Addressing Unsheltered Homelessness and Substance Use Disorder From Tent Encampment to Safe Spaces, Boston 2021–2022

Increasing numbers of individuals experiencing unsheltered homelessness and substance use disorder are living in tent encampments in cities across the United States. In response, the City of Boston, Massachusetts employed a public health approach comprising four implementation components: centralized leadership with cross-agency collaboration, creation of low-threshold spaces, person-centered engagement, and stakeholder-driven long-term planning. These steps led to the equitable transition of unsheltered individuals into harm reduction spaces and formed the foundation for future planning and encampment response in the city. (<i>Am J Public Health</i>. 2025;115(5):689-692. https://doi.org/10.2105/AJPH.2025.308009).