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Advocates, clinicians, policy makers, and survivors frequently cite intimate partner violence (IPV) as an immediate cause of or precursor to housing problems. Research has indicated an association between homelessness and IPV, yet few studies examine IPV and housing instability. Housing instability differs from homelessness, in that someone experiencing housing instability may currently have a place to live but faces difficulties with maintaining the residence. We present baseline findings from a longitudinal cohort study of 278 female IPV survivors with housing as a primary concern. Our analysis indicates the greater the number of housing instability risk factors (e.g., eviction notice, problems with landlord, moving multiple times), the more likely the abused woman reported symptoms consistent with PTSD (p < .001), depression (p < .001), reduced quality of life (p < .001), increased work/school absence (OR = 1.28, p < .004), and increased hospital/emergency department use (OR = 1.22, p < .001). These outcomes persist even when controlling for the level of danger in the abusive relationship and for survivors' drug and alcohol use. Importantly, both housing instability and danger level had stronger associations with negative health outcomes than other factors such as age, alcohol, and drug use; both make unique contributions to negative health outcomes and could contribute in different ways. Housing instability is an important and understudied social determinant of health for IPV survivors. These findings begin to address the literature gap on the relationship between housing instability, IPV, and survivors' health, employment, and utilization of medical care services.

The purpose of this paper is to describe a CDC-funded study examining the effectiveness and cost-effectiveness of the Volunteers of America Home Free program, an innovative program that offers survivors of intimate partner violence (IPV) permanent housing rent assistance coupled with client-centered advocacy. We briefly discuss the challenges and barriers faced by women who try to separate from abusive partners and who have an immediate need for housing, describe the innovative approach to service provision adopted by the Volunteers of America Home Free program in Portland, Oregon, and describe the CDC-funded cooperative agreement to compare the effectiveness and cost-effectiveness of this approach with the usual housing services available to women fleeing abusive relationships.

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