Public Health Model

Adapting the public health model

The Framework for Homelessness Prevention adapts the public health model of prevention, which has been used since the 1940s to reduce the risk and harms associated with illnesses. The public health model provides a range of prevention interventions that should take place simultaneously:

 

Primary prevention

Refers to structural-level initiatives that apply to everyone, in order to reduce the risk of homelessness and build protective factors. This can include educational programs, poverty reduction strategies, anti-violence work, and early childhood supports, that build assets, enhance housing stability, and promote inclusion. The framework breaks down primary prevention into a set of strategies that target different populations:

  • Universal – policies and interventions that target the broad public and help to create greater equality. Sometimes they are targeted at people who have reached a particular time in their life, such as old age. Examples: affordable housing and poverty reduction strategies, such as greater access to affordable child care, old age pensions, and subsidized housing
  • Selected – prevention efforts aimed at particular groups who may be at higher risk of homelessness, such as individuals facing discrimination, in particular Indigenous Peoples, and programs aimed at addressing gender-based violence. Examples: school-based programs and anti-oppression strategies, support for people facing discrimination to access public and private services
  • Indicated – applies to all those who face disadvantage due to individual characteristics to ensure they do not experience homelessness

Examples: support for families experiencing violence and individuals facing mental health and addictions challenges

Secondary prevention

Intervention strategies that identify and address the problem immediately after it is detected or is highly likely to occur. They are aimed at those who are at imminent risk of homelessness (i.e. received an eviction notice) with the goal of avoiding homelessness, as well as those who have recently become homeless, by employing crisis interventions to quickly move out of homelessness. Examples are case management and shelter diversion strategies, emergency financial assistance, family mediation, landlord-tenant mediation, and domestic violence victim support. It also involves working with public institutions to prevent individuals leaving hospital, child protection, and corrections, from being discharged into homelessness.

Tertiary prevention

Prevention initiatives that support individuals and families who have previously experienced homelessness to ensure that it doesn’t happen again. An example is the Housing First model, as it provides individuals experiencing homelessness with safe, affordable, and adequate housing and supports to maintain housing stability. These classifications exist along a continuum. To effectively prevent homelessness, all three forms of prevention must occur at the same. Structural and systemic interventions that work at the level of primary prevention are needed to provide the policy, practice, and funding backbone for individual interventions to be successful.