April is Minority Health and Stress Awareness Month and from 4/6 – 4/12, it is also Public Health Week! Public Health Week highlights the conditions and circumstances that shape health outcomes across communities, and homelessness remains one of the most urgent public health challenges in the US.

For minorities, the health issues associated with homelessness are intensified, due to what researchers describe as “weathering,” or the cumulative impact of repeated social and economic adversity.1 This includes both the stress of homelessness and the ongoing strain of systemic inequities. As we know, homelessness places individuals in a constant state of survival and fight or flight, triggering harmful biological responses such as raised levels of cortisol. Over time, this can raise blood sugar to dangerous levels, increasing the risk of or escalating pre-existing conditions, i.e., Type 2 Diabetes and hypertension.

In 2025, Fourth Street Clinic served 5,754 patients, many of whom identify as a minority. Our Diabetes Educator and Pharmacist, Shideh Hafezi, PharmD, sees the correlation between homelessness, chronic stress, minority populations and diabetes every day. In March of 2023, Shideh started treating a patient who lost their sight as a result of living with untreated diabetes, which was exacerbated by three pregnancies while experiencing homelessness. Being blind and having extensive nerve damage, she also could not check her feet for diabetes sores. When this patient first came to Fourth Street Clinic, her A1C level was 13.2%, but after receiving education around diabetes and working with Shideh, her A1C lowered to 8.5% by January of 2024. She was also able to see our volunteer podiatrist, to help manage her feet and neuropathy.

Patients are the reason we are driven to provide integrated, trauma-informed and culturally responsive care that addresses not only health disparities, but the toll of chronic stress amongst minorities experiencing homelessness. Our staff is intentionally diverse, and many are bilingual, because we want our patients to see not only themselves in us, but trust that we are invested in continuing to offer a space where every patient feels supported and valued. Minority Health and Stress Awareness Month and Public Health Week serve as a reminder that improving access improves health outcomes for vulnerable populations.

  1. Richard, M. K. (2025). Homelessness and race: the impact of structural conditions on Black, White, and Latine homelessness. Social Problems.