causes of homelessness in america essay

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Why it’s so hard to end homelessness in america.

City of Boston workers clear encampments in the area known as Mass and Cass.

Craig F. Walker/The Boston Globe via Getty Images

Alvin Powell

Harvard Staff Writer

Experts cite complexity of problem, which is rooted in poverty, lack of affordable housing but includes medical, psychiatric, substance-use issues

It took seven years for Abigail Judge to see what success looked like for one Boston homeless woman.

The woman had been sex trafficked since she was young, was a drug user, and had been abused, neglected, or exploited in just about every relationship she’d had. If Judge was going to help her, trust had to come first. Everything else — recovery, healing, employment, rejoining society’s mainstream — might be impossible without it. That meant patience despite the daily urgency of the woman’s situation.

“It’s nonlinear. She gets better, stops, gets re-engaged with the trafficker and pulled back into the lifestyle. She does time because she was literally holding the bag of fentanyl for these guys,” said Judge, a psychology instructor at Harvard Medical School whose outreach program, Boston Human Exploitation and Sex Trafficking (HEAT), is supported by Massachusetts General Hospital and the Boston Police Department. “This is someone who’d been initially trafficked as a kid and when I met her was 23 or 24. She turned 30 last year, and now she’s housed, she’s abstinent, she’s on suboxone. And she’s super involved in her community.”

It’s a success story, but one that illustrates some of the difficulties of finding solutions to the nation’s homeless problem. And it’s not a small problem. A  December 2023 report  by the U.S. Department of Housing and Urban Development said 653,104 Americans experienced homelessness, tallied on a single night in January last year. That figure was the highest since HUD began reporting on the issue to Congress in 2007 .

Abigail Judge of the Medical School (from left) and Sandra Andrade of Massachusetts General Hospital run the outreach program Boston HEAT (Human Exploitation and Sex Trafficking).

Niles Singer/Harvard Staff Photographer

Scholars, healthcare workers, and homeless advocates agree that two major contributing factors are poverty and a lack of affordable housing, both stubbornly intractable societal challenges. But they add that hard-to-treat psychiatric issues and substance-use disorders also often underlie chronic homelessness. All of which explains why those who work with the unhoused refer to what they do as “the long game,” “the long walk,” or “the five-year-plan” as they seek to address the traumas underlying life on the street.

“As a society, we’re looking for a quick fix, but there’s no quick fix for this,” said Stephen Wood, a visiting fellow at Harvard Law School’s Petrie-Flom Center for Health Law Policy, Biotechnology and Bioethics and a nurse practitioner in the emergency room at Carney Hospital in the Dorchester neighborhood of Boston. “It takes a lot of time to fix this. There will be relapses; there’ll be problems. It requires an interdisciplinary effort for success.”

A recent study of 60,000 homeless people in Boston found the average age of death was decades earlier than the nation’s 2017 life expectancy of 78.8 years.

Illustration by Liz Zonarich/Harvard Staff

Katherine Koh, an assistant professor of psychiatry at HMS and psychiatrist at MGH on the street team for Boston Health Care for the Homeless Program, traced the rise of homelessness in recent decades to a combination of factors, including funding cuts for community-based care, affordable housing, and social services in the 1980s as well as deinstitutionalization of mental hospitals.

“Though we have grown anesthetized to seeing people living on the street in the U.S., homelessness is not inevitable,” said Koh, who sees patients where they feel most comfortable — on the street, in church basements, public libraries. “For most of U.S. history, it has not been nearly as visible as it is now. There are a number of countries with more robust social services but similar prevalence of mental illness, for example, where homelessness rates are significantly lower. We do not have to accept current rates of homelessness as the way it has to be.”

“As a society, we’re looking for a quick fix, but there’s no quick fix for this.” Stephen Wood, visiting fellow, Petrie-Flom Center for Health Law Policy, Biotechnology and Bioethics

Success stories exist and illustrate that strong leadership, multidisciplinary collaboration, and adequate resources can significantly reduce the problem. Prevention, meanwhile, in the form of interventions focused on transition periods like military discharge, aging out of foster care, and release from prison, has the potential to vastly reduce the numbers of the newly homeless.

Recognition is also growing — at Harvard and elsewhere — that homelessness is not merely a byproduct of other issues, like drug use or high housing costs, but is itself one of the most difficult problems facing the nation’s cities. Experts say that means interventions have to be multidisciplinary yet focused on the problem; funding for research has to rise; and education of the next generation of leaders on the issue must improve.

“This is an extremely complex problem that is really the physical and most visible embodiment of a lot of the public health challenges that have been happening in this country,” said Carmel Shachar, faculty director of Harvard Law School’s Center for Health Law and Policy Innovation. “The public health infrastructure has always been the poor Cinderella, compared to the healthcare system, in terms of funding. We need increased investment in public health services, in the public health workforce, such that, for people who are unhoused, are unsheltered, who are struggling with substance use, we have a meaningful answer for them.”

