Health and Social Service Interventions for Homeless Populations

Homelessness represents a nexus of health inequities driven by structural deprivation, complex multimorbidity and social exclusion. Interventions span multiple domains, from rapid housing provision and long-term supportive accommodation to integrated health and social care delivery. Housing First models, which decouple shelter access from treatment compliance, have yielded consistent gains in housing stability and reductions in acute care use. Permanent supportive housing combines long-term tenure with wraparound support, showing promise in enhancing quality of life, although effects on psychiatric symptoms and substance use remain mixed. Complementary strategies include intensive case management, outreach clinics in shelters, peer navigation programmes and income assistance schemes. These low-threshold interventions seek to bridge systemic gaps by addressing social determinants such as income security, social support and access to preventive services. Tailored mental health and addiction services, combined with training for health-care staff in trauma-informed practice, foster engagement and continuity of care. The global significance of these approaches is underscored by their adaptability to diverse urban and rural contexts and their potential to reduce emergency health–social service utilisation, advance health equity and inform policy frameworks that integrate housing and health outcomes.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Health and Social Service Interventions for Homeless Populations publication trend

The graph below shows the total number of articles in health and social service interventions for homeless populations across all publications each year (not limited to Nature Index journals).

Technical terms

Housing First: A model that provides immediate, non-conditional access to permanent housing without requiring prior sobriety or treatment compliance.

Permanent Supportive Housing: Long-term housing combined with on-site or mobile supportive services to address health, social and behavioural needs.

Low-threshold Interventions: Services designed with minimal eligibility criteria and reduced administrative barriers to facilitate access by marginalised populations.

Case Management: A coordinated approach in which a dedicated professional assesses needs, liaises with service providers and plans individual support pathways.

Navigation Programmes: Initiatives where trained personnel assist individuals in negotiating complex health and social systems to secure appointments, benefits and follow-up care.

References

1. Cancer risk factors and access to cancer prevention services for people experiencing homelessness. The Lancet Public Health (2024).
2. Effects of Housing First approaches on health and well-being of adults who are homeless or at risk of homelessness: systematic review and meta-analysis of randomised controlled trials. Journal of Epidemiology & Community Health (2019).
3. Effectiveness of permanent supportive housing and income assistance interventions for homeless individuals in high-income countries: a systematic review. The Lancet Public Health (2020).
4. The prevalence of mental disorders among homeless people in high-income countries: An updated systematic review and meta-regression analysis. PLOS Medicine (2021).
5. Effectiveness of interventions to improve the health and housing status of homeless people: a rapid systematic review. BMC Public Health (2011).