Public Health and Homelessness: New Strategies at Hand

Your chances of dying are three times higher if you’re a person experiencing homelessness, compared to the general population. That’s the result of a recent study that looked at the issue in Minnesota, performed by the Minnesota Department of Health and their partners, with support from the CDC Foundation.

And at last count in 2022, more than half a million people in the United States experienced homelessness. Almost 30 percent of the unhoused were families with children. That’s a record high in the history of this type of data collection, and some experts believe this number and other surveys of this population to be undercounted by as many as a million people.

Homelessness Leads to Higher Risk of Illness

For people experiencing homelessness, also known as PEH, their living situations leave them at much greater risk for getting an infectious disease, including tuberculosis (TB), hepatitis A and C, COVID-19 and HIV/AIDS, as well as a host of other infections. 

That’s because illnesses like TB and COVID-19 can spread in crowded places like shelters and because PEH may not have regular access to health care. That lack of care can also lead to worse outcomes, including severe illness and death. Mental illness, substance use disorders and heart and lung disease are also significant ongoing concerns for PEH, according to the Centers for Disease Control and Prevention (CDC).

It often falls to public health departments to try and manage disease outbreaks among this population. The Minnesota study was part of a recent exploratory project from the CDC Foundation and CDC that showed that various agencies and community partners working together can have a greater impact on these serious health issues.

Public Health Partnerships Can Help

Rolling out in two major cities and the state of Minnesota, the pilot program looked at ways to promote collaborative problem-solving between homeless service providers, health care providers, academic institutions and state, tribal, local and territorial health departments. In consultation with other partners and experts, a guide/toolkit was developed that offers strategies, best practices and other resources to help health departments better serve people in their communities who are experiencing homelessness. 

This innovative toolkit can be found on the CDC Foundation health equity resource page and includes guidance, examples and worksheets for health departments and others on topics including:

  • Reducing the spread of diseases among PEH
  • Building and strengthening partnerships
  • Engaging people who’ve been homeless to advise and assist
  • Making sure PEH have equal access to resources
  • Collecting, sharing and applying data and information

The project identified even more ways to help, including making it easier for PEH to find and use hygiene supplies, services and public restrooms and establishing better methods for gathering more accurate data on homelessness and the spread of disease.

“The support we received from CDC and CDC Foundation was invaluable to our efforts as a state health department to understand and address the public health risks of homelessness,” said Josh Leopold, senior advisor on Health, Homelessness and Housing for the Minnesota Department of Health. “This toolkit will be an essential resource for other public health departments looking to create or expand programs for people experiencing homelessness.” 

A paper on the project was recently published by the Journal of Public Health Management & Practice, and CDC has more information on homelessness and health on its website.


Toni Perling
Toni Perling is a senior communications officer for the CDC Foundation.
Alaina Whitton
Alaina Whitton is a program officer for the CDC Foundation.