Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised citizens. In recent decades, federal agencies, nonprofit organizations, and the philanthropic community have worked hard to develop and implement programs to solve the challenges of homelessness, and progress has been made. However, much more remains to be done. Importantly, the results of various efforts, and especially the efforts to reduce homelessness among veterans in recent years, have shown that the problem of homelessness can be successfully addressed. Although a number of programs have been developed to meet the needs of persons experiencing homelessness, this report focuses on one particular type of intervention: permanent supportive housing (PSH). Permanent Supportive Housing focuses on the impact of PSH on health care outcomes and its cost-effectiveness. The report also addresses policy and program barriers that affect the ability to bring the PSH and other housing models to scale to address housing and health care needs.

Using rich and detailed data, this groundbreaking book explains why homelessness has become a crisis in America and reveals the structural conditions that underlie it. In Homelessness Is a Housing Problem, Gregg Colburn and Clayton Page Aldern seek to explain the substantial regional variation in rates of homelessness in cities across the United States. In a departure from many analytical approaches, Colburn and Aldern shift their focus from the individual experiencing homelessness to the metropolitan area. Using accessible statistical analysis, they test a range of conventional beliefs about what drives the prevalence of homelessness in a given city—including mental illness, drug use, poverty, weather, generosity of public assistance, and low-income mobility—and find that none explain the regional variation observed across the country. Instead, housing market conditions, such as the cost and availability of rental housing, offer a far more convincing account. With rigor and clarity, Homelessness Is a Housing Problem explores U.S. cities' diverse experiences with housing precarity and offers policy solutions for unique regional contexts.

There have always been homeless people in the United States, but their plight has only recently stirred widespread public reaction and concern. Part of this new recognition stems from the problem's prevalence: the number of homeless individuals, while hard to pin down exactly, is rising. In light of this, Congress asked the Institute of Medicine to find out whether existing health care programs were ignoring the homeless or delivering care to them inefficiently. This book is the report prepared by a committee of experts who examined these problems through visits to city slums and impoverished rural areas, and through an analysis of papers written by leading scholars in the field.