“You can either be admitted to a hospital with a substance-use disorder, or you can be admitted with a psychiatric disorder, but very, very rarely will you be admitted to what’s called a dual-diagnosis bed,” said Wood, a nurse practitioner in the emergency room at Carney Hospital.

Kris Snibbe/Harvard Staff Photographer

Experts say that the nation’s unhoused population not only experiences poverty and exposure to the elements, but also suffers from a lack of basic health care, and so tend to get hit earlier and harder than the general population by various ills — from the flu to opioid dependency to COVID-19.

A recent study of 60,000 homeless people in Boston recorded 7,130 deaths over the 14-year study period. The average age of death was 53.7, decades earlier than the nation’s 2017 life expectancy of 78.8 years. The leading cause of death was drug overdose, which increased 9.35 percent annually, reflecting the track of the nation’s opioid epidemic, though rising more quickly than in the general population.

A closer look at the data shows that impacts vary depending on age, sex, race, and ethnicity. All-cause mortality was highest among white men, age 65 to 79, while suicide was a particular problem among the young. HIV infection and homicide, meanwhile, disproportionately affected Black and Latinx individuals. Together, those results highlight the importance of tailoring interventions to background and circumstances, according to Danielle Fine, instructor in medicine at HMS and MGH and an author of two analyses of the study’s data.

“The takeaway is that the mortality gap between the homeless population and the general population is widening over time,” Fine said. “And this is likely driven in part by a disproportionate number of drug-related overdose deaths in the homeless population compared to the general population.”

Inadequate supplies of housing

Though homelessness has roots in poverty and a lack of affordable housing, it also can be traced to early life issues, Koh said. The journey to the streets often starts in childhood, when neglect and abuse leave their marks, interfering with education, acquisition of work skills, and the ability to maintain healthy relationships.

“A major unaddressed pathway to homelessness, from my vantage point, is childhood trauma. It can ravage people’s lives and minds, until old age,” Koh said. “For example, some of my patients in their 70s still talk about the trauma that their parents inflicted on them. The lack of affordable housing is a key factor, though there are other drivers of homelessness we must also tackle.”

The number was the highest since the U.S. Department of Housing and Urban Development began reporting on the issue to Congress in 2007 .

Most advocates embrace a “housing first” approach, prioritizing it as a first step to obtaining other vital services. But they say the type of housing also matters. Temporary shelters are a key part of the response, but many of the unhoused avoid them because of fears of theft, assault, and sexual assault. Instead, long-term beds, including those designated for people struggling with substance use and mental health issues, are needed.

“You can either be admitted to a hospital with a substance-use disorder, or you can be admitted with a psychiatric disorder, but very, very rarely will you be admitted to what’s called a dual-diagnosis bed,” said Petrie-Flom’s Wood. “The data is pretty solid on this issue: If you have a substance-use disorder there’s likely some underlying, severe trauma. Yet, when we go to treat them, we address one but not the other. You’re never going to find success in the system that we currently have if you don’t recognize that dual diagnosis.”

Services offered to those in housing should avoid what Koh describes as a “one-size-fits-none” approach. Some might need monthly visits from a caseworker to ensure they’re getting the support they need, she said. But others struggle once off the streets. They need weekly — even daily — support from counselors, caseworkers, and other service providers.

“I have seen, sadly, people who get housed and move very quickly back out on the streets or, even more tragically, lose their life from an unwitnessed overdose in housing,” Koh said. “There’s a community that’s formed on the street so if you overdose, somebody can give you Narcan or call 911. If you don’t have the safety of peers around, people can die. We had a patient who literally died just a few days after being housed, from an overdose. We really cannot just house people and expect their problems to be solved. We need to continue to provide the best care we can to help people succeed once in housing.”

“We really cannot just house people and expect their problems to be solved.”  Katherine Koh, Mass. General psychiatrist

Koh works on the street team for Boston Health Care for the Homeless Program.

Photo by Dylan Goodman

The nation’s failure to address the causes of homelessness has led to the rise of informal encampments from Portland, Maine, to the large cities of the West Coast. In Boston, an informal settlement of tents and tarps near the intersection of Massachusetts Avenue and Melnea Cass Boulevard was a point of controversy before it was cleared in November.

In the aftermath, more than 100 former “Mass and Cass” residents have been moved into housing, according to media reports. But experts were cautious in their assessment of the city’s plans. They gave positive marks for features such as a guaranteed place to sleep, “low threshold” shelters that don’t require sobriety, and increased outreach to connect people with services. But they also said it’s clear that unintended consequences have arisen. and the city’s homelessness problem is far from solved.

Examples abound. Judge, who leads Boston HEAT in collaboration with Sandra Andrade of MGH, said that a woman she’d been working with for two years, who had been making positive strides despite fragile health, ongoing sexual exploitation, and severe substance use disorder, disappeared after Mass and Cass was cleared.

