Experiencing Housing Instability in Rural North America and Access to Health Care and Supportive Services: A Scoping Review.

Roncarati JS, Cusack M, True G, Browne J, Harris T, deRussy A, Tsai J, Elwy AR, Byrne TH, Montgomery AE. Experiencing Housing Instability in Rural North America and Access to Health Care and Supportive Services: A Scoping Review. Journal of health care for the poor and underserved. 2025 Jan 1; 36(1):21-55, DOI: 10.1353/hpu.2025.a951583.

Related HSR&D Project(s)

• RCS 23-081 – HSR&D Research Career Scientist Award

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Abstract:

OBJECTIVE: We conducted a scoping review of 45 peer-reviewed articles to characterize the intersection of housing instability and homelessness, care, and services in rural North America. We sought gaps in literature related to geographically based health disparities among people experiencing housing instability and identify practices that may promote better health outcomes. We offer practical implications for health care and service provision for people experiencing housing instability in rural areas. METHODS: We reviewed the literature and according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) standards. RESULTS: We identified 45 articles matching the inclusion criteria for full-text review. Emerging themes included subpopulations and demographics, physical and behavioral health, and services. CONCLUSIONS: More information is needed on housing instability in rural settings such as housing instability among unsheltered individuals, Native Americans, and older persons. Solutions to end homelessness should consider tailoring resources and services to the rural context.