Analysis of the population served by the Street Clinic in Suzano

The Street Clinic is a Ministry of Health program, created as a Primary Care strategy in Brazil in the 1990s to meet the health demands of the homeless population. In this way, it is an action to promote social inclusion and citizenship.¹

In Suzano, the Street Clinic team operates in modality I. However, identifying the profile of the population served by the Street Clinic team is a considerable challenge due to social vulnerability that makes it difficult to collect accurate information about their health conditions, needs and socioeconomic background, as does the lack of documentation, distrust of the health service and the itinerant nature of this population, which leads to incomplete or inaccurate data.

Therefore, the aim of this study is to characterize the sociodemographic profile of the homeless people cared for, as it makes it possible to recognize the specific and unique needs, facilitating the creation of more effective and personalized interventions, adapted to the context, as well as the adequate allocation of resources to carry out these actions.²

This is a quantitative, descriptive and exploratory documentary analysis study. The study was carried out in the city of Suzano, located in the state of São Paulo, Brazil. It has an estimated population of around 300,000 inhabitants, 602 of whom are registered as homeless.

The sample consisted of the medical records of patients seen by the Street Clinic team, from its implementation in 2014 to the present day in 2024, with no exclusion criteria. Stratified convenience sampling was used. The sample calculation was based on the completeness rate of each medical record with the proportion of items completed. The sample was sized to estimate this rate, which had a standard deviation of 0.1194, a margin of error of 0.015 and a 95% confidence level; for all these conditions to be met, a minimum of 244 medical records had to be observed.

The data was collected using an instrument built in the Excel® program with questions relating to sociodemographic data to characterize the homeless people in the municipality of Suzano, and a descriptive analysis was carried out, compiling frequency/percentage and occurrence measures of the variables collected to analyze the sociodemographic profile.

A total of 244 medical records were analyzed, of which 69 were exclusively for social assistance and 175 for health care.

The main findings of the study show that the population served is mostly male (64%), with 37.3% self-declared as brown and 34.02% in the 36–45 age group, with incomplete primary schooling (24.18%), and 45.49% from São Paulo (Table 1).

Table 1.

Sociodemographic characteristics of the population served by the Street Clinic in Suzano, 2024.

Variables and categories	N°	%
Gender
Female	26	10.66
Male	157	64.34
NI	61	25
Age group
18–25	8	3.28
26–35	42	17.21
36–45	83	34.02
46–55	56	22.95
56–65	30	12.29
66–75	7	2.87
NI	18	7.38
Race
White	38	15.57
Black	33	13.52
Brown	91	37.30
Yellow	2	0.82
Not informed	80	32.79
Education
Illiterate	3	1.23
Elementary incomplete	59	24.18
Elementary school complete	35	14.34
High school incomplete	18	7.38
High school complete	22	9.02
Higher education incomplete	3	1.23
Higher education complete	3	1.23
Not informed	101	41.39
State of birth
SP	111	45.49
BA	13	5.33
PR	6	2.46
Other states	30	12.40
Not informed	84	34.42

The Preliminary Report on the Homeless Population of 2023 describes that the national data is similar, as indicated by the variables of sex, where 87.49% of the population is male; age, with 29.04% being in the age range of 40–49 years; and ethnicity, where 50.44% are classified as brown.³ This is in line with the survey carried out with those enrolled in CadÚnico until 2019, which showed a predominance of males, 86.8% of whom were black in 67.5% of cases, and incomplete high school education (81.9%).⁴

A study carried out in the central area of the city of São Paulo, including the districts of Sé, República, Pari, Brás, Cambuci, Liberdade, Consolação, Bela Vista, Santa Cecília and Bom Retiro, recognized the predominance of males, with an average age of 40, declared by the team of field researchers as “non-white”. In terms of educational level, illiteracy was higher than the general figure for the municipality of São Paulo, with the majority not having completed elementary school. With regard to place of birth, there was a predominance of migrants from the south-east of Brazil, mainly from São Paulo and Minas Gerais.⁵

By understanding the characteristics of this population, it is possible to develop more appropriate intervention strategies, such as the use of multiprofessional teams that address not only physical health issues but also social, emotional, and reintegration needs. This helps guide the development of more inclusive and effective public health policies, promoting equity in access to care and contributing to the reduction of inequalities faced by people experiencing homelessness.

We would like to thank FAPESP (PROCESS PPPP 2023/09191-5) for funding the project and making it possible to carry it out.

Ethical considerations

This study was approved by the Ethics Committee of the School of Nursing of the University of São Paulo under the number CAEE 78510824.4.0000.5392, respecting the ethical principles involving research with human beings (CNS Resolution n. 466/2012).

Funding

FAPESP (PROCESSO PPPP 2023/09191-5).