Changes in Physical Health After Supported Housing: Results from the Collaborative Initiative to End Chronic Homelessness
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The permanent supported housing model is known to improve housing outcomes, but there has been sparse research on the effects of supported housing on physical health. Various organizations including the National Academy of Sciences have called for research in this area.
This observational multi-site outcome study examined changes in physical health among chronically homeless adults participating in a comprehensive supported housing program and the associations between changes in physical health, housing status, and trust in primary care providers.
Data are presented from an observational outcome study analyzed with mixed linear modeling and regression analyses.
A total of 756 chronically homeless adults across 11 sites were assessed every 3 months for 1 year.
The Collaborative Initiative to End Chronic Homelessness provided adults who were chronically homeless with permanent housing and supportive primary healthcare and mental health services.
Days housed, physical health-related quality of life (HRQOL) measured by the Short Form-12 health survey, number of medical conditions, number of treated medical conditions, and number of preventive medical procedures received.
Participants showed reduced number of medical problems and receipt of more preventive procedures over time, but there was no statistically significant change in physical HRQOL. Changes in housing were not significantly associated with changes in any physical health outcomes. Over time, participants’ trust in primary care providers was positively associated with increased numbers of reported medical problems and preventive procedures received but not with physical HRQOL.
Entry into supported housing with linked primary care services was not associated with improvements in physical HRQOL. Improvement in other medical outcome measures was not specifically associated with improved housing status.
KEY WORDShomelessness public health primary care physical health supported housing
Compliance with Ethical Standards
Conflict of Interest
J. Tsai, L. Gelberg, and R. Rosenheck both do not report any conflicts of interest with this work.
- 1.National Academies of Sciences E, and Medicine. Permanent supportive housing: Evaluating the evidence for improving health outcomes among people experiencing chronic homelessness. Washington, DC: The National Academies Press 2018.Google Scholar
- 4.Stergiopoulos V, Hwang SW, Gozdzik A, Nisenbaum R, Latimer E, Rabouin D, et al. Effect of scattered-site housing using rent supplements and intensive case management on housing stability among homeless adults with mental illness: A randomized trial. JAMA. 2015;313(9):905–15.PubMedPubMedCentralGoogle Scholar
- 9.Kelly JT. Trauma: With the example of San Francisco’s shelter programs. In: Brickher PW, Scharer LK, editors. Health Care of Homeless People. New York: Springer-Verlag; 1985. p. 77–91.Google Scholar
- 10.McAdam JM, Brickner PW, Scharer LL, Crocco JA, Duff AE. The spectrum of tuberculosis in a New York City men’s shelter clinic (1982-1988). Chest Surg Clin N Am 1990;97(4):798–805.Google Scholar
- 13.O’Connell JJ. Premature mortality in homeless population: A review of the literature. Nashville: National Health Care for the Homeless Council, Inc.; 2005.Google Scholar
- 17.Ware JE, Kosinski M, Keller SE. How to score the SF-12 physical and mental health summary scales. 3rd ed. Lincoln: Quality Metric, Inc.; 1998.Google Scholar
- 19.Anderson LA, Dedrick RF. Development of the Trust in Physician scale: A measure to assess interpersonal trust in patient-physician relationships. Psychol. Rep. 1990;67(3, Part 2):1091–100.Google Scholar
- 20.Derogatis LR, Spencer N. The brief symptom index: Administration, scoring, and procedure manual. Baltimore: Johns Hopkins; 1982.Google Scholar
- 23.O’Toole TP, Johnson EE, Aiello R, Kane V, Pape L. Tailoring Care to Vulnerable Populations by Incorporating Social Determinants of Health: the Veterans Health Administration’s “Homeless Patient Aligned Care Team” Program. Prev Chronic Dis 2015;30(7):886–98.Google Scholar
- 25.Thom DH, Hall MA, Pawlson LG. Measuring patients’ trust in physicians when assessing quality of care. Health Aff (Millwood) 2004;23(4):124–32.Google Scholar
- 28.Thompson SJ, McManus H, Lantry J, Windsor L, Flynn P. Insights from the street: Perceptions of services and providers by homeless young adults. Eval Program Plann 2006;29(1):34–43.Google Scholar