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Housing is Healthcare

GUEST BLOG by Dr. Tim Huffman.

Medical experts across the world advise tell us: wash hands, keep distance, and stay home. But you can’t follow this advice if you don’t have a home. Worse yet, unhoused people are more likely to have chronic medical issues that put them at higher risk for serious illness or death from the coronavirus. Also, Black citizens in St. Louis—who are at higher risk from the virus—make up a disproportionate number of people without homes and face more housing discrimination. So what do we do?

We find a way to house people, because housing is healthcare.

That said, housing those who are chronically ill and homeless is more than finding them four walls; it requires offering ongoing support. The St. Louis Housing is Healthcare project aims to provide comprehensive services—including bridge housing, long-term housing, ongoing social support, and mobile healthcare—to the 100 people living without homes who are at greatest risk of severe or deadly illness. It will also provide safe haven and housing-focused case management to 650 additional people. Read the full proposal here.

The initiative draws on a multidisciplinary team from nonprofit and for-profit organizations in the human service, shelter, healthcare, affordable housing and academic sectors in St. Louis, Missouri. This includes representatives from Horizon Housing, The T, St. Patrick Center, City Hope STL, Gateway Housing First, Saint Louis University, BJC, and more.

Failing to house medically vulnerable people without homes will endanger their lives. It will also cost the health, human service, and public safety infrastructure roughly $35 million in emergency healthcare, inefficient shelter programs, law enforcement interactions, and downstream system effects. Providing services without housing is akin to giving someone socks with no shoes. It might seem cheaper, but in the long run, the hardship of walking without shoes repeatedly destroys the socks and ultimately costs more (and causes blisters, or in this metaphor, worsens people’s health). This is always true, but it is made more extreme as the pandemic increases the burden on systems and cost of care. Inversely, if people have shoes with no socks, they will find the shoes are uncomfortable, and their sweat will damage the shoes. People need the shoe for its protective structure just as they need the sock for its supple, soft, and absorbent qualities. In the same way, if we want to protect people from the ravages of the virus, we must provide both the housing and the supportive social and health services. All too often, only one gets funded. This project integrates both.

This project is currently seeking funding from various foundations, including Jack Dorsey’s COVID-19 Start Small Foundation. Funding this project will reduce the chance of death from COVID-19. It will also cost roughly 80% less than the alternative: $7.5 to operate for two years ($5 million for the first year and $2.5 million per additional year). By addressing the racial and economic injustices connected to housing and healthcare, we can create the necessary conditions for human dignity and flourishing. It will also lead to a roughly 40% reduction in chronic homelessness in St. Louis. If you want to help, retweet the project! Contact Tim Huffman ( to get involved or learn more.

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