By: Nyoko Brown
Permanent supportive housing (PSH) provides housing and a variety of services to people who have experienced chronic homelessness. It can come in two forms, one being a single-site housing unit and the other being scatter-site housing units (Henwood et al, 2017). Research on such programs in Los Angeles is not extensive but is comprehensive enough for one to conclude that ending homelessness requires more than providing housing alone. A lot more support is needed to rehabilitate individuals regarding the adverse physical and mental health outcomes that are associated with homelessness.
One example of how services within PSH are not improving previously homeless individuals' health outcomes is seen in how food insecurity is actually increased within this population. The study titled Food insecurity among formerly homeless individuals living in permanent supportive housing defined food security as, “a household having access to adequate nutritious and safe foods...” (Bowen et al, 2019). It found that of those living in Los Angeles PSH who were 45 years old, 67% percent of those residents reported low or very low food security (Bowen et al, 2019). Furthermore, it was reported that food insecurity often is found among individuals with other ailments commonly associated with chronic homelessness. These variables can include diabetes, HIV/AIDS, mobility impairments, depressive symptoms, and much more (Bowen et al, 2019). To put into perspective how extensive this problem is for those living in PSH, the study compared the 67% of their participants experiencing food insecurity to the fact that 22% of the general population experiences food insecurity as a whole. Their value also exceeds 55% of currently homeless individuals experiencing food insecurity. It should be noted that PSH programs aid their residents by providing subsidized rent that is typically 30% of their income, and this article points out that individuals may still struggle to meet other expenses.
One should consider how overwhelming it may be for individuals to now have one location limiting the distance they can travel for resources. Especially in settings like scatter-site housing units, where services can be more than a block away. This is a significant distance on Skid Row (Henwood et al, 2017). Couple this along with other resources not associated with their PSH program that may be further away, and it becomes clearer just how much of a barrier the current delivery of PSH services can be. The Bowen et al. study did find that just by a $100 increase in monthly income, there was an 8% decrease in the odds of low or very low food security. Therefore, one promising solution could be to increase the income of those living in PSH. Overall, there is currently a large gap in the improvement of health as one transitions from unstable housing to PSH.
These associations are important because they emphasize how more comprehensive services are required to help individuals recover from experiencing homelessness. Because of the heavy correlations specifically between food insecurity and illnesses that tend to be exacerbated in homeless populations, there should be an increased effort to ensure proper nutrition access and education in rehabilitative settings like PSH.
Henwood BF;Harris T;Woo D;Winetrobe H;Rhoades H;Wenzel SL; (n.d.). Availability of comprehensive services in permanent supportive housing in Los Angeles. Health & social care in the community. Retrieved February 13, 2022, from https://pubmed.ncbi.nlm.nih.gov/28984074/
Bowen, E. A., Lahey, J., Rhoades, H., & Henwood, B. F. (2019, April). Food insecurity among formerly homeless individuals living in permanent supportive housing. American journal of public health. Retrieved February 13, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6417590/