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A Data-driven Re-design of Housing Supports and Services for Aging Adults who Experience Homelessness in New York City

Funded by the New York State Health Foundation, and in collaboration with the University of Pennsylvania and New York University School of Medicine, this study focuses on the shelter and health care use of older homeless adults in New York City.  Recent evidence suggests a unique cohort effect of post-World War II “baby boomers” born between 1955 and 1965 who have shown a disproportionately high risk of homelessness over the last two decades (Culhane et al, 2013).  Older homeless adults have medical needs that exceed the norms for their biological ages, experiencing geriatric medical conditions at rates on par with their housed counterparts 20 years older (Brown et al., 2012; Brown, Hemati, & Riley, 2017).

This report forecasts the future of the aged homeless population in New York City (specifically those 55 years of age or older), outlines one approach to consider the scope and cost of this future aged homeless population, and suggests a range of policy interventions.  This study is one of three studies, with companion projects in Boston and Los Angeles County.

Findings

The number of homeless individuals in shelter age 55+ increased by about 250% from 2004 to 2017 and the number of homeless individuals age 65+ increased over 300% during the same time period.  Forecasts suggests that if nothing is done, by 2030 the homeless population over 65 will triple again, with similar gains in the homeless population over 55.  This projected increase in the population comes with an associated increase in their aging-related health care costs.

Addressing housing and health care needs for this population requires a continuum of housing and health-focused interventions based on the mix of services use of this population.  Cluster analysis was applied to better categorize the mix of services used by the study sample. Based on that information, a range of potential interventions were considered. Prior research was utilized to estimate potential reductions in shelter and health care service costs from these interventions. Estimates indicate that the proposed intervention costs could be recouped from avoidance of future shelter, health, and nursing home costs.

Documents and Links

A Data-driven Re-design of Housing Supports and Services for Aging Adults who Experience Homelessness in New York City
The Emerging Crisis of Aged Homelessness: A Multi-site Research Project
Multi-site Report

Partners

Funded by New York State Health Foundation
In collaboration with University of Pennsylvania Social Policy & Practice
New York University Langone Health
NYC Department of Homeless Services
NYS Department of Health
Center for Medicare & Medicaid Services