{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T02:09:30Z","timestamp":1789697370689,"version":"4.0.1"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000867","name":"Robert Wood Johnson Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000867","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Urban Health"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>There is growing recognition of the need for collaboration between the healthcare and housing sectors to address the needs of people experiencing homelessness. This study explores how these cross-sector collaborations can be improved from the perspective of those with histories of homelessness and complex health needs. In-depth, semi-structured qualitative interviews (<jats:italic>N<\/jats:italic>\u2009=\u200923) were used to (1) understand the challenges faced by people with complex health needs when navigating services at the intersection of healthcare and housing and (2) identify strategies for improving these services. While some participants reported accessing cross-sector services, many found those efforts to be lacking and ineffective. Participants reported receiving support with healthcare needs from housing providers more frequently than assistance with housing needs from healthcare providers. They described challenges related to provider turnover, perceived stigma and discrimination, and insufficient resources. Proposed solutions included modernizing and centralizing care, providing an effective balance of in-person and virtual offerings with an emphasis on in-person services, and improving provider sensitivity to reduce stigma against service recipients. These findings align with existing research on cross-sector collaborations in other fields and highlight the need for comprehensive, compassionate care tailored to the unique needs of people experiencing homelessness. The study also underscores the urgent need for more effective implementation and evaluation of these cross-sector efforts to improve outcomes for this vulnerable population.<\/jats:p>","DOI":"10.1007\/s11524-025-00966-z","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T07:14:19Z","timestamp":1742973259000},"page":"530-539","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Improving Cross-Sector Collaborations between Healthcare and Housing: Challenges and Strategies Identified by Unhoused People with Complex Health Needs"],"prefix":"10.1007","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7934-0961","authenticated-orcid":false,"given":"Emmy","family":"Tiderington","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora","family":"Sullivan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Yedidia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel C.","family":"Cantor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"issue":"2","key":"966_CR1","first-page":"3","volume":"20","author":"VH Garrison","year":"2018","unstructured":"Garrison VH, Pollack CE. Guest editors\u2019 introduction: the health-housing nexus: new answers to key questions. Cityscape. 2018;20(2):3\u20136.","journal-title":"Cityscape"},{"key":"966_CR2","doi-asserted-by":"publisher","first-page":"112571","DOI":"10.1016\/j.socscimed.2019.112571","volume":"243","author":"CB Swope","year":"2019","unstructured":"Swope CB, Hern\u00e1ndez D. Housing as a determinant of health equity: a conceptual model. Soc Sci Med. 2019;243:112571. https:\/\/doi.org\/10.1016\/j.socscimed.2019.112571.","journal-title":"Soc Sci Med."},{"key":"966_CR3","doi-asserted-by":"publisher","unstructured":"Taylor L. Housing and health: an overview of the literature. Health Aff (Millwood). Published June 7, 2018. https:\/\/doi.org\/10.1377\/hpb20180313.396577\/full\/","DOI":"10.1377\/hpb20180313.396577\/full"},{"issue":"5","key":"966_CR4","doi-asserted-by":"publisher","first-page":"758","DOI":"10.2105\/AJPH.92.5.758","volume":"92","author":"J Krieger","year":"2002","unstructured":"Krieger J, Higgins DL. Housing and health: time again for public health action. Am J Public Health. 2002;92(5):758\u201368. https:\/\/doi.org\/10.2105\/AJPH.92.5.758.","journal-title":"Am J Public Health"},{"issue":"1","key":"966_CR5","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1001\/jama.2017.20081","volume":"319","author":"HK Koh","year":"2018","unstructured":"Koh HK, Restuccia R. Housing as health. JAMA. 2018;319(1):12\u20133. https:\/\/doi.org\/10.1001\/jama.2017.20081.","journal-title":"JAMA."