Breaking the Links Between Poor Health and Homelessness

– In recognition of Health Care for the Homeless Day on August 13th during National Health Center Week 2014, we welcome guest contributor Dan Rabbitt, Health Policy Organizer for the National Health Care for the Homeless Council

Dan Rabbitt, Health Policy Organizer for the National Health Care for the Homeless Council

Homelessness is bad for your health – and also bad for your health care. People experiencing homelessness don’t have the basic supports most people take for granted. A safe place to rest and heal, protection from the elements, and a secure place to store medications are all hard to come by without stable housing. The lack of housing—a key social determinant of health– makes people sicker, exacerbates existing illnesses, and makes effective treatment incredibly challenging. It is no wonder those experiencing homelessness die 30 years earlier than their housed counterparts.

Thankfully, the Health Center program, which includes Health Care for the Homeless (HCH) projects, is dedicated to surmounting these challenges, having provided care to more than 1.1 million homeless patients in 2012. For over 30 years, HCH programs have been serving those without stable housing and have learned how to adapt their services for a population with such limited resources. The National HCH Council Clinician’s Network has developed adapted clinical guidelines to treat dozens of medical and behavioral health conditions common among those without homes, and the Health Center model of patient-centered, team-based care effectively delivers care needed to treat the complex health and social needs of individuals and families experiencing homelessness.

Furthermore, the Health Center program is often the only place people with little or no income can turn for health care besides emergency rooms. Serving everyone regardless of their ability to pay is an essential requirement of the Health Center program and allows very low-income people to access essential primary and preventative care. Many HCH programs have sliding fee scales that charge no copays for those earning less than the federal poverty level, a policy that significantly reduces barriers to care. In turn, these policies save the entire health care system by preventing unnecessary emergency room and inpatient hospital costs.

While access to quality clinical services is critical, housing is the best medicine for individuals and families without homes. Many HCH programs partner with housing providers in their communities to help those they serve obtain stable housing and the supports needed to maintain it. While a wide range of housing programs are available, permanent supportive housing is a particularly successful and cost-effective model for those struggling with significant health care conditions. The National HCH Council and our ally CSH are currently working to promote partnerships between health centers and permanent supportive housing programs, hoping to expand the reach health centers can have to improve the health of those without homes.

The Health Center and HCH program has learned a great deal in the past 30 years and now have more data and better policies to support housing stability for those that need it. In recognition of Health Center Week and HCH Day this year, celebrate the strides made to make homelessness rare and brief and further strengthen your commitment to improve the health of your patients who lack stable housing and need your support more than ever.

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