Homelessness has been linked to negative health outcomes, but some health systems have trouble reaching these patients and discharging them safely at the care course's conclusion.
A study published Aug. 29 found that homeless older adults have higher mortality rates. The frequency at which this population reported cancer or heart disease was lower than the frequency at which they died from it, indicating a "lack of access to care and delayed diagnosis," according to the study's authors.
Another study, published Sept. 20, found that young children who had experienced eviction faced poorer health and higher hospital admissions.
Health systems and homeless populations are intertwined even after care ends, according to a September brief from the Public Policy Institute of California. Almost half of the state's homeless patients visited an emergency department at least four times a year, and 8 percent of people admitted to an ED identify as homeless.
"We have folks who show up because they’re cold and hungry — we’re often the one safe place that they know they can go to 24 hours a day," an ED social worker said in the brief. "It puts a tremendous strain on [staff] and for the social work team, in particular, to have to just turn people out onto the street."
From street teams to housing assistance, the following health systems are increasing their efforts to to provide care for the homeless.
1. Oregon Health & Science University (Portland): An estimated 300 undergraduate and graduate nursing students at OHSU's Ashland campus will participate in the university's recently expanded street nursing program by the end of 2023, according to the Lund Report. Participants help homeless populations access resources — such as telehealth and in-person medical appointments and prescriptions — treat minor wounds and infections and offer preventive education.
2. NYC Health + Hospitals (New York City): NYC Health + Hospitals launched ExpressCare, a virtual urgent care platform, in 2020. The platform served 75,000 New Yorkers with 95 percent patient satisfaction, according to a July 26 news release. A three-year grant, announced in July, will expand ExpressCare to provide psychiatric support and substance abuse treatment. Additionally, the grant will aim to expand the platform's reach.
3. UCR Health (Riverside, Calif.): In June, the University of California Riverside received a grant to reopen a clinic for Riverside County's homeless population that closed in May 2019, according to a June 7 article on the university's website. The clinic, set to reopen in January, will provide primary and preventive care to same-day and walk-in patients.
4. Kaiser Permanente (Oakland, Calif.): The health system has partnered with Mid-Willamette Valley Community Action Agency and Project HOME, both in Salem, Ore., to provide housing assistance to homeless individuals, according to a March 14 news release. The community action agency and Kaiser Permanente medical teams will identify high-risk individuals to bring into the program, which aims to serve 100 people by the end of 2023.
5. Bon Secours Mercy Health (Cincinnati): From December 2020 to October 2021, Bon Secours provided immediate financial assistance to 174 households facing eviction, according to a June 14 article on the Catholic Health Association of the United States' website. The health system worked with local nonprofits to identify recipients, and produced a follow-up report on the effort.
6. St. Louis hospitals: Mercy Hospital St. Louis, SSM Health Saint Louis University and Barnes-Jewish Hospital, also in St. Louis, partnered with Catholic Charities U.S.A's Healthy Housing Initiative in 2021, according to a Feb. 11 article on Catholic Charities' website. Within a year, the hospitals referred 388 individuals to the St. Patrick Center — a homeless center in the city — 313 of whom received housing and needs-based services.