Mike Jellison, a peer counselor who works on Boston Health Care for the Homeless Program’s street team, said dismantling the encampment dispersed people around the city and set his team scrambling to find and reconnect people who had been receiving medical care with providers. It’s also clear, he said, that Boston Police are taking a hard line to prevent new encampments from popping up in other neighborhoods, quickly clearing tents and other structures.

“We were out there Wednesday morning on our usual route in Charlesgate,” Jellison said in early December. “And there was a really young couple who had all their stuff packed. And [the police] just told them, ‘You’ve got to leave, you can’t stay here.’ She was crying, ‘Where am I going to go?’ This was a couple who works; they’re employed and work out of a tent. It was like 20 degrees out there. It was heartbreaking.”

Prevention as cure?

Successes in reducing homelessness in the U.S. are scarce, but not unknown. The U.S. Department of Veterans Affairs, for example, has reduced veteran homelessness nationally by more than 50 percent since 2010.

Experts point out, however, that the agency has advantages in dealing with the problem. It is a single, nationwide, administrative entity so medical records follow patients when they move, offering continuity of care often absent for those without insurance or dealing with multiple private providers. Another advantage is that the VA’s push, begun during the Obama administration, benefited from both political will on the part of the White House and Congress and received support and resources from other federal agencies.

The city of Houston is another example. In 2011, Houston had the nation’s fifth-largest homeless population. Then-Mayor Annise Parker began a program that coordinated 100 regional nonprofits to provide needed services and boost the construction of low-cost housing in the relatively inexpensive Houston market.

Neither the VA nor Houston was able to eliminate homelessness, however.

To Koh, that highlights the importance of prevention. In 2022, she published research in which she and a team used an artificial-intelligence-driven model to identify those who could benefit from early intervention before they wound up on the streets. The researchers examined a group of U.S. service members and found that self-reported histories of depression, trauma due to a loved one’s murder, and post-traumatic stress disorder were the three strongest predictors of homelessness after discharge.

In April 2023, Koh, with co-author Benjamin Land Gorman, suggested in the Journal of the American Medical Association that using “Critical Time Intervention,” where help is focused on key transitions, such as military discharge or release from prison or the hospital, has the potential to head off homelessness.

“So much of the clinical research and policy focus is on housing those who are already homeless,” Koh said. “But even if we were to house everybody who’s homeless today, there are many more people coming down the line. We need sustainable policies that address these upstream determinants of homelessness, in order to truly solve this problem.”

The education imperative

Despite the obvious presence of people living and sleeping on city sidewalks, the topic of homelessness has been largely absent from the nation’s colleges and universities. Howard Koh, former Massachusetts commissioner of public health and former U.S. assistant secretary for Health and Human Services, is working to change that.

In 2019, Koh, who is also the Harvey V. Fineberg Professor of the Practice of Public Health Leadership, founded the Harvard T.H Chan School of Public Health’s pilot Initiative on Health and Homelessness. The program seeks to educate tomorrow’s leaders about homelessness and support research and interdisciplinary collaboration to create new knowledge on the topic. The Chan School’s course “Homelessness and Health: Lessons from Health Care, Public Health, and Research” is one of just a handful focused on homelessness offered by schools of public health nationwide.

“The topic remains an orphan,” said Koh. The national public health leader (who also happens to be Katherine’s father) traced his interest in the topic to a bitter winter while he was Massachusetts public health commissioner when 13 homeless people froze to death on Boston’s streets. “I’ve been haunted by this issue for several decades as a public health professional. We now want to motivate courageous and compassionate young leaders to step up and address the crisis, educate students, motivate researchers, and better inform policymakers about evidence-based studies. We want every student who walks through Harvard Yard and sees vulnerable people lying in Harvard Square to not accept their suffering as normal.”

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Issue of Homelessness in America Essay

Introduction, literature review, research methodology, recommendations.

Homelessness is the condition in which individuals or families lack permanent shelter. In other words, the individuals or the families lack a place to call home. Homeliness is not only a condition associated with the minorities but also people with regular income. However, the income cannot afford a decent housing. In most cases, homeless is caused by lack of adequate income to cater for a decent housing.

However, extreme poverty and lack of affordable housing has been attributed to increased cases of homelessness. Actually, minorities constitute the largest percentage of the homeless people. In most cases, the homeless families are composed of single mothers having children of less than six years. Low education levels, poor job skills and limited job opportunities that could pay for a livable wage characterize the single homeless mothers. In fact, such families experience increased rate of domestic violence, mental health problems and high costs of medical care. Even though not all homeless people have similar experience, studies indicate that majority are found within the descriptive bracket.

Generally, most of the homeless families and individuals go through a traumatic experience. In fact, the circumstances in which the individuals and families have no shelter coupled with the disconnections from support services are stressful. The problem is exacerbated in single motherhood where mothers have multifaceted roles ranging from being the breadwinner to parenting. Based on the longitudinal studies that have been conducted, single parents with no homes have increased vulnerability to sexual and other abuses as well as exposure to other form of violence particularly within the family or in relationships.

