National Academy of Medicine

Integrating Health Care and Supported Housing to Improve the Health and Well-Being of the Homeless: A Population Health Case Report

By John Lovelace
March 29, 2016 | Discussion Paper

Poor health is both a cause and a result of homelessness. According to the National Health Care for the Homeless Council, people who are homeless are three to six times more likely to become ill than those with stable housing and three to four times more likely to die prematurely. The average life expectancy in the homeless population is estimated to be between 42 and 52 years, compared to 78 years in the general population.

For many reasons, individuals who are homeless and need medical treatment do not receive it. Barriers to health care among homeless individuals include inability to pay, lack of knowledge about where to seek treatment, lack of transportation, difficulty completing forms, and self-consciousness about appearance and hygiene when living on the streets. Consequently, many homeless people use hospital emergency departments as their primary source of health care. Underuse of preventive and primary care services leading to mostly unplanned interventions in more costly settings contributes to poor health outcomes, high health care costs, and inadequate coordination of care for this high-need population subgroup.

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Integrating health care and supported housing


Disclaimer: The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.