On any given night in 2024, approximately 771,480 people experienced homelessness in the United States, including more than 150,000 people in California. Nearly 40% of people experiencing homelessness are unsheltered, meaning they sleep in places not intended for human habitation such as sidewalks, encampments, bus stations, or abandoned buildings. 

People experiencing unsheltered homelessness face disproportionately high rates of chronic disease, mental illness, substance use disorders, injury, and premature death. Limited access to clean water, nutritious food, sanitation, and protection from the elements further increases the risk of illness and injury, including infections, burns, frostbite, falls, and untreated chronic conditions. Despite having some of the greatest health needs, people experiencing unsheltered homelessness face significant barriers to accessing traditional healthcare, including: 

• Lack of transportation or reliable communication (phone or internet)

• Limited access to identification or insurance documentation

• Financial instability 

• Mental illness and substance use disorders

• Difficulty maintaining continuity of care

• Mistrust of healthcare systems and providers

• Prior experiences of trauma, stigma, discrimination in healthcare settings

These structural and experiential barriers make it difficult for many Californians to receive care until their conditions become severe. 

In response to the recognition that many people experiencing homelessness are unable to access traditional clinic-based care, modern street medicine was born. 

Street medicine is a healthcare delivery model that brings medical care directly to people experiencing unsheltered homelessness wherever they are: on streets, in encampments, under freeway overpasses, and in other places not intended for habitation. Rather than waiting for patients to come to healthcare, street medicine providers bring healthcare to patients. 

No two street medicine programs are identical; each is tailored to meet the needs of its local community. Care is often delivered by multidisciplinary teams that may include some combination of physicians and nurse practitioners, social workers and behavioral health clinicians, case managers, and/or peer support specialists with lived experience of homelessness. Providers often practice medicine from their backpacks while conducting outreach in encampments, city streets, parks, rural areas, and other places where unsheltered Californians live. 

Street medicine services commonly include: 

• Primary care

• Urgent and episodic medical care

• Chronic disease management

• Wound care

• Mental health assessment and treatment

• Substance use treatment, including medication-assisted treatment

• Care coordination, housing navigation, and connections to community resources 

Street medicine serves as a critical entry point into healthcare for people who might otherwise remain disconnected from medical services. Nationally, the majority of street medicine programs provide comprehensive primary care, more than two-thirds diagnose and treat mental health conditions and substance use disorders, and approximately 60% offer medication-assisted treatment for opioid use disorder. Street medicine also advances health equity, serving a disproportionately high number of historically underserved populations. 

By meeting people where they are—with the fundamental principles of dignity, respect, and relationship-centered care—street medicine reconnects Californians to the broader healthcare ecosystem and improves health outcomes, all the while building trusting and lasting relationships.