Hailey Shingleton, Author at Fourth Street Clinic

Recognition for Extraordinary Care

Hailey Shingleton — Thu, 16 Jul 2026 23:11:49 +0000

In June, the Utah Office of Homeless Services and the Utah Homeless Services Board recognized Fourth Street Clinic for the extraordinary care our team provides to Utah's most vulnerable neighbors. In their words, our staff "meet people in the hardest moments of their lives with unwavering dignity, professionalism, and genuine compassion."

We were especially honored to be the only organization recognized during this presentation. As the award was shared, members of the Utah Homeless Services Board reflected on Fourth Street Clinic's impact and the vital role we play in our community.

Randy Shumway, Board Chair, Utah Office of Homeless Services:
"Supporting Fourth Street Clinic's expansion was the easiest letter I've ever written because of the volume of capacity and the quality of care they're providing."

Mayor Erin Mendenhall, Board Member:
"Fourth Street Clinic is a giant in our city, a uniquely critical and unreplicated component of care. They are incredibly valuable, irreplaceable, and have outgrown their current facility."

Spencer P. Eccles, Board Member:
"The University of Utah Medical School is the only medical school in the country where first-year students work directly with patients, and Fourth Street Clinic is one of those clinics. We're grateful for those on the front lines, caring for this population while helping train the next generation of physicians through compassionate, hands-on care."

As we celebrate this recognition, we also recognize that the work is far from finished. Every day, individuals and families experiencing homelessness depend on Fourth Street Clinic for compassionate, comprehensive health care, and every day, the demand continues to grow.

Your continued support ensures that no one is denied access to the care they deserve. Together, we can build a healthier future where every person, regardless of their circumstances, has access to quality health care, hope, and the opportunity to heal. If you are able, please consider making a gift today to help us continue this life-changing work and bring our vision for the future to life.

Thank you for believing in Fourth Street Clinic. Together, we are creating a place where healing happens and lives are transformed.

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More Than a Smile: Oral Health and Homelessness

Hailey Shingleton — Wed, 08 Jul 2026 20:28:19 +0000

When people think about health, they often focus on conditions like diabetes, heart disease, or high blood pressure. Yet oral health plays a critical role in overall well-being. Healthy teeth and gums affect our ability to eat, speak, sleep, work, and even connect with others. Poor oral health can lead to pain, infection and tooth loss and has been linked to many serious chronic health conditions.

For individuals experiencing homelessness, maintaining oral health can be especially difficult.

Most people take having access to a toothbrush, toothpaste, clean water and a safe place to store personal belongings for granted. For someone experiencing homelessness, whether living on the streets, in a shelter, or moving between temporary housing, basic necessities may not be available. Limited access to preventive dental care, transportation barriers, lack of insurance, mental health challenges and competing priorities such as finding food and safe places to sleep often push oral health to the bottom of the list.

As a result, small dental problems can quickly become serious health concerns. A simple cavity can develop into a painful infection that affects a person’s ability to eat and sleep, or work. Dental pain is one of the most common unmet health needs among people experiencing homelessness, yet many do not receive treatment until the problem becomes severe.

At Fourth Street Clinic, we see firsthand how oral health impacts overall health and quality of life. Damaged or missing teeth can affect a person’s confidence, employment opportunities and willingness to engage with others. For many patients, restoring their oral health is about more than treating pain – it is about restoring dignity.

Men’s oral health is an especially important focus. In 2025, 61% of the patients served by Fourth Street Clinic were men. Research shows that men are less likely than women to seek preventive dental care and are more likely to delay treatment until problems become serious. Men also experience higher rates of gum disease and oral cancer, making regular dental care and good oral hygiene particularly important.

At Fourth Street Clinic, we believe oral health care is health care. Through integrated dental services, we help patients address immediate dental needs while supporting their long-term health and well-being. Every person deserves access to quality dental care, regardless of their housing status or ability to pay.