Currently, the government and various agencies are collaboratively focusing their efforts towards preventing and ending the problem of homelessness among the population. The efforts are backed by a policy framework that provide clear guidelines and responsibilities to the governments at all levels as well as various agencies on how to manage the preventive measures and stop the problem of homelessness. Moreover, the current policy framework focuses on all groups of homelessness particularly the families.

Problem Statement

Currently the numbers of homeless families have significantly increased compared with the number in 1980s and earlier. The number of homeless in 1980 accounted for less than one percent. However, the numbers of homeless individuals and families have considerably augmented by over thirty percent in the last ten years. Given the number of homeless families, the increasing rate of homelessness is alarming calling for appropriate interventions from the governments at all levels. However, studies on homeless families indicate that other problems the families face obfuscate the pressing need of having a decent place called home. Moreover, interventions methods have not been focused on addressing the related problems rather on real issues concerned with homelessness.

The Purpose of the Study

The main aim of this study is to establish the manner in which US government is aiding various local government agencies in the prevention and ending the problem of homelessness in their various jurisdictions. The study will be critical in the understanding of the manner in which the federal government helps their local counterparts in alleviating the problem of homelessness among the various city populations.

Research Question

Upon completion of the study, the following question will be answered.

• Is the federal government helping local governments reduce homelessness within their cities?

Hypothesis Testing

The study tends to test the assertion that the US government is helping the local governments reduce homelessness in their various cities. As such, the hypothesis of this study include

• H0: US government is helping local government reduce homelessness
• H1: US government is not helping local government reduce homelessness

Definition of Terms

Homelessness refers to the situation in which an individual or families lack permanent shelter or descent housing.

Affordable housing refers to less expensive rental houses provided by the government or any agency to the public. In most cases, affordable houses are normally targeted for the low-income earners.

Homeless families are families that have no pace to call home. In fact, most of the homeless families normally lack adequate income even to rent affordable houses.

Studies indicate that factors such as the mental illness, the childbirths, hospitalization of parents are not the causes of homelessness. Essentially, these factors are associated with individual susceptibility of being homeless (Bassuk, 2010). In addition, these factors simply indicate individuals that are likely to be affected by structural issues related to homelessness. In fact, this review is chosen due to its focus on the stated topic and its ability to answer directly the stated study question. In other words, the review tends to provide a broader view of the topic while directly answer the research question.

Causes of Homelessness

Various factors have been cited to cause homeless in America. Studies indicate that acute shortage of basic needs and deficiency in reasonably priced housing are the major causes of homeless (Bassuk, 2010; Guarino & Bassuk, 2011). Statistics indicate that the number of affordable rental housing units have reduced drastically by approximately 23%. The percentage represents an estimated number of 1.2 million housing units.

Besides, over six million Americans both individuals and families are at the level of increased risk of being homeless (Guarino & Bassuk, 2011). Such kinds of families are characterized by huge amount of their income being allocated to housing. Even though the families spend over fifty percent of their income on housing, they still dwell in substandard private residences. Besides, such families have little or no resources for other important necessities including food and clothing (Guarino & Bassuk, 2011).

To make it worse such individuals have no housing vouchers. In the circumstances that the vouchers are available, they still face difficulties in turning the vouchers into decent housing. The vulnerable economic conditions and increased levels of housing for disclosures worsen the housing situations of these families. Studies indicate that during the 2008 economic recession, the number of homelessness increased by over nine percent (Herman, Conover, Felix, Nakagawa & Mills, 2007).

In fact, families that find themselves homeless normally experience residential instability as well as community disconnections. Further, studies indicate that families headed by women have increased vulnerability of becoming homeless (Guarino & Bassuk, 2011; Geller & Bassuk, 2006). The reason is that single woman parents have insufficient access to programs geared towards eradicating poverty as well as childcare support. Moreover, single mother have increased multiple roles to play ranging from being the breadwinners to homemakers. The reasons explain why over single families headed by women account for over 84% of the homelessness.

Strategies Applied by the Government to Address Homelessness

Given the current situation of homelessness, policy makers often find it difficult to formulate a comprehensive policy framework that would completely address the current needs of the homeless individuals. Before, the federal policy on homelessness focused its efforts towards ending acute homeless among individuals of advanced age or the elderly (Geller & Bassuk, 2006). In most cases, the federal government through the policy supported the states or local governments plans geared towards ending acute homelessness among the elderly individuals.

The support was being provided through Housing First Approaches (HFP) that rapidly provided housing to the needy individuals. Through the program, chronically needy people have been provided with decent shelters regardless of whether they have met certain conditions (Geller & Bassuk, 2006; Herman et al., 2007).

The Corporation for Supportive Housing (TCSH) argues that approximately over eighty percent of supportive housing leaseholders tend to preserve their housing for a minimum of one year and engage in meaningful and productive services (Herman et al., 2007).