},{"issue":"6","key":"966_CR6","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1097\/MLR.0000000000001984","volume":"62","author":"A Celano","year":"2024","unstructured":"Celano A, Keselman P, Barley T, et al. National overview of nonprofit hospitals\u2019 community benefit programs to address housing. Med Care. 2024;62(6):359\u201366.","journal-title":"Med Care"},{"issue":"2","key":"966_CR7","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1353\/hpu.2013.0053","volume":"24","author":"KM Doran","year":"2013","unstructured":"Doran KM, Ragins KT, Gross CP, Zerger S. Medical respite programs for homeless patients: a systematic review. J Health Care Poor Underserved. 2013;24(2):499\u2013524.","journal-title":"J Health Care Poor Underserved"},{"issue":"2","key":"966_CR8","doi-asserted-by":"publisher","first-page":"295","DOI":"10.5206\/ijoh.2022.2.15134","volume":"3","author":"M Enich","year":"2022","unstructured":"Enich M, Tiderington E, Ure A. Street medicine: a scoping review of program elements. Int J Homelessness. 2022;3(2):295\u2013343. https:\/\/doi.org\/10.5206\/ijoh.2022.2.15134.","journal-title":"Int J Homelessness."},{"key":"966_CR9","doi-asserted-by":"publisher","unstructured":"Mohan B, Freeman AL, Doran, KM. Health and housing consortia: responding to COVID-19 through cross-sector learning and collaboration. Health Aff (Millwood). Published April 21, 2020. https:\/\/doi.org\/10.1377\/forefront.20200420.917823\/full\/","DOI":"10.1377\/forefront.20200420.917823\/full"},{"key":"966_CR10","unstructured":"National Academies of Sciences, Engineering, and Medicine. Permanent supportive housing: evaluating the evidence for improving health outcomes among people experiencing chronic homelessness. National Academies Press; 2018."},{"key":"966_CR11","unstructured":"Yedidia, M et al. Serving healthcare needs of people experiencing homelessness: strategies and challenges for cross-sector experiences. Center for State Health Policy, Rutgers University. Unpublished manuscript. 2025."},{"issue":"6","key":"966_CR12","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.2105\/AJPH.2014.302248","volume":"105","author":"TP Baggett","year":"2015","unstructured":"Baggett TP, Chang Y, Singer DE, et al. Tobacco-, alcohol-, and drug-attributable deaths and their contribution to mortality disparities in a cohort of homeless adults in Boston. Am J Public Health. 2015;105(6):1189\u201397. https:\/\/doi.org\/10.2105\/AJPH.2014.302248.","journal-title":"Am J Public Health"},{"issue":"1","key":"966_CR13","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1007\/s00127-017-1456-z","volume":"53","author":"S Feodor Nilsson","year":"2018","unstructured":"Feodor Nilsson S, Laursen TM, Hjorth\u00f8j C, Nordentoft M. Homelessness as a predictor of mortality: an 11-year register-based cohort study. Soc Psychiatr Psychiatr Epidemiol. 2018;53(1):63\u201375. https:\/\/doi.org\/10.1007\/s00127-017-1456-z.","journal-title":"Soc Psychiatr Psychiatr Epidemiol"},{"key":"966_CR14","unstructured":"Meyer BD, Wyse A, Logani I. The first national calculation of mortality of the US homeless population. Am Enterp Inst. Published May 24, 2024. https:\/\/www.aei.org\/articles\/the-first-national-calculation-of-mortality-of-the-us-homeless-population\/. Accessed\u00a012 Sept 2024."},{"issue":"1","key":"966_CR15","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1146\/annurev-publhealth-040617-013553","volume":"40","author":"PJ Fowler","year":"2019","unstructured":"Fowler PJ, Hovmand PS, Marcal KE, Das S. Solving homelessness from a complex systems perspective: insights for prevention responses. Annu Rev Public Health. 2019;40(1):465\u201386. https:\/\/doi.org\/10.1146\/annurev-publhealth-040617-013553.","journal-title":"Annu Rev Public Health"},{"issue":"1","key":"966_CR16","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1370\/afm.2632","volume":"19","author":"M Bazargan","year":"2021","unstructured":"Bazargan M, Cobb S, Assari S. Discrimination and medical mistrust in a racially and ethnically diverse sample of California adults. Ann Fam Med. 2021;19(1):4\u201315. https:\/\/doi.org\/10.1370\/afm.2632.","journal-title":"Ann Fam Med"},{"issue":"7","key":"966_CR17","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1007\/s11606-007-0183-7","volume":"22","author":"CK Wen","year":"2007","unstructured":"Wen CK, Hudak PL, Hwang SW. Homeless people\u2019s perceptions of welcomeness and unwelcomeness in healthcare encounters. J Gen Intern Med. 2007;22(7):1011\u20137. https:\/\/doi.org\/10.1007\/s11606-007-0183-7.","journal-title":"J Gen Intern Med"},{"key":"966_CR18","unstructured":"Saldana J. The coding manual for qualitative researchers. London: Sage; 2021."},{"key":"966_CR19","unstructured":"Padgett DK. Qualitative methods in social work research. 3rd ed. Los Angeles: SAGE Publications; 2017."},{"key":"966_CR20","unstructured":"Patton MQ. Qualitative research & evaluation methods: integrating theory and practice. 