Homelessness and health care: considerations for evaluation, management, and support within the primary care domain.

here are significant challenges to addressing the health needs of the omeless. The complex nature of homelessness, coupled with the cripling effects of poverty, limit the extent to which primary care providers re able to effectively deliver care within a traditional clinical environent. To provide appropriate and supportive patient care, the clinical ractice of the primary care provider should be augmented to include onsiderations for the broader social determinants of health. Only then an we begin to assure the human right to health for the most visibly mpoverished among us. The definition of “Homelessness” reveals that individuals who are omeless are not always visible. According to the Federal Bureau of rimary Health Care, an individual is considered homeless if (1) s/he is ithout permanent housing (eg, lives on the streets; stays in a shelter, ission, single-room occupancy facility, abandoned building or vehicle; r any other unstable or nonpermanent situation); (2) s/he is “doubledp,” a term referring to a situation in which individuals are unable to aintain their housing situation and are forced to stay with a series of riends or extended family members; and/or (3) s/he was released from rison or a hospital and does not have a stable housing situation to return o. Health Resources and Services Administration, an agency of the US epartment of Health and Human Services, emphasizes that the distinuishing feature of homelessness is the instability of an individual’s iving arrangement, rather than the physical space that one may call her r his own. Because this definition of homelessness is broad, accurate