Today's homeless population includes people from every walk of life, people who work hard and who have never missed a day of work can still find themselves without a home and looking for a place to stay. The number one cause of homelessness, is poverty and low wages. Wages are often too low for people to afford permanent housing for themselves and their families. Add into that equation a lack of transportation, the rising cost of food, and the lack of healthcare, and the situation becomes exacerbated.

Complicating the situation even further, the lack of access to reliable high-speed internet and the ability to keep consistent phone service can further limit access to housing, transportation, food, education, workforce development, jobs, childcare, and even healthcare. The side-effect of not having reliable internet access often leads to those experiencing homelessness being stuck in a vicious cycle, unable to get out.

But all of this begs the question, why should the average American care? Why is it essential to work to end homelessness and provide digital equity and digital health equity as a society? The simple answer is that it's significantly cheaper to solve this challenge than to ignore it. It could easily be said that the impact of homelessness on our healthcare system alone is enough reason to find equitable solutions to solve this crisis and end homelessness as we know it in America.

Factors Contributing to the Homelessness Crisis

Poverty itself is the single most significant root cause of homelessness. Subsequently, the rising cost of housing and the lack of affordable housing becomes the biggest challenge for those experiencing homelessness to find long-term, stable housing. Beyond affordable housing, other factors contribute to homelessness as well that include:

• Inflation
• Addiction
• Ability to Earn a livable wage
• Domestic Violence
• Unemployment
• Lack of Affordable Childcare
• Lack of Education and Skills Training
• Lack of Internet Access
• Mental Health Issues
• Lack of Reliable Communication

Poverty, stagnant wages, and inflation, keep people trapped in poverty in a never-ending circle and place them at greater risk for homelessness. Child poverty significantly affects a child's life and puts these children at greater risk of growing up with health issues and becoming homeless later in life. Children growing up in extreme poverty experience reduced academic outcomes, skill-building opportunities and undercut their ability to learn, all negatively affecting their ability to graduate and obtain good-paying jobs in the future.

Homelessness and the Impact on Healthcare

Most homeless people do not have Healthcare or a primary care physician. Instead, they rely upon hospital emergency rooms, which are legally required to provide care, regardless of a person's ability to pay. The average homeless person visits the emergency room 5 times a year, and the highest number of users visit the emergency room weekly. The cost to taxpayers for emergency room visits for the average homeless person is more than $18,000 a year and over $44,000 a year for those homeless individuals with the highest number of emergency room visits. That equates to an annual cost of $9,950,940,000.00 based solely upon the "average" homeless person seeking care in the emergency room 5 times per year.

Telehealth can potentially improve outcomes for homeless people and drive down the cost of their healthcare for taxpayers. The challenge, however, is that nearly half of all homeless people lack internet access, a device to connect to the internet, or a phone to talk to healthcare professionals. By default, the lack of these critical resources forces homeless individuals to seek care in the more expensive community emergency rooms, where the average cost per visit is $3700. A recent study published in the Telemedicine and e-Health Journal compared satisfaction ratings between in-person and telehealth visits and found that telehealth visits had a 92.7% satisfaction rating amongst homeless individuals.

Additionally, nearly a third of all participants stated that if they had not been able to access their healthcare through the telehealth system, they would not have been able to seek treatment at all simply because they lacked transportation. Another third of the participants said they would have sought treatment in an emergency room, further driving up the cost of their Healthcare. The final report showed that the vast majority of these people felt their overall health would significantly improve if they had consistent, reliable access to healthcare, including telehealth.

Today, many hospitals and other healthcare providers are distributing cell phones with their telehealth apps to homeless people in an effort to provide digital health equity while simultaneously driving down the cost of serving these individuals and decreasing the overcrowding of their emergency departments. The cost of supplying these smartphones to their homeless communities has been offset by the reduced cost of providing care to homeless individuals in the emergency room. This both saves the taxpayer and the hospital money, and it improves the healthcare for those who are experiencing homelessness.

A hospital system in the mid-west recently estimated that the average cost of admitting a homeless person into the hospital costs their hospital and the taxpayers an average of $100,000 per homeless person admitted. Based upon this single line-item cost, a hospital or other healthcare provider can distribute nearly 250 smartphones, including one year of service to the homeless and those underinsured in their community, to drive down costs, improve care and reduce the burden on their hospital's emergency departments.

A study from Fierce Healthcare shows that patients experiencing homelessness are more apt to want information about chronic health and mental health issues as well as information about smoking cessation, addiction, domestic violence, and pregnancy. The study also found that these individuals were twice as likely to look up health information compared to the general population when they had internet access. The bottom line is simple: Telehealth is cost-effective and effective in delivering quality healthcare. Additionally, its ability to provide quality healthcare for people who are homeless and lack transportation to get to and from the doctor's office is a game-changer. The only requirement to delivering it is that the individual must be connected. They must have a reliable internet connection.

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