NHPF-Authored Articles & Industry Reports

etc., meaning projects with units available for people with incomes up to 60% area median income. The units serve mostly those at 50%-60%. To truly reduce the number of homeless, the affordable housing industry should change the current dynamic by establishing referral relationships with health-sector partners, creating set asides for people with special needs, and reducing all but the most significant barriers with a screen-in, rather than screen-out, approach. In some places this is already happening. Panelist Stephen Brown, Director of Preventive Emergency Medicine, University of Illinois Hospital leads “Better Health Through Housing,” which has provided 42 homeless individuals with affordable supportive housing. Brown and his colleagues began the effort to house the chronically ill/chronically homeless in his hospital because several randomized control trials (RCT) show providing supportive housing to hospital patients results in very high housing retention rates (over 80%) and reductions in healthcare costs and utilization between 38% and 72%. Since the program began in November 2015, UI Health’s research has revealed several significant findings: • H omeless is a dangerous health condition. The average life expectancy of a chronically homeless individual is 27 years less than the average American. The program found a shocking 30% mortality rate in the first 26 patients it placed into permanent supportive housing. • T he majority of homeless pass through a hospital unnoticed . 1,220 are homeless in a given year, and 4,660 have been identified since 2010. Many are pregnant women.In March of 2018, 15 pregnant women gave birth in the hospital’s OB unit. They had not been previously identified as homeless. • T he homeless create exorbitant healthcare costs and utilization. There are 132 homeless that are in the top 10th decile of the most expensive patients, (healthcare costs ranging from $36,578 to $938,133) 5.23 to 134 times as expensive as our average patient cost. • T here are significant benefits for hospitals to house the homeless. Housing the homeless has resulted in a 21% drop in healthcare costs, a 67% drop in ED visits and a 67% drop in inpatient hospitalizations. Program costs can also impact a non-profit hospital’s Community Benefit Statement to the IRS. Healthcare-to-housing programs deliver direct improvements to the health of the community that a hospital serves by helping reduce the number of readmissions which hover around 50% for homeless vs. 18.9% for all other chronic conditions.

Harnessing Data to Demonstrate Impact

Although the industry has spent decades making the case for supportive housing with rigorous evaluation, program monitoring, and outcomes tracking, a successful affordable housing reboot will require even more strategic use of data to demonstrate impact on people, communities and systems. Affordable housing can work to develop data-sharing agreements and engage evaluation partners to better understand the impact of housing on health.

An Affordable Housing Reboot Will Improve Community Health


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