Completed
Regional focus
North America
Topics
An expert committee under the Science and Technology for Sustainability (STS) Program, in collaboration with the Board on Population and Public Health Practice (BPH), completed a report that assesses the evidence on the impact of permanent supportive housing (PSH) programs on improved health outcomes and health care costs for those experiencing chronic homelessness. The report offers 9 recommendations for actions to increase knowledge on the relationship of PSH and health to help address policy and program barriers that affect the ability to bring PSH to scale to address housing and health care needs.
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Consensus
·2018
Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised cit...
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Description
An ad hoc committee, under the auspices of the Science and Technology for Sustainability (STS) Program and the Board on Population and Public Health Practice, will evaluate interventions and policy options for addressing urban homelessness, particularly permanent supportive housing programs.[1] Specifically, the study will address the fundamental question, to what extent have permanent supportive housing programs improved health outcomes and affected health care costs in people experiencing homelessness? To address this question, the committee will take into consideration any variation in outcomes for different subsets of homeless populations, including people experiencing chronic homelessness and people identified as high-utilizers of health care services, as well as the variation in outcomes related to different housing configurations and approaches to services delivery and financing associated with permanent supportive housing.
The committee will focus on the following questions:
• What is the evidence that permanent supportive housing improves health-related utilization and outcomes in homeless persons with serious, chronic or disabling conditions (e.g., substance use disorders, serious mental illness, physical disabilities, diabetes, etc.)? How cost effective is permanent supportive housing for addressing homelessness and health outcomes compared with usual care and alternative interventions?
• What are individual and other characteristics that may be associated with the health related outcomes and costs of permanent supportive housing (e.g., age, health conditions, other demographics)?
• What characteristics of permanent supportive housing programs, if any, result in improved health outcomes and evidence of cost effectiveness?
• How generalizable are the findings from studies evaluating outcomes associated with the use of permanent supportive housing in the chronically homeless to other homeless populations (families with children, disabled persons, etc.)?
• Are the outcomes associated with the use of permanent supportive housing translatable to other populations or systems (e.g., what are common characteristics that might translate to an institutionalized population)?
• What are the key policy barriers and research gaps associated with developing programs to address the housing and health needs of homeless populations?
The committee will produce a consensus report with findings and recommendations.
[1] Permanent supportive housing is defined as decent, safe, and affordable community-based housing that provides residents the rights of tenancy under state and local landlord-tenant laws.
Contributors
Committee
Chair
Member
Member
Member
Member
Member
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Sponsors
Blue Shield of California Foundation
California Health Care Foundation
Conrad N. Hilton Foundation
Department of Veterans Affairs
Elsevier
Kresge Foundation
Melville Charitable Trust
The Gates Foundation
Staff
Michael Dorsey
Lead