New Jersey Launches Its First Street Medicine Program

The Model That Has Proven Highly Successful Across the Country Has Now Come to the Garden State

In May, RWJBarnabas Health launched a new street medicine program designed to bring essential health care services directly to the homeless people who need them. This program is the first of its kind in the state of New Jersey and operates across the city of Elizabeth, with plans to expand into other areas in the future.

Street Medicine Programs Fill a Big Need

The new street medicine team from RWJBarnabas travels around the city in a clearly marked van, visiting locations such as homeless shelters, encampments, transitional housing centers, and other spaces where groups of homeless people gather together. The team is equipped to provide a wide range of care on site, including management and prevention of chronic diseases, urgent and acute care, mental health care, street psychiatry, and substance use support and harm reduction.

For situations beyond their scope, the street medicine team can refer people to other services and provide transportation to local clinics for long-term or specialized care. This removes barriers for some who have previously found it difficult to access care. The trusting relationships built over time between the street medicine team and their patients can make it easier to access further care and reach more people.

“Our Street Medicine Program is born from a culture that recognizes everyone, regardless of circumstance, is deserving of compassion and access to the world-class healthcare we provide,” said Mark E. Manigan, President and Chief Executive Officer, RWJBarnabas Health. “Being the first in New Jersey to put such a focus on the immediate healthcare needs of some of our most vulnerable residents is something in which RWJBarnabas Health takes tremendous pride.”

While they may have been the first in New Jersey, they’re far from the first.

Street Medicine Works

Street medicine teams have been active in cities and states across the country for many years now. In nearby Philadelphia, the well-established mobile crisis team program may soon expand to provide mental health care and prescription delivery as part of its services. In California, even some rural areas are served by the state’s network of street medicine teams.

The effectiveness of street medicine has been well established by numerous peer-reviewed studies. And now, with funding from the state through its Our Healthy Communities initiative, it’s coming to New Jersey.

“I’m excited that we are officially launching the Street Medicine Program, and I look forward to helping lead this team,” said Edward Egan, MD, Medical Director, Street Medicine. “We know the unhoused population faces disproportionate barriers to receiving the care they need. This program will make a meaningful difference in our patients’ lives and help prevent hospitalizations, ensuring we can continue to deliver world-class care to our patients.”

The disproportionate barriers to receiving care that Dr. Egan speaks of are numerous. On top of the everyday annoyances that housed people are familiar with, like taking time off work to attend appointments, there are unique challenges that keep traditional healthcare out of reach for many homeless people. A lack of insurance is, of course, a big one, coupled with a lack of knowledge about any supplemental benefits programs they may be eligible for.

Not having the right identification documents can sometimes result in people being turned away, depending on each provider’s policies. Unsheltered people are also less likely to have access to reliable transportation, making it challenging to get to and from appointments. Picking up prescriptions poses a similar problem, since without a physical address, you can’t have them delivered. And without a secure place to store your belongings, that medication can easily be lost, damaged, or destroyed in a sweep.

On top of all this, medical providers are unfortunately not immune to the cultural demonization of homeless people that has been pushed more and more in recent years. They may harbor conscious or unconscious biases that lead homeless patients to have bad experiences with medical care, making them more hesitant to return in the future.

In light of these issues, it’s easy to see why street medicine is so effective. It eliminates the barrier of transportation by coming directly to patients instead of expecting patients to come to the clinic. It employs trauma-informed professionals who either have lived experience or are trained to address the unique circumstances homeless people face, meaning they won’t unnecessarily require ID and will be knowledgeable enough to connect people with the programs they’re eligible for to access better care. And the consistency of the care allows people to build a trusting relationship with a care provider over time, in a less emotionally charged environment than a hospital or doctor’s office.

This whole-person approach can even lead to better housing outcomes!

Street Medicine is Essential to Counter the Effects of Homelessness

Homelessness is hard on your health, both physically and mentally. On average, experiencing homelessness can reduce a person’s total life expectancy by 28 years. Homeless people are 16 times more likely to die suddenly from causes like heart attacks, gastrointestinal disorders, and infections that went unnoticed until it was too late.

Lack of access to nutritious foods increases rates of diabetes in this population. The incidence of late-stage cancers is also higher due to a lack of access to screenings that could have caught it sooner.

Oral health deteriorates the longer you go without a visit to the dentist. Few people are going in for an eye test when they have so much else to deal with. Stress compounds these conditions. There are still all the health hazards of living in close quarters with others, out in the elements, and with limited access to hygiene facilities.

Being homeless affects not only how often you get sick, but also how well you are able to recover. And in the midst of all this, unsheltered people face 10 times more barriers to medical care than housed people do. Street medicine is essential to bridge this divide.