Housing First Programs Lead to Net Economic Benefits

The Community Preventive Services Task Force (CPSTF) finds economic benefits exceed the intervention cost for Permanent Supportive Housing with Housing First programs (Housing First) in the United States. The finding is based on a systematic review that showed societal cost savings of $1.44 for every $1 invested.

As detailed in a recent publication from the Journal of Public Health Management and Practice, the CPSTF recommends Housing First programs to promote health equity for people who are experiencing homelessness and have a disabling condition. Evidence shows Housing First programs decrease homelessness, increase housing stability, and improve quality of life for persons who are experiencing homelessness and living with a disabling condition, including HIV infection.

Unlike Treatment First approaches that require clients to be “housing ready” before they are eligible for permanent supportive housing, Housing First programs propose that individuals or families experiencing homelessness are capable of maintaining a home when provided the opportunity along with range of services.¹

What are Housing First Programs?

Housing First programs provide regular, subsidized, time-unlimited housing to individuals and families experiencing homelessness in which the head of household has a disabling condition (e.g., mental health or substance use disorders, difficulties in independent working and living, HIV infection). They also offer clients a range of services to support housing stability. Housing First programs do not require clients be “housing ready,” (i.e., substance free or in treatment) to participate in the program. Once housed, they are encouraged, but not required, to maintain sobriety.

Why is this important?

Homelessness is associated with multiple health problems, increased mortality, and increased use of health care and other services.² Approximately half of the people experiencing homelessness have a disabling condition, which the U.S. Department of Housing and Urban Development defines as having limitations in conducting daily life activities, or in working or living independently, or having a diagnosis of HIV infection.³

For More Information

• The Community Guide
  • Summary of effectiveness and economic evidence
  • One Pager: Permanent Supportive Housing with Housing First
  • Health Equity
• The U.S. Department of Housing and Urban Development

¹ National Academies of Sciences, Engineering, and Medicine. Permanent supportive housing: evaluating the evidence for improving health outcomes among people experiencing chronic homelessness. National Academies Press; Washington (DC): 2018.
² Caton CL, Wilkins C, Anderson J. People who experience long-term homelessness: Characteristics and interventions. In Toward understanding homelessness: The 2007 national symposium on homelessness research. U.S. Department of Health and Human Services and US Department of Housing and Urban Development; Washington (DC): 2007.
³ U.S. Department of Housing and Urban Development (HUD). The 2017 Annual Homeless Assessment Report (AHAR) to Congress. PART 2: Estimates of Homelessness in the United States. Washington (DC): 2018.