Hospital Homeless Count

Counting the “hidden homeless” in New York City hospitals 

With all that is happening in healthcare and housing reform, the Consortium saw the need to conduct research to better identify and understand the health and housing needs of Bronx residents so that we can coordinate our existing services more effectively and advocate for more resources necessary to meet those needs. Every January, the NYC Department of Homeless Services conducts its annual Homeless Outreach Population Estimate (HOPE) Count. This event, which takes place in the middle of the night during the winter, consists of an outdoor street count throughout the five boroughs and MTA system to identify homeless individuals.

Understanding that homeless and unstably housed populations are a significant driver of hospital-based health care utilization, in 2014 the Consortium began its own count of people experiencing homelessness in hospital emergency departments on the night of the DHS HOPE Count. These patients can be considered the “hidden homeless” because they are indoors and not subject to being counted during HOPE. 

2020 Findings

On January 27, 2020—the same night of the New York City Homeless Outreach Population Estimate (HOPE) throughout NYC streets and subways—the Health & Housing Consortium led an independent effort to count the number of people experiencing homelessness who were seeking care or shelter in NYC hospitals. This population is considered the “hidden homeless” because they are missed by the City’s estimate. Volunteers surveyed individuals in emergency department (ED) treatment areas and waiting rooms and other non-medical locations such as lobbies and hallways.

individuals experiencing unsheltered homelessness counted in NYC hospitals on a single night

30 hospitals were surveyed in the Bronx, Brooklyn, Manhattan, and Queens, including all 11 NYC Health + Hospital (H+H) sites.

69% of respondents reported not having a regular doctor outside of the ED.

76% of respondents reported 10 or more visits to the ED within past year, including 22% who reported visiting the hospital every day.

An additional 30 individuals were identified as homeless and living in a shelter.