Exploring Pre- and Post-Covid-19 Health and Disability Factors in Homeless Shelter Program Entry and Outcomes

Context: Our analysis examines barriers to housing transition for homeless individuals, focusing on health/disabling conditions, mental health, and substance use disorders. The effect of these conditions on shelter exit outcomes and changes in their incidence due to the disruptive COVID-19 pandemic are investigated to inform program success factors.

Objective: This study aims to assess the prevalence and impact of health/disabling conditions, mental health disorders, and substance use disorders on program success and exit destinations at LifeMoves Maple Street Shelter, a leading homeless services provider in the South Bay Area. This study also aims to assess if COVID-19 induced a structural break in the impact of the aforementioned factors, creating new or eliminating previous trends.

Study Design and Analysis: A retrospective observational study analyzed LifeMoves’ client data. Univariate analyses identified potential health condition-program outcome relationships. Logistic regression models further discerned these health conditions’ predictive impacts on multinomial program outcomes.

Setting or Dataset: The data was sourced from the de-identified client records of LifeMoves, spanning a period from mid 2016 to early 2023.

Population Studied: The study included homeless clients enrolled in LifeMoves programs at Maple Street Shelter.

Intervention/Instrument: Regression models were adapted to determine correlations of demographics and health information separately. Independence testing was utilized to reveal significant differences in exit destinations.

Outcome Measures: We assessed exit destinations (permanent housing vs. homelessness), stay duration, and prevalence changes in health conditions, disabilities, and substance use disorders due to pandemic disruption.

Results: We found significant exit destination variations, especially in homeless exits, influenced by demographic variables and health conditions. Post-COVID, shifts were observed in client demographics, with increased entries from racial minorities. Unexpectedly, reports of substance use and chronic health and mental disorders decreased post-COVID.

Conclusions: Our study underscores that the presence of physical disabilities, mental and substance use disorders are negatively associated with exits to permanent situations. These insights illuminate transition complexities to permanent housing, informing targeted interventions and paving way for further research.