Meeting Houston’s Homeless Where They Are: UH Researcher's Interventions for Houston’s Unhoused Community

UH Researcher, Ben King, Ph.D.

For Immediate Release: March 23, 2025 

By Alison Medley  

HOUSTON—Homelessness in the U.S. has rapidly surged to the highest level on record in 2024, according to the U.S. Department of Housing and Urban Development. More than 770,000 people experienced homelessness, an 18 percent increase from 2023. 

University of Houston researcher, Ben King, Ph.D., M.P.H., is at the forefront of efforts to better understand the intersection of homelessness, substance use and mortality trends in Houston. King recently concluded his pilot project focusing on Houston’s unhoused community, entitled, “Identifying Opportunities for Interventions to Prevent Overdose Deaths associated with Homelessness." The project was awarded $50,000 by HEALTH-RCMI and NIMHD. 

In Houston, the stark reality is that an individual experiencing homelessness dies approximately every 36 hours. For the past 4 years, King has tracked mortality rates among homelessness in Harris County, and he has compiled comprehensive reports to better understand the causes of death and identify methods to reduce mortality: the Harris County Homelessness Mortality Reports.

“Dying while experiencing homelessness is something that is surreally inexplicable—to understand why we even have this problem in America,” King said. “It is a tragedy that is hard to acknowledge and therefore, sometimes, hard for us to talk about,” King said. “But worst of all by far, it is avoidable.” 

For King, his work to explore interventions to prevent deaths in Houston's unhoused community is rooted in a passion to find solutions. King's pilot initiative involved organizing focus groups for both treatment providers and community members.

Through the focus groups, participants discussed the influential factors involved in toxicity deaths among the homeless community across Houston. The unhoused community's feedback was essential--since it was informed by community members' past lived experiences or current experiences.

One of the conclusions from King's work was that street outreach is one of the most effective ways to engage with the "broadest range and largest number of unique folks in Houston’s homeless population."  

“Street outreach may be one of the best coordinated in Houston than I’ve seen in any of the other big cities,” King said. “The data strongly suggests that street outreach teams are one of the most effective methods for engaging those who are not actively seeking help.”  

King has collaborated with multiple community partners for this pilot project, including the Coalition for the Homeless of Houston/Harris County (CFTH), Houston’s Council on Recovery, The Harris Center for Mental Health and IDD, New Hope Housing and most recently, Harris County Public Health. 

A disquieting discovery from King’s research is that a significant number of individuals who die while experiencing homelessness are often not engaging in the available services. Many had never been connected to outreach programs or entered into housing waitlists, indicating a gap and opportunity in intervention strategies. King underscored that it sheds light on new opportunities to invest in more services, rather than reflecting a failure of current engagement. 

“There’s no single location or system currently in place to reach the most vulnerable populations before it’s too late,” King said. “What we found when you link to mortality records is there were a lot of gaps.”  

King’s research reveals a troubling shift in toxicity-related deaths among Houstonians experiencing homelessness. While historically, alcohol and cocaine were the leading substances contributing to mortality, his recent findings indicate that opioids and methamphetamine have now exceeded these substances, driving a surge in deaths since 2023.  

His study also underscores the role of seasonality in mortality trends, with methamphetamine-related deaths spiking in the summer and cardiovascular-related deaths increasing in the winter. 

“The people who are dying while experiencing homelessness—a surprising number were not connected to social services,” King said. “There’s an opportunity, explanation for this—whether it could be people who are vulnerable to dying are also self-isolating from services.” 

Houston has been nationally respected in its work to provide an effective, compassionate response to the growing homeless population. Since 2011, Houston has reduced its annual count of people sleeping in shelters or on the street by more than two-thirds. Mayor John Whitmire has now announced a new $70 million-a-year proposal to ensure that everyone has a place to stay “off the street.”  

King has been an ardent advocate of the Housing First model, and he echoes that it provides the one big solution that we know works, "housing people helps them get out of homelessness."

“We have the opportunity to do that in a way that still has fidelity to the Houston model,” King said. “If we want to make unsheltered homelessness more manageable, more survivable—we should also fund the housing programs. If we don’t, we will lose people this year. We must continue to house people, or we will get so many people falling back into homelessness.” 

Despite the efficacy of street outreach programs, King notes that geographic coverage remains a major challenge. His research shows that homelessness-related deaths are not concentrated in urban centers, but are occurring throughout Harris County, including in suburban and rural areas. Expanding street outreach beyond Downtown Houston, Midtown, and the 1960 Corridor will be essential, yet existing resources remain insufficient to meet this growing demand, according to King. 

“We need to emphasize that street outreach should exist beyond the perimeters of Midtown, Downtown and the Loop,” King said. “They’re not able to get geographic coverage to the scale of the county. These deaths are occurring all across the county. There’s a locus in 1960 Corridor which experiences poverty and high concentration of homelessness, and, Midtown, Downtown. We also see it west, east, way out south, League City, and all over the county and in between.” 

King’s qualitative research also explores gaps in recovery services, particularly the high relapse rates between treatment programs. Many individuals struggle to maintain long-term recovery due to limited treatment durations and lack of sustained peer support. To address this, King aims to collaborate with organizations like the Houston Recovery Center and the Council on Recovery to highlight the success of longitudinal peer coaching models that provide continuous support beyond traditional treatment strategies. 

“People relapse in between treatment programs,” King said. “It’s in the transitions between the treatment programs where people can get lost most easily. Most treatment programs are 24-hour for sobering, or they are out-patient encounters. They have a time-limited number of days where they can get recovery treatment. Most of them don’t get 90 days for treatment. These are the gaps where people fall back into patterns with their social networks.”

As the federal landscape shifts in its approach to homelessness, King underscores the importance of balancing immediate shelter solutions with long-term housing investments. While King acknowledges the need for emergency shelter expansion, he warns that without a strong commitment to permanent housing solutions, Houston risks simply relocating homelessness rather than resolving it. 

“If the city wants to create a number of compassionate, resource-driven facilities for unsheltered homeless resolution, I’m all for it,” King said. “I think we have to that do that with housing as an integrated part of the program. Otherwise, you just have detention centers that don’t effectively resolve people’s homelessness. It can’t just be a law enforcement solution. For one thing, that puts an unfair expectation on law enforcement which doesn’t usually want to be in that role. Law enforcement doesn’t fix the problem; it just relocates the problem, which I’m not convinced is sufficient.”   

Looking ahead, King is exploring new funding opportunities to continue his work, including potential collaborations with Harris County’s Overdose Data to Action (OD2A) grants and future NIH/NIMHD initiatives. He remains committed to refining evidence-based interventions that not only address homelessness and substance use mortality but also prioritize inclusion health approaches that ensure no one is left behind. 

“I want to work with the current system to improve the system,” King said. “We can do this in a way that has fidelity to the success that we’ve had over the past 15 years. We can find a way to do that smartly together, and that’s what I’m interested in.” 

For more information on Dr. Ben King’s research and ongoing projects, visit UH HEALTH Center for Addictions Research and Cancer Prevention. 

If you would like more information about this topic, please contact Alison Medley at 713.320.0933 or email aemedle2@central.uh.edu