By Monica E. Oss, Chief Executive Officer, OPEN MINDS
Issues related to housing are dominating the news. The last of the COVID-era federal eviction ban and foreclosure moratorium just lapsed, though individual states have their own rules. The housing market is ‘readjusting’ from its COVID high. Rents are rising. And at the same time, investors are taking new interest in rental real estate.
How all of this squares with the new data on homeless Americans is unclear. In 2021, about 600,000 Americans were homeless on any given day. About 79% of people experiencing homelessness were staying in sheltered locations—the other 21% were in unsheltered locations, defined as places not ordinarily used for sleeping (streets, vehicles, parks, etc.). An estimated 226,000 of these people are sleeping outside, in cars, or in abandoned buildings.
From 2020 to 2021, the number of people staying in sheltered locations decreased by 8% (defined as people who are staying in emergency shelters, transitional housing programs, or safe havens)—maybe the result of the COVID-era moratoria. According to the recently released annual U.S. Department of Housing and Urban Development (HUD) report on homelessness, The 2021 Annual Homeless Assessment Report (AHAR) To Congress, this decline in the use of sheltered homelessness continues a decline that began in 2015 and includes shelter facilities for children, veterans, and unaccompanied youth.
The statistics for the chronically homeless show an opposite trend—the number of sheltered individuals identified as chronically homeless increased by 20% between 2020 and 2021 and has increased for several years running. HUD defined this population as people with a disability, who have been continuously homeless for at least one year, or have been homeless four times over three years.
Based on emerging studies, homelessness and housing instability appear to be the social determinant that is most strongly associated with increased health care costs. Health care spending for homeless or housing insecure individuals is 2.5 times more than the general population.
The question is how to address the needs of this highly heterogeneous population. Health plans have provided a great deal of financial support for initiatives related to the homelessness issue. Both Aetna and UnitedHealthcare recently made contributions to support programs for this population. And states are finding innovative ways to assist. In Colorado, The Denver Basic Income Project is testing the effect of giving cash to people experiencing homelessness. There are two intervention groups—one group will receive $1,000 per month, the other will receive $6,500 as a lump sum and $500 per month, while the control group will receive $50 per month.
The issues of housing insecurity and homelessness are going to continue to plague government policy makers and legislators at all levels. Rents continue to outstrip increases in compensation. The average U.S. renter is currently paying $1,326 a month, but the average asking rent is now $1,900, with single-family houses averaging $2,018 a month, and a typical apartment renting for $1,659. And the retirement bubble ahead will present new challenges. As of January 2022, the average Social Security benefit is $1,657 per month. For executives serving consumers with the most complex social support needs, housing is a key part of that equation—and will need to be part of any care coordination approach.