The Effect of Homelessness on Our Health

The Effect of Homelessness on Our Health

The numbers are staggering and embarrassing: According to the National Alliance to End Homelessness, on any given night in the U.S. there are over 550,000 homeless Americans living in shelters or on the streets. Over the course of one year, from 2013 to 2014, around 2.5 million kids—a historic high—experienced homelessness at some point, according to the non-profit group the American Society for the Positive Care for Children.

Who are these people? Neighbors, classmates of your children, people working at minimum wage jobs. Approximately 195,000 are people in families. Only 75,000 are chronically homeless. Yet it is the chronically homeless—those who are addicted, mentally ill, long time-residents of the streets—who are the public face of homelessness. As a result, many turn away from looking at the problem and fail to understand the cost economically and in terms of public and personal health.

Causes of homelessness
According to the National Coalition for the Homeless, the causes of homelessness are an increasing lack of employment opportunities and affordable housing, a rise in foreclosure rates, a decline in public assistance and a lack of affordable healthcare. People fall into poverty and are one illness, one accident or one missed paycheck away from finding themselves living in their car, in a shelter or on the streets.

The consequences of homelessness
Once homeless, health problems multiply quickly. For young children, homelessness can lead to changes in brain architecture that can interfere with emotional self-regulation, cognitive skills and social relationships. Homeless children are twice as likely to have a learning disability, repeat a grade or to be suspended from school. In addition, exposure to violence, always a component of homelessness, can result in PTSD, which means children may develop psychosocial and behavioral difficulties, ranging from withdrawal to aggression and substance abuse problems. Health issues like ear infections, asthma, iron deficiency anemia and obesity (associated with worry about going hungry and access only to poor quality food) are common in homeless children.

Adults also suffer profound health risks when they become homeless. The Street Health Report conducted in Toronto in 2007 found that compared to the general population homeless people are five times more likely to have heart disease, four times more likely to have cancer, three and a half times more likely to have asthma, three times more likely to have arthritis or rheumatism and twice as likely to have diabetes.

The cost to the rest of us
According to Green Doors, a central Texas organization dedicated to ending homelessness, the average homeless person visits an emergency room five times per year—where tax payer dollars provide free care. Visits cost $3,700; that's $18,500 spent per year for the average homeless person and $44,400 spent per year for the highest users of emergency departments.

Innovative solutions for homelessness
Two communities decided to find a solution to the homeless crisis: The Los Angeles County Department of Health Services created its own housing authority to reduce homelessness. As a result, L.A. County saves $32,000 per homeless person per year in health care and hospitalization costs, while improving overall health outcomes. Among the specific savings: A 77 percent reduction in emergency room visits and inpatient admissions and an 85 percent reduction in inpatient days.

In Seattle, a comprehensive program, Survive the Streets, resulted in per-person health cost savings of $42,964—more than three times what it cost ($13,440) to provide sustainable housing and aligned services to those individuals.

So, the next time someone talks about the issues surrounding homelessness, remind them that we are better off as individuals and as a society, in terms of emotional and physical health and finances (including taxes), when we make sure everyone can put a roof over their head. You’ll help by making others as knowledgeable as you are about the importance of stopping homelessness so that people stay healthier, use fewer public services, have a better chance of getting a job and kids are able to develop to their full potential.

Medically reviewed in March 2020.

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