Homelessness is a multifaceted public health and social issue with many risk factors associated to the experience that impacts one’s social determinants of health.

Shelter is one of the basic human needs. Many factors can influence homelessness.[1] Prime among them is the availability of adequate housing. Additionally, behavioral, social, and infrastructure factors impact homelessness.

Experiencing homelessness creates a higher risk to be impacted disproportionately by communicable diseases due to various barriers that exist when living unhoused: including spaces to isolate, equitable access to healthcare, and consistent hygiene and nutrition.

People who are unhoused are likely to have poorer health outcomes such as higher rates of HIV, Hepatitis, or Covid-19 infections, poor mental health, or alcohol or drug addiction. They may not have a place to seek medical care other than the emergency department and they may have challenges complying with a treatment plan. According to the American Public Health Association, “People experiencing homelessness die, on average, 17 years earlier than those who are housed.”[2] Homeless people may have experienced or are experiencing things in their lives that may make it difficult to obtain and maintain housing. Examples include experience with or post-traumatic stress from violence, discrimination, or lack of access to adequate food, protection, or social support. Social programs that aid the homeless in finding employment, accessing health care, promoting housing stability, and improving quality of life can help reduce chronic homelessness.[3]

According to the 2022 Point in Time Count, the unsheltered (not accessing shelters) population in Spokane county has increased by 54% since 2020, with a current population of individuals experiencing homelessness totaling 1,757 people.

Top reasons for not using a shelter

     Safety/fear of violence

Top reasons for homelessness

     Lack of affordable housing
     Substance use disorders
     Loss of employment
     Lack of social supports

Barriers among the homeless

     31% Serious mental health diagnosis
     22% Substance use disorders
     10% Domestic violence

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Spokane Regional Health District is committed to providing public health services and prevention measures in order to promote welfare of those who are experiencing homelessness for improved health outcomes.

[1] Sleet DA, Francescutti LH. Homelessness and Public Health: A Focus on Strategies and Solutions. Int J Environ Res Public Health. 2021 Nov 6;18(21):11660. doi: 10.3390/ijerph182111660. PMID: 34770173; PMCID: PMC8583397. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8583397/

[2] https://community.solutions/understanding-public-health-and-homelessness/


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