Denver’s Homelessness Crisis: A Physician’s Plea for Housing as Healthcare
On a recent early fall morning, hope was in short supply. The escalating crisis of homelessness in Denver is not just a social issue, but a profound public health emergency, according to one physician on the front lines.
Denver Health, the region’s safety net hospital, is witnessing the devastating consequences of a lack of affordable housing firsthand. In 2024, the hospital served over 16,000 patients experiencing homelessness, resulting in 78,000 visits to the integrated health system. This overwhelming volume underscores a critical point: for many, the streets have become a waiting room for preventable illness and injury.
The Human Cost of Falling Through the Cracks
The story of “Mr. D,” a 50-year-old patient with diabetes, exemplifies the tragic cycle. After five years living on Denver’s streets, including two years relying on a walker, Mr. D returned to the hospital with a limb-threatening infection. The progression of the ulceration on his foot necessitated another amputation, leaving him dependent on a wheelchair. “Doc, I just keep falling through the cracks,” he lamented, a sentiment echoing the experiences of thousands.
Those living unsheltered are susceptible to preventable conditions like frostbite and heatstroke, and for many, homelessness is ultimately fatal. Last year, at least 223 people died while living on Denver’s streets. Moreover, homeless adults stay an average of 2.4 days longer in the hospital than housed patients, resulting in 5,400 excess hospital days for Denver residents alone, and face substantially higher readmission rates.
The severity of the issue has led the Center for Medicaid and Medicare Services to recognize homelessness as a comorbid condition, giving it the same weight as chronic illnesses like heart disease or diabetes. The physician also describes the “moral injury” experienced by healthcare providers witnessing this preventable suffering. “Treating the symptoms of homelessness without addressing the underlying cause feels like treating a gunshot wound with a Band-Aid,” they explain.
The Cure: Affordable and Supportive Housing
Despite the grim realities, a solution exists: deeply affordable and supportive housing. The “Housing First” approach,which prioritizes housing as a foundation for engagement in healthcare,has proven effective in achieving housing stability and reducing healthcare costs.However, many patients, like Mr. D,struggle to navigate the existing system.
In 2021, only 53% of patients on Denver health’s homeless registry were utilizing homeless services. The chaos of homelessness, coupled with physical and mental health challenges, often prevents individuals from accessing the support they need. This creates a heartbreaking paradox: those with the greatest needs are frequently enough the most underserved.
Denver’s Progress and the Threat of Federal Policies
Denver has made strides in addressing the crisis. In 2023, Mayor Mike johnston issued an emergency declaration and enacted “All in Mile High,” a citywide strategy to reduce street homelessness. By August 27, 2025, Denver announced a 45% reduction in unsheltered homelessness between January 2023 and january 2025.
Denver Health has actively contributed to these efforts through strategic partnerships.Since 2023, the hospital has discharged roughly 700 patients into medical respite beds through a partnership with the Colorado Coalition for the Homeless. the hospital also sold its former governance building to the Denver Housing Authority, which redeveloped it into 14 apartments for temporary housing and case management for elderly or disabled patients. To date, most of the 39 patients housed there have transitioned to more permanent housing. Denver Health also participates in the Housing to Health Program, a permanent supportive housing initiative launched in 2022.
However,these gains are threatened by recent federal actions. Policies that criminalize homelessness, defund Housing First initiatives, and dismantle essential benefits will exacerbate the crisis, leading to increased hospitalizations and unsustainable costs for safety net hospitals like Denver Health.
As a physician working at the intersection of housing and health,the author believes hospitals are crucial partners in ending homelessness. Despite witnessing the hopelessness that homelessness can bring, they also see the transformative potential of partnerships. Now, when encountering patients like Mr. D, they see possibility rather than a dead end. Their stories, filled with adversity, beauty, strength, and resilience, offer a glimmer of hope at a time when it seems in short supply.
