142nd APHA Annual Meeting and Exposition

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Housing First an Effective Solution to Homelessness in Alaska

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 9:10 AM - 9:30 AM

Sarah Shimer, MPH , Institute for Circumpolar Health Studies, University of Alaska Anchorage, Anchorage, AK
David Driscoll, PhD, MPH , Institute for Circumpolar Health Studies, University of Alaska Anchorage, Anchorage, AK
Janet Johnston, PhD , Institute for Circumpolar Health Studies, University of Alaska Anchorage, Anchorage, AK
Travis Hedwig, PhD , Institute for Circumpolar Health Studies, University of Alaska Anchorage, Anchorage, AK
Rebecca Barker, BA , Institute for Circumpolar Health Studies, University of Alaska Anchorage, Anchorage, AK
Chelsea Chapman, PhD(c) , Institute for Circumpolar Health Studies, University of Alaska Anchorage, Anchorage, AK
Background: Urban homelessness in Alaska is characterized by a harsh climate and threats from wildlife. Many of those who are homeless have a co-occurring physical and mental illness.  Housing First is an evidence-based solution to homelessness and emphasizes harm reduction. Beginning in December 2011, two project-based Housing First facilities opened to house the most vulnerable among urban homeless chronic alcoholics in Anchorage and Fairbanks, Alaska.

Methods: Ninety-four tenants participated across two facilities.  Tenant semi-structured interviews and quantitative health surveys were conducted at the time of move in and one year later.  Participant interviews asked about social life, engagement with services, health status, housing & employment history, and alcohol consumption.  Staff interviews asked about experiences with tenants and working at Housing First. 

Results: Both Housing First facilities had over 80% tenant retention over the course of the evaluation.  Tenants reported a significant decrease in alcohol consumption, with a 30% decrease in daily drinking.  Tenants reported an 8% increase in high medication adherence.  There are an array of benefits of living at Housing First facilities such as reconnecting with family members, decreased exposure to violence, and engagement in preventative medical services.

Conclusions: This evaluation adds to the evidence that living in a project-based Housing First facility provides significant health benefits over living in camps and shelters, although some challenges still remain.  Successful implementation of Housing First facilities in Alaska provides additional support to policymakers considering project-based Housing First facilities in other urban centers in sparsely populated states.

Learning Areas:

Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice

Learning Objectives:
Describe Alaska's Housing First project effect on tenants' health. Discuss changes in alcohol consumption before and after living at Housing First.

Keyword(s): Alcohol Use, Healthy Housing

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted interviews, surveys, and other data collection for this Housing First program evaluation, in addition to analyzing qualitative and quantitative data. I have experience in program evaluation and public health research over the past 3 years. For this project, I have been mentored by Dr. Driscoll and Dr. Johnston, who have extensive experience in program evaluation and data analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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