Addressing health disparities of individuals experiencing homelessness in the U.S. with community institutional partnerships: An integrative review

Abstract

Aims: To examine existing community-institutional partnerships providing health care services to people experiencing homelessness by addressing social determinants of health (SDOH) at multiple socioecological levels.

Design: Integrative review.

Data sources: PubMed (Public/Publisher MEDLINE), CINAHL (The Cumulative Index of Nursing and Allied Health Literature database), and EMBASE (Excerpta Medica database) were searched to identify articles on health care services, partnerships, and transitional housing.

Review methods: Database search used the following keywords: Public-private sector partnerships, community-institutional relation, community-academic, academic community, community university, university community, housing, emergency shelter, homeless persons, shelter, and transitional housing. Articles published until November 2021 were eligible for inclusion. The Johns Hopkins Nursing Evidence-Based Practice Quality Guide was used to appraise the quality of articles included in the review by two researchers.

Results: Seventeen total articles were included in the review. The types of partnerships discussed in the articles included academic-community partnerships (n = 12) and hospital-community partnerships (n = 5). Health services were also provided by different kinds of health care providers, including nursing and medical students, nurses, physicians, social workers, psychiatrists, nutritionists, and pharmacists. Health care services spanning from preventative care services to acute and specialized care services and health education were also made possible through community-institutional partnerships.

Conclusion: There is a need for more studies on partnerships that aim to improve the health of homeless populations by addressing social determinants of health at multiple socioecological levels of individuals who experience homelessness. Existing studies do not utilize elaborate evaluation methods to determine partnership efficacy.

Impact: Findings from this review highlight gaps in the current understanding of partnerships that seek to increase access to care services for people who experience homelessness.

No patient or public contribution: The results of the systematic review were solely from the articles reviewed and do not include information from patients, service users, caregivers, or members of the public.

Keywords: community institutional partnership; community-academic partnership; health services; homelessness; partnership; prevention; shelter; systematic review; transitional housing.