Coaching

As Public Health thought leaders push for greater understanding of the social determinants of health, they increasingly focus on stable, affordable housing as a critical piece of the puzzle for reducing the risk of worsening chronic health conditions, frequent and/or avoidable hospitalization, increased costs, and early mortality for vulnerable populations.   Kaiser-Permanente Chief Community Health Officer Bechara Choucair and National Health Care for the Homeless Council CEO Bobby Watts persuasively argue in Rx for Health: A Place to Call Home that “homelessness itself can accurately be characterized as a dangerous health condition.”[1] The statistics they cite demonstrating dramatic health outcome and mortality disparities for people experiencing homelessness strongly suggest that increasing access to safe and secure housing would, at a population health level, have an enormous impact. [2]  Simply stated, preventing people from losing their housing in the first place also prevents poor health outcomes.  In turn, re-housing people who have become homeless reduces the danger of rapidly deteriorating health that is part and parcel of homelessness.  Yet there are thousands upon thousands of people across the U.S. whose unmanaged chronic conditions have already been exacerbated by homelessness.  Effectively and sustainably addressing their needs entails grappling with an array of policy and operational challenges.  

National experts have called out the aging of the homeless population as an impending crisis. [1] This demographic shift is happening rapidly, mirroring general population trends. Nationwide, currently half of single homeless adults are aged 50 or older, compared to 11% in 1990. [2] Moreover, according to a white paper prepared by the Corporation for Supportive Housing (CSH) and presented to a New York City coalition studying ways to address the aging of the homeless population, “not only are those on the streets getting older, but their health is deteriorating at rates much faster than the general population.” [3] The paper cites research showing that homeless adults over 50 had a higher prevalence of geriatric conditions than that seen in housed adults 20 years older. [4] Another study showed that older homeless adults were 3.6 times as likely to have a chronic medical condition as homeless adults under 50. [5] Such findings clearly indicate a pressing need for housing and services that specifically address geriatric conditions among older homeless adults living across varied environments. [6]