Updated December 2023.

Health and homelessness are inextricably linked. Health problems can cause a person’s homelessness as well as be exacerbated by the experience.

Health and Homelessness

An acute physical or behavioral health crisis or any long-term disabling condition may lead to homelessness; homelessness itself can exacerbate chronic medical conditions. A person can become chronically homeless when his or her health condition becomes disabling and stable housing is too difficult to maintain without help.

According to the U.S. Department of Housing and Urban Development, people living in shelters are more than twice as likely to have a disability compared to the general population. On a given night in 2023, 31 percent of the homeless population reported having a serious mental illness, 24 percent conditions related to chronic substance abuse, and nearly 11,000 people had HIV/AIDS.

Conditions such as diabetes, heart disease, and HIV/AIDS are found at high rates among the homeless population, sometimes three to six times higher than that of the general population.

People who have mental health and substance use disorders and who are homeless are more likely to have immediate, life-threatening physical illnesses and live in dangerous conditions. Also, more than 10 percent of people who seek substance abuse or mental health treatment in our public health system are homeless.

The issue of opioid abuse has risen to a level of national crisis as the number of people abusing prescription drugs and heroin has dramatically risen, and the rate of opioid-related overdose deaths has quadrupled since 2010. While the epidemic is notable for affecting people from any race, gender, socioeconomic status, its effects are felt in unique and notably harmful ways by people who are experiencing homelessness. Substance use disorders are known risk factors for homelessness, and substance abuse and overdose disproportionately impact homeless people.

Health Care Access

Treatment and preventive care can be difficult to access for people who are experiencing homelessness. This is often because they lack insurance or have difficulty engaging health care providers in the community.

Most communities have Federally Qualified Health Centers and more specifically, Health Care for the Homeless Clinics, which provide some basic health services without substantial cost. The advent of the Affordable Care Act has also opened up options by allowing states to expand their Medicaid programs to cover people with very low incomes.

Housing as the Solution

When housing is a platform, people with a substance abuse disorder who are experiencing homelessness have the opportunity to engage in treatment fully without the additional stress of living on the streets. Housing stability is a key contributor to long-term recovery and reduces relapse for people who are homeless.

For chronically homeless people, the intervention of permanent supportive housing provides stable housing coupled with supportive services as needed – a cost-effective solution to homelessness for those with the most severe health, mental health and substance abuse challenges.

Quick Facts

  • On a single night in 2023, 653,104 people were experiencing homelessness.
  • 143,105 individuals experience chronic homelessness on any given night.
  • In 2021, almost 23 percent in the United States experienced mental illness, and 5.5 percent had serious mental illness (SMI). In contrast, 31.4 percent of people who experienced homelessness had SMI.
  • While only one in 12 people in the U.S. has a diagnosed substance use disorder, one in five people experiencing homelessness suffer from a substance use disorder.
  • Schizophrenia affects less that 1 percent of the general U.S. population, but some estimates suggest that up to 20 percent of people experiencing homelessness are living with the disorder.
  • Veterans who seek medical treatment for opioid use disorders are 10 times more likely to experience homelessness than the general veteran population.
  • People experiencing homelessness and overdose on opioids are nine times more likely to die than their stably housed counterparts.