Doctor works to keep homeless healthy, safe
Pursuing a career in medicine allowed Jeffrey Norris to engage in his passions for science, social justice and health care. He’s worked as a researcher focused on epidemiology in Utah and with the Centers for Disease Control and Prevention, as a physician in New Mexico, and currently as medical director of Father Joe’s Villages Village Health Center, overseeing primary care, psychiatry, behavioral health, dental and medical-assisted treatment.
“When I went to medical school, I knew that I wanted to be a doctor that worked with those forgotten or stigmatized by society. As a white man from an affluent family, I was afforded many privileges. I wanted to be able to use that privilege to fight for those with less opportunity than me,” he says. “Further, I wanted to work not just with individual patients, but also address the larger societal/political issues that negatively impact people’s individual health. My backup plan, if I didn’t get into medical school, was to get a PH.D. in public health.”
His public health work now is proving critical in reducing the spread of the novel coronavirus, particularly among San Diego’s homeless population. Norris and his team work with the other programs at Father Joe’s, as well as with the organization’s partners, to comprehensively meet the needs their patients have for health care, along with housing, income and personal safety.
Norris, 35, lives in North Park with his wife, Sonia Ponce, and their daughter, Alex. He also serves on the board of Integrated Health Partners and is chair of the clinician committee, and serves on the steering committee for National Healthcare for the Homeless. He took some time to talk about his work serving homeless patients during this pandemic and the importance of addressing the social and policy issues that contribute to a person’s health.
Q: You’ve previously worked as a researcher, studying epidemiology. What appealed to you about that area of study?
A: People’s individual health issues never in exist in a vacuum. Culture, public policy, social issues, etc., all influence an individual’s health. Understanding those broader issues is essential for me to take better care of individual people, and nowhere is this truer than for those experiencing homelessness. You cannot ignore what is going on in the community. I am a better doctor because of the system-level work I do, and I am better able to improve systems because I still see patients.
Q: Do you find that there are things you do differently, as a medical professional, for those who have housing insecurity?
A: Definitely. The social issues faced by those with housing insecurity are as important, if not more important, than their health issues. We must coordinate and collaborate very closely with other programs at Father Joe’s Villages and other agencies. If we, as providers of services, are not on the same page, we cannot provide high-value care to our patients. We collaborate to bring coordinated services that address the unique barriers that individual is facing to housing and income. That approach is very apparent right now at the (San Diego) Convention Center. Working as a team with the city and county, we are better able to meet the needs of individuals living there.
One of the biggest challenges folks on the streets face is a lack of personal safety. They constantly must worry about being attacked or having their things stolen or lost. For example, medications are very frequently lost or stolen, and this makes managing acute and chronic health issues very challenging. We work with patients first and foremost to get housing so that medications
are not lost or stolen. In this way, obtaining that housing is often a critical step to achieving better health outcomes or even to saving a life.
Q: What have been some of your most pressing concerns for the homeless populations you serve, during this novel coronavirus pandemic?
A: The most pressing concern is the vulnerability of homeless populations to complications and death from COVID-19. This is due to high rates of smoking, chronic lung disease (like chronic obstructive pulmonary disease), heart disease and diabetes. As an example, 50 percent of our adult patients are smokers. Though there have not yet been many individuals experiencing homelessness with COVID-19 in San Diego, if an outbreak occurs, it could be devastating.
Additionally, while most of us will be able to stay safe or recover in our homes, our neighbors experiencing homelessness face an added layer of challenges, including less access to preventative hygiene practices, such as hand washing and sanitation, and close and often unsanitary living conditions in encampments, canyons and on streets. The interventions put in place (the county isolation hotels, the convention center, etc.) are helping to minimize the risks to our homeless neighbors.
Q: In what ways is this virus affecting people experiencing homelessness differently than how people who have secure housing are experiencing this virus?
A: Our crisis with homelessness has been 40-plus years in the making. Though Father Joe’s Villages and our partners have worked on addressing homelessness for years, society at large has largely ignored the underlying causes of homelessness (income inequality and costs of housing). This means that those experiencing homelessness continue to get sicker and sicker over time. Now, during COVID-19, we are trying to fix those decades of issues within the span of a few months. The silver lining is that city, county and state governments are looking to make long-term investments, including buying motels, to address homelessness more effectively.
Q: What kinds of conclusions are you coming to as it relates to how to best care for people who are homeless during this time?
A: First and foremost, it is essential to connect people to, at a minimum, shelter that meets the CDC’S recommendations around hygiene and physical distancing. The convention center shelter has helped to make this possible in San Diego.
Second, we need to make sure we are aggressively lab testing as many individuals experiencing homelessness as possible. There are active efforts to make that possible in shelters in San Diego.
Third, now more than ever, we need to continue outreach to engage those who are unsheltered on the streets. We’re actively working to bring those on the streets into the convention center as rapidly as possible. It’s important to build relationships with unsheltered individuals before they can learn to trust the resources you’re offering. That’s why the work of our outreach team is so crucial at this time.
Q: What’s been challenging about your work during this pandemic?
A: We are all working far more hours and under more stress than ever before. The urgency of this crisis cannot be understated. Lives are at stake. The positive is that I have seen our community come together in ways I never would have imagined. The speed with which service providers, city governments, the county and regional authorities have come together to develop and implement programs has been astounding. This teamwork is what gives energy needed to keep forging ahead.
Q: Has there been anything rewarding about this work?
A: Multiple days during this pandemic, we have had no call outs or late calls from our staff of almost 60 people. The passion, dedication, and energy our team brings to their work every day gives me energy to keep fighting.
Q: What is the best advice you’ve ever received?
A: The best advice I’ve received is to be willing to admit when you are wrong. A degree of humility is essential if you are going to work well in a team.
Q: What is one thing people would be surprised to find out about you?
A: I am a quarter Japanese. My paternal grandmother was an immigrant to the U.S. just after World War II and experienced, firsthand, the hardships of being a minority.
Q: Please describe your ideal San Diego weekend.
A: Running 7 to 8 miles at Mission Bay, road biking up to Mission Trails, making buttermilk pancakes, and spending time with my wife and 3-year-old daughter!