{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T04:23:31Z","timestamp":1775535811478,"version":"3.50.1"},"reference-count":68,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Homelessness has risen sharply in the US in recent years, posing a major threat to population health. Although researchers have identified factors contributing to differences in homelessness prevalence between jurisdictions, factors contributing to year-over-year change in homelessness are poorly understood.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine competing explanations for rising levels of homelessness within US states between 2019 and 2024.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This longitudinal cohort study was conducted to measure the association between changing state-level factors and relative change in counts of people experiencing homelessness from 2019 to 2024. The sample comprised adults (aged \u226518 years) and children (aged &amp;lt;18 years) experiencing homelessness in all 50 states and Washington, DC, as measured in the US Department of Housing and Urban Development point-in-time (PIT) homeless count data. Due to PIT count limitations owing to the pandemic, outcome data for 2021 were excluded.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n State-year average rents, unemployment, pandemic-era housing supports (including emergency rental assistance and eviction moratoria), substance use (proxied by overdoses), immigration, and climate-related property damage were measured via a variety of publicly available datasets.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was year-over-year change in homelessness within states overall, by homelessness type (sheltered or unsheltered), and by age (children or adults).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n From 2019 to 2024 (excluding 2021; N\u2009=\u2009255 state-years), eviction moratoria and climate-related damages were consistently associated with change in homelessness within the 50 states and Washington, DC. The mean (SD) year-over-year increase in homelessness was 7.0% (22.5%), and there were mean (SD) changes of 6.1% (29.1%) for sheltered homelessness, 16.0% (36.5%) for unsheltered homelessness, 7.2% (20.6%) for adult homelessness, and 8.4% (44.0%) for child homelessness. Each additional 1.0% of person-time covered by a moratorium was associated with a 0.36\u2013percentage point (pp) lower increase in homelessness (95% CI, 0.10-0.61 pp;\n P<\/jats:italic>\n \u2009=\u2009.01). Each home-equivalent lost to climate-related events per 10\u202f000 population was associated with a 1.00-pp greater increase in overall homelessness (95% CI, 0.78-1.22 pp;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). Results were largely consistent by homelessness type and age. Whereas the mean (SD) year-over-year increase in homelessness was 11.0% (36.4%) for a typical state in 2022, homelessness would have risen by an estimated 19.9% (95% CI, 13.5%-26.3%) absent eviction moratoria, while counts would have risen by only 7.8% (95% CI, 7.1%-8.5%) absent property loss due to climate-related disasters.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study of 50 states and Washington, DC, measured over 5 years, eviction moratoria and climate-related damages were associated with within-state, relative change in homelessness. These findings suggest that to attenuate surges in homelessness, policymakers should take action to prevent evictions and address climate change.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.5187","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T15:00:46Z","timestamp":1775487646000},"page":"e265187","source":"Crossref","is-referenced-by-count":1,"title":["Factors Associated With Rising Homelessness Within US States, 2019 to 2024"],"prefix":"10.1001","volume":"9","author":[{"given":"Kathryn M.","family":"Leifheit","sequence":"first","affiliation":[{"name":"Department of Health Policy and Management, UCLA Fielding School of Public Health, University of California, Los Angeles"},{"name":"Department of Pediatrics, UCLA David Geffen School of Medicine, University of California, Los Angeles"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leah","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department 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