“Homelessness is a chronic human condition impacting 0.2 percent of all Americans with direct individual and populational implications,” said Rolando Trejos. “The housing crisis is not a new phenomenon; however, it has been exacerbated in urban communities in the last decade.”

To further understand the health disparities and factors impacting urban homelessness, USF College of Public Health (COPH) doctoral student Rolando Trejos recently published a review that mapped the last five years’ literature around homelessness in U.S. urban communities by utilizing the socio-ecological model to analyze system-based implicated factors.

The socio-ecological model considers the complex interplay between individual, relationship, community and societal factors.

The review, “Homelessness in urban communities in the US: A Scoping Review Utilizing the Socio-Ecological Model,” published by the Florida Public Health Review, resulted from a long-term collaboration between the USF Morsani College of Medicine and the COPH to generate an evidence-based approach to homelessness in Tampa.

Throughout this collaboration, multiple educational seminars were conducted in 2021 for USF Health’s students, faculty and staff. As a result of this educational effort, a clear gap in studies on homelessness from a public health perspective was identified. Trejos’ collaborated with USF professors Drs. Joe Bohn, Karen Liller and Lynette Menezes, two medical students, Lauren Linkowski and Shannon Hall, and COPH alumna Carla Salazar in this scoping review.

The review utilized PubMed articles from 2016-2020 that involved homeless individuals and families in urban communities. A total of 145 articles were found for screening. Forty-nine articles met the selection criteria. They also used the USF Morsani College of Medicine’s Tampa Bay Street Medicine Team as a case study.

The Tampa Bay Street Medicine is a student organization at USF Health dedicated to improving the health of vulnerable populations in our community. Through outreach on the streets and in local shelters and free clinics, they seek to provide medical care, education and community connections to the homeless and unsheltered.

The results of this scoping review suggest that structural, systemic and historical factors at all the levels of the socioecological model are implicated in the complex reality of homelessness in U.S. urban communities generating individual and collective disparities. Future research and practice need to elucidate the impact of intersectionality among factors associated with homelessness.

“Even when findings from this scoping review highlight the complex nature of homelessness, it also presents opportunities for prevention, especially among those individuals experiencing transient homelessness and those at a higher risk for homelessness like minors, gender and sexually diverse individuals, veterans and others,” Trejos said.

“Even when historical landmarks situate the start of the U.S. housing crisis around the last mid-century, scientific research has yet to understand its policy and community-level implications within urban communities, including Tampa,” Trejos said. “Therefore, for the research team, it means a lot to be able to summarize findings and highlight potential next steps to prevent homelessness from a system and public health perspective.”

Story by Caitlin Keough, USF College of Public Health