12 million people of the U.S. adult population have experienced literal homelessness at some time in their lives. In 1996, the most recent year for which such data are available, 3.5 million Americans were homeless at least once during the year, an increase of 1.2 million over that estimated 10 years earlier. The condition of homelessness has been associated with mental illness, substance abuse, and health problems, sometimes alone, but often in combination. "There is a need to advance the knowledge base on the factors underlying chronic homelessness, accelerate the development of evidence-based preventive interventions, and disseminate effective interventions, treatments, and service models to benefit the mentally ill at greatest risk of long-term housing instability," observes Ezra Susser, MD, DrPH, Anna Cheskis Gelman and Murray Charles Gelman Professor of Epidemiology, professor of Psychiatry, chair of the Department of Epidemiology, and center co-director.

To date, most of the empirical work on homelessness has been cross-sectional or of limited duration of follow-up. Therefore, there is little understanding of the impact of homelessness over the life course or its association with access to services or participation in social and community activities. "What is now needed is an assertive, coordinated effort to thrust the science of homelessness prevention forward," says Dr. Susser.

Preliminary evidence as well as field experience suggests that homelessness experiences can exacerbate existing illnesses, impede recovery, and provoke new illnesses. "For all these reasons, we believe that our prevention program must focus on both high risk and population-level prevention," notes Dr. Caton. The strategy of the Columbia Center for Homelessness Prevention Studies is to develop an agenda for homelessness prevention studies ranging from pre-intervention research to Phase I, II, and III clinical trials and effectiveness studies.

Richard Parke
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Contact: Stephanie Berger
sb2247@columbia.edu
212-305-4372
Columbia University's Mailman School of Public Health
17-Nov-2005

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