The Open Health Services and Policy Journal

2010, 3 : 41-52
Published online 2010 March 22. DOI: 10.2174/1874924001003010041
Publisher ID: TOHSPJ-3-41

A Paradigm Shift in Housing and Homeless Services: Applying the Population and High-Risk Framework to Preventing Homelessness

Jocelyn Apicello
Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, 722 W. 168th Street, 5th Floor, New York, NY 10032, USA.

ABSTRACT

Prevention is critical in any effort to end homelessness. Unfortunately, the practice of homelessness prevention is still in its infancy and there is little science base for its implementation. Risk factors for homelessness have been identified at multiple levels: the individual, institutional, and societal levels. Addressing all three in prevention practice is necessary. The population/high-risk framework is the most appropriate framework for conceptualizing how to design programs and policies to prevent homelessness because it draws attention to the need for direct intervention among those at most risk, and also for modifying the overall context. This review of the literature and technical reports points to a number of strategies that demonstrate preliminary effectiveness or are in need of rigorous evaluations. Reductions in homelessness as a result of targeted, high-risk approaches alone are achievable, but will be short-lived unless low-cost and affordable housing and income are addressed at the population level. Simultaneous implementation and evaluation of both population and high-risk prevention strategies will bring us closer to reaching our goal of ending homelessness.

Keywords:

Context, high-risk, homelessness , housing, intervention, policy, population, prevention, structural.