Homelessness is now recognized as a significant public health problem in North America and throughout advanced economies of the world. The causes of homelessness are complex but the lack of affordable housing, unemployment, poverty, addiction, and mental illness all contribute to the risk for homelessness. We argue that homelessness is increasingly exacerbated by system-wide infrastructure failures occurring at the municipal, state, and federal government levels and whose catastrophic impacts on population health and the response to the COVID-19 pandemic are the consequence of the decades-long devolution of government and neglect to invest in public infrastructure, including a modern public health system.
Keywords: environment; homelessness; infrastructure; poverty; public health; social determinants of health.