{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:49:43Z","timestamp":1760147383299,"version":"build-2065373602"},"reference-count":61,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,31]],"date-time":"2023-01-31T00:00:00Z","timestamp":1675123200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Municipalities and HS organizations"},{"name":"The Maastricht University"},{"name":"the Radboud University Nijmegen"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Healthcare and social services aim to ensure health equity for all users. Despite ongoing efforts, marginalized populations remain underserved. The Dutch HOP-TR study intends to expand knowledge on how to enable the recovery of homeless service users. Methods: A naturalistic meta-snowball sampling resulted in a representative sample of homeless services (N = 16) and users (N = 436). Interviews collected health and needs from user and professional perspectives in a comprehensive, rights-based ecosystem strategy. We calculated the responsiveness to needs in four domains (mental health, physical health, paid work, and administration). Results: Most service users were males (81%) with a migration background (52%). In addition to physical (78%) and mental health needs (95%), the low education level (89%) and functional illiteracy (57%) resulted in needs related to paid work and administration support. Most had vital needs in three or four domains (77%). The availability of matching care was extremely low. For users with needs in two domains, met needs ranged from 0.6\u201313.1%. Combined needs (&gt;2 domains) were hardly met. Conclusions: Previous research demonstrated the interdependent character of health needs. This paper uncovers some causes of health inequity. The systematic failure of local services to meet integrating care needs demonstrates the urgency to expand recovery-oriented implementation strategies with health equity in mind.<\/jats:p>","DOI":"10.3390\/ijerph20032546","type":"journal-article","created":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T02:29:03Z","timestamp":1675218543000},"page":"2546","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Vital Needs of Dutch Homeless Service Users: Responsiveness of Local Services in the Light of Health Equity"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6039-3115","authenticated-orcid":false,"given":"Coline","family":"van Everdingen","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Neuropsychology, Maastricht University, 6200 MD Maastricht, The Netherlands"},{"name":"Van Everdingen Health Care Consultancy, 6132 TP Sittard, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter Bob","family":"Peerenboom","sequence":"additional","affiliation":[{"name":"Tangram Health Care Consultancy, 7006 CP Doetinchem, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4002-3413","authenticated-orcid":false,"given":"Koos","family":"van der Velden","sequence":"additional","affiliation":[{"name":"Department of Primary and Community Care, Radboud University Medical Centre, 6500 HB Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7420-0898","authenticated-orcid":false,"given":"Philippe","family":"Delespaul","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neuropsychology, Maastricht University, 6200 MD Maastricht, The Netherlands"},{"name":"Mondriaan Mental Health Trust, 6401 CX Heerlen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,31]]},"reference":[{"key":"ref_1","unstructured":"Wyatt, R., Laderman, M., Botwinick, L., Mate, K., and Whittington, J. 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