Interview: Howard Koh, MD, MPH

March 2020

Q: How did you become interested in the intersection of health and homelessness?

A: The intersection of health and homelessness has been a part of my life both professionally and personally. One harsh winter years ago, when I served as Massachusetts Commissioner of Public Health, almost a dozen homeless people froze to death on the streets of Boston. In response to the public outrage, I ended up convening a state task force that met over several years to improve services and coordination and reduce deaths. That work humbled me. Much of that effort involved close partnership with my lifelong friend and colleague Dr. Jim O’Connell, President of Boston Health Care for the Homeless Program (BHCHP). Since then, I have become even more concerned about how little societal attention, including from academia, has been dedicated to the health of homeless and other underserved individuals. When serving as US Assistant Secretary for Health, I worked with the Health Resources and Services Administration, which now oversees some 300 healthcare for the homeless organizations in the country. Now my daughter Dr. Katie Koh is a physician at Massachusetts General Hospital and a street psychiatrist for BHCHP. Jim is her boss! They and so many other dedicated professionals have inspired me to become even more involved.

Q: What are your goals for this Initiative?

A: We want to build an academic community committed to education, research and service learning in the area of health and homelessness.  Too few academic centers anywhere have dedicated work in this arena so we hope to begin to fill the void. Our Initiative can serve as a convener for students, faculty and researchers who are pursuing academic work and provide guidance, mentorship, and spark grant funding opportunities. We host monthly research and practice seminars to raise awareness and foster collaboration. In our opening months, we have also enjoyed connecting with a broad range of enthusiastic community partners. I am grateful to our dedicated Steering Committee—Jim, Dr. Karen Emmons, Professor Nancy Turnbull, Mr. Kirk Vanda, Mr. Ruslan Nikitin—and our Program Manager Emily Crawford for their dedication in launching the Initiative.

Q: How is the Initiative supporting the health of the homeless population during the COVID-19 pandemic? 

A: As part of pandemic response, we have necessarily redirected almost all of our work—for the time being—to addressing the threat to homeless people who are so vulnerable and at highest risk for infection and death.  It’s hard for anyone to follow the advice to stay at home when you have no home.  We want to particularly support clinical and community teams that are on the frontline right now. In the meantime, we are developing a research framework—through the leadership of Dr. Emmons —that can guide future research investigations and begin to address the host of health inequities that have threatened people who are homeless for far too long.