’t have any outside germs)

FDA reviews the results of these tests and inspects the factories where the vaccine is made. This helps make sure the vaccines meet standards for both quality and safety.

Vaccines in the Media

In 1998, an article was published by Andrew Wakefield in the Lancet paper that stated that the MMR (measles, mumps and rubella) vaccine contained toxic substances that went into the bloodstream, traveled to the brain, and caused children to develop autism (Gould, 2017). However, Wakefield had been paid by a company with a patent pending on a rival measles vaccine as well as acted unethically and participated in slander and fear mongering for to gain profit. This discovery was too late to reverse the public’s belief that vaccinations were unsafe.

Public figures like Jenny McCarthy and the President of the United States (POTUS) Donald Trump have vocalized their opinions regarding the correlation between childhood vaccinations and autism. Political figures and celebrities have created confusion and fueled inaccurate discussion on this topic for years (Gould, 2017).

In this video clip from CNN during the Republican Presidential candidate debate, Donald Trump, states he is in favor of vaccinations, but believes the doses are too big for children. He then tells a story about a two-year-old child who was perfectly healthy prior to receiving vaccinations, but then developed autism a week after receiving vaccinations.

  • Even though evidence-based guidelines and professional recommendations have been published, the public still believes public figures and celebrities over proven data (Gould, 2017).

This video clip posted by CNN debates Jenny McCarthy’s beliefs that vaccinations cause autism. The narrator discusses how in this celebrity suffused culture, McCarthy’s claims could have a deadly impact on scaring parents away from vaccines. Jenny McCarthy is one of the first celebrities to publicly claim vaccinations cause autism after her son was diagnosed with developmental delays. In this video, she states vaccinations “triggered” her son’s autism.

Why is there an uprise in Autism today?

Prevalence of autism has changed because of advanced diagnostic fashions, changing diagnostic criteria, and more trained diagnosticians, a willingness to accept a particular diagnosis, earlier age diagnosis, and better recording systems (Taylor, 2009).  Basically, it’s a big coincidence that there are more vaccinations recommended by the CDC and the uprise in autism diagnoses. The CDC supports the Institution of Medicine’s (IOM) conclusion that there is no relationship between vaccinations and autism (Taylor, 2009).

This video clip by CNN interviews two mothers and why they chose not to vaccinate their children. One mother claims there are too many vaccinations recommended by the CDC. Another claims she does not trust the MMR vaccination because she believes her children are healthy.

Anti-vaccination believers argue that autism has been increasingly more prevalent today compared to 20 years ago, and there are more required vaccinations children need today than there were back then (Knopf, 2017). Vaccinations against infectious diseases has been advancing with the increase of available technology, which explains why there are more vaccinations required for children to receive compared to 20 years ago.

Don’t wait, vaccinate!

The CDC website provides an excellent venue for curious citizens inquiring about vaccination safety and how they work. It also has the most up to date schedule recommended for children to receive certain vaccinations. Vaccinations are safe, effective, and they protect the public from deadly diseases.




Gould, K. (2017). Vaccine safety: evidence-based research must prevail. Dimensions of Critical Care Nursing, 36(3), 145-147.

Knopf, A. (2017). Vaccines do not cause autism: Pediatricians fight back against anti-science. Brown University Child & Adolescent Behavior Letter331-2.

Taylor, B. (2006). Vaccines and the changing epidemiology of autism. Child: Care, Health & Development32(5), 511-519.



Diabetic Foot Care & Prevention


Prevention is the best way to take care of your feet! Take care of your feet, look for signs of breakdown and act fast! If there are signs of breakdown, consult your physician and find the best treatment. If you already have break down and wounds on your feet, be aware of changes such as increased redness and increased drainage, as these may be signs of infection and your physician should be notified. Here are some quick tips to prevent breakdown:

  • Check your feet every day
  • Wear the proper shoes
  • Wash your feet every day
  • Keep skin soft & smooth
  • Trim toenails when needed if you are able to
  • Wear shoes & socks at all times

See this quick video for some more quicks tips for prevention of diabetic foot ulcers:

Daily foot care for diabetics should look like this:


  • Numbness or tingling sensation
  • Skin discoloration
  • Loss of feeling
  • Blisters or other wounds without pain
  • Painful tingling

This video shows some natural remedies for diabetic foot ulcers. There are no medical studies that prove that this remedy works. Before trying natural remedies, you should always consult your doctor. Videos like these are misleading to the public because it does not describe the wounds that this may work on. This video was also concerning because the main photo when you can select this video from youtube shows two feet soaking in a bowl of water. Soaking feet in water is not recommended for patients with diabetes.

This video was the most informational for the public. The video is from a medical professional who explains his credentials prior to explaining his recommendations of wound care and breaks down terms that may be harder to understand for people without a medical education. Dr Pelto not only explains the cause of diabetic wounds, but how he would go about treating and healing diabetic wounds that are medically supported.

