February 18, 2025

A commitment to systemic change: ASU professors team up to help homeless people through health care research

At the Sandra Day O’Connor College of Law at Arizona State University, education doesn’t just happen inside the classroom, it extends into the real world to shape positive change in communities. Diana Bowman, the associate dean for applied research and partnerships and professor of law, is one of the many faculty members at the college who is using her expertise to tackle some of society’s most pressing issues, like the health challenges facing older adults experiencing homelessness.

Bowman teamed up with Heather Ross, assistant professor at Edson College of Nursing and Health Innovation, to focus on the unique health needs of people experiencing homelessness, especially older adults. 

“My colleague, Professor Heather Ross, has been engaging with high-risk populations for several years. Her work highlighted how very little research is actively done in a shelter setting, meaning that what policies and procedures are often put into place are not done based on sound science/evidenced-based research,” said Bowman. “Our goal is to address many of the research gaps, and do so in partnership with the provider and their clients.”

A key focus of their research is the growing number of older adults who experience homelessness, a group whose needs are often overlooked in traditional healthcare settings. 

“The fastest growing population of those who end up homeless are 55 years and above. While there are several reasons for this — cost of living, cost of housing, etc. — there is very little known about the risks of cognitive impairment. We wanted to see if this was part of the complex ecosystem that increases risk, and if so, begin to think about ways to better support these individuals once they are housed,” Bowman explained.

To better understand the health needs of this population, Bowman and Ross launched two studies - one focused on dementia screening, with the second exploring the impact of poor sleep quality and cognitive performance. They are working with the Central Arizona Shelter Service where residents can be more vulnerable to cognitive decline and poor health outcomes. 

“Our partnership with the Central Arizona Shelter Services is exactly that – a partnership,” Bowman said. “Their team is actively engaged in the research projects and their team has been incredibly welcoming. By working together, we are better able to understand their unique needs, and co-develop ideas and interventions with them, for them.”

While research in traditional health care environments is already challenging, Bowman explained it’s even more complex in a homeless shelter setting. “It is also an environment where limited scientific research has been undertaken. So we can move only at the speed of trust, knowing that it may be two steps forward, one step back on any given day,” she said.

Despite those obstacles, Ross, Bowman said their team is seeing positive outcomes. “CASS has now implemented the screening tool into their intake process, and the tool is being picked up and used by other shelter services,” she said. “With that project, our next step is to involve the legal community and start to think through what this means for individuals who do not have a legal guardian, who may not be able to make informed decisions about their health care needs.”

This research also has the potential to drive larger systemic change in how health care and housing systems address the needs of vulnerable populations. Through her work, Bowman is exemplifying the values of the late Sandra Day O’Connor and leading the way in making real, lasting change for vulnerable populations

Written by Crystal Jimenez