Street Medicine: A Scoping Review of Program Elements

Abstract

Globally, homelessness has grown over the past decade due to a diverse range of social and economic factors, including lack of affordable housing and retrenchment of social programs. People experiencing homelessness (PEH) experience markedly higher disease burdens than housed populations, as well as reduced access to healthcare. Street Medicine is a promising form of healthcare delivery that seeks to address the healthcare needs of this population despite known structural barriers to access. However, there is limited empirical literature describing Street Medicine practice and program elements. To address this gap, scoping review methods were used to review two major academic databases, web-based literature, and sources provided by content experts. Studies had to specifically reference “Street Medicine” as healthcare delivery and at least one of the review’s primary focuses: definitions, philosophies, or program elements. We conducted qualitative analysis to identify relevant themes. Of 1,016 unique sources identified, 349 met inclusion criteria. Six practice categories were identified: direct care, wraparound health services, harm reduction services, psychosocial case management, provision of life necessities, and education/research/advocacy. Despite a shared definition, there are a wide variety of Street Medicine program elements in use. This review sets parameters around which future research on effectiveness of these elements could be based.