University of Oklahoma Health Sciences Center

Homeless Persons

IDENTIFYING AND ADDRESSING SOCIAL NEEDS IN PRIMARY CARE SETTINGS

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Social determinants of health (SDOH) are widely recognized as having an important impact on health and
mortality,1 and there is now strong evidence of the benefits of addressing people’s unmet social needs.
For example, ensuring access to healthy foods and providing
supportive housing for people facing homelessness have been
found to lower healthcare utilization and costs.2 In addition, there
is emerging evidence that screening for and attempting to address
unmet needs within a primary care setting can improve patient
health.3 In response to this growing body of evidence, primary care
practices and health systems are increasingly integrating formal
screening for social needs into clinical care services.

Keywords

social needs primary care SDOH social determinants of health

Clinical guideline for homeless and vulnerably housed people, and people with lived homelessness experience

Author/s:

Pottie, K."

KEY POINTS

Clinical assessment and care of homeless and vulnerably housed populations should include tailoring approaches to a person’s gender, age, Indigenous heritage, ethnicity and history of trauma; and advocacy for comprehensive primary health care.
As initial steps in the care of homeless and vulnerably housed populations, permanent supportive housing is strongly recommended, and income assistance is also recommended.
Case-management interventions, with access to psychiatric support, are recommended as an initial step to support primary care and to address existing mental health, substance use and other morbidities.
Harm-reduction interventions, such as supervised consumption facilities, and access to pharmacologic agents for opioid use disorder, such as opioid agonist treatment, are recommended for people who use substances.