Homeless women – too vulnerable for care, too invisible for statistics

Published: 17 December 2025

Reading time: 4 minutes

Women experiencing homelessness are often subjected to discrimination in healthcare encounters and die prematurely. Yet they remain nearly invisible in both statistics and research. In her research project, Elisabet Mattsson and her team give space to the women’s own voices – and expose a system that all too often fails them.

Research on homelessness has long been dominated by male perspectives, creating a significant knowledge gap regarding homeless women's living conditions, health, and needs. Women are severely underrepresented in studies on the subject, and their specific vulnerability – which almost always includes violence – is rarely reflected in statistics, policy, or practice.

Elisabet Mattsson, Professor Emerita at Marie Cederschiöld University, has led a Forte-funded project investigating access to healthcare for women experiencing homelessness. Interviews, focus groups, and register analyses were used to highlight structural barriers affecting quality of life and life expectancy. She believes the results become more relevant and useful by involving the target group as research assistants.

– We’ve heard many stories where patient safety has failed this group. The lack of knowledge among healthcare staff is still significant, and prejudice is widespread. For example, one woman with a stroke was sent home because staff assumed she was under the influence of drugs. Another risked losing a leg due to an infection that wasn’t taken seriously. These aren’t isolated incidents – they’re the tip of the iceberg, says Elisabet.

Regardless of what the women seek care for, they are referred to addiction services.

Sanna Vahlman

Operations Manager, Ersta Fristad and Ersta Möjlighet

No access to technology means being shut out

The group of women living in homelessness is heterogeneous: for some, the lack of housing is linked to addiction or long-term vulnerability, while others live in hiding with protected identities after fleeing partner violence.

Mattsson’s research shows that homeless women often stand outside the regular healthcare system – they are frequently not registered with health centers and may lack identification or the means to pay patient fees. Accessing digital healthcare is nearly impossible without a mobile phone, BankID, or internet connection.

– Often, women seek help only when absolutely necessary, and then it’s the emergency room they turn to. Another major issue is that women with protected identities are often exposed during healthcare encounters and excluded from digital options because there is still no technology for secure identification, says Elisabet.

Referred to addiction services regardless of diagnosis

Sanna Vahlman, who has been involved in the research project from the start, can testify to how the situation looks in practice. She is the operations manager for both Ersta Fristad and Ersta Möjlighet – two protected shelters for women with different needs.

– Many of the women who come to our shelter Ersta Möjlighet have a combination of addiction issues and exposure to violence. They receive fewer interventions from both healthcare and social services, and the distrust they encounter eventually leads them to avoid seeking help, she explains.

Sanna explains that the care chain for women with addiction problems is practically non-existent.

– Almost regardless of what the women seek care for, they are referred to addiction services. This makes it extremely difficult for them to receive appropriate interventions. Even when our women seek help for severe mental illness, they are sent to addiction emergency services. The addiction diagnosis overshadows everything else, she states.

Good care means being seen as an individual. Not as an addiction diagnosis, not as a homeless person.

Elisabet Mattsson

Professor Emerita, Marie Cederschiöld University

“Just looking for drugs”

Both Elisabet and Sanna point out that prejudice and ignorance are root causes of the poor treatment within healthcare. Women experiencing homelessness report that healthcare staff often speak disparagingly about them while they are standing nearby, or accuse them of “just looking for drugs.”

– Almost regardless of what the women seek care for, they are referred to addiction services. This makes it extremely difficult for them to receive appropriate interventions. The addiction diagnosis overshadows everything.

– There’s a perception that this group is more manipulative or aggressive and therefore harder to handle. But our experience shows that this isn’t true, says Sanna, adding:

– Moreover, women are judged more harshly than men because we live in a patriarchal society. There’s an expectation that they should manage on their own, be stronger and more responsible – even in crisis.

Passed around without anyone taking overall responsibility

Research and practice show that women experiencing homelessness live in danger. They are discriminated against, receive poorer care, and die earlier than others. The lack of coordination means that homeless women are often passed around between different agencies without anyone taking overall responsibility.

Elisabet’s research points to an urgent need for coordinated efforts that combine addiction care, housing support, and psychosocial support to reduce excess mortality. She hopes the project will contribute to a more equitable and respectful healthcare system.

– Good care means being seen as an individual. Not as an addiction diagnosis, not as a homeless person. What’s needed is respect, coordination – and the courage to let the women themselves help shape the solutions.

Nicole Kling (English translation by Forte)

What Is Homelessness?

The National Board of Health and Welfare defines homelessness broadly, including people without a roof over their heads, those temporarily staying with others, living in institutions or emergency shelters, and those without permanent housing.

Homelessness Without Addiction or Mental Illness

More than half of people experiencing homelessness have neither a documented addiction nor a psychiatric diagnosis. This challenges the common perception that homelessness mainly affects people with extensive social problems.

Homeless with a Job

A significant proportion of homeless individuals have some form of income from work, but still cannot afford or access their own housing – especially in major cities where the housing shortage is most severe.

“Invisible Homelessness”

The largest group of homeless people in Sweden live in long-term housing solutions supported by the municipality – not on the streets. This makes homelessness less visible in public spaces, but no less serious.