The Status of Homeless Women in Massachusetts: Are We Adequately Addressing the Social Determinants of Their Health?
Author: Pooja Mehta, MD Class of 2019
Mentor(s): Roseanna Means, MSc, MD; Jo-Anna Rorie, CNM, MPH, PhD
PURPOSE: Massachusetts has been a leader in the nation in addressing homelessness and creatively thinking about how to approach the needs of this vulnerable population. Despite current efforts, the number of homeless women in Massachusetts appears to be on the rise as is the demand for resources. The purpose of this paper is to provide information about the way homeless individuals are counted in Massachusetts, discuss key social determinants of health that affect homeless women, and offer policy recommendations.
METHODS: A multifactorial approach involving a historical review, literature, and policy review, primary data from nonprofit organizations, and key informant interviews were used in this paper.
RESULTS: The current point-in-time methodology for determining the prevalence of homelessness does not explicitly count and likely undercounts the number of homeless women. From 2012 to 2016, the number of women aged 60+ seen at Health Care Without Walls (HCWW) increased by 44%. In 2017, HCWW cared for six women over 90-years-old and in 2018, that number increased to 10. From 2013 to 2017, the Boston Health Care for the Homeless Program (BHCHP) outpatient program saw a 66% increase in the number of women aged 60+. At the Women’s Lunch Place, the number of resource center visits almost doubled and the number of meals served increased from 71,000 to nearly 105,000 from 2013 to 2017. At Rosie’s Place, the number of meals served increased from 80,000 to 104,000 during that same time period. Woods-Mullen Shelter, one of a handful of female-only shelters operated by the City of Boston, regularly exceeds its capacity by 10-15%.
CONCLUSIONS: There is a clear and increasing need for an accurate account of women experiencing homelessness and additional services that address the social determinants of health for homeless women. We recommend the establishment of a Massachusetts Commission on Homeless Women whose primary purpose would be to accurately study the incidence and prevalence of homelessness amongst women in the state and assess gaps in safety net services.