A healthy smile is about more than appearance. It is about confidence, nutrition, dignity and improving overall health. By expanding access to dental care, we are helping individuals experiencing homelessness take an important step toward healthier and more stable lives.

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A Missed Opportunity: Why Access to Healthcare Still Matters

Hailey Shingleton — Wed, 08 Jul 2026 20:24:00 +0000

Fourth Street Clinic is encouraged to see a reported 1.6% decrease in homelessness reflected by the 2026 Point-in-Time (PIT) Count. Although modest, this progress demonstrates what is achievable when healthcare providers, housing partners, outreach teams, municipalities and community organizations work together in a coordinated and sustained way. We see what expanding collaboration, strengthening street outreach efforts, increasing behavioral health coordination, and connecting individuals to healthcare, housing navigation and supportive services can do. These collective efforts matter, and the PIT Count results suggest the community is taking small steps in the right direction.

At the same time, the PIT Count represents only a snapshot of a much larger and increasingly complex issue. Fourth Street Clinic is the only frontline provider of integrated comprehensive health care in Salt Lake County, and despite the decrease, our waitlist and patient volumes continue to demonstrate a need for services.

We have seen an extraordinarily high demand for medical, mental health, substance use, dental, pharmaceutical and case management services among individuals experiencing homelessness. In 2025, 91% of our patients were unhoused. We saw a 14% increase in demand for behavioral health and substance use disorder support, as well as an 11% increase in prescriptions dispensed – from 90,517 in 2024 to 103,605 in 2025. We consistently operate well above our staff and facility capabilities, and every day we must turn away 25% of walk in patients.

In addition, the 2026 legislative session displayed a missed opportunity by state officials to approve our 18-million-dollar appropriation for the expansion of our downtown clinic. Although the legislature allocated up to 44-million-dollars in funding toward homelessness services, zero dollars were invested in our goal to increase access to vital services. An expansion of Fourth Street Clinic means more patients are connected to care, resulting in stronger stabilization of outcomes, reduced strain on hospital and emergency systems, and greater long-term community impact. 

The lack of legislative investment toward our expansion consequently denies enhanced access to the vital health care services our patients need most, particularly during a time when we see such extraordinarily high demand. To make meaningful reductions in homelessness, continued investment is not only required in health care, but in housing and the supportive service systems that help individuals stabilize and remain housed.

Fourth Street Clinic remains committed to working collaboratively with community partners and policymakers to ensure progress continues. We know that now more than ever, investment in Fourth Street Clinic will help ensure that efforts do not stall. Thank you for standing with us as we work to see a continued reduction in homelessness in 2027 and beyond.

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Healing Without Barriers

Hailey Shingleton — Fri, 01 May 2026 21:00:50 +0000

Mental health challenges, substance use disorder and homelessness are often deeply connected – and deeply misunderstood. Stigma, past trauma, and broken trust can make seeking care feel impossible, leaving many without the support they need.

At Fourth Street Clinic, we believe care begins with meeting people where they are at, building trust and providing compassionate behavioral health care and substance use disorder support that treats the whole person, not just their addiction.

At just 21, Atreyo began experiencing homelessness, cycling in and out of the prison system while battling substance use disorder for over a decade. Exhausted and ready for change, he came to Fourth Street Clinic in 2023 seeking sobriety and care. Week after week, he rode the FrontRunner from a halfway house in Ogden, determined to show up for himself.

Through behavioral health support and medication-assisted treatment, Atreyo began to rebuild. Now 34, he recently entered his third year of sobriety and has steady work, as well as a stable place to call home. He continues to meet regularly with his provider at Fourth Street Clinic, maintaining his commitment to recovery.

“You guys saved my life,” he says. “You do awesome work here and help a lot of people.”

Alabama’s story is different, but no less shaped by determination.

Creative and free-spirited, she spends her days with her dog, Ellie, crafting jewelry to sell at the Liberty Park Drum Circle. She lives with PTSD and suicidal ideation, along with a reluctance to seek care shaped by past medical trauma. As the sole caretaker of her son, who became disabled after open-heart surgery, accessing care has never been simple.

