Department of health care policy research fellow Charley Willison, PhD, MPH, MA has published a book titled “Ungoverned and Out of Sight: Public Health and the Political Crisis of Homelessness in the United States” through Oxford University Press. 

Offering a critical investigation into the relationship between local governments, chronic homelessness, and public health, the book seeks to understand the political processes that influence the homelessness policies in cities across the United States. Willison argues that decentralization of homeless policy governance to primarily non-governmental actors, fragmentation, and conflict across policy approaches reduces policy alternatives for publicly funded evidence-based approaches to chronic homelessness.

Millions of Americans experience homelessness at rates similar to or higher than other indicators of morbidity and mortality. Although acute or chronic homelessness contributes to adverse outcomes for people throughout their lives, there is little attention given to homelessness as a determinant of health or as a reflection of health inequalities. 

“I wrote this book in response to our incredibly limited understanding of the systems responsible for designing and delivering responses to homelessness and homelessness policy in the United States,” Willison explains, “We know so much about health care institutions, but almost nothing about systems of governance for solutions to homelessness. While my book focuses exclusively on policy solutions to addressing chronic homelessness, the work the book does to identify and understand the governance structures responsible for homeless policy make it also broadly applicable to understanding responses to homelessness overall, how they work, and why they were developed.”

Drawing on research from case studies based in San Francisco, CA, Shreveport, LA and Atlanta, GA, as well as exclusive interviews with public actors involved in local homeless policy decision-making including government officials and practitioners, Willison explores conflicting policy solutions in municipalities across the country. She provides recommendations for practitioners, policymakers, and students aimed at improving homeless governance systems and developing policies that will effectively abolish chronic homelessness.

As an NIMH trainee research fellow in the department of health care policy, Willison collaborates with Henry J. Kaiser Professor of Health Care Policy Haiden A. Huskamp, PhD and Margaret T. Morris Professor of Health Economics Richard G. Frank, PhD. Willison will continue to focus on identifying the primary governance structures for solutions to homelessness in the United States, the Continuums of Care, and the entities that receive federal funding to address homelessness in collaboration with colleagues at the University of Michigan School of Public Health and Johns Hopkins Bloomberg School of Public Health.