Homelessness
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Abstract
This chapter assesses the effects of homelessness on public health. Homelessness has the power to move people to action like few other issues. Unfortunately, efforts to tackle homelessness have fallen short. Historically, making housing contingent on sobriety and employment has imperiled millions. Encouragingly, Housing First—a program that provides housing and support services without requiring employment or pretreatment for mental health conditions and substance use disorders—has started to gain traction. The program has led to improvements in housing stability, reduced hospitalizations and use of emergency departments, and better quality of life. Adding to the challenge, however, is the fact that over 8 million more Americans are just one step away from homelessness. Unlike the homeless, they are often invisible. Preventing homelessness in these lower income households requires the creation of a living wage. Prevention is also about identifying risk and providing supportive services when an individual or family is on the brink.