After surviving domestic violence and losing connection with her family, Alabama found herself alone and eventually homeless. “I’ve always been a mom – that’s what my whole life revolved around,” she reflects.

For Alabama, the healthcare system has not felt safe. “Every doctor I’ve spoken to about my mental health issues has only ever written me a prescription and has never done an evaluation,” she shares. So, care comes to her.

Through our Medical Outreach Street Team, Alabama’s provider meets her where she is – creating space for trust and real support. For the first time, Alabama will receive a behavioral health assessment and begin getting the care she deserves.

“I want people to remember me in a good place, and I want to get my soul back,” she says.

On May 16 Fourth Street Clinic will walk with our community in NAMI Walks, standing for mental health awareness and the belief that no one should have to navigate these challenges alone. Stories like Atreyo’s and Alabama’s remind us that healing doesn’t look the same for everyone, but with the right support, it is always possible.

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How Homelessness Worsens Health, Especially for Minorities

Hailey Shingleton — Thu, 02 Apr 2026 23:15:12 +0000

April is Minority Health and Stress Awareness Month and from 4/6 – 4/12, it is also Public Health Week! Public Health Week highlights the conditions and circumstances that shape health outcomes across communities, and homelessness remains one of the most urgent public health challenges in the US.

For minorities, the health issues associated with homelessness are intensified, due to what researchers describe as “weathering,” or the cumulative impact of repeated social and economic adversity.¹ This includes both the stress of homelessness and the ongoing strain of systemic inequities. As we know, homelessness places individuals in a constant state of survival and fight or flight, triggering harmful biological responses such as raised levels of cortisol. Over time, this can raise blood sugar to dangerous levels, increasing the risk of or escalating pre-existing conditions, i.e., Type 2 Diabetes and hypertension.

In 2025, Fourth Street Clinic served 5,754 patients, many of whom identify as a minority. Our Diabetes Educator and Pharmacist, Shideh Hafezi, PharmD, sees the correlation between homelessness, chronic stress, minority populations and diabetes every day. In March of 2023, Shideh started treating a patient who lost their sight as a result of living with untreated diabetes, which was exacerbated by three pregnancies while experiencing homelessness. Being blind and having extensive nerve damage, she also could not check her feet for diabetes sores. When this patient first came to Fourth Street Clinic, her A1C level was 13.2%, but after receiving education around diabetes and working with Shideh, her A1C lowered to 8.5% by January of 2024. She was also able to see our volunteer podiatrist, to help manage her feet and neuropathy.

Patients are the reason we are driven to provide integrated, trauma-informed and culturally responsive care that addresses not only health disparities, but the toll of chronic stress amongst minorities experiencing homelessness. Our staff is intentionally diverse, and many are bilingual, because we want our patients to see not only themselves in us, but trust that we are invested in continuing to offer a space where every patient feels supported and valued. Minority Health and Stress Awareness Month and Public Health Week serve as a reminder that improving access improves health outcomes for vulnerable populations.

Richard, M. K. (2025). Homelessness and race: the impact of structural conditions on Black, White, and Latine homelessness. Social Problems.

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Why Safe Access to Health Care Matters for Women Experiencing Homelessness

Hailey Shingleton — Tue, 17 Mar 2026 20:19:54 +0000

In partnership with Huntsman Cancer Institute, Fourth Street Clinic hosts a Women’s Health Day every quarter to expand access to essential preventive care. During this event, unsheltered women receive mammograms, cervical cancer screenings, vaccines, and early HPV detection services in a supportive and welcoming environment.

This focus on high-quality care for women experiencing homelessness is especially important during Patient Safety Week in March, a nationwide effort to reduce harm and strengthen safe care practices across the health care system. By prioritizing preventive services and patient safety, Fourth Street Clinic works to ensure that every patient receives care in an environment built on compassion, trust and respect.

