According to the National Health Care for the Homeless Council, poor health is a major cause of homelessness. For instance, if an injury or chronic condition results in someone being unable to work, paying rent or a mortgage may become an issue. Conversely, homelessness may create or exacerbate existing health conditions due to weather conditions, lack of healthcare, unhealthy diet, street violence, etc.

Homeless individuals have two times the rate of high blood pressure, heart attacks and diabetes as compared to the housed population. Mental illness, substance use disorders and incarceration are other factors that both contribute to, and result in, homelessness.

COVID-19 impact

Living in an encampment or a crowded homeless shelter, increases the risk of being exposed to communicable diseases. Dr. Chelsea Haring-Cozzi, executive director for the Coalition for Homelessness Intervention & Prevention (CHIP), explained that through recent work with a COVID-19 homelessness response team – comprised of state of Indiana, Marion County and Indianapolis representatives – she has witnessed the pandemic’s impact on the homeless population across the state with two specific emerging challenges.

First, it is difficult to follow social distance and shelter-in-place directives in an open crowded shelter or encampment. Remaining healthy and safe, particularly for those already at high risk, is compounded by the fact there are limited places for homeless individuals with COVID–19 to isolate or quarantine themselves, so they frequently remain in close contact with other shelter residents. Outbreaks occurring in shelters can rapidly spread and involve a large number of persons.  

And second, individuals who have lost their jobs due to the pandemic are behind on rent and could face eviction. This can increase the number of homeless individuals on the streets or in shelters. Indianapolis is working hard to address this problem, advocating for a statewide strategy on the pending eviction crisis.

“Individuals experiencing homelessness have higher rates of illness and die on average 12 years sooner when compared to the general U.S. population.”

National Health Care for the Homeless Council

Types of assistance

Haring-Cozzi explained that as part of the COVID-19 response, hotels were leased to give people safe places to live and recover from infection as well as lessen the number of individuals in shelters. However, as hotel leases expire residents will need to find rehousing options. The team also is working on a relief program to assist households at risk of losing their homes due to non-payment during the pandemic.

“We are ensuring that more don’t become homeless by providing various housing pathways,” Haring-Cozzi said. “There is not enough quality, affordable housing, particularly in Indianapolis. And, there is not enough variation. We have lots of one- and two-bedroom apartments but larger families can’t find three- to four-bedroom apartments.”

Contributing factors

Haring-Cozzi noted that the homeless in Indiana experience challenges with other systems as well. “When you’re homeless, it becomes harder to access stable healthcare and to find healthcare providers.  It is hard to maintain a continuum of care when experiencing homelessness,” she said.

Additionally, she pointed to racial disparities. “Black people have an even higher prevalence of homelessness and disease,” Haring-Cozzi said. “COVID-19 is exacerbating already critical issues.”

According to the Indiana University Public Policy Institute’s Homelessness in Indianapolis 2019 report, “Black individuals disproportionately experience homelessness compared to white individuals.” Although Blacks only make up 29% of Marion County’s population, they represent nearly 61% of the homeless population, representing the highest rate of racial disparity in the last five years.

“Housing and health issues are so intrinsically linked,” said Haring-Cozzi. “With our partners, we will continue to advocate on a statewide level for mobilization of housing. FSSA is a key partner when it comes to homelessness and mental health, Medicaid coverage, substance abuse, and more.”


CHIP is the only organization in Indianapolis driving a system-wide, community response to make homelessness rare, short-lived, and recoverable.

Through leadership and collaboration, CHIP is doing the following:

  • Secure funding for housing and services
  • Manage and analyze data collected by homeless providers
  • Advocate for policy change at the local and national levels
  • Support community partners and work together to end homelessness

About Economic Security

Economic security plays a pivotal role in our overall health and well-being. When we have access to the things we need to survive—food, shelter, health care, clothing—our opportunities for growth and development are far greater. Yet, if we struggle to afford life’s most basic needs, we often have to make trade-offs. These trade-offs—between food and utilities, for example, can directly and indirectly impact our physical, mental and emotional health. Economic well-being provides a sense of security, satisfaction and fulfillment, and the means to care for ourselves and those around us.