Permanent Supportive Housing with Housing First: Findings from a Community Guide Systematic Economic Review

Verughese Jacob
Sajal K Chattopadhyay
Sharon Attipoe-Dorcoo
Yinan Peng
Robert A Hahn
Ramona Finnie
Jamaicia Cobb
Alison E Cuellar
Karen M Emmons
Patrick L Remington
Peer-Reviewed Article
March 2022


The economic benefits of permanent supportive housing (PSH) programs with a Housing First approach exceed the costs in the U.S., with a benefit-to-cost ratio of 1.8:1. 


Chronic homelessness is a costly societal issue, potentially carrying an economic burden of more than $3 billion dollars annually. Permanent supportive housing programs with a “Housing First” approach are designed to address chronic homelessness by providing time-unlimited housing to people experiencing homelessness with disabling conditions with no requirement of sobriety, versus a Treatment First approach that requires treatment and sobriety to be eligible for housing. An earlier Community Preventive Services Task Force (CPSTF) systematic review found that Housing First programs are effective at decreasing homelessness, increasing housing stability, and improving the quality of life for people experiencing homelessness with a disability. This study details the results of the systematic economic review completed by CPSTF.


The economic review of 17 studies from the U.S. concluded that the median total benefit of PSH programs was $18,247 per person per year, with a median intervention cost of $16,479. The benefit-to-cost ratio of 1.8:1.


The benefit-to-cost ratio is useful for organizations interested in implementing and funding permanent supportive housing programs with a Housing First approach.

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