This video was misleading because the title says “How to Cure a Diabetic Foot Ulcer.” This is a 2 minute video that briefly describes prevention of diabetic foot ulcers and then recommends two different treatments possible for foot ulcers before recommending the patient see a medical professional.


The treatments for diabetic foot ulcers includes revascularization, management of infection with antibiotics, wound dressings and debridement, hyperbaric oxygen treatment, skin grafting and topical negative pressure therapies. Some of these words may sound like they come from another world. Revascularization? Debridement?  Grafts? Lets break it down:

  • Treatment depends on the degree of ulceration, or break down, of each of the wounds
  • Healthcare professionals will look at the depth of the wound, the amount of blood flow to the affected area, and the amount of time the patient has had the wound
  • At the beginning of the breakdown of skin, the treatment of choice may be topical creams and dressings to protect the wound and all allow the proper environment for healing. Skin substitutes have been proven to help reconstruct lost tissue and may be used as the first line of treatment
  • Treatment could include pressure relief or debridement if necessary, which means that a physician would remove the damaged tissue from the wound
  • If a wound is not healing properly and there is not proper blood flow to the wound or the wound is not being treated properly, it could result in other forms of treatment such as revascularization, skin grafting or the worst case scenario, amputation


For further questions consult these resources or call your physician’s office

American Diabetes Association

Government Resources


Gray, K., Game, F. & Pinnington, L. (2018). Encouraging reduction of activity amongst patients with diabetic foot ulcers. Wounds UK, 14(3). 34-39.

Leese, G. & Stang, D. (2011). Strategies for improving diabetic foot care: an example from Scotland. Diabetic Foot Journal, 14(4). 171-176

Tchero, H., Herlin, C., Bekara, F., Kangambega, P., Sergiu, F. & Teot, L. (2017). Failure rates of artificial dermis products in treatment of diabetic foot ulcer: a systematic review and network meta-analysis. Wound Repair and Regeneration,25(1). 691-696.

Young ,M. & Stang, D. (2018). Stay classy: the classification of diabetic foot ulcers and its relevance to management: part 1. Diabetic Foot Journal,21(1). 52-55.



Diabetes is a long-term disease that affects the body’s ability to process sugar. With careful management, people with diabetes can live long happy lives. There are many myths that surround diabetes. This blog post will attempt to debunk many of the common theories that surround diabetes.

By: Free Images
  1. All diabetes is the same-FICTION

There are four clinical categories of diabetes. These include type one diabetes, type two diabetes, gestational diabetes, and diabetes caused by other specific conditions such as genetic defects, or chemical induced diabetes (American Diabetes Association, 2014).

  1. Insulin can be dangerous-FACT

Any medication can potentially cause harm, however there are a group of drugs known as High Alert Medications (HAM) that carry a high risk of potential patient harm. HAM are broken up into four different categories: anticoagulants, sedatives, opioids, and insulins. Even when given correctly, these drugs can still cause significant harm. These drugs have a narrow therapeutic index and cause significant harm if they are given by the wrong route or a system failure happens. Several reports indicate that most insulin errors occur from human error. This includes concentration errors, distractions, and forgetfulness.

An example of a concentration error is between U-500 insulin and U-100 insulin. U-500 insulin is a form of insulin that is 5 times more potent than U-100 insulin. There are special syringes for U-500 insulin, however patients on U-500 are often taught to draw up their insulin in a tuberculin syringe. For example, a patient that that receives 150 units of U-500 would be taught to draw up 0.3ml utilizing a tuberculin syringe. However, without being familiar with this technique, 30 units of insulin could mistakenly be drawn up if they just notice the 0.3ml. They could even attempt to give 150 units of U-500 utilizing U-100 syringes (Anderson & Townsend, 2010).

  1. Consuming too much sugar leads to diabetes-FICTION

By: EllyFilho

Patients with type one diabetes develop the disease due to destruction of cells of the pancreas, nothing to do with sugar consumption. Type two diabetes is due to the body being unable to respond to insulin. Type two diabetes can develop due to weight gain, which many link to over-consumption of sugar, however there is no direct link to sugar consumption and development of type 2 diabetes (Singh, 2014).

  1. Diabetics can take insulin pills to manage their blood sugar so they do not need to inject insulin-FICTION

While all patients with type one diabetes need to take insulin, those with type two diabetes may not necessarily require insulin. However, there are no oral forms of insulin. If insulin was given orally, it would be destroyed by the digestive enzymes in the body. These pills can help type two diabetics make more insulin or use the insulin they have more efficiently. These pills do not work for type one diabetics because their bodies no longer make insulin (Singh, 2014).


American Diabetes Association. (2014). Standards of medical care in diabetes. Diabetes care, 37(1), 14-80.

Anderson, B. P., & Townsend, T. (2010). Medication errors. American Nurse Today, 10(5), 23-27.

Singh, M. (2014). Myths about Diabetes among Adolescents and Their Parents. J Child Adolesc Behav, 2(4), 1-3.