Applying a prevention framework to address homelessness as a population health issue

This paper presents a population health framework for homelessness prevention. Rooted in the Los Angeles County Homeless Initiative, the framework includes strategies that affect social determinants of health that influence a broad range of health outcomes prevalent among the homeless. For each prevention level, we consider the purpose of prevention, the sub-population of interest, and evidence of the effectiveness of interventions in addressing factors that affect health and health outcomes. Our review highlights the importance of cross-cutting strategies and the limits of our knowledge about more targeted preventive interventions. We note that a prevention orientation requires attention to the social and physical environments that affect homelessness plus connections between the homelessness services sector and mainstream systems of care and support.