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Advocacy for Shelter Access

January 20, 2023

Family Connections with Pediatrics Blog
Each night in the US, at least 109,000 children are homeless.1 This number does not reflect those at risk of being homeless, nor the estimated 1.5 million other families who may become homeless because of the ongoing COVID-19 pandemic.2,3 These numbers likely give most of us pause and lead us to wonder and worry about what can be done. Lack of affordable housing and shelter beds has long been a problem, so how can we improve access? In an article being early released online this month in Pediatrics, ‘Community- Academic Advocacy to Improve Shelter Access for Families Experiencing Homelessness’, Kanak et al describe how emergency department (ED) doctors in one state worked to change state policy that had made it hard to access shelters (10.1542/peds.2022-057935).

What was the challenge with shelter access?
Starting in 2012, Massachusetts made families, unless they needed emergency shelter because of domestic abuse or natural disaster, prove that they were homeless before they could get shelter. This meant that families had to get someone to verify that they were, for example, sleeping in a car, park, or train station. As a result, the authors noted more families in the ED reporting homelessness, not medical issues, as their main concern.

How did the authors work to improve shelter access?
The authors worried that the rule change was a barrier and led families to spend a night in the ED to be able to get into a shelter.

The article outlines in detail the ways the authors worked to improve shelter access, such as:

  • Storybanking: They wrote down stories in real time and stored them in a “bank” to share (see Table 1 in article)
  • Coalition building: They joined community legislative events to advocate against this state policy e and share stories from the storybank
  • Tailored messaging: They gave testimony to help change policy
  • Data sharing: They used information from the ED to do research and publish articles to be used as advocacy tools

The full article also shares their progress in improving access to shelters.

What can you do with this article?

  • If your family is at risk of being homeless, talk with your child’s doctor for help.
  • If you work or serve in a community organization, share this article for ideas of how to build a coalition with families and pediatric clinicians for shelter access or other issues affecting children and families.


  1. US Interagency Council on Homelessness. Homelessness in America: Focus on Families with Children. 2018. Available at:
  2. Coughlin CG, Sandel M, Stewart AM. Homelessness, children, and COVID-19: A looming crisis. Pediatrics. 2020;146(2). doi:10.1542/peds.2020-1408
  3. Wulfhorst E. Coronavirus could put 1.5 million US families on cusp of homelessness. Reuters. April 8, 2020. Available at: s-families-on-cusp-of-homelessnessidUSKBN21Q27M
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