Contact Us  |  Search:  
 
The National Academies of Sciences, Engineering and Medicine
Science and Technology for Sustainability Program
Science and Technology for Sustainability Program
Policy and Global Affairs
Home About Us STS Roundtable Sustainability Across The Academies
Quick Links

Newsletter

Download a description of our program

Upcoming Events

No More Time to Waste: Moving Science to Action at Scales that Matter
December 10, 2018, Washington, DC
6:45 PM - 8:45 PM

View a list of Sustainability-related meetings at the National Academies of Sciences, Engineering, and Medicine

Recent Events

Reducing Food Loss and Waste Workshop
October 17, 2018, Washington, DC

Report Release: Housing, Health and Homelessness
July 11, 2018 11am-12pm, Washington, DC

Roundtable on Science and Technology for Sustainability

January 30-21, 2018, Washington, DC

Symposium at the National Council for Science and the Environment Conference

January 23, 2018 Arlington, VA



Housing, Health, and Homelessness: Evaluating the Evidence 
 

HHH Report Cover Permanent Supportive Housing: Evaluating the Evidence for Improving Health Outcomes among People Experiencing Chronic Homelessness (2018)
Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised citizens. In recent decades, federal agencies, nonprofit organizations, and the philanthropic community have worked hard to develop and implement programs to solve the challenges of homelessness, and progress has been made. However, much more remains to be done. Importantly, the results of various efforts, and especially the efforts to reduce homelessness among veterans in recent years, have shown that the problem of homelessness can be successfully addressed.

Although a number of programs have been developed to meet the needs of persons experiencing homelessness, this report focuses on one particular type of intervention: permanent supportive housing (PSH). Permanent Supportive Housing focuses on the impact of PSH on health care outcomes and its cost-effectiveness. The report also addresses policy and program barriers that affect the ability to bring the PSH and other housing models to scale to address housing and health care needs.
  Project Information  

Project Scope
Meetings and Events
Reports
Committee Membership
Sponsors

SDG 3SDG11SDG17


Project Scope

A committee, under the auspices of the Science and Technology for Sustainability (STS) Program and the Board on Population and Public Health Practice, evaluated interventions and policy options for addressing urban homelessness, particularly permanent supportive housing programs.[1] Specifically, the study addressed the fundamental question, to what extent have permanent supportive housing programs improved health outcomes and affected health care costs in people experiencing homelessness? To address this question, the committee took into consideration any variation in outcomes for different subsets of homeless populations, including people experiencing chronic homelessness and people identified as high-utilizers of health care services, as well as the variation in outcomes related to different housing configurations and approaches to services delivery and financing associated with permanent supportive housing.

The committee focused on the following questions:
 

  • What is the evidence that permanent supportive housing improves health-related utilization and outcomes in homeless persons with serious, chronic or disabling conditions (e.g., substance use disorders, serious mental illness, physical disabilities, diabetes, etc.)? How cost effective is permanent supportive housing for addressing homelessness and health outcomes compared with usual care and alternative interventions? 
  • What are individual and other characteristics that may be associated with the health related outcomes and costs of permanent supportive housing (e.g., age, health conditions, other demographics)?
  • What characteristics of permanent supportive housing programs, if any, result in improved health outcomes and evidence of cost effectiveness? 
  • How generalizable are the findings from studies evaluating outcomes associated with the use of permanent supportive housing in the chronically homeless to other homeless populations (families with children, disabled persons, etc.)?
  • Are the outcomes associated with the use of permanent supportive housing translatable to other populations or systems (e.g., what are common characteristics that might translate to an institutionalized population)? 
  • What are the key policy barriers and research gaps associated with developing programs to address the housing and health needs of homeless populations?


The committee produced a consensus report with findings and recommendations. The report will be released on July 11. View the event announcement and register to attend before July 9.

[1] Permanent supportive housing is defined as decent, safe, and affordable community-based housing that provides residents the rights of tenancy under state and local landlord-tenant laws.


Public input: The committee welcomed written input from the public to enhance its ability to address the questions outlined above. Such input included but was not limited to publications or analyses that address aspects of housing, health, or homelessness and the relationships among them.  Submissions became part of the public access file for this project and may be made available to the public upon request to the National Academies’ Public Access Records Office. 

 

Meetings & Events

Meeting 1: Housing, Health, and Homelessness: Evaluating the Evidence
October 4-5, 2016
National Academy of Sciences
2101 Constitution Ave NW Washington, DC

Meeting 2: Housing, Health, and Homelessness: Evaluating the Evidence
October 27, 2016
Hyatt Place Hyatt House Denver Downtown
440 14th Street Denver, CO 80202

October 28, 2016
San Jose Marriott
301 S Market Street San Jose, CA 95113

Meeting 3: Housing, Health, and Homelessness: Evaluating the Evidence
December 15-16, 2016
Arnold and Mabel Beckman Center
100 Academy Dr. Irvine, CA

Meeting 4: Housing, Health, and Homelessness: Evaluating the Evidence
January 26-27, 2017
Keck Center
500 5th Street NW Washington, DC 20001

Report Release: Permanent Supportive Housing: Evaluating the Evidence for Improving
Health Outcomes among People Experiencing Chronic Homelessness

July 11, 2018
11:00 am - 12:00 pm
The National Academy of Sciences (NAS) Building, Room 120
2101 Constitution Ave., NW, Washington, DC 20001

Reports

HHH Report Cover Permanent Supportive Housing: Evaluating the Evidence for Improving Health Outcomes among People Experiencing Chronic Homelessness (2018)
Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised citizens. In recent decades, federal agencies, nonprofit organizations, and the philanthropic community have worked hard to develop and implement programs to solve the challenges of homelessness, and progress has been made. However, much more remains to be done. Importantly, the results of various efforts, and especially the efforts to reduce homelessness among veterans in recent years, have shown that the problem of homelessness can be successfully addressed.

Although a number of programs have been developed to meet the needs of persons experiencing homelessness, this report focuses on one particular type of intervention: permanent supportive housing (PSH). Permanent Supportive Housing focuses on the impact of PSH on health care outcomes and its cost-effectiveness. The report also addresses policy and program barriers that affect the ability to bring the PSH and other housing models to scale to address housing and health care needs.


Committee Members

  • Kenneth W. Kizer (NAM) (Chair), University of California, Davis
  • Barbara Brush, University of Michigan School of Nursing
  • Seiji Hayashi, Human Diagnosis Project (Human Dx)
  • Stephen Hwang, St. Michael’s Hospital
  • Mitchell Katz (NAM), NYC Health + Hospitals
  • Mahasin Mujahid, University of California, Berkeley School of Public Health
  • James O’Connell, Boston Health Care for the Homeless Program
  • Barbara Samuels, American Civil Liberties Union of Maryland
  • Marybeth Shinn, Vanderbilt University
  • Ping Wang, Washington University in St. Louis
  • Suzanne Wenzel, University of Southern California


Biographies of committee members are provided on the National Academies of Sciences, Engineering and Medicine's Current Projects System site.

For more information, please contact Emi Kameyama EKameyama@nas.edu

Sponsors

The project is supported by the Conrad N. Hilton Foundation, California Health Care Foundation, Melville Charitable Trust, Kresge Foundation, Bill and Melinda Gates Foundation, Blue Shield of California Foundation, U.S. Department of Veteran Affairs, and Elsevier.