Housing & Health
Housing is a Crucial Social Driver of Health
Housing directly affects an individual’s ability to access quality health care. Efforts to address homelessness and health-related social needs are ongoing and multifaceted. By recognizing the intersection of housing and health, communities can work towards providing comprehensive support and improving the well-being of vulnerable populations.
According to the National Health Care for Homelessness Council, persons experiencing homelessness (PEH) have higher rates of illness and experience mortality rates 3-4 times higher than the general population. PEH also are:
- 3-4x more likely to die prematurely.
- 2x more likely to have a heart attack or stroke.
- 3x more likely to die of heart disease if they are between 25 and 44 years old.
- Experience an average life expectancy of 48 years.
Source:https://www.hchmd.org/homelessness-makes-you-sick
Access to Healthcare
PEH often have limited access to preventative and primary healthcare, leading to:
- Delayed diagnosis and treatment of medical conditions.
- Worsening preexisting medical conditions. Higher risk of contracting and/or spreading infectious disease.
- Frequent mobility and lack of a stable address, which can hinder follow-up care and medication adherence.
Prevalent Health Conditions Among PEH
- Mortality and unintentional injuries
- Musculoskeletal disorders and chronic pain Malnutrition
- Wounds and skin infections Infectious diseases
- Dental problems
- Lung diseases (TB, Bronchitis, pneumonia) Chronic diseases and disorders
- Sexual and reproductive care Mental health issues
Experiencing physical or mental illness or injury can also lead to homelessness
- An injury or illness can start out as a health condition, and can lead to loss of employment.
- Medical debt is the leading cause of personal bankruptcy filing in the US.
- >20% of Americans between 19-64 years old struggle to pay theirmedical bills.
- At least 25% of people experiencing homelessness have aserious mental illness.
- A majority of these individuals also deal with addiction.
- Drug-, alcohol-, injury-, and mental health/psychiatric-relateddiagnoses are the most common reasons a PEH presents to the ED.
Source:https://www.hchmd.org/homelessness-makes-you-sick
Mental Health
Homelessness is closely related to mental health challenges, as individuals experiencing homelessness are more susceptible to depression, anxiety, and substance abuse due to the stress and trauma associated with their situation.
Limited access to mental health services and medications further exacerbates these issues.
On a given night in 2023, 31% of PEH reported having a serious mental illness, according to data from the US Department of Housing and Urban Development.
According to data from Alaska statewide emergency department (ED) visits, it is estimated that 20-30% of visits among PEH include some mental health concern (depression, anxiety disorders, PTSD, bipolar- type disorders, schizophrenia spectrum disorders, etc.)
An average of 14% of visits among PEH involve some aspect of suicidality or self-harm.
Source:https://files.hudexchange.info/reports/published/CoC_PopSub_NatlTerrDC_2023.pdf
Substance Use
On a given night in 2022 in the US, 16% of PEH reported conditions related to chronic substance use.
Total drug overdose death rates have increased annually since 2018 in Alaska, largely driven by narcotic and psychotropic drugs.
About 2% of visits to the ED in Alaska among PEH involve an overdose.
About 17% of visits to the ED among PEH involve alcohol or alcohol related problems.
- This is complicated by the fact that alcohol use causes a wide range of immediate and long-term health conditions and can cause direct impacts (e.g. alcohol poisoning) and indirect impacts (e.g. DUI accidents), so this number is not all encompassing, but an estimate.
- Alaska has the 10th highest prevalence rate of adult binge drinking in the country and the second highest age-adjusted rate in the US of alcohol induced mortality.
Sources: