Head Start services fill a critical need in rural areas. They support the health of children and families, including those experiencing homelessness. This resource describes the health needs of children facing rural homelessness. It also offers strategies to support health-related needs in rural communities.

How is homelessness defined?

The McKinney-Vento Act defines homeless children as "individuals who lack a fixed, regular, and adequate nighttime residence." This definition includes families staying with relatives, friends, or others because they can't afford a home. Review Module 3 of the Supporting Children and Families Experiencing Homelessness series for an overview of the definition. This module also has tips for how to identify children and families experiencing homelessness.

Homelessness in Rural Communities

Homelessness is increasing in rural areas. This is because there are not enough jobs, and the jobs that are available don’t pay very much. It can be hard to find an affordable place to live. Rural areas may not have enough resources to help families with housing needs. There are also fewer services and supports for things like domestic violence, substance use disorder, mental health concerns, or disabilities that can contribute to homelessness.

Children experiencing homelessness in rural communities are often unidentified and uncounted. Because there are few emergency housing programs, they are more likely to live doubled-up with other families in crowded homes. Agencies may not count children living in these conditions as homeless. Families may live in cars, tents, barns, sheds, trailers, garages, or other structures without plumbing or electricity. They may not feel comfortable talking about their housing. It is important to identify all children who are experiencing homelessness so they can get services and support.

Health Risk Factors and Homelessness in Rural Areas

Children experiencing homelessness in rural communities may have more undiagnosed health issues. Their families may not have transportation to get to health appointments. Their community may not have enough health care providers and clinics. They may not have services for disabilities, including early intervention. Homelessness often involves moving frequently, which makes it harder to get consistent care.

Families face other stressors besides homelessness. These include rural isolation, poverty, undiagnosed or untreated health conditions, and higher rates of domestic violence and substance use disorders. The Rural Health Information Hub has tools and resources related to rural health issues and how to address them.

Strategies to Support the Health of Children Facing Rural Homelessness

The strategies below can help you support the health of children facing homelessness in rural areas. They go hand in hand with helping families access quality health care.

Engage your program’s Health Services Advisory Committee and Policy Council.

Members of your program’s Health Services Advisory Committee (HSAC) are your champions. In rural communities, they help find ways to meet housing needs. Policy Council members can offer information about resources and potential support. Families and staff who have experience with homelessness can describe their experiences with getting health care. Your HSAC and Policy Council may also help you find ways to identify families who are living doubled up or in other situations where they may not be identified as homeless.

Use community data to identify risks and protective factors.

The Head Start community assessment can help you find community strengths and gaps in housing services. Use this information to address risk factors, foster resilience, and improve health outcomes.

Gather data from school districts and housing programs in the service area. The McKinney-Vento liaison in each school district collects and can share data. Work with them to identify the younger siblings of school-age children and enroll them in your Head Start program. Ask housing programs for data on how many families they serve. Other data may come from domestic violence and substance use programs, child welfare agencies, and child care resource and referral agencies.

Use data to understand the services that families may need. Use the community assessment to learn where to find services such as temporary housing and help with utilities, transportation, and food.

Reduce barriers to health and behavioral health services.

Programs can use these strategies to reduce barriers to health and behavioral health services for families:

• Offer access to computers with internet.
• Provide phone cards, charging stations, gas cards, and travel vouchers.
• Have a resource pantry at the Head Start program for items such as drinking water, clothing, shoes, and hygiene and menstrual products.
• Offer access to restrooms, showers, laundry, and kitchens.
• Keep applications for health benefits on site. Display information on how to get services.
• Offer space to local peer navigators who can help families get health care services.
• Hold health fairs with health, dental, and behavioral health providers.
• Schedule times for health, dental, and behavioral health providers to offer services on-site at the Head Start program.

Match up referral processes with key community partners.

Agencies refer any families experiencing homelessness to the Head Start program, and the program refers families with identified housing needs to community partners.

Here’s what programs can do:

• Coordinate services so programs are not duplicating work to reach or serve families.
• Keep a contact list of community organizations.
• Share data and work together to collect data.

Develop strong community partnerships.

These strategies may help strengthen community partnerships to support child and family well-being:

• Share training resources and offer joint staff training.
• Advocate together for funding and expanded services.
• Provide Head Start services in the same location as other important services for families facing homelessness. Offer mobile services or provide space in one another’s programs.
• Share information about services by making the information available where people in rural communities may gather, such as convenience stores or places of worship.
• Develop local options for services, shelters, and other supports that may not be available nearby.
• Connect with Federally Qualified Health Centers (FQHCs) or other rural community health centers. Some are funded to provide health clinic services for families experiencing homelessness in rural areas.

Potential Community Partners

Here is a list of potential community partners:

Housing Services

• Emergency shelters and transitional housing programs
• Programs that help families find or pay for housing (e.g., housing vouchers, public housing, emergency utility help)
• Services that focus on domestic violence, substance use, or helping families of incarcerated people

School District Services

• Local McKinney-Vento liaison
• School nutrition programs that may support siblings or distribute food
• Transportation resources
• School counselors, social workers, and psychologists
• Programs that offer internet and broadband access

Economic Services to Meet Basic Needs

• Agencies that have public federal, state, or local benefit programs, such as Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance to Needy Families (TANF), and Medicaid
• Nonprofits, churches, and others with emergency and ongoing support for children and families
• Job training, education, apprenticeship, and job search services
• Food pantries, soup kitchens, and other access to nutritious food in the community
• Transportation services or rideshare programs and gas vouchers
• Libraries and other resources that offer access to phones and internet

Health Services

• FQHCs and rural community health centers
• Pediatric clinics and school-based health centers, health care providers, and school nurses
• Prenatal care providers
• Dental care professionals
• Infant and early childhood mental health consultants and providers
• Specialists who treat diabetes, asthma, disabilities, vision problems, or hearing loss
• Adult health care providers
• Adult therapists and recovery services
• Medical transportation providers
• Virtual health and behavioral health providers

Last Updated: April 17, 2024