Homelessness and Healthcare in Chester County
Homelessness itself is a serious health condition. According to the National Health Care for the Homeless Council, people who are homeless have higher rates of illness and die on average 12 years sooner than the general U.S. population. Individuals without stable housing are also more likely to suffer from chronic illnesses, mental health issues, and substance abuse disorders. An injury or illness can quickly turn into homelessness when you account for the loss of employment that comes with being ill, the unhealthy living conditions that exacerbate any health issues, and the lack of access to healthcare.
Homelessness itself is a serious health condition. According to the National Health Care for the Homeless Council, people who are homeless have higher rates of illness and die on average 12 years sooner than the general U.S. population. Individuals without stable housing are also more likely to suffer from chronic illnesses, mental health issues, and substance abuse disorders. An injury or illness can quickly turn into homelessness when you account for the loss of employment that comes with being ill, the unhealthy living conditions that exacerbate any health issues, and the lack of access to healthcare.
From Injury to Homelessness
Illness and injuries are a major cause of homelessness. Initially, a health condition can lead to employment issues due to frequent absences, depletion of sick leave, and an inability to maintain a regular work schedule. This is particularly apparent in physically demanding, labor-intensive industries such as construction or manufacturing, where an injury may make it impossible to continue to work. The resulting job loss creates a vicious cycle: without income, paying for necessary healthcare becomes impossible, preventing recovery and reemployment. Savings deplete quickly, and relying on family and friends for support is often a short-term solution, leading to housing instability or homelessness.
The Impact of Unhealthy Living Conditions
The absence of essential resources like clean water and sanitation creates a vicious cycle where poor health both causes and results from homelessness. Living on the streets or in crowded shelters is extremely stressful, increasing exposure to communicable diseases, violence, and malnutrition. Homeless individuals have exposure to harsh elements such as extreme heat, rain, and snow, among other elements, making it impossible to recover from illness. Managing chronic diseases and healing from infections or injuries becomes incredibly challenging without a stable place to live, especially without access to regular medications or if medications are lost or stolen on the streets. These conditions underscore the urgent need for stable housing as a foundation for effective healthcare.
Barriers to Healthcare Due to Medical Costs
Many individuals face barriers such as high medical costs, transportation issues, and limited availability of services. Patients without housing are more likely to be admitted to hospitals several times for the same condition, and when admitted tend to stay 2.3 days longer. As a result, healthcare costs multiply for homeless individuals.
What We’re Doing to Help
The Chester County Partnership to End Homelessness has supported partners in increasing the availability of affordable housing units and in offering various support services, including the Eviction Prevention Case Resolution program and emergency rental assistance. These programs aim to provide immediate relief and long-term stability for those at risk of homelessness. However, while the latest Point-In-Time Count shows an overall decrease in homelessness, the latest Continuum of Care System Performance Data highlights a concerning increase in the average length of stay in emergency by 61% from 103 days in 2022 to 128 days in 2023 due to continued inflation, the high cost of housing, fewer openings in the rapid rehousing programs, and fewer vouchers issued through the Housing Choice Voucher Program. Crucial programs have also faced funding cuts, further straining the system.
How You Can Help
To support the Chester County Partnership to End Homelessness and make a tangible impact, please consider giving to the Partnership’s Fund. Your contributions help provide essential services and support to those in need.
Unraveling the Threads: Race, Gender and Sexuality & Homelessness
Understanding the complexities of homelessness requires an exploration of the interconnected threads that shape the fabric of our lives. Social determinants of health, as defined by the American Medical Association, encompass the community-wide conditions in which people are born, grow, live, work, and age. Among these determinants, race, gender, and sexuality play pivotal roles in shaping housing outcomes.
Understanding the complexities of homelessness requires an exploration of the interconnected threads that shape the fabric of our lives. Social determinants of health, as defined by the American Medical Association, encompass the community-wide conditions in which people are born, grow, live, work, and age. Among these determinants, race, gender, and sexuality play pivotal roles in shaping housing outcomes.
African Americans and Indigenous people are disproportionately affected by homelessness, a consequence of historical and structural racism deeply embedded within societal systems. Despite comprising a smaller percentage of the general population, African Americans represent a significant majority of those experiencing homelessness, particularly among families with children. Similarly, the LGBTQ+ community faces heightened risks of homelessness, with studies indicating that LGBTQ+ adults are twice as likely as the general population to experience homelessness in their lifetime. Transgender individuals are especially vulnerable, with 8% experiencing homelessness within a single year. Moreover, LGBTQ+ youth often find themselves without stable housing after coming out to their families, contributing to the overrepresentation of LGBTQ+ individuals within the homeless population.
In honor of Pride Month and Juneteenth, this month’s blog will focus on the interplay between race, gender, sexuality, and housing instability. Read on to learn more:
Race and Homelessness
Recent research has highlighted the link between race and homelessness in the United States. A comprehensive data analysis conducted over an 11-year period from 2007 to 2017, as outlined in the Journal of Racial and Ethnic Disparities, reveals concerning trends: Black, American Indian or Alaska Native, and Native Hawaiian and Pacific Islander individuals and families consistently faced a higher likelihood of experiencing homelessness compared to their non-Hispanic White counterparts. These findings underscore the persistent and escalating nature of racial disparities in homelessness, emphasizing the urgent need for targeted interventions to address systemic inequities.
