Concurrent Session 2B: Homelessness is a public health emergency: translating best-practice principles into action

Homelessness and poor health are closely connected, with a cyclical relationship in which health conditions can lead to housing loss, while the experience of homelessness compounds and accelerates health deterioration. People experiencing homelessness face significant health inequities, including high rates of chronic disease, mental ill health, and substance use, alongside elevated rates of infectious disease. These inequities translate into avoidable hospitalisations, increased emergency department presentations, and a life expectancy gap of up to 30 years compared with the general population.

Despite these significant health needs, people experiencing homelessness often remain disconnected from primary and preventive care. When care is accessed, it is frequently crisis-driven and fragmented, resulting in missed opportunities for prevention and early intervention. One of the most significant barriers to effective health service provision is

the continued lack of integration of health within broader homelessness responses. Rather than being embedded as a core component of housing and homelessness systems, health care is often delivered separately, leaving people to navigate fragmented and complex pathways.

A recent AHURI research paper calls for homelessness to be recognised as a public health emergency, urging governments to embed integrated health responses within homelessness systems. This requires sustained investment, workforce development, and cross-sector collaboration to address structural inequities and prevent housing loss.

This presentation illustrates how these best-practice principles are being put into practice through St Vincent’s Homeless Health Service (HHS), a leading multidisciplinary assertive outreach model delivering compassionate, connected, and comprehensive care directly to people where they are. HHS bridges the gap between hospitals, primary care, and community settings, prioritising lived experience, culturally led care, and partnership. The service works closely with Aboriginal Health Workers and peer support workers to ensure care is trauma-informed, relational, and culturally safe.

Through case studies and lived-experience insights, the presentation will demonstrate how HHS builds trust, integrates care across systems, and addresses both structural and relational barriers to health and housing access. It offers a tangible, scalable model for embedding health as a foundation of homelessness responses, ensuring that care is not only delivered to people without homes but co-designed with and alongside them.

Presenters

Ms Erin Longbottom

Nursing Unit Manager, Homeless Health Service, St Vincent’s Health Network Sydney

Australia

Erin Longbottom is the Nursing Unit Manager of St Vincent’s Hospital Sydney’s Homeless Health Service, where she leads a multidisciplinary outreach team delivering essential healthcare to people experiencing homelessness across the inner city. Working on the front line, Erin provides compassionate, person-centred care to some of the community’s most underserved individuals, many of whom live with complex, chronic, or untreated health conditions.

With more than 20 years of nursing experience spanning the USA, New Zealand and Australia, Erin brings deep clinical expertise in both critical and community care. She has been instrumental in developing and implementing innovative models of outreach, including St Vincent’s Mobile Health Clinic, to improve health access and outcomes for people experiencing homelessness.

A passionate advocate for social justice, health equity, and the fundamental right to housing, Erin works collaboratively with people with lived experience, health providers, and government agencies to drive systemic change. In recent years, she has championed reform for non-resident individuals without access to Medicare, income, or support services—who make up around 20% of Sydney’s rough sleepers.

Erin is deeply committed to creating a more inclusive, just and equitable health system and to advancing efforts to make homelessness in Australia rare, brief, and non-recurring.

Chris Hartley

Research Fellow, City Futures Research Centre, University of New South Wales

Australia

Chris Hartley is a Research Fellow at the City Futures Research Centre, UNSW Sydney, and a leading researcher in housing, homelessness, and social policy. His work examines the intersections between homelessness, disability, trauma, and service systems, with a particular focus on embedding trauma-informed care at organisational and policy levels. Chris is the co-chief investigator on several national studies exploring innovative and integrated models of homelessness intervention, including his recent major AHURI report on public health responses to homelessness. He is also a co-author of the Australian Homelessness Monitor 2024 and 2022. His research seeks to build an evidence base that connects human experience, social policy, and systemic reform through co-designed, participatory approaches that drive more compassionate and effective service systems.