Organizations seeking to improve health care and housing services for homeless individuals may benefit from forming partnerships with other service providers, according to a new study led by researchers at Rutgers University. The study was conducted by Joel Cantor, director of the Rutgers Center for State Health Policy and Distinguished Professor at the Edward J. Bloustein School of Planning and Public Policy, along with Michael Yedidia, a research professor at the same center.
“Our paper describes how homeless services and health care providers are working together to tackle the challenge of providing health care to the unhoused,” said Cantor. “With the right organizational and financial arrangements, organizations are demonstrating that it is possible to make effective use of limited resources.”
The findings come amid concerns about potential delays in federal aid for people experiencing homelessness and changes in harm reduction strategies. These issues could affect an estimated 770,000 people nationwide who are unhoused, including about 14,000 in New Jersey.
Homeless individuals face increased risks for infectious diseases, injuries, overdoses, violence and early death. Despite these risks, there has been little academic focus on how housing and health care organizations can work together effectively.
To address this gap, Cantor and Yedidia interviewed 14 administrators and 10 frontline providers from eight programs in New Jersey that integrate both housing and health services. The interviews were conducted between October 2023 and July 2024.
Cantor noted that while only 24 interviews were held, participants “are representative, not in a statistical sense, but in a qualitative sense of what’s going on in this field.”
Analysis of the interviews identified several successful strategies for collaboration: aligning client preferences with available options; maintaining regular interaction between partner organizations; co-locating health and housing services; and meeting clients where they are—both physically and figuratively.
“Asking someone who hasn’t been able to shower for weeks to come to a clinic isn’t going to work,” said Cantor. “Having nurses available in shelters is far more effective.”
Partnerships were often driven by recognition of the link between stable housing and better health outcomes as well as concerns over costs associated with treating medical needs without addressing homelessness first. One program director remarked: “There’s not much you can do if someone doesn’t have a place to live as they’re struggling with their own depression or anxiety or serious mental illness.”
However, challenges remain due to limited affordable housing availability—affected by factors such as restrictive zoning laws—and resistance from communities wary of hosting facilities for homeless individuals. Cantor explained: “The availability of affordable housing is a longstanding and growing problem for a variety of reasons, from restrictive zoning and affordability to the NIMBY factor—people not wanting facilities for the homeless in their neighborhoods.”
Another obstacle is shifting attitudes within healthcare itself toward patients whose immediate priorities may not be medical appointments but basic needs like shelter or food. “Health care providers are used to dealing with people who are deeply focused on their health, and that’s not always the case with the unhoused,” Cantor said. “If I don’t have a place to sleep or enough to eat, how can I possibly think about seeing a doctor?”
Despite these barriers, Cantor believes cross-sector collaboration remains crucial as resources become more constrained: effective partnerships can help organizations extend their reach while adapting services based on client realities.
As he stated: such collaborations are increasingly essential because “money is going to get tighter everywhere.”
The Edward J. Bloustein School of Planning and Public Policy at Rutgers University conducts research on public policy topics such as community development and public health through its dedicated centers (source). The school offers accredited undergraduate- and graduate-level programs focused on planning policy areas—including urban planning ranked among top programs nationally—and operates as part of Rutgers University (source).