THE PROBLEM
The statistics are staggering
Nationally, Oregon has the fourth highest rate of homelessness in the nation.
The system isn't built to reach people living outside, so we go to them. The 2025 Multnomah County point-in-time count showed that 10,526 of our neighbors are living without a home, up 67% in just two years. More than 4 in 10 of the folks surviving outside are carrying a chronic health condition, just as many live with a physical disability, and nearly half meet the federal definition of chronic homelessness. These aren't problems you fix in one visit, so we keep showing up, backpacks loaded, because everyone deserves health care.
10,500+
Number of people who experienced homelessness in Multnomah County on a single night in January 2025.
48 Years
The life expectancy of an unhoused person can be 30 years shorter than their housed counterpart.
1800 medical visits
In FY2025, we delivered 1800 medical visits
500+ patients
In FY2025, we saw 500 unique patients
Unhoused folks in our community face stigma, social isolation, and loss of relationships. They suffer a disproportionate burden of illness and premature death.
The life expectancy of an unhoused person is a shockingly low 48 years. The daily struggle for food, shelter, clothing, and safety relegates health to a low priority, which in turn increases health risks, exacerbates chronic conditions, and complicates treatment. Infections, injuries, and other acute conditions go untreated; and communicable diseases such as tuberculosis, AIDS, and viral hepatitis readily spread.
Unhoused people in our community are structurally marginalized and suffer a disproportionate burden of illness and premature death, largely from conditions like these that are treatable or preventable. Nearly all our patients have had traumatic experiences with mainstream medicine, which adds fear and mistrust to the many barriers for accessing care.
To improve health outcomes for this population, care options must include relational street-based and trauma informed care, including public health harm reduction and health education services that open a window for further engagement. In response to this need we are unique in the Portland Metro region as the only provider of this type of outreach and engagement, offering a strong net of wrap around services.
Portland Street Medicine is based on two proven strategies that can quickly improve the health of unhoused peoples: access and continuity. Those without access to healthcare are at increased risk for later-stage diagnosis of disease, poor control of manageable conditions (e.g. hypertension, diabetes), and hospitalization for preventable conditions.
Without continuity, the trust that is necessary to make change over time is impossible to gain. The three most common causes of death— overdose, cancer, and heart disease—are either preventable or treatable in the traditional health care setting. Addressing the health care issues of unhoused peoples is perhaps the greatest health equity challenge of our time.