Similarly, insights from "Homelessness Is a Housing and Racism Problem" by Bill Pitkin underscore the intricate relationship between housing market dynamics, structural racism, and homelessness. Despite popular misconceptions attributing homelessness to individual vulnerabilities such as addiction and mental health issues, research instead indicates that housing market challenges - exacerbated by historical legacies of racism - play a pivotal role in driving homelessness rates. While racial composition alone does not entirely explain regional disparities in homelessness levels, structural racism deeply embedded within housing and social welfare systems perpetuates racial inequalities, amplifying the risk of housing insecurity among communities of color.
As efforts to combat homelessness continue to evolve, a multifaceted approach that not only addresses immediate housing needs but also confronts the root causes of racial disparities is required to bring the vision of housing justice grounded in equity and inclusivity to reality.
Gender, Sexuality and Homelessness
Furthermore, understanding the connection between gender, sexuality, and homelessness sheds light on the challenges faced by LGBTQIA+ individuals, particularly youth, who are disproportionately represented among the homeless population. Discrimination, harassment, and a lack of support services contribute to their vulnerability, often leading to rejection by families and subsequent homelessness.
Studies reveal alarming statistics: up to 40% of homeless youth identify as LGBTQIA+, and they are 120% more likely to experience homelessness than their non-LGBTQIA+ peers. These youth often face abuse and unsafe conditions in shelters, driving many to avoid them altogether. Discharge from foster care is a significant contributor to LGBTQIA+ youth homelessness, with studies showing high rates of homelessness post-discharge. Moreover, LGBTQIA+ homeless youth are more likely to engage in survival sex and face higher risks of victimization, mental health issues, and suicide attempts compared to their heterosexual peers.
Recognizing these challenges, efforts to support LGBTQIA+ individuals experiencing homelessness include LGBTQIA+ cultural sensitivity training for service providers, LGBTQIA+ inclusive shelters, and initiatives for LGBTQIA+ specific housing. The commitment to addressing the unique needs of LGBTQIA+ individuals facing homelessness extends beyond Pride Month, reflecting the need for a year-round commitment to cultural sensitivity and support.
Understanding the complex relationship between race, gender, sexuality, and homelessness underscores the need for action. As we mark Pride Month and Juneteenth, let’s move beyond reflection and take steps towards equity and justice by supporting policies that tackle systemic inequalities, backing initiatives offering culturally sensitive support, and elevating the voices of those most impacted. Together we can ensure everyone has a stable, safe place to call home.
Further Reading & Resources
Housing and Homes
People’s homes can have a major impact on their health and well-being. Healthy People 2030 focuses on reducing health and safety risks in homes.
Southeastern Pennsylvania Community Health Needs Assessment
A group of local hospitals and health systems collaborated on the Southeastern Pennsylvania Community Health Needs Assessment, with specific focus on Bucks, Chester, Delaware, Montgomery, and Philadelphia Counties, to continue collaboration and provide opportunities to expand and improve upon the last assessment process. Participants recognize this assessment as an important part of how health systems, multi-sector partners, and communities work together to achieve meaningful and positive community change.
Homelessness and Public Health: A Focus on Strategies and Solutions
This report published in the National Library of Medicine addresses many of these issues in the context of public health and explore the public health implications and potential solutions to homelessness, focusing on contemporary and emerging research and innovative strategies, and highlighting best practices to address homelessness among key populations.
Housing and Health: A Roadmap for the Future
In this report, the American Hospital Association shares data on the connection between health and housing stability. To be physically and mentally healthy, individuals need a safe, stable place to sleep at night. Housing-insecure individuals have worse health status and outcomes than those in stable housing.
National Health Care for the Homeless Homelessness & Health: Whats the Connection?
People who are homeless have higher rates of illness and die on average 12 years sooner than the general U.S. population. Homelessness can take many forms, with people living on the streets, in encampments or shelters, in transitional housing programs, or doubled up with family and friends. While the federal government reports 1.5 million people a year experience homelessness, other estimates find up to twice this number of people are actually without housing in any given year. The connection between housing and homelessness is generally intuitive, but the strong link between health and homelessness is often overlooked. This fact sheet outlines how health and homelessness are intertwined—and why housing is health care.
People who are homeless have higher rates of illness and die on average 12 years sooner than the general U.S. population. Homelessness can take many forms, with people living on the streets, in encampments or shelters, in transitional housing programs, or doubled up with family and friends. While the federal government reports 1.5 million people a year experience homelessness, other estimates find up to twice this number of people are actually without housing in any given year. The connection between housing and homelessness is generally intuitive, but the strong link between health and homelessness is often overlooked. This fact sheet outlines how health and homelessness are intertwined—and why housing is health care.
Integrate Health Care
The U.S. Interagency Council on Homelessness outlines the importance of integrated health care for people experiencing homelessness, as well as strategies for integration and better access to care.