The medical cost of homelessness

Social determinants significantly contribute to adverse health outcomes. Housing is one of them. But housing alone will not solve the problems of people experiencing homelessness.

Getting sick can result in your being homeless and being homeless will make you sick. They are connected. Homelessness is also caused by and exacerbates poverty, poor health, addiction, mental illness, and violence.

Here are some other things you might not have known about homelessness .

Health professionals see the faces of homeless people every day. Unfortunately, because the problem is wicked and there is no single bullet to solve it, homeless patients are in a revolving door and return on a regular basis. It also contributes to workforce burnout and moral injury.

Nerdwallet estimated that?57.1 percent?of U.S. personal bankruptcies are due to medical bills, making it the leading cause of the financial calamity that often precedes homelessness. For women, the connections between health and homelessness are even more disturbing. One in four women are homeless because of domestic violence.

There is international concern, both in Europe and North America, that sustained and repeated homelessness has significant impacts on public expenditure. Costs for health care systems, including mental health services and emergency services at hospitals are high, as are many costs for the criminal justice system.

Evidence shows that people who experience homelessness for three months or longer cost on average ￡4,298 per person to NHS services, ￡2,099 per person for mental health services and ￡11,991 per person in contact with the criminal justice system. (Better than cure? 2016 )

Data merging in Scotland has indicated that NHS service use is 24 per cent higher among homeless people in Scotland and previous research as suggested that homelessness increases reoffending rates (among people with criminal records) by 20 per cent.

?In one study of how homeless people use the healthcare system in Boston, a research team?found ?that it cost Massachusetts $16 million per year to care for 6,500 homeless people in the state’s emergency rooms.

Who pays for that care? Research shows that about 40% of homeless individuals are insured under Medicare and Medicaid. The remaining 60% have no insurance, though many are eligible for Medicare or Medicaid due to their age or disability status. This second group is poised to grow considerably;?a well-regarded study ?has shown that the number of elderly experiencing homelessness will triple in the next ten years. Likewise, the same study finds that the cost of sheltering and providing healthcare to homeless seniors in Los Angeles County will reach $540 million by 2026, an 80% increase since 2011.

More than a third of college students don't always have enough to eat and they lack stable housing, according to a?survey? published Tuesday by researchers at Temple University and the Wisconsin HOPE Lab.

Overall the study concluded 36 percent of college students say they are food insecure. Another 36 percent say they are housing insecure, while 9 percent report being homeless. The results are largely the same as last year's survey, which included fewer students.

Here are some solutions. According to the Department of Housing and Urban Development, it would cost $20 billion to end homelessness in the United States.

To put that in perspective, the average 25- to 34-year-old reported spending?$2,008 per year?at coffee shops, and according to a survey by the money app Acorns, 41% of millennials admitted to spending more on coffee in the past year than they had invested in their retirement accounts.

These days, a lot of people are losing their jobs and the worst might be yet to come if there is a deep recession. One of them could be you and that mocha latte will be out of reach, just like the digital health app you were developing was for the homeless living in the sick care digital divide.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs