Why would a physician give a homeless woman a pedicure? “For women with severe mental illness, taking their blood pressure in the usual way is scary for them. We discovered that clipping their toenails and giving them a foot massage would unlock the mistrust,” said Roseanna Means, M.D.
Help for the homeless is primarily geared to men, Means said. Women experiencing homelessness, however, have very different needs, especially if they have children. To address those needs, Means started Women of Means, a network of volunteer physicians who provide free medical care to about 2,500 homeless women in the Boston area each year.
Raised by a single mother and a survivor of domestic violence, cancer, divorce and the death of a child, Means has dedicated her life to helping other women overcome challenges. She spends about 80 hours each week providing care or coordinating thousands of health care visits made by her volunteer colleagues.
She and her colleagues have provided all levels of care, from serving a cup of coffee to accompanying a woman to the hospital for cancer surgery. She has hundreds of success stories to tell—women who now have jobs and homes and have reconnected with their families, thanks in part to the resolution of their medical issues and to the emotional support provided by Women of Means.
Many of these patients suffer from chronic conditions, such as diabetes and hypertension, and from psychiatric conditions that may worsen if their physical health deteriorates. Every patient—regardless of their housing status—needs to have a primary care doctor and access to primary care services, Means said. “Our goal is to provide these women with a ‘medical home without walls’ and focused clinical case management.”
That is, indeed, what she and her colleagues do: Women of Means does not have its own clinic, but provides free medical care at homeless shelters in the Boston area.
For her courage and commitment to creating a model of care that treats homeless women whenever they need it and wherever they are, Means has been named one of 10 recipients of the Robert Wood Johnson Foundation Community Health Leaders Award, which honors exceptional men and women who have overcome significant obstacles to tackle some of the most challenging health and health care problems facing their communities.
In the decade since she started the program, Means and her colleagues have developed a curriculum to train health practitioners about how to provide care to women who lack stable housing. To date, they have trained more than 1,000 medical and nursing students, physicians and medical residents. She plans to expand Women of Means’ focus to help the elderly homeless. Half of the women she serves are over 50 years old; 8 percent are over 70.
Deborah Blazey-Martin, M.D., who has volunteered with Women of Means, said that Means has a special rapport with the women she cares for. “Roseanna has faith in these women, and finds her own inspiration in the resilience of those who survive on the streets against all odds.”