The U.S. Department of Housing and Urban Development’s 2024 Point-in-Time (PIT) Estimates of Homelessness revealed that on a single night in January, 771,480 people experienced homelessness in the United States. This staggering number represents those in emergency shelters, safe havens, transitional housing programs, or unsheltered locations. However, it is important to recognize that this figure does not include those who are “doubled up” with friends or family or living on the brink of homelessness—an omission that underscores the true extent of the affordable housing crisis. It is a total injustice that so many people are without stable housing in the wealthiest country on the planet.
Homelessness impacts everyone—there were increases across the board in families with children, unaccompanied youth, and individuals, both unsheltered and sheltered. The only group to see a reduction was veterans, whose outcomes are supported by the VA system, which has a single, integrated payer structure, enabling better coordination of care and services. This disparity highlights a critical point: comprehensive, coordinated health care and service systems—like the VA–are essential to ending homelessness.
A particularly troubling statistic is the growing number of older individuals facing homelessness. In 2024, 20% of those counted were over 55, with nearly half of them living unsheltered. Like all older adults, this population has more medical and supportive needs, which are often unmet in shelters, forcing them to live on the streets. Additionally, many shelters are not accessible to people with limited mobility, resulting in a disproportionate number of disabled individuals remaining unsheltered.
We also cannot ignore the role of systemic racism in perpetuating homelessness. Black people continue to experience homelessness at nearly three times the rate of the general population—32% versus 12%. Anti-Black racism is not only a predictor of homelessness but also contributes to poor health outcomes, further compounding the challenges faced by those affected.
The intersection of homelessness and health care cannot be overstated. Poor health is both a cause and a consequence of homelessness. Without access to consistent health care and supportive services, individuals in crisis are less likely to receive the treatment they need, leading to further health decline. Comprehensive health care and stable housing are the only solutions to breaking the cycle of homelessness. Cutting essential services will only deepen the crisis, leading to more illness, disability, and suffering.
As a new Congress and Administration take office, we are deeply concerned about proposed cuts to vital programs that serve vulnerable populations. A focus on “efficiency” that proposes reducing health care, housing, and other basic services will only exacerbate homelessness and related health disparities. True efficiency in government should prioritize access to care and housing, which strengthens individuals and communities, rather than pushing more people into a downward spiral.
We must reject the notion that blaming new arrivals or migrants for the housing crisis. This distracts from the real issue: a chronic shortage of affordable housing. This shortage, not citizenship status, is driving homelessness across the nation.
In closing, the National Health Care for the Homeless Council urges policymakers to invest in proven programs that support health and housing, including Medicaid, health centers, street medicine, and medical respite care. Comprehensive solutions—providing both stable housing and access to health care—are the path forward to ending homelessness in this country.
For more information on how to advocate for these essential services, visit our resources on the impact of the 2024 election and our policy priorities for 2025-2029.