People experiencing homelessness, a highly vulnerable low socioeconomic status group, face extraordinary health and health services disparities. The burden of homelessness falls disproportionately on racial/ethnic minorities and individuals living in rural areas. Medicaid programs offer opportunities to improve engagement of diverse populations experiencing homelessness in high quality health services, but there are significant gaps in evidence needed to advance effective strategies. Permanent supportive housing (PSH) is a promising intervention that integrates rental assistance with tenancy, social, and health care support services, but its potential for addressing disparities among Medicaid-enrolled homeless persons is not well understood.
This study will fill this critical need for evidence by using twelve years of linked Medicaid and homeless services administrative records from Pennsylvania and New Jersey – encompassing demographically and geographically diverse populations – along with rich survey and qualitative data to support the first large-scale study of health disparities associated with homelessness and evaluation of PSH effectiveness in remedying these disparities. Specifically, the study aims to:
- Characterize racial/ethnic and geographic variation in health services patterns associated with homelessness among adult Medicaid beneficiaries.
- Evaluate the impact of PSH for homeless adults on long-term health services outcomes and disparities.
- Identify PSH program features associated with reductions in health services disparities and inform policy and program strategies to improve PSH impact.