Homelessness: Experts push data, collaboration, and lived experience
Homelessness was at the center of a Harvard T. H. Chan School of Public Health Studio event on April 13 in Boston, where public health and public safety experts discussed prevention strategies and long-term solutions. Panelists said the rising cost of living in the U. S. is helping drive record numbers of Americans into homelessness, and they urged a response built on data, partnership, and the voices of people who have lived through it. The discussion focused on how homelessness is being shaped by health, housing, justice, and community systems all at once.
Experts call for a cross-sector response
The panel brought together Monica Bharel, clinical lead for global health, public health, and public sector health at Google and former commissioner of the Massachusetts Department of Public Health; Leslie Credle, founder of Justice4Housing in Boston; Gil Kerlikowske, former director of national drug control policy under President Obama and former police chief in multiple U. S. cities including Seattle; and Peter Koutoujian, sheriff of Middlesex County, Mass. Howard Koh, Harvey V. Fineberg Professor of the Practice of Public Health Leadership and faculty chair of the School’s Initiative on Health and Homelessness, moderated the event.
Panelists said homelessness is a complex, multifaceted crisis that cannot be solved by one institution alone. They emphasized a cross-sector approach involving public health, government, public safety, community groups, and people with lived experience.
Data and services at the center of the strategy
Koutoujian said social workers can respond to certain police calls, including conflicts involving a person with mental illness, instead of law enforcement. He said that approach can help people avoid incarceration and connect with the resources they need to get back on track. Bharel said public health leaders need to understand the perspectives of people outside their field in order to tackle the reasons people become homeless, including chronic illness, mental health and substance use disorders, financial issues, and childhood trauma.
Bharel described a framework that starts with localizing the problem and collecting data on the people most affected. She said services should meet immediate needs while partnerships are built for longer-term solutions. She pointed to her work on overdose death prevention as commissioner, when she brought together criminal justice, medical, and behavioral health data. Among the findings she cited was that people with substance use disorders released from incarceration were 120 times more likely to die of an overdose than others in Massachusetts, with the first month carrying the highest risk.
For homelessness, Bharel said the response should include robust clinical services where people can reach them, whether at a clinic, on a street corner, or in prison. She also said partners should help provide nutritious meals and income-earning opportunities for people experiencing homelessness.
Lived experience shapes the message
Credle spoke about the stigma she faced reentering society after incarceration and said people with lived experience must be part of the table when homelessness prevention solutions are being developed. She described that perspective as essential to understanding what people go through and to building responses that work in the real world.
The event framed homelessness as a public health issue that intersects with public safety, reentry, and access to care. It also reinforced the idea that homelessness cannot be addressed through enforcement alone.
What happens next
The discussion did not announce a new policy or program, but it made clear that the next steps on homelessness will likely hinge on stronger collaboration, better data, and deeper engagement with people who have lived the problem firsthand. As the pressure around homelessness continues, the panel’s central message was straightforward: solutions will have to be local, coordinated, and shaped by experience.
