• Jack Tsai, Lillian Gelberg, and Robert A Rosenheck.
• National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, West Haven, CT, USA. Jack.Tsai@yale.edu.
• J Gen Intern Med. 2019 Sep 1; 34 (9): 170317081703-1708.

BackgroundThe permanent supported housing model is known to improve housing outcomes, but there has been sparse research on the effects of supported housing on physical health. Various organizations including the National Academy of Sciences have called for research in this area.ObjectiveThis observational multi-site outcome study examined changes in physical health among chronically homeless adults participating in a comprehensive supported housing program and the associations between changes in physical health, housing status, and trust in primary care providers.DesignData are presented from an observational outcome study analyzed with mixed linear modeling and regression analyses.ParticipantsA total of 756 chronically homeless adults across 11 sites were assessed every 3 months for 1 year.InterventionsThe Collaborative Initiative to End Chronic Homelessness provided adults who were chronically homeless with permanent housing and supportive primary healthcare and mental health services.Main MeasuresDays housed, physical health-related quality of life (HRQOL) measured by the Short Form-12 health survey, number of medical conditions, number of treated medical conditions, and number of preventive medical procedures received.Key ResultsParticipants showed reduced number of medical problems and receipt of more preventive procedures over time, but there was no statistically significant change in physical HRQOL. Changes in housing were not significantly associated with changes in any physical health outcomes. Over time, participants' trust in primary care providers was positively associated with increased numbers of reported medical problems and preventive procedures received but not with physical HRQOL.ConclusionsEntry into supported housing with linked primary care services was not associated with improvements in physical HRQOL. Improvement in other medical outcome measures was not specifically associated with improved housing status.

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