COVID-19's IMPACT ON HEALTH OF THE UNSHELTERED
[image of gear with exclamation point in the center]
PROBLEM
Pre-Pandemic
People experiencing unsheltered homelessness — such as those sleeping in parks and vehicles, or on streets — were at higher risk of physical and mental health issues than their sheltered counterparts. (see Reference #1)
[images of blue figure outside a house and two red figures inside the house]
1 in 3 individuals experiencing homelessness is unsheltered.
[images of five blue gears surrounding one larger red gear]
The overall rate of homelessness grew from 2018-2019, due to an increase in the unsheltered population, particularly through growth in these groups. (see reference #2)
28% Native American
10% gender non-conforming
10% Black
12% female
43% transgender
NOW
Those experiencing unsheltered homelessness are at high risk of COVID-19 morbidity and mortality because they are less connected to health care and other support systems and more likely to have other health conditions. And, the groups that have increased the unsheltered population also represent those most at risk of negative health consequences of COVID-19. Despite increased risk, the true impact of the pandemic on the unsheltered is unknown, due to extremely limited data.
[images of magnifying glass with hospital and masked face inside, four red figures and two blue figures underneath
[image of gear with check mark inside]
WHAT PUBLIC HEALTH CAN DO
SHORT TERM
[image of house with keys inside]
ENGAGE with local housing groups to support rapid-rehousing efforts. Check out the Homekey Program (https://www.hcd.ca.gov/grants-funding/active-funding/homekey.shtml) supporting Californians experiencing homelessness during the pandemic.
ADVOCATE for local, state and federal COVID tracking systems to incorporate housing status to determine the health impact of the pandemic on those experiencing homelessness.
SUPPORT efforts to prioritize COVID-19 vaccination of vulnerable groups, especially those experiencing unsheltered homelessness.
LONG TERM
[image of hospital and office building]
ENGAGE with housing groups to support Housing First approaches such as Permanent Supportive Housing (https://nhchc.org/clinical-practice/homeless-services/permanent-supportive-housing/), which increases access to health services and housing stability.
WORK with community-based organizations serving groups that experienced recent growth — such as BIPOC and LGBTQ+ and women-serving organization — to identify common barriers to housing.
Logo: American Public Health Association
References
1. Montgomery, Ann E., Dorota Szymkowiak, Jessica Marcus, Paul Howard, and Dennis P. Culhane. 2016b. “Homelessness,
Unsheltered Status, and Risk Factors for Mortality: Findings from the 100,000 Homes Campaign.” Public Health
Reports 131 (6): 765–72. https://doi.org/10.1177/0033354916667501
2. Henry, Meghan, Rian Watt, Anna Mahathey, Jillian Ouellette, and Aubrey Sitler. 2020. The 2019 Annual Homeless
Assessment Report (AHAR) to Congress. Part 1: Point-In-Time Estimates of Homelessness. Washington, DC: US
Department of Housing and Urban Development, Office of Community Planning and Development. Accessible here:
https://www.huduser.gov/portal/sites/default/files/pdf/2019-AHAR-Part-1.pdf