According to the National Alliance to End Homelessness, women without stable housing are disproportionately affected by gender-based violence, including domestic, dating, and sexual violence or exploitation, as well as stalking and human trafficking. The organization reports that 80% of women self-report trauma or abuse as the cause of their homelessness.

For Fourth Street Clinic and our Medical Outreach Street Team (MOST), the connection between gender-based violence and homelessness among women is clear. “A lot of the women we typically see while on outreach are either in or have experienced relationships where domestic violence occurs,” says Callie Larson, Supervisor of the MOST.

Fourth Street Clinic works to ensure women feel safe seeking care by fostering an empathetic and patient-focused environment. “Every day we tell our patients that we care about them and reassure them that we’re here for them; they aren’t alone. Helping them feel safe is centered around offering support and guiding them to resources that are available, if and when they are ready,” Callie says.

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As Homelessness Grows, Care Must Too

Hailey Shingleton — Wed, 04 Feb 2026 17:24:04 +0000

From January 29–31, volunteers across Salt Lake County participated in the nation-wide 2026 Point-in-Time Count. This annual count determines how many people are currently experiencing homelessness, including those sleeping on the street, in shelters, or in places such as cars and parks. The data collected during the count informs forward-looking decision-making for homeless service providers throughout the county; in 2025, the Point-in-Time Count showed an 18% increase in homelessness compared to 2024.

For Fourth Street Clinic, the Point-in-Time Count is a critical tool for estimating the level of health care need among people experiencing homelessness in Salt Lake County, allowing us to scale and adapt both our in-clinic and outreach services so we can meet patients where they are. The need for the trauma-informed, integrated health care we provide continues to grow and, currently, we are forced to turn away approximately 25% of walk-in patients due to the constraints of our clinical space.

Fourth Street Clinic is actively working to secure the funds needed to rebuild our current site, ensuring that individuals experiencing homelessness can access the care they need. In contrast to a $1,500 emergency room visit or costly hospitalization, Fourth Street Clinic spends only $500. Therefore, the preventative care provided at our clinic is not only cost-effective, but results in huge money savings for our community. If a patient falls below 200% of the Federal Poverty Line, the most they would ever pay for a clinic visit is $4.

Without care, many patients face significantly higher risks of developing complex health conditions – many of which are either directly caused or worsened by homelessness itself.
Consider managing diabetes, asks our Medical Director, Van Aston; “How can diabetics manage blood sugar through diet changes if they have nowhere to cook fresh food and vegetables? How can someone clean a wound daily if they don’t have access to a shower? These are things many people don’t realize they take for granted.”

In addition:

Long-term exposure to the elements weakens the immune system and keeps patients in a constant state of fight-or-flight.
Infections such as strep throat or MRSA spread quickly within shelter systems, and for patients with COPD, the risk of severe lung infections increases dramatically.
Chronic lack of sleep and personal safety leads to ongoing stress, which is proven to have serious and lasting impacts on health.

“We know that quality sleep is foundational to long-term health outcomes,” Van explains. “Living on the street or in shelters means patients are always on guard, even while sleeping. The data on chronic stress is clear – it can even alter your DNA.” Our patients’ experiences have consistently demonstrated that stable resources, access to health care, and housing support are vital to healthy outcomes. Ann Schmitt, MD, recently saw David for a diabetes checkup. “He had cut his diabetes numbers in half,” she shares. “When I asked what had changed, he told me he had received reduced housing and could finally cook his own meals.”

The Point-in-Time Count makes one reality unmistakably clear: as homelessness increases, so does the demand for accessible, integrated health care. Fourth Street Clinic stands at the intersection of these needs, providing care that stabilizes health, reduces emergency room utilization, and helps patients take meaningful steps toward recovery and independence. Expanding our facility is not simply a matter of space – it is an essential investment in public health, fiscal responsibility, and human dignity.

To learn more about our Capital Campaign, click here.

Fourth Street Clinic team members and volunteers after the 2026 Point-in-Time Count.

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