4th ed.\u00a0Los Angeles: SAGE Publications; 2014."},{"issue":"5","key":"966_CR21","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1176\/ps.48.5.659","volume":"48","author":"K Hopper","year":"1997","unstructured":"Hopper K, Jost J, Hay T, Welber S, Haugland G. Homelessness, severe mental illness, and the institutional circuit. Psychiatr Serv. 1997;48(5):659\u201365.","journal-title":"Psychiatr Serv"},{"key":"966_CR22","unstructured":"Beeson T, McAllister, BD, Regenstein M. Home\u2014National Center for Medical-Legal Partnership. George Washington University. Published 2013. https:\/\/medical-legalpartnership.org\/. Accessed 12 Sept 2024."},{"issue":"2","key":"966_CR23","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1016\/j.acap.2019.10.001","volume":"20","author":"ON Bell","year":"2020","unstructured":"Bell ON, Hole MK, Johnson K, Marcil LE, Solomon BS, Schickedanz A. Medical-financial partnerships: cross-sector collaborations between medical and financial services to improve health. Acad Pediatr. 2020;20(2):166\u201374. https:\/\/doi.org\/10.1016\/j.acap.2019.10.001.","journal-title":"Acad Pediatr"},{"issue":"2","key":"966_CR24","doi-asserted-by":"publisher","first-page":"e0117395","DOI":"10.1371\/journal.pone.0117395","volume":"10","author":"JG Chrystal","year":"2015","unstructured":"Chrystal JG, Glover DL, Young AS, et al. Experience of primary care among homeless individuals with mental health conditions. PLoS ONE. 2015;10(2):e0117395. https:\/\/doi.org\/10.1371\/journal.pone.0117395.","journal-title":"PLoS ONE"},{"issue":"2","key":"966_CR25","first-page":"85","volume":"20","author":"S Lucas","year":"2018","unstructured":"Lucas S. Connecting fragmented systems: public housing authority partnerships with the health sector. Cityscape. 2018;20(2):85\u2013106.","journal-title":"Cityscape"},{"issue":"2","key":"966_CR26","first-page":"19","volume":"20","author":"AL Freeman","year":"2018","unstructured":"Freeman AL, Li T, Kaplan SA, et al. A pilot community health worker program in subsidized housing: the Health + Housing project. Cityscape. 2018;20(2):19\u201338.","journal-title":"Cityscape"},{"key":"966_CR27","doi-asserted-by":"publisher","first-page":"1124054","DOI":"10.3389\/frhs.2023.1124054","volume":"3","author":"AJ Anderson","year":"2023","unstructured":"Anderson AJ, Noyes K, Hewner S. Expanding the evidence for cross-sector collaboration in implementation science: creating a collaborative, cross-sector, interagency, multidisciplinary team to serve patients experiencing homelessness and medical complexity at hospital discharge. Front Health Serv. 2023;3:1124054. https:\/\/doi.org\/10.3389\/frhs.2023.1124054.","journal-title":"Front Health Serv."},{"key":"966_CR28","unstructured":"Monarch Housing Associates. NJHMFA Hospital Partnership Subsidy Program\u2014Monarch Housing Associates. Published 2021. https:\/\/monarchhousing.org\/njhmfa-hospital-partnership-subsidy-program\/. Accessed 12 Sept 2024."},{"issue":"3","key":"966_CR29","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1111\/1468-0009.12514","volume":"99","author":"FJ Thompson","year":"2021","unstructured":"Thompson FJ, Farnham J, Tiderington E, Gusmano MK, Cantor JC. Medicaid waivers and tenancy supports for individuals experiencing homelessness: implementation challenges in four states. Milbank Q. 2021;99(3):648\u201392. https:\/\/doi.org\/10.1111\/1468-0009.12514.","journal-title":"Milbank Q"},{"key":"966_CR30","doi-asserted-by":"publisher","unstructured":"Enich, M (2023) Identifying homelessness in Medicaid claims: a mixed methods approach. Dissertation. Rutgers, The State University of New Jersey. https:\/\/doi.org\/10.7282\/t3-498s-yh07","DOI":"10.7282\/t3-498s-yh07"}],"container-title":["Journal of Urban Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11524-025-00966-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11524-025-00966-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11524-025-00966-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T08:22:46Z","timestamp":1757146966000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11524-025-00966-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,24]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["966"],"URL":"https:\/\/doi.org\/10.1007\/s11524-025-00966-z","relation":{},"ISSN":["1099-3460","1468-2869"],"issn-type":[{"value":"1099-3460","type":"print"},{"value":"1468-2869","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,24]]},"assertion":[{"value":"10 January 2025","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 March 2025","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}]}}