Impact of housing first programs on health outcomes for chronically homeless persons

This presentation will describe the health outcomes of 40-50 chronically homeless persons housed in the Housing First program in Quincy, Massachusetts. Upon entry into housing, these participants had been homeless for several years, living in a shelter and/or on the streets, and suffering from complex medical, mental health and substance abuse problems. Housing First targets those most difficult to serve with a harm reduction approach. In this model housing occurs prior to addressing other service needs and is linked to intensive case management services in the home. Acceptance of these services, however, is not a requirement for ongoing tenancy.

This presentation will track changes in health from two years prior to and up to two years after participation in the housing model which occurs either in congregate living or at scattered sites. Quantitative data include medical, mental health, and substance abuse outcomes and service use. Qualitative information is collected through in-person interviews with all participants on quality of life and perception of health. Preliminary cost estimates of medical service usage prior to and after the housing intervention will also be presented. In addition, patient case reports will illustrate the impact of housing on chronic disease management.

This study underscores the link between housing models that include intensive services and health outcomes for chronically homeless people. The focus on housing as a medical intervention can be used in support of a paradigm shift in statewide homeless policy from an emergency shelter-based approach to a housing-based approach.