The prevalence of homelessness can be an indicator of a community's ability to provide stable jobs that pay a living wage, adequate support for the unemployed, affordable housing and accessible health care. Homelessness is related to larger issues such as poverty, employment, mental health, substance abuse, and family violence. The way a community cares for its more vulnerable citizens can also be a marker of collaboration and social support systems.

MetroWest had a rate of 17 homeless persons per 10,000 residents in 2022, lower than the state rate of 22 and the national rate of 17. The region's rate was down from a recent high of 30 in 2014 but still up from 15 in 2008. Since 2007, the statewide rate decreased slightly from 24 to 22, and the national rate has a pattern of modestly decreasing, falling from 21 to 17.

It is very difficult to obtain an exact count of homeless persons, due to transience and limited resources for record-keeping. Comparable data presented for available counties are currently limited to point-in-time counts done on one night in January. Data for this indicator are released annually in October.