A Primary Care Approach to Treating Women Without Homes

Roseanna H. Means, MD, MSc

In This Article


The number of women without homes is growing. They come to our clinics, emergency rooms, hospitals, shelters, and rehabilitation centers. While homelessness itself is not a disease but a social condition, it is one with ramifications in healthcare. The primary care of homeless persons is not part of the core curriculum in our medical schools. Providers of primary medical care to homeless women are liable to feel overwhelmed and frustrated without the proper tools. With improved understanding of the background, context, and risk of illness to the homeless woman patient, many obstacles can be overcome. As for any complex problem in medicine, the most effective approach is one that takes into account every facet of this condition.

The care of women without homes requires applying a new paradigm to the delivery of healthcare. This paradigm demands that we not see these women as solely victims and to recognize their extraordinary achievements in the face of many obstacles. That so many women without homes can follow through at all and also demonstrate humor, determination, good will, forgiveness, and courage gives us the opportunity to witness the power of the human spirit.

As we face a future of high productivity and reduced face-to-face time, it is important to accept the reality that in some populations, an investment of time in the short term will lead to higher engagement and improved compliance in the long run. Homeless women need such an approach in order to regain trust, social connections, and improved health. As providers of healthcare to all persons, it is our responsibility to reach out in the best way we can to this deserving population.


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