1. Accessibility of Showers and Bathrooms Among Boston’s Homeless Population: An Exploratory Study Kaitlyn Moran, MPH, Debora Perez, MPH (c), and Becca Walmer, MPH Boston University School of Public Health BACKGROUND Urban homeless populations face numerous challenges, including insufficient access to bathing facilities. Although the city of Boston has many outreach services in place to address the need for shelter and basic medical and mental health services, access to bathing facilities has traditionally received limited attention. This study identified numerous barriers to accessing showers and bathrooms for individuals experiencing homelessness. We plan on conducting interviews with service providers to obtain their perspectives on this topic. We will also analyze medical record data to better understand the burden of hygiene-related disease among homeless individuals. We hope our findings will help inform cost-effective, practical solutions to improve the services available to this population, as access to showers and bathrooms has many implications for health and well-being. RESULTS METHODS DISCUSSION CONCLUSION & NEXT STEPS Data Collection: An 18-item questionnaire was administered to 34 homeless patients at Boston Healthcare for the Homeless Program’s (BHCHP) medical respite facility over 3 mornings in February and March, 2016. Questionnaire was administered via semi-structured interview to both English and Spanish-speaking patients who were admitted to respite within the past 30 days. Questions assessed demographics, housing status, ease of accessing existing showering facilities, barriers impacting shower access, and suggestions for improving access to these facilities in Boston. OBJECTIVES We aimed to explore the accessibility of public showering facilities available to Boston’s homeless population, with an emphasis on the following objectives: 1)Identify barriers and facilitators that impact utilization of bathing facilities. 2)Identify physical health conditions associated with irregular personal hygiene. 3)Share findings with relevant stakeholders. Table 1. Characteristics of Respondents Total (n)34 Gender (n) Male20 Female13 Trans1 Mean Age (years)49.6 (30-66) Mean Age When First Homeless (years) 33.1 (14-65) Race/Ethnicity (n) White Non-Hispanic24 Black Non-Hispanic4 Hispanic4 Two or more races1 Other1 Language (n) English30 Spanish4 Many respondents faced difficulties accessing public bathrooms “You can bring your kid into Dunkin or Starbucks to use the bathroom” but as a homeless person you “get labeled” The Stigma of Homelessness & it’s Effects Despite the many challenges in accessing bathrooms and showers, many respondents reported that they would be able to find a place to wash up if they needed to In addition to public bathrooms, respondents reported washing up in park fountains, bath houses, playground spray pools, the Charles River, and, in the case of one women who was a prostitute, at her “john’s” or clients’ Resiliency Respondents explained their fears of getting arrested for trespassing while trying to access public bathrooms A male respondent shared the story of a friend who was arrested for indecent exposure for going to the bathroom in an alleyway one night The Criminalization of Homelessness Our preliminary findings show that accessing showers and bathrooms is a challenge for those that experience homelessness in Boston, with 79% of subjects stating that there aren’t enough public showers available. Subjects also reported that, on average, they are unable to shower when they wanted to 3 days out of the week. Access to showers was particularly limited on weekends. Access to public toilets also emerged as a major issue, with many respondents explaining the numerous challenges in using public bathrooms as a homeless individual. The majority of our respondents were middle-aged and white, which could limit the generalizability of findings. Although our sample size was small, which may be seen as a limitation, it allowed us to gather a substantial amount of in-depth qualitative feedback. QUALITATIVE RESULTS ACKNOWLDGEMENTS This project was funded through an Urban Research Award from the BU Initiative on Cities. We also want to thank our faculty advisors Dr. Yvette Cozier and Dr. Jessica Leibler for their support.