"The homeless population in Portland is growing older, more disabled, and is on the streets for longer periods. The "chronically homeless" have increased from 6% in 2015 to 13% in 2017. Homeless 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 a homeless person is a shockingly low 47 years. 72% of Portland"s homeless report a chronic disabling condition. 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 fester; and communicable diseases such as tuberculosis, AIDS, and viral hepatitis readily spread. Health disparities are exacerbated by mental health issues, substance use problems, and violence on the streets and in crowded shelters.Portland Street Medicine is based on two proven strategies that can quickly improve the health of people experiencing homelessness: 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. And without continuity, the trust that is necessary to make change over time is impossible to gain. The three most common causes of deathdrug overdose, cancer, and heart diseaseare either preventable or treatable in the traditional health care setting. Addressing the health care issues of homeless people is perhaps the greatest health equity challenge of our time."