Head Start programs often serve children and families who are eligible for services because they lack housing or live in temporary housing. Children who experience homelessness are at risk for poor medical, oral, and mental health outcomes. This resource describes the health care needs of children experiencing homelessness, and it has tips for helping families access quality health care for their children.
Head Start programs often serve children and families who are eligible for services because they lack housing or live in temporary housing. This includes families who live in crowded conditions, have substandard housing, move often because of unstable housing, or are refugees who are resettling in this country. Some families may be living in motels, campgrounds, shelters, cars, parks, public spaces, abandoned buildings, or bus or train stations. Unemployment, poverty, low wages, and lack of affordable housing are among the leading causes of homelessness. Natural disasters (e.g., hurricanes, earthquakes, fires) and domestic violence are other reasons that some children and families may be living in temporary circumstances or lack housing. The McKinney-Vento Act defines the eligibility requirements for rights and services available to families who lack housing.
A family’s housing status is a social determinant of health. Social determinants of health are conditions, such as housing, education, jobs, and environments, that affect a wide range of health outcomes. A stable and safe home is a protective factor that promotes family well-being and children’s healthy development.
Health Care Needs of Children Experiencing Homelessness
A lack of quality or stable housing may increase certain health and behavioral health problems. These include:
- Ear infections
- Overweight and obesity
- Tooth decay
- Lack of sleep
- Mental health concerns
- Developmental delays
These problems may occur alone or together and become difficult to manage. It is essential for children experiencing homelessness to see medical and dental providers who:
- Know about their complex health needs
- Can link families to specialists and supports
- Offer preventive care
- Provide person-centered and trauma-informed care
While children without stable housing need quality medical and oral health care, they are less likely to have a medical or dental home. Families experiencing homelessness may struggle with other basic needs, such as food, jobs, or transportation, and may not have money to pay for health care. They may not have insurance or be able to pay for regular office visits with the insurance they do have. Families may not have a mailing address or telephone number that is often needed to access care. As a result, families may take their children to emergency departments for common childhood illnesses and other issues that do not need urgent care, rather than visiting a medical or dental home for holistic, person-centered care and preventive services. This can mean children may not get comprehensive care for their needs.
Finding health care providers who understand the issues and complexities of family homelessness can be difficult. Families may experience stigma or shame about their living circumstances. Families who do not have positive experiences with health care providers may be less willing to seek future care.
Tips to Help Families Access Care
Create and maintain community partnerships.
Build and maintain partnerships to connect families with organizations and services in the community that serve families experiencing homelessness, including local shelters and peer support specialists. Some national organizations that work with families experiencing homelessness include Continuum of Care grantees, Maternity Group Homes, and Family Promise affiliates.
Make it a priority to connect families to a medical and dental home as soon as possible.
Families experiencing a lack of housing or who are in temporary housing may not be able to stay enrolled in the same Head Start program due to frequent moves. Since time with a family may be short, plan to discuss their health care needs and connect the family to a medical and dental home as soon as possible, even as you work to connect them to housing support and other resources for their basic needs.
A Head Start program can support families by keeping their child’s health records. Reassure the family that this is a role you play for all enrolled families, and they can access their records at any time. For families experiencing homelessness, the Head Start program is often in the best position to coordinate a child’s health care needs when families are in transition and referrals are in process.
If possible, connect families who leave your program to a Head Start program in the community where they will be living. To make the transition easier, you may want to contact the receiving Head Start program to share information and learn about the new setting. If the program is full, ask for referrals. Be sure to tell the family the result of your calls, and where possible, share the name of a contact at the new agency. This “warm handoff” will help the family connect with someone who is familiar with their situation and needs. To prevent a gap in health services, help the family find a new medical and dental home for their child in their new location.
Help families overcome barriers to quality health care.
Some barriers that prevent families from having quality health care can be addressed by connections to services offered by your community partners. For example, you can:
- Connect families to local housing programs and make sure their basic needs are met (e.g., safety, food, etc.)
- Help them find a job or enroll in a job training program
- Connect them to medical, dental, and mental health providers in the community that specialize in services for families experiencing homelessness
- Help them enroll in insurance programs and related benefits
- Help them fill out forms that providers need from new patients
- Offer rides to and from the provider’s office
Use strengths-based approaches to engage families.
When engaging families experiencing homelessness, use strengths-based approaches that consider each family’s cultural perspective. Using strengths-based approaches acknowledges the strategies families may be using to connect themselves and their child to your program and other resources in the community. Comment on their resilience where appropriate and focus on:
- Naming families’ strengths first
- Building a shared understanding and learning from differences
- Showing openness to adapting practices based on family preferences
- Sharing decision-making
- Approaching families as equal partners
- Seeing families as able to make their own change
- Striving to offer consistent and reliable support
Resource Type: Publication
National Centers: Health, Behavioral Health, and Safety
Last Updated: May 11, 2022