Health & Healthcare: All Related Resources

Californians experiencing homelessness have poor health, struggle to access care, and face high ER and hospitalization rates—despite high rates of insurance. In this cross-sectional, representative study of adults experiencing homelessness in California, we found poor access to health care and high rates of short-term health care utilization that reflected how homelessness is negatively associated with health care access. Predisposing contextual and need factors, including being unsheltered, using illicit drugs, and having functional impairments, were associated with reduced access to care and increased use of short-term care. These findings underscore the necessity for health care and housing interventions that are tailored to the needs of people experiencing homelessness.

Homelessness is detrimental to health, and clinicians can play an essential role in mitigating the deleterious effects of homelessness. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, discusses this and more with JAMA Senior Editor Karen E. Lasser, MD, MPH. Dr. Kushel said, "When you are an individual provider, in a room, you are trying to understand the difficult environmental conditions that your patient has and do things to decrease that part."

People experiencing homelessness have worse mental and physical health than the general population. They also have limited access to primary care for reasons including the absence of health insurance, lack of money for co-payments or transportation, and communication barriers. In this JAMA Insights, researchers examine the adverse effects of homelessness on physical and mental health and suggest strategies to improve access to care.

Unhoused patients have worse surgical outcomes than the general population, resulting in premature mortality. Researchers conducted 26 semi-structured interviews of clinicians who care for patients with surgical disease. The researchers identified 5 themes, including, but not limited to: patients and clinicians face multiple challenges meeting preoperative requirements; although surgeons do not make major operative decisions based on housing status, some take it into consideration for minor care decisions; clinicians perceive that unhoused patients have negative postoperative experiences in the hospital.