The agency further noted that the use of more expensive services such as criminal justice system and emergency healthcare decreases. The Federal Collaborative Initiative to end Chronic Homelessness (FCICH) indicated that the provision of descent housing contributes to the family stability and reduced usage of public utilities as well as reduced healthcare costs (Geller & Bassuk, 2006). Even though the federal policies were aimed at accomplishing the stated benefits, fewer quantities of funds were allocated to only one group of homeless people. The policy framework assumed the statuses of the homeless families.

In 2010, the Interagency Council on Homeless (ICH) issued all-inclusive strategic plan aimed at preventing and ending homelessness. In fact, the strategic plan majorly focused on homeless families particularly with minors. The strategic plan called upon the government agencies at all levels to put their resources collectively towards providing descent housing to the homeless families (Guarino & Bassuk, 2011). The policy framework was supported by various legislations allowing government agencies at all levels to adopt collaborative approach in order to prevent and stop homeless within the population. Within the last five years, the policy has made remarkable achievements regarding the provision of descent housing particularly to the acute needy families.

In fact, the policy framework has increased the collaborative efforts between the private and public sectors geared towards reducing chronic homelessness. Besides, the pubic-private sector partnership have contributed hugely to the reduction of chronically-ill sub-group of homeless individuals as well as persons that have experienced homelessness for longer periods (Guarino & Bassuk, 2011). The strategic plan has also provided a roadmap through which tragic housing problems can be addressed among the sub-groups of homeless people. In fact, the policy ensures interagency collaboration at all levels of government, help in strengthening the collaborative efforts of the private-public sectors partnerships both at the state and local government levels and align mainstream resources towards stopping and preventing homeless.

Local Government Intervention Programs

At the local government level, the policy provides a framework on how various projects and programs should work to attain the desired outcome. In fact, all programs focusing on homeless families should emphasize on activities that address the need of individual families. At minimum, the programs at the local government level should focus on rapidly re-housing the families (Geller & Bassuk, 2006). Local governments are supposed to participate on funding the programs efforts geared towards rapidly re-housing the families. In addition, local governments should support programs that rapidly respond to the immediate requirements of the families.

Moreover, the local governments have the responsibility of linking housing projects with government services and support (Geller & Bassuk, 2006). Collaboratively, the local governments and various programs operating within the jurisdiction are supposed to assess families and come up with individualized housing and support services plans that take into consideration the needs of individual homeless families.

The section of the study provides the methods of gathering the required information to answer the research questions and hypothesis. The methodology used in any study should be judged by the manner in which it informs the research purposes. Essentially, the aim of the research methodology is to provide data that responds to the research issues, present logical background assumptions and to ensure that techniques used account for the credibility of the study results.

The Study Design

As indicated, the study will utilized a survey as the method of data collection. The survey method of data collection is chosen due to its effectiveness in reaching out to the respondents and the quality of the obtained data. The desired data for this novel study will be obtained through administering self-designed survey questionnaires..Moreover, the data will be gathered from respondents selected through random sampling procedures.

In other words, the empirical data will be collected within the specified number of participants. In addition, the number of participants will be limited to a few numbers of respondents and will be chosen through simple random sampling procedures. Besides, in terms of data analysis, integrated statistical analysis tools including Microsoft office applications and statistical software have been applied. The analyzed data will be presented through the application of Line graphs, tables as well as statistical bar charts. Further, the methods of data collection are chosen due to the reliability and validity of the obtained results.

Population and Research Sample

The study focused on whether the federal government is supporting local governments to reduce homelessness. Moreover, the study is focused on actions taken by various local government agencies to reduce the homelessness. Therefore, all the representatives of various agencies focusing their efforts towards reducing homelessness were deemed viable for the study. However, only a small number of participants were selected through random sampling procedures and depending on the frequency with which they were involved in the actions geared towards reducing the homelessness. In addition, other attributes including type of the organization particularly the government sponsored were also taken into consideration. From the total number of representatives that could have been sampled, just 10 participants from various agencies particularly from homeless outreach Miami Beach were selected via a technique dubbed as convenience simple random sampling strategy. The self-administered survey was conducted, which helped in addressing the formulated research questions.

The study procedures are divided into various activities that are allocated certain duration in which they are supposed to be completed. Besides, the study is divided into four main parts including preparation, data collection and analysis as well as writing the research paper. In preparation, sequential activities begin with the consultation of the supervisor to provide guidelines on selecting the research topic, designing the study, creating the study questionnaire as well as acquiring the study literature.

Data Collection Procedures

As one of the most important studies, the required information were collected through administering properly well-designed survey questionnaires to unbiased selected participants. The soundly designed survey questionnaires were administered to 20 participants. Each part of the questionnaires constituted of key items that suitably attend to the research questions. For instance, part one constituted the possible causes of homeless in Miami while other parts will generate insights on the government intervention methods and aids towards reducing homelessness. Some items in the questionnaire threw light on efforts of various agencies towards doing away with the problem of homelessness.

