Women of Skid Row

- Introduction -

Women experiencing homelessness have compounding healthcare needs that are largely unmet by existing healthcare systems – a problem made progressively worse by the increasing numbers of these women living in Los Angeles’ Downtown Skid Row Community (a 55-square block area in Los Angeles’ Central City East).

Since 2013, the number of women experiencing homelessness has increased by 55% in Los Angeles County.

The Downtown Women’s Center, in partnership with the University of Southern California Suzanne Dworak-Peck School of Social Work, L.A. Health Care Plan, Los Angeles Central Providers Collaborative, United Homeless Healthcare Partners, and Wesley Health Centers, formed a steering committee that would focus on improving the health of women living and receiving services in the Skid Row Community of Los Angeles, California. This effort was supported by the Robert Wood Johnson Foundation’s Spreading Community Accelerators through Learning and Evaluation, or SCALE Initiative, which is part of the 100 Million Healthier Lives Campaign, and is a project of the Institute for Healthcare Improvement (IHI).

As a Pacesetter Community, the steering committee in Los Angeles looked at a growing need to improve health outcomes of women experiencing homelessness in the Skid Row Community; particularly those at risk for or living with chronic diseases such as diabetes. Three women with lived experience of homelessness, one of whom is diabetic, served as key members of the SCALE steering committee.

Having a better understanding of the barriers to diabetes treatment for this population, the steering committee executed a 12-month direct service diabetes intervention program, Women for Wellness, as well as a collaborative of 14 partners forming the Skid Row Diabetes Learning Collaborative.

Being part of an initiative that involves consumers in the actual planning process, was an invaluable experience!
I learned that consumers bring amazing ideas that we as program planners may not have considered. Enlisting the participation of consumers in project planning is critical to the success of any initiative.
SCALE not only enables disparate stakeholders to convene, but it also helps them develop mutual understanding while working on issues of shared importance.
SCALE taught me that relationships and trust are critically important, especially when working with others on difficult issues; the challenge may be insurmountable, but the company you are with can make it palatable.

- SCALE Steering Committee Members

Health Equity

The Centers for Disease Control and Prevention notes that, “health equity is achieved when every person has the opportunity to ‘attain his or her full health potential’ and no one is ‘disadvantaged from achieving this potential because of social position or other socially determined circumstances.’” As health inequities lead to shorter life spans, complex health concerns, and reduced access to health care, the steering committee made decisions with, not for, community members with lived experience. 

In order to improve health outcomes for the Skid Row Community, partners had to learn about the barriers to care and, more importantly, the benefits of flexible, patient-centered approaches to overall service delivery.

As a core strategy to achieving health equity in our local community, community partners that work outside the homeless healthcare setting were invited to collaborate in new and innovative ways.