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This study examines how air quality influences health disparities among homeless populations, employing an instrumental variable (IV) approach with wind direction as an instrument to address potential endogeneity. Specifically, we investigate whether homelessness increases vulnerability to diseases linked to air quality compared to housed populations. The study further analyzes variations within homeless groups, focusing on age, gender, race, and youth status. We hypothesize that poor air quality disproportionately impacts homeless individuals, particularly among elderly people, racial minorities, women, and youth. Additionally, we examine whether the performance of Continuum of Care (CoC) programs moderates this relationship, expecting that stronger CoC performance mitigates health disparities among these marginalized groups. The study underscores the importance of tailored institutional interventions to effectively reduce health inequities associated with environmental vulnerabilities in homeless populations.