Caring for patients experiencing homelessness

Abstract

### What you need to know There has been a worldwide rise in homelessness over the past 10 years.1 On a single night in 2024 roughly 771 480 people in the United States were experiencing homelessness, the highest figure since reporting began in 2007.2 Equivalent figures in England showed that, on a given night in 2024, an estimated 354 016 people were homeless which is 1 in 160 people.3 Health and homelessness are closely interconnected, and there is much that can be done by healthcare professionals to improve the lives of people experiencing homelessness. Here, we explore the health impacts of homelessness and barriers to accessing healthcare, with a focus on adults in high income countries. We also offer practical considerations for clinicians providing care to people experiencing homelessness. Patterns of homelessness are complex and diverse and include rough sleeping; staying in temporary accommodation such as night shelters, hostels, and women’s refuges; and hidden forms of homelessness such as staying with friends, sofa surfing, and living in squats or “beds in sheds.”4 The support needs of people experiencing homelessness are also diverse. A person who has become homeless due to a job loss but without other risk factors may require little support and be able to return to housing quickly. For many, however, homelessness can be a longer term problem, resulting from an accumulation of risks and traumatic experiences at different points along their life course.5 The landmark Marmot Review in 2010 drew widespread attention …