Housing First Promotes Health Equity

The Community Preventive Services Task Force (CPSTF) recommends Permanent Supportive Housing with Housing First programs (Housing First) to promote health equity for people who are experiencing homelessness and have a disability. Evidence from the systematic review shows Housing First programs decrease homelessness, increase housing stability, and improve quality of life for homeless persons living with disabilities, including those with HIV infection.

Unlike Treatment First approaches that maintain clients must take steps to become “housing ready” before given permanent supportive housing, Housing First programs propose that homeless individuals or families 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 in which the head of household has a disabling condition, which may include mental health or substance use disorders, a work-related disability, difficulties in independent living, and 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, and more than 9% are veterans.³

For More Information

• The Community Guide
  • One Pager: Permanent Supportive Housing with Housing First
  • Health Equity
• The U.S. Department of Housing and Urban Development
• Substance Abuse and Mental Health Services Administration
• U.S. Department of Veterans Affairs

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.