- Posted by EmpowerNonprofit
- On January 16, 2018
On any given night, at least a half-million people are homeless in the U.S., an embarrassing fact for the world’s wealthiest nation. But homelessness is more than an embarrassment, it’s expensive. The average chronically homeless person costs their community $30,000-$50,000 per year. This money is spent on police and court time, incarceration, temporary shelter and, especially, health care: Homeless individuals are frequent visitors to emergency departments and hospitals. If that’s the case, wouldn’t it be logical to operate as if housing is health care for homeless individuals? That’s exactly what research is telling us.
Life on the streets wreaks havoc on the human body. Some sources suggest that for individuals experiencing long-term homelessness, each year unhoused will advance their biological age by two years. As a result, we’re encountering homeless individuals as young as 40 or 50 experiencing what we normally think of as geriatric conditions.
I learned about this firsthand while working for a social services agency in Oregon. Our typical newly housed formerly homeless client was being treated for three chronic illnesses. The ailments encountered included hypertension, diabetes, COPD, heart failure, emphysema, kidney disease and chronic infections. On top of that, many showed signs of cognitive impairment as well as a history of brain trauma, mental illness, alcoholism or substance use disorder.
Not surprisingly, these aging, unhoused and unhealthy individuals are frequent ER visitors and exist on what seems to be a circular conveyor belt between a hospital bed and homelessness. They are sometimes called “super utilizers” or more derisively, “frequent flyers.” Yet often there isn’t much frivolity about their ER visits. These people are at risk of dying and need medical attention.
Homelessness is a complicated problem, with myriad contributing causes and lots of debate over solutions. Yet more and more people are focusing on two realities: 1) We’ll make the most progress if we attack homelessness as a health care problem; and 2) The best intervention for this particular health care problem is housing.
A new study by the RAND Corporation confirms the effectiveness of housing as a health care intervention for Los Angeles’ homeless population. That city’s Housing for Health program yielded some eye-popping results in just one year. By providing housing and a variety of support services (the technical term for this is “permanent supportive housing”), L.A. reduced health care expenditures by $20 million and overall public costs attributable to the study’s population of homeless individuals by 60 percent. Supportive housing isn’t free, but even factoring in rent and support costs, the program still saved the city 20 percent over doing nothing.
This isn’t the first research to produce these kind of results; in fact, it’s just the latest in a long line of studies telling us that permanent supportive housing can solve our homelessness/health care problem. That’s why Hawaii and other states are considering making it legal for doctors to write housing prescriptions. It’s also why hospitals and health insurance companies are getting involved by funding supportive housing programs. It’s time that more American cities followed their lead and started believing that housing is health care—and the best treatment for homelessness.