Permanent Supportive Housing: Addressing Homelessness and Health Disparities?

Benjamin F. Henwood, is with the School of Social Work, University of Southern California, Los Angeles. Leopoldo J. Cabassa is with the School of Social Work, Columbia University, New York, NY. At the time of the study, Catherine M. Craig was with Community Solutions, Washington, DC. Deborah K. Padgett is with the Silver School of Social Work and the Global Institute of Public Health, New York University, New York, NY.
American Journal of Public Health (Impact Factor: 4.55). 10/2013; 103(S2). DOI: 10.2105/AJPH.2013.301490
Source: PubMed


Permanent supportive housing (PSH) is an intervention to address long-term homelessness. Evidence has resulted in a shift in US policy toward using PSH rather than shelters and transitional housing. Despite recognizing that individuals transitioning from homelessness to PSH experience a high burden of disease and health disparities, public health research has not considered whether and how PSH improves physical health outcomes. Based on diverse areas of research, we argue that in addition to improved access to quality health care, social determinants of health (including housing itself, neighborhood characteristics, and built environment) affect health outcomes. We identify implications for practice and research, and conclude that federal and local efforts to end long-term homelessness can interact with concurrent efforts to build healthy communities. (Am J Public Health. Published online ahead of print October 22, 2013: e1-e5. doi:10.2105/AJPH.2013.301490).

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Available from: Benjamin F Henwood, Sep 23, 2014
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    • "Housing programs with supportive services have been a growing health intervention (Henwood et al. 2013) with upwards of 289,000 units nationally (HUD 2013). These programs have coupled permanent housing with ongoing coordinated health care and case management services (Rog et al. 2014). "
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    ABSTRACT: Objectives This study examined whether and how permanent supportive housing (PSH) programs are able to support aging in place among tenants with serious mental illness.DesignInvestigators used a mixed-method approach known as a convergent parallel design in which quantitative and qualitative data are analyzed separately and findings are merged during interpretation. Quantitative analysis compared 1-year pre-residential and post-residential outcomes for PSH program enrollees, comparing adults aged 35–49 years (n = 3990) with those aged 50 years or older (n = 3086). Case study analysis using qualitative interviews with staff of a PSH program that exclusively served older adults identified challenges to providing support services.ResultsSubstantial declines in days spent homeless and in justice system settings were found, along with increases in days living independently in apartments and in congregate settings. Homelessness and justice system involvement declined less for older adults than younger adults. Qualitative themes related to working with older adults included increased attention to medical vulnerability, residual effects of institutional care, and perceived preference for congregate living.ConclusionsPSH is an effective way to end homelessness, yet little is known about how programs can support housing stability among aging populations. Additional support and training for PSH staff will better promote successful aging in place. Copyright © 2014 John Wiley & Sons, Ltd.
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