Illinois Interagency Task Force on Homelessness 

9/12/2024

Director Sameer Vohra, IDPH

Janice Phillips, Assistant Director, IDPH

Ashley Thoele, Deputy Chief Operating Officer, IDPH

Jenny Epstein, Deputy Director, IDPH

Colleen Mahoney, Senior Policy Advisor, IDPH

Home Illinois

  • A key Home Illinois plan strategy is working to close the mortality gap between people experiencing homelessness and the general population. 
  • To better understand the mortality gap, IDPH and partners at UIC developed the Illinois Homelessness Mortality and Morbidity Report, 2017-2022.

Homelessness and Health

  • Homelessness and health have a bidirectional relationship:
    • Poor health increases households' risk of homelessness
    • Experiencing homelessness is linked to rapid declines in health. 
  • To improve health, work is needed to: 
    • prevent entrances to homelessness, 
    • strengthen systems of care for people currently experiencing homelessness 
    • and strengthen system capacity to support exits to housing. 

Illinois Homelessness Mortality and Morbidity Report, 2017-2022

This report:

  • Draws on a long history of local and community groups doing homeless mortality reporting as a systems change tool
  • Only the second such report by a State
  • Unique in the inclusion of morbidity (hospital data) 

Acknowledgements: 

  • Illinois Department of Public Health University of Illinois Chicago School of Public Health
    • Lee Friedman, PhD, MS, Dana Madigan, PhD, DC, MPH, Hannah Matzke, PhD, MS 
  • UIC Institute for Healthcare Delivery Design
  • Illinois Office to Prevent and End Homelessness

Mortality Data

  • Years of life lost: 
    • Average age at time of death was almost 20 years younger among PEH compared to the general IL population 
    • 56.3 years for PEH vs 74.2 years old for non-PEH
  • Sharp increase in mortality: overall increase of 36.6% in deaths of PEH since March 2020, while there has been only a 6.1% increase in deaths in the general population over the same time.

Disproportionate contributing causes of death

  • Drug-related overdoses
    • 32.9% of PEH deaths vs 3.4%
  • Traumatic injuries inc. homicides
    • 12.3% of PEH deaths vs 3.6%
    • Homicides PEH 2.9% vs. 1%
  • Cold deaths
    • 3.8% of PEH deaths vs .1%

Housing status and hospital utilization

  • During years a person had at least one hospital visit coded for homelessness, they had an average of seven ED visits and 2.5 hospital admissions.
  • In contrast, during years these same individuals had no hospital visits coded for homelessness, they had an average of 1.7 ED visits and 0.4 hospital admissions.

Strengthening Systems of Care

  • The HMMR highlights the need for improved hospital discharge options for people experiencing homelessness:
    • The majority of PEH were discharged to home or self-care. For PEH, this may be a discharge to a shelter or the streets, which may result in difficulty accessing continued care or treatment.
    • Discharge to medical respite programs have demonstrated some success in limiting readmissions, but most patients are discharged to other settings (own care, nursing homes, etc.; Madigan 2021) that do not achieve similar results (Kertesz 2009).

Strengthening Systems of Care: Example Strategy

  • Medical respite: short-term, post-acute care for people experiencing homelessness who are too ill or frail to recover from an illness or injury on the street or in shelter, but who do not require hospital level care.
  • Increasing the availability of medical respite: 
    • Improves individual health outcomes,
    • Strengthens hospital and shelter systems, and
    • Prevents unnecessary nursing home placements. 

Thank you

See the full report, executive summary and a webinar presenting the findings in more detail at: https://dph.illinois.gov/data-statistics/homelessness-mortality-morbidity.html.  

Appendix

Hospital Data

  • 62,158 unique people identified
    • Median of 14 hospital visits per person over the 6 years studied
    • Total of 1,428,984 emergency department (ED), outpatient and in patient visits
  • 25% of PEH (75th percentile of the distribution) had 28 or more visits  and one person had 1,470 hospital visits.
  • Total cost billed for PEH utilizing Illinois hospitals was $16,429,817,828 for 2017-2022 (2020 US dollars) 

Injuries

  • Approximately 15-20% of hospital visits were for injuries
    • Most commonly poisoning, falls, assault/homicide, temperature-related, and transportation-related (pedestrian or bicyclist struck by motor vehicle)
    • 28,860 visits from assaults (more common in ED visits) 1
    • 5,578 visits from suicide attempts (more common in admissions)