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Abstract
Background The homeless experience some of the worst health in society and yet paradoxically receive some of the least accessible care. Healthcare systems aim to provide accessible medical care to the population, yet numerous barriers prevent the homeless population from engaging with this. Without addressing these barriers, the inequalities seen today will continue to rise, leaving the vulnerable members of society even further behind. A review of the literature was conducted to consolidate and address the common barriers to accessing healthcare currently faced by the homeless population.
Methods
A review of the literature on the MEDLINE database was conducted using specific search criteria.
Titles and abstracts were reviewed, followed by full text review. The search results were reviewed for relevance, study design and quality.
The themes from selected publications on the barriers to meeting the healthcare requirements of people experiencing homelessness were extracted and summarised.
The barriers were discussed as well as their implications on policy and practice.
Results The initial search criteria provided 458 results. Once limited to the last five years this produced 208 results. Nine relevant papers were identified using a process of abstract review followed by full text review. The common themes that were highlighted by the literature review included the personal barriers of stigmatisation and lack of trust as well as the practical barriers of physically accessing primary care and the incompatibility of the system with the needs of the homeless.
Discussion The current healthcare system is failing the vulnerable homeless population and facilitating inequalities. However, there is an opportunity to change this and create an equal and inclusive healthcare system. Recommendations for change include homeless healthcare training in healthcare currciulums, in-reach work with peer advocates and an increased versatility in the system. If service-wide action is implemented we can tackle health inequalities and create a truly accessible healthcare system for all, including the most vulnerable members of our society.