Integrating healthcare services for people experiencing homelessness in Australia: key issues and research principles.
Background: In 2016, the Australian Census found approximately 116 000 people to be experiencing homelessness.1 People experiencing homelessness have higher morbidity and mortality than the general population,2 and so require meaningful access to quality healthcare, as well as integrated service responses across health, social and housing domains. Improving health outcomes requires understanding the complex role of structural determinants of homelessness, such as the availability of secure housing and employment, gender equality, racism, in addition to the funding and structure of health and social services.3 The requirement for health service responses that are tailored to people experiencing homelessness has been highlighted by the COVID-19 pandemic. People experiencing homelessness have few resources with which to support prevention measures from COVID-19, such as accommodation that enables social distancing and self-isolation or hygiene facilities, compounding the risk from higher rates of diseases such as chronic respiratory conditions.4 These factors require an integrated service response from health and housing in order to successfully protect health and reduce transmission risk.
In this article, we first present three key issues identified in our work for the integration of healthcare of people experiencing homelessness in Australia: the adequate recognition of homelessness in health services, the need to enhance access to healthcare, and the need for effective integration across health, housing and social services. We then outline some principles with which to underpin future healthcare service delivery and research for people experiencing homelessness.
