Access to Basic Needs and Healthcare by People Experiencing Unsheltered Homelessness.

Objective: To investigate the experience of people experiencing unsheltered homelessness (PEUH) in meeting their basic needs for food, drinking water, toilet, hygiene, and healthcare in Los Angeles County.

Methods: Cross-sectional, in-person health assessment survey (modified HOUSED BEDS instrument) from 2022 to 2023 among PEUH age 18+ years and initiating care with street medicine (N = 665).

Results: Few participants reported access to a toilet (23%), shower (44%), primary care (7%), and food (x̅ = 8.3 meals per week ±5.7). Geographical area was associated with statistically significant differences in participant demographic characteristics, access to, and source type of basic resources.

Conclusions: Key gaps in access to basic resources for survival for PEUH continue to exist in an urban county where state and local government entities have prioritized addressing homelessness by heavily investing in housing solutions.

Policy implications: Pervasive unmet needs for basic resources among PEUH threatens wellbeing and holds important implications for public health, healthcare providers, and payers. Geographical differences in access to basic resources for PEUH suggests a need for heterogeneous services, resources, solutions, and policies to better support PEUH.