“This report sheds light on the true cost of homelessness, which extends far beyond the immediate needs of those experiencing it,” said Dr. Philip Huang, director of DCHHS in a statement. “These costs impact taxpayers, healthcare systems, and our entire community.”
Huang and coauthor Ali Dadpay based the study on Housing Forward's 2023 Point-in-Time count, an annual census of the homeless in the two counties. In 2023, the count found 4,410 people were experiencing homelessness — a likely undercount given how hard it can be to find people living on the streets. Drawing on data and studies in both the U.S. and abroad, they estimate the price of services to those in the count came out to $43,901 per person on average in 2023. That's about 63% of the median salary for entire households in Dallas, according to census data.
The report cited the Dallas R.E.A.L. Time Rapid Rehousing initiative, a partnership between local governments and homelessness organizations that aims to rapidly rehouse homeless people and provide them subsidies and connections to services to help them stay housed and improve their health. The DCHHS study noted that the initiative's original goal was to spend $70 million to provide housing and help to 2,700 people. Left on the streets, those 2,700 people would rack up costs totaling $118,532,700, based on the report's per capita estimate.
That's a substantial savings, not to mention that providing shelter and care to the destitute is, in some quarters anyway, considered the good and compassionate thing to do. It also reduces the number of homeless encampments in the area, a bonus to homeowners and businesses.
According to the report, medical treatment accounted for the biggest share of the total cost of homelessness at 31% or $60,406,945. Other high-dollar items on the list were:
- Hospitalizations: $49,383,753
- Mental health services: $17,257,247
- Emergency room visits: $16,493,400
- Incarceration: $16,850,311
- Emergency sheltering: $33,214,708
She also noted that the savings derived from a program like the R.E.A.L. Time Rapid Rehousing initiative require more than just putting a roof over someone's head.
"So I think what we think what we've seen consistently in the research for many many years is that people experiencing homelessness, particularly those that are in shelter, are cycling in and out of emergency departments, inpatient hospital stays, psychiatric crisis facilities, emergency shelters, jails, and these are all super super costly," she said.
In March, The New York Times reported about a $26.7 million investment made by Aetna, a managed care organization, in an $80-million affordable housing project in Louisiana. The project will offer tenants access to a medical clinic onsite and study patients' health outcomes. That was one of many similar efforts investing hundreds of millions of dollars nationwide to develop affordable housing that could deliver returns not just for the companies but for taxpayers too.
Providing shelter plus links to services that provide primary and preventive medical care or psychological or substance abuse treatment cuts down on the use of much more expensive crisis care and hospital stays, not to mention jail stays, Kahn said.
"And that's pretty consistent in the data," she said. "... So much so that managed care organizations and healthcare institutions across the nation, now a lot of them have started to invest in housing as a healthcare intervention because of the cost savings to those systems. We see that happening with corrections facilities as well. We've seen in certain states and cities that across corrections or healthcare institutions they have seen enough evidence that by housing people we reduce recidivism rates and we reduce the need for emergency care, and so it's worth it for them to invest."
