Certain groups, including individuals with disabilities, low-income families, and marginalized communities, are disproportionately affected by housing insecurity, exacerbating socioeconomic disparities. According to NLIHC (2023), approximately 11 million households—one in four renters—struggle with housing affordability in the United States. These individuals often experience financial hardship, making it difficult to maintain stable housing.

Lack of access to healthcare is a major challenge for this population. Individuals experiencing housing insecurity frequently delay medical care due to cost concerns, lack of insurance, and transportation barriers. Poor living conditions and limited access to nutritious food contribute to chronic illnesses such as hypertension, diabetes, and respiratory diseases (Fitzpatrick & Willis, 2021). Mental health disorders, including depression and anxiety, are also prevalent due to financial stress and instability. Many individuals in this population experience difficulties adhering to medication regimens and often require emergency care for preventable conditions. Expanding access to community-based healthcare programs and social support networks is essential in addressing these challenges (Willison et al., 2021).

Cultural Considerations in Nursing Care

Providing culturally competent nursing care requires understanding the specific challenges and health disparities faced by housing-insecure individuals. Many in this group prioritize basic survival needs over medical care, leading to untreated chronic conditions and delayed treatment of acute illnesses. Implementing mobile health clinics that deliver services directly to shelters and community centers can improve healthcare access and reduce transportation barriers (Rennert et al., 2024).

Trust in the healthcare system is often low among housing-insecure individuals due to past negative experiences and perceived discrimination. Hernandez et al. (2021) emphasize the importance of trauma-informed care and nonjudgmental communication in fostering trust. Cultural competence training for healthcare providers can improve patient engagement and adherence to treatment plans.

Financial instability and lack of identification documents often prevent individuals from obtaining healthcare services. Nurses can play a crucial role by connecting patients with social workers and community organizations that offer low-cost or free healthcare. Collaborations with food pantries, housing agencies, and other social services can help address the social determinants of health and promote long-term well-being (Garcia et al., 2024). By integrating culturally responsive strategies, healthcare providers can work towards reducing disparities and improving patient outcomes.

Healthcare Disparities and Social Determinants of Health

Housing-insecure individuals experience significant healthcare disparities due to financial instability, limited medical access, and social stigma. Many lack consistent healthcare providers and rely on emergency departments for treatable conditions. This results in worsening chronic illnesses, higher hospitalization rates, and increased mortality risks (Garcia et al., 2024). Limited access to vaccinations and routine screenings further increases susceptibility to infectious diseases.

Different subgroups within the housing-insecure population face distinct challenges. Families with children often struggle with pediatric care and disruptions in education, while elderly individuals find it difficult to manage chronic conditions without stable housing. Veterans are at high risk for mental health disorders and substance abuse, and LGBTQ+ youth often experience homelessness due to family rejection, leading to increased vulnerability to violence and exploitation (Miller, 2021).

Addressing these disparities requires a multifaceted approach. Mobile clinics can provide essential healthcare services in shelters and public spaces, reducing barriers to care. Trauma-informed nursing practices are essential for fostering trust and improving engagement. Social workers and housing programs play a crucial role in supporting this population by connecting individuals with financial assistance and stable housing options. The Boston Health Care for the Homeless Program (BHCHP) serves as an exemplary model of culturally competent healthcare, integrating medical, mental health, and substance use treatment within shelters and community spaces (Boston Health Care for the Homeless Program, 2024).

The impact of social determinants on homelessness cannot be overlooked. Economic barriers such as unemployment, low wages, and the rising cost of housing contribute significantly to housing insecurity. Environmental factors, including exposure to extreme weather and un