Data Analysis

To obtain the best correlation approximation values, the study quantitative data analysis were carried out by utilizing the integrated Statistical Analysis Tool (WISAT). In addition, the data were also analyzed through the application of various techniques including statistical analytical software such as the SPSS to come with measures such as percentages, frequency distribution and deviations to help in the understanding of the type of correlation between the variables. The techniques were used to determine the research respondents’ proportions that chose various responses. The methods were also applied for each group of items available in the questionnaire that ideally corresponded to the formulated research question and objectives. Line graphs, tables as well as statistical bar charts were used to make sure that quantitative data analysis is simply comprehensible.

Assumptions

The major assumption in this study is that all the procedures would be successful. However, various problems have to be encountered and sorted out. In addition, it was assumed that the methods applied would provide the desired data. Further, the study assumed that there would be one hundred percent response from the survey questionnaires. In other words, the study assumed that all the respondents would return the questionnaires with all the questions answered.

Limitations

Given the kind of research study that were carried out, the stipulated timeframe might hindered the full investigation and covering of all the required aspects as well as the parameters. Moreover, most of the factors were not easily measured since such variables are non-quantifiable. The limitations were anticipated to pose considerable threats when the gathered research data were to be evaluated and consequently analysed.

The findings indicate that the federal government is hugely supporting the local governments in their efforts towards reducing homelessness in their various cities. In fact, the federal government is supporting the local governments through various interventions particularly providing a policy framework and guidelines, which the local government agencies base their operations. In addition, the federal government support the local government programs through the provision of funds and technical capabilities critical in attaining their set objectives. However, the findings indicate that the federal government still focus on the chronic cases of homelessness.

Various government agencies are currently focusing their efforts towards reduction and prevention of homelessness in US. In particular, the federal government through policy intervention and promotion of private-public sector partnerships have managed to support the local governments on their efforts aimed at reducing the cases of homelessness among all groups. Therefore, the hypothesis that the US government is supporting the local governments to reduce homelessness in several cities of jurisdiction is supported by the findings of this study.

The study is very limited in terms of scope design and resources. In fact, the anticipation of this study is that it should inform further research. Therefore, further studies should increase the scope of the study to make the results have reliable and valid conclusions. In addition, the study is limited to only one organization dealing with homelessness. In other words, many government and non-government agencies need to be studied in order to come up with valid and reliable conclusion.

Bassuk, E. L. (2010). Ending child homelessness in America. American Journal of Orthopsychiatry, 80 (4), 496–504. Web.

Geller, S. & Bassuk, E. L. (2006). The role of housing and services in ending family homelessness. Housing Policy Debate, 17 (4), 781–806. Web.

Guarino, K., & Bassuk, E. (2011). Working with families experiencing homelessness. Journal of Zero To Three: National Center for Infants, Toddlers, and Families, 30 (3), 11–20. Web.

Herman, D., Conover, S., Felix, A., Nakagawa, A. & Mills, D. (2007). Critical time intervention: An empirically supported model for preventing homelessness in high risk groups. Journal of Primary Prevention, 28 , 295-312. Web.

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IvyPanda. (2024, January 11). Issue of Homelessness in America. https://ivypanda.com/essays/issue-of-homelessness-in-america/

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IvyPanda . 2024. "Issue of Homelessness in America." January 11, 2024. https://ivypanda.com/essays/issue-of-homelessness-in-america/.

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IvyPanda . "Issue of Homelessness in America." January 11, 2024. https://ivypanda.com/essays/issue-of-homelessness-in-america/.

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The Obvious Answer to Homelessness

And why everyone’s ignoring it

Updated at 2:52 p.m. ET on December 23, 2022.

When someone becomes homeless, the instinct is to ask what tragedy befell them. What bad choices did they make with drugs or alcohol? What prevented them from getting a higher-paying job? Why did they have more children than they could afford? Why didn’t they make rent? Identifying personal failures or specific tragedies helps those of us who have homes feel less precarious—if homelessness is about personal failure, it’s easier to dismiss as something that couldn’t happen to us, and harsh treatment is easier to rationalize toward those who experience it.

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But when you zoom out, determining individualized explanations for America’s homelessness crisis gets murky. Sure, individual choices play a role, but why are there so many more homeless people in California than Texas? Why are rates of homelessness so much higher in New York than West Virginia? To explain the interplay between structural and individual causes of homelessness, some who study this issue use the analogy of children playing musical chairs . As the game begins, the first kid to become chairless has a sprained ankle. The next few kids are too anxious to play the game effectively. The next few are smaller than the big kids. At the end, a fast, large, confident child sits grinning in the last available seat.

You can say that disability or lack of physical strength caused the individual kids to end up chairless. But in this scenario, chairlessness itself is an inevitability: The only reason anyone is without a chair is because there aren’t enough of them.

Now let’s apply the analogy to homelessness. Yes, examining who specifically becomes homeless can tell important stories of individual vulnerability created by disability or poverty, domestic violence or divorce. Yet when we have a dire shortage of affordable housing, it’s all but guaranteed that a certain number of people will become homeless. In musical chairs, enforced scarcity is self-evident. In real life, housing scarcity is more difficult to observe—but it’s the underlying cause of homelessness.

