As of 2017, the $18 trillion dollar United States economy is ranked #1 in the world. The U.S. spends far more on healthcare, as a percent of its economy (GDP), than any other major industrialized nation. Notwithstanding, we rank poorly on many health measures including health access, equity, and life expectancy. 

In addition, our country is on the cusp of a "senior" aging boom that will exact unprecedented financial stress on the two major economic sectors of both health and housing. We need to understand the seismic demographic forces at hand and collaborate on innovative solutions.

Well-intentioned lawmakers have an obligation to create and promote policies, on behalf of all Americans, to navigate these challenges.

Rising costs, changing demographics, and epidemic levels of provider stress and burnout are taking their toll. Hard-working Americans are paying the price.

The bottom line is public policy has failed to keep pace.

The "boom years" of post WW2 America have receded to the levels of the past few decades. Adjusted for inflation, middle class workers haven’t seen a pay raise over the last 40 years. U.S. income inequality, on the rise for decades, is now the highest it’s been since 1928.

Home ownership has been a good deal for most Americans. Federal income tax deductions for home mortgage interest and property taxes are double what the government spends on all lower-income housing programs combined.

Historical federal housing expenditures are unbalanced.

• Little went to families who struggle the most - they pay very high shares of their income for housing and other related expenses

• Subsidies weighted on higher-income households - incomes $200K+ received 4x average housing benefit than $20K and below

• Homeownership favored over renting - even though renter households have exploded since 2008, highest in 50 years

Housing DEMAND

Is high for all forms of housing in the U.S. but there’s not enough supply because:

• Buyer/lender credit requirements

• Shortage of buildable land and lots

• Dearth of skilled craftsmen

Of the 115 mayors of cities in 39 states across the country surveyed, only 13% said they thought their housing stock matched the needs of their constituents. Initiative on Cities Monino Survey of Mayors, 1/24/18

Affordable housing has been shown to:

• Sharply reduce homelessness and housing instability among families with children including veterans

• Cut foster care placements, often triggered by parent’s inability to afford suitable housing, by more than half

• Greatly reduces moves from one school to another

• Cut rates of alcohol dependence, psychological distress, and domestic violence victimization among adults with whom the children lived

Statistically, more than a half million people are sleeping outside or in an emergency shelter or transitional housing program on any given night. 

-National Alliance to End Homelessness. 

Clear Correlation

According to the National Coalition for the Homeless:

Substance misuse can be both a cause and a result of homelessness

• Two-thirds of the chronically homeless have a primary substance use disorder or other chronic health condition

Mental illness is often an underlying cause of addiction

• 30% of people experiencing chronic homelessness have a serious mental illness

Altogether, such physical and mental health issues may create difficulties in accessing and maintaining stable, affordable, and appropriate housing for an individual…or an entire family.

Veterans are at higher risk of experiencing Traumatic Brain Injuries (TBI) and Post-Traumatic Stress Disorder (PTSD), both of which have been found to be among the most substantial risk factors for homelessness. These realities and others combine to create a perfect storm in which vets are 50% more likely to become homeless than other Americans. 

The high rate of veteran homelessness is driven by a number of factors:

• Low socioeconomic status - significantly increased risk of homelessness  

• Deployments -  multiple and extended 

• Co-morbidities - 50% have serious Mental Health disorders and 70% have Substance Abuse issues

• Unemployment and Family Conflict - which can lead to isolation and poverty
  

The research is clear, putting people into housing and offering services they need is both preventive and more cost-effective. Successful models promote:  

• Collaboration between service providers

• Coordination of the continuum of care offered by member agencies

• Track and analyze outcomes for clients moving through member agency programs

According to the National Coalition for the Homeless, for highest need residents, every $10 invested resulted in savings of almost $22