Poverty & Health
According to the U.S. Census Bureau, an estimated 14.5% of the U.S. population (45.3 million people) are living in poverty. Having limited resources creates competing priorities for meeting basic needs, and too often, health care is neglected in order to secure more immediate necessities such as housing and food.
While Medicaid expansion has improved access to health care for many, the shortage of affordable housing and livable wages continues to take a toll on the health of the poorest members of our communities.
The irrefutable correlation between poverty and health has precipitated new and innovative approaches to address social determinants of health in clinical practice. This page provides resources expanding on the impact of poverty on health, considerations for providing care to this population, and administrative resources related to this topic.
Homelessness can take many forms, with people living on the streets, in encampments or shelters, in transitional housing programs, or doubled up with family and friends. While the federal government reports 1.5 million people a year experience homelessness, other estimates find up to twice this number of people are actually without housing in any given year. The connection between housing and homelessness is generally intuitive, but the strong link between health and homelessness is often overlooked. This fact sheet outlines how health and homelessness are intertwined—and why housing is health care.
Clinicians with extensive experience caring for individuals who are homeless routinely adapt their practice to foster better outcomes for these patients. This document is intended for health care professionals, students, and ancillary personnel who have less experience working with this population and may not realize that some of their patients are homeless.
Poverty Guidelines | Office of the Assistant Secretary for Planning and Evaluation
The federal poverty guidelines are issued each year by the Department of Health and Human Services (HHS). These guidelines are one version of the poverty thresholds that are used administratively to HUD determine eligibility for various programs, including health centers.
UDS Mapper | American Academy of Family Physicians
The UDS mapper is an interactive tool that allows users to explore the geographic extent of the federal Health Center Program compared to medically underserved areas and demographic information, such as income levels and race.
Maness DL, Khan M. Care of the Homeless: An Overview | American Family Physician, 89(8): 634-40, 2014
People experiencing homelessness face complex health concerns and have poorer health outcomes than those who are housed. This article identifies the demographics and risk factors of individuals experiencing homelessness, common health conditions, and discusses how an interdisciplinary approach can be used to address the various needs of this population.
The correlation between homelessness and mental illness has long been established, but how does this impact health service use? This study suggests that there may be a gap between need and utilization of services.
This article provides an overview of various health interventions and care models that have proven to be effective in providing care to people experiencing homelessness, including primary care approaches, mental health care, permanent supportive housing, and medical respite care.
Baggett TP, Hwang SW, O’Connell JJ, Porneala BC, Stringfellow EJ, Orav EJ, Singer DE, Rigotti NA. | Mortality among homeless adults in Boston: shifts in causes of death over a 15-year periodalth Interventions for people who are homeless | JAMA Internal Medicine, 173(3):189-95, 2013
This study looks at the cause of death for individuals who had received services at an HCH in Boston, Massachusetts in order to identify current trends and changes over time.
Massachusetts’ early expansion of Medicaid provided the opportunity to determine the disease burden and health care utilization for insured individuals experiencing homelessness. This study offers an idea if the impact of Medicaid expansion for this population.
A universal health system can provide rich information and a more complete picture of individuals receiving health services. This study compares health utilization between housed and homeless individuals, looking at ambulatory care, emergency department, medical-surgical hospitalization, and psychiatric hospitalization encounters, and the resulting cost differences between groups.
The Health care for the Homeless model has been providing targeted services for 30 years. This article provides an overview of lessons learned over the last three decades, reflecting on key strategies, barriers, and the history of HCH work, as well as implications for the future.
Many people experiencing homelessness must also contend with food insecurity. This study explores the relationship between lack of accessible food and use of acute health services.