The American Academy of Family Physicians (AAFP) supports Housing First programs that offer rapid access to permanent, affordable housing integrated with health care and supportive services. Housing First is a model defined by the U.S. Department of Housing and Urban Development (HUD) as a method to ‘quickly and successfully connect individuals and families experiencing homelessness to permanent housing without preconditions and barriers.’ Preconditions and barriers can include but are not limited to sobriety, treatment, or service participation requirements.
Housing is health care. Access to safe and affordable housing is a social determinant of health. People who are unhoused may have an exacerbation of existing health conditions, or the development of new health conditions as a direct result of unstable or lacking shelter. Persons who are experiencing homelessness frequently experience co-occurring severe physical, psychiatric, substance use, and social problems that affect both individuals and families. Health care services are more effective when a patient is housed, and maintaining housing is more likely when comprehensive primary health care services are available. Effective strategies to end homelessness must consider this complexity of health conditions and disability faced by persons who are unhoused. (1988) (July 2023 BOD)