Effects of Housing First Approaches on Health

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Homelessness is associated with poor health. A policy approach aiming to end homelessness across Europe and North America, the ‘Housing First’ (HF) model, provides rapid housing, not conditional on abstinence from substance use. We aimed to systematically review the evidence from randomized controlled trials for the effects of HF on health and well-being.

What this study adds

  • There is good evidence to support the use of Housing First in
    providing stable housing to homeless people.
  • Housing First does not appear to cause an increase in
    substance misuse, compared with treatment as usual.
  • Housing First approaches do not appear to consistently
    improve or harm health in the short-term, but long-term
    impacts are unknown.

The conclusion is Housing First approaches successfully improve housing stability and may improve some aspects of health.

All four studies reported measures of housing stability, either recording a proportion of total days reported as ‘stably housed’ or a proportion of the population in stable housing at the end of the trial period.


Baxter, Andrew J., Emily J. Tweed, Srinivasa Vittal Katikireddi, and Hilary Thomson. “Effects of Housing First Approaches on Health and Well-Being of Adults Who Are Homeless or at Risk of Homelessness: Systematic Review and Meta-Analysis of Randomised Controlled Trials.” Journal of Epidemiology and Community Health 73, no. 5 (May 2019): 379–87. https://doi.org/10.1136/jech-2018-210981.


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