Understanding Permanent Supportive Housing and Rapid Re-Housing Sustainability Among Youth Experiencing Homelessness: A Survival Analysis on Homelessness Management Information System Data

Background and Purpose:

Homelessness among youth is an imperative social issue that needs to be addressed. Indeed, approximately 3.5 million youth experience homelessness (YEH) in the United States. Experiencing homelessness may be detrimental to youth’s safety, development, and a host of health and behavioral health outcomes. Two housing programs have emerged as top funding priorities: permanent supportive housing (PSH; permanent housing coupled with comprehensive services) and rapid re-housing (RRH; temporary housing with supportive services). Both are designed to promote stable homelessness exit for YEH with the ultimate goal of preventing returns to homelessness. However, correlates of stable homelessness exits via PSH and RRH (i.e., housing sustainability) remain understudied. Using administrative data collected from communities across the US, this study aims to explore factors associated with YEH’s sustainability in PSH and RRH over time.

Methods:

The current study used homelessness management information system (HMIS) data collected from 16 communities across the US between January 1, 2015 and May 1, 2017 (n=10,902). With housing program entry date and exit date documented in HMIS, survival analysis was conducted to investigate correlates (e.g., age, race/ethnicity, gender, rurality, sexual orientation, and overall vulnerability as measured by the Transition Age Youth-Vulnerability Index-Service Prioritization Decision Assistance Tool[TAY-VI-SPDAT]) of YEH’s PSH (n=577) and RRH (n=2,883) sustainability separately. The event of interest in the current study (i.e., failure in survival analysis) is exiting from assigned housing programs. YEH who received PSH or RRH resources and remained within the allocated housing until the dataset conclusion date were censored in the analysis.

Results:

For youth who received housing at least 6 months prior to the dataset conclusion date, 96% of PSH receivers were able to stay in housing for more than 6 months and 89.7% of RRH receivers were able to stay in housing for more than 6 months. The multivariate survival analysis results suggest that, for YEH receiving PSH, only higher level of vulnerability was positively associated with greater hazard of exiting PSH; for youth receiving RRH, being underage (i.e., 17 years old or less), a racial/ethnic minority, previous engagement in homeless services (i.e., shelter services and transitional living programs), and higher level of vulnerability were associated with higher hazard of exiting RRH.

Conclusions and Implications:

High rates of YEH receiving PSH or RRH are able to sustain their housing. However, considering YEH with higher vulnerability are at greater risk of exiting both PSH and RRH, comprehensive supportive services targeting high vulnerability youth should be integrated in housing programs to prevent youth from re-entering homelessness. Furthermore, future RRH programs should take racial and ethnic disparities in housing stability into consideration to promote stable housing among YEH who are of racial/ethnic minority status, particularly as literature has shown minority youth may experience homelessness disproportionately as compared to White youth. Finally, more tailored supportive services, such as independent living services, may be needed for underage YEH in RRH, as YEH under 18 years of age are disproportionately likely to return to homelessness.