In their book, Homelessness Is a Housing Problem , the University of Washington professor Gregg Colburn and the data scientist Clayton Page Aldern demonstrate that “the homelessness crisis in coastal cities cannot be explained by disproportionate levels of drug use, mental illness, or poverty.” Rather, the most relevant factors in the homelessness crisis are rent prices and vacancy rates.

Jerusalem Demsas: Housing breaks people’s brains

Colburn and Aldern note that some urban areas with very high rates of poverty (Detroit, Miami-Dade County, Philadelphia) have among the lowest homelessness rates in the country, and some places with relatively low poverty rates (Santa Clara County, San Francisco, Boston) have relatively high rates of homelessness. The same pattern holds for unemployment rates: “Homelessness is abundant,” the authors write, “only in areas with robust labor markets and low rates of unemployment—booming coastal cities.”

Why is this so? Because these “ superstar cities, ” as economists call them, draw an abundance of knowledge workers. These highly paid workers require various services, which in turn create demand for an array of additional workers, including taxi drivers, lawyers and paralegals, doctors and nurses, and day-care staffers. These workers fuel an economic-growth machine—and they all need homes to live in. In a well-functioning market, rising demand for something just means that suppliers will make more of it. But housing markets have been broken by a policy agenda that seeks to reap the gains of a thriving regional economy while failing to build the infrastructure—housing—necessary to support the people who make that economy go. The results of these policies are rising housing prices and rents, and skyrocketing homelessness.

It’s not surprising that people wrongly believe the fundamental causes of the homelessness crisis are mental-health problems and drug addiction. Our most memorable encounters with homeless people tend to be with those for whom mental-health issues or drug abuse are evident; you may not notice the family crashing in a motel, but you will remember someone experiencing a mental-health crisis on the subway.

I want to be precise here. It is true that many people who become homeless are mentally ill. It is also true that becoming homeless exposes people to a range of traumatic experiences, which can create new problems that housing alone may not be able to solve. But the claim that drug abuse and mental illness are the fundamental causes of homelessness falls apart upon investigation. If mental-health issues or drug abuse were major drivers of homelessness, then places with higher rates of these problems would see higher rates of homelessness. They don’t. Utah, Alabama, Colorado, Kentucky, West Virginia, Vermont, Delaware, and Wisconsin have some of the highest rates of mental illness in the country, but relatively modest homelessness levels. What prevents at-risk people in these states from falling into homelessness at high rates is simple: They have more affordable-housing options.

With similar reasoning, we can reject the idea that climate explains varying rates of homelessness. If warm weather attracted homeless people in large numbers, Seattle; Portland, Oregon; New York City; and Boston would not have such high rates of homelessness and cities in southern states like Florida, Georgia, Alabama, and Mississippi such low ones. (There is a connection between unsheltered homelessness and temperature, but it’s not clear which way the causal arrow goes: The East Coast and the Midwest have a lot more shelter capacity than the West Coast, which keeps homeless people more out of view.)

America has had populations of mentally ill, drug-addicted, poor, and unemployed people for the whole of its history, and Los Angeles has always been warmer than Duluth—and yet the homelessness crisis we see in American cities today dates only to the 1980s . What changed that caused homelessness to explode then? Again, it’s simple: lack of housing. The places people needed to move for good jobs stopped building the housing necessary to accommodate economic growth.

Homelessness is best understood as a “flow” problem, not a “stock” problem. Not that many Americans are chronically homeless—the problem, rather, is the millions of people who are precariously situated on the cliff of financial stability, people for whom a divorce, a lost job, a fight with a roommate, or a medical event can result in homelessness. According to the Los Angeles Homeless Services Authority, roughly 207 people get rehoused daily across the county—but 227 get pushed into homelessness . The crisis is driven by a constant flow of people losing their housing.

The homelessness crisis is most acute in places with very low vacancy rates, and where even “low income” housing is still very expensive. A study led by an economist at Zillow shows that when a growing number of people are forced to spend 30 percent or more of their income on rent, homelessness spikes.

Academics who study homelessness know this. So do policy wonks and advocacy groups. So do many elected officials. And polling shows that the general public recognizes that housing affordability plays a role in homelessness. Yet politicians and policy makers have generally failed to address the root cause of the crisis.

Few Republican-dominated states have had to deal with severe homelessness crises, mainly because superstar cities are concentrated in Democratic states. Some blame profligate welfare programs for blue-city homelessness, claiming that people are moving from other states to take advantage of coastal largesse. But the available evidence points in the opposite direction—in 2022, just 4 percent of homeless people in San Francisco reported having become homeless outside of California. Gregg Colburn and Clayton Aldern found essentially no relationship between places with more generous welfare programs and rates of homelessness. And abundant other research indicates that social-welfare programs reduce homelessness. Consider, too, that some people move to superstar cities in search of gainful employment and then find themselves unable to keep up with the cost of living—not a phenomenon that can be blamed on welfare policies.

