The patient had to stay at the hospital to finish their IV antibiotics because they were unhoused. The patient said to me, “if I go back to the streets, I’ll die.”

The health department found lead in the family’s home. During our visit, water started leaking in through the ceiling of a poorly maintained building. The patient is getting evicted from their apartment and has nowhere to go. The family of five was living in a hotel room because they couldn’t find housing. We had to find a hotel room for an unhoused patient with active tuberculosis to prevent the spread of TB in the community. The patient couldn’t stay at the shelter because all the beds were full. The patient had their medications stolen while they were sleeping at a homeless encampment.

The above are only a very few examples of how housing and housing costs have affected the patients I have worked with in the hospital and in the community during my 15 years as a registered nurse. To say that the lack of housing has impacted the patients that I work with is an understatement. It is time for nurses and other healthcare providers to step forward and acknowledge the impact of housing on our patients, to advocate for humane living conditions for all human beings and to acknowledge poor health outcomes associated with housing insecurity and being unhoused on individuals, families and our communities.

It’s time to get upset that our patients who sleep in their cars or shelters, who struggle to pay rent every month, or who sleep on a sidewalk, will not experience the health outcomes of those who have access to housing. Our efforts benefit patients who already have resources; the patients who don’t consistently fall behind.

In addition to impacting individuals, the health care system itself also experiences strain in the current housing market. All too often, patients cannot be discharged safely home from an inpatient setting because of lack of resources, safety issues or simply not having a home to go to. A 2018 study found that people experiencing homelessness averaged six emergency department visits per year, compared with 1.6 visits for individuals who were housed.

Additionally, unhoused patients experienced four more discharge delay days than their housed counterparts. Public health agencies struggle to address infectious diseases in vulnerable populations who have no better options than to congregate in shared living spaces. Patients who have minimal necessities or lack a safe place to sleep at night cannot adhere to medication regimens and lifestyles that promote health and prevent diseases that lead to hospitalizations.

The housing market no longer supports families or individuals who want to secure a place to call their own. Instead, it favors investments, increasing assets for businesses and hedge funds, landlords who rent overpriced rentals or vacation properties. There must be legislation that supports the interests of individuals and families in securing a place to live, that doesn’t allow housing to be a commodity only afforded to the wealthiest of those among us. Without a shift, there will only be more struggles for everyone well into the future.

There are reasonable solutions to the housing crisis, which include increased funding for affordable housing, tax incentives for developers to build low-income housing, and rental assistance programs. Capping rent increases keeps people in their homes. Investment in reasonably priced housing options saves money in the long run, giving people spending power to invest in healthier choices. Rent is the biggest expense for most people. It is time to explore investment in housing options that benefit individuals and working families, not large corporations and the wealthy.

I, for one, would like to never again have to see one of my patients leave the facility where I work and die in the street. As healthcare professionals, we have a clear view of how societal issues affect our patients. We are in a unique position to advocate for them, both at the bedside and through policy change. Houses are places for people to live and our patients deserve a place to call home.