• Verughese Jacob, Sajal K Chattopadhyay, Sharon Attipoe-Dorcoo, Yinan Peng, Robert A Hahn, Ramona Finnie, Jamaicia Cobb, Alison E Cuellar, Karen M Emmons, and Patrick L Remington.
• From the Community Guide Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: hir0@cdc.gov.
• Am J Prev Med. 2022 Mar 1; 62 (3): e188e201e188-e201.

IntroductionThe annual economic burden of chronic homelessness in the U.S. is estimated to be as high as $3.4 billion. The Permanent Supportive Housing with Housing First (Housing First) program, implemented to address the problem, has been shown to be effective. This paper examines the economic cost and benefit of Housing First Programs.MethodsThe search of peer-reviewed and gray literature from inception of databases through November 2019 yielded 20 evaluation studies of Housing First Programs, 17 from the U.S. and 3 from Canada. All analyses were conducted from March 2019 through July 2020. Monetary values are reported in 2019 U.S. dollars.ResultsEvidence from studies conducted in the U.S. was separated from those conducted in Canada. The median intervention cost per person per year for U.S. studies was $16,479, and for all studies, including those from Canada, it was $16,336. The median total benefit for the U.S. studies was $18,247 per person per year, and it was $17,751 for all studies, including those from Canada. The benefit-to-cost ratio for U.S. studies was 1.80:1, and for all studies, including those from Canada, it was 1.06:1.DiscussionThe evidence from this review shows that economic benefits exceed the cost of Housing First Programs in the U.S. There were too few studies to determine cost-benefit in the Canadian context.Copyright © 2021. Published by Elsevier Inc.

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