But liberalism is largely to blame for the homelessness crisis: A contradiction at the core of liberal ideology has precluded Democratic politicians, who run most of the cities where homelessness is most acute, from addressing the issue. Liberals have stated preferences that housing should be affordable, particularly for marginalized groups that have historically been shunted to the peripheries of the housing market. But local politicians seeking to protect the interests of incumbent homeowners spawned a web of regulations, laws, and norms that has made blocking the development of new housing pitifully simple .

This contradiction drives the ever more visible crisis. As the historian Jacob Anbinder has explained , in the ’70s and ’80s conservationists, architectural preservationists, homeowner groups, and left-wing organizations formed a loose coalition in opposition to development. Throughout this period, Anbinder writes, “the implementation of height limits, density restrictions, design review boards, mandatory community input, and other veto points in the development process” made it much harder to build housing. This coalition—whose central purpose is opposition to neighborhood change and the protection of home values—now dominates politics in high-growth areas across the country, and has made it easy for even small groups of objectors to prevent housing from being built. The result? The U.S. is now millions of homes short of what its population needs .

Annie Lowrey: The U.S. needs more housing than almost anyone can imagine

Los Angeles perfectly demonstrates the competing impulses within the left. In 2016, voters approved a $1.2 billion bond measure to subsidize the development of housing for homeless and at-risk residents over a span of 10 years. But during the first five years, roughly 10 percent of the housing units the program was meant to create were actually produced. In addition to financing problems, the biggest roadblock was small groups of objectors who didn’t want affordable housing in their communities.

Los Angeles isn’t alone. The Bay Area is notorious in this regard. In the spring of 2020, the billionaire venture capitalist Marc Andreessen published an essay , “It’s Time to Build,” that excoriated policy makers’ deference to “the old, the entrenched.” Yet it turned out that Andreessen and his wife had vigorously opposed the building of a small number of multifamily units in the wealthy Bay Area town of Atherton, where they live.

The small- c conservative belief that people who already live in a community should have veto power over changes to it has wormed its way into liberal ideology . This pervasive localism is the key to understanding why officials who seem genuinely shaken by the homelessness crisis too rarely take serious action to address it.

The worst harms of the homelessness crisis fall on the people who find themselves without housing. But it’s not their suffering that risks becoming a major political problem for liberal politicians in blue areas: If you trawl through Facebook comments, Nextdoor posts, and tweets, or just talk with people who live in cities with large unsheltered populations, you see that homelessness tends to be viewed as a problem of disorder, of public safety, of quality of life. And voters are losing patience with their Democratic elected officials over it.

In a 2021 poll conducted in Los Angeles County, 94 percent of respondents said homelessness was a serious or very serious problem. (To put that near unanimity into perspective, just 75 percent said the same about traffic congestion—in Los Angeles!) When asked to rate, on a scale of 1 to 10, how unsafe “having homeless individuals in your neighborhood makes you feel,” 37 percent of people responded with a rating of 8 or higher, and another 19 percent gave a rating of 6 or 7. In Seattle, 71 percent of respondents to a recent poll said they wouldn’t feel safe visiting downtown Seattle at night, and 91 percent said that downtown won’t recover until homelessness and public safety are addressed. There are a lot of polls like this.

As the situation has deteriorated, particularly in areas where homelessness overruns public parks or public transit, policy makers’ failure to respond to the crisis has transformed what could have been an opportunity for reducing homelessness into yet another cycle of support for criminalizing it. In Austin, Texas, 57 percent of voters backed reinstating criminal penalties for homeless encampments; in the District of Columbia, 75 percent of respondents to a Washington Post poll said they supported shutting down “homeless tent encampments” even without firm assurances that those displaced would have somewhere to go. Poll data from Portland , Seattle , and Los Angeles , among other places, reveal similarly punitive sentiments.

This voter exasperation spells trouble for politicians who take reducing homelessness seriously. Voters will tolerate disorder for only so long before they become amenable to reactionary candidates and measures, even in very progressive areas. In places with large unsheltered populations, numerous candidates have materialized to run against mainstream Democrats on platforms of solving the homelessness crisis and restoring public order.

By and large, the candidates challenging the failed Democratic governance of high-homelessness regions are not proposing policies that would substantially increase the production of affordable housing or provide rental assistance to those at the bottom end of the market. Instead, these candidates—both Republicans and law-and-order-focused Democrats—are concentrating on draconian treatment of people experiencing homelessness. Even in Oakland, California, a famously progressive city, one of the 2022 candidates for mayor premised his campaign entirely on eradicating homeless encampments and returning order to the streets—and managed to finish third in a large field.

During the 2022 Los Angeles mayoral race, neither the traditional Democratic candidate, Karen Bass, who won, nor her opponent, Rick Caruso, were willing to challenge the antidemocratic processes that have allowed small groups of people to block desperately needed housing. Caruso campaigned in part on empowering homeowners and honoring “their preferences more fully,” as Ezra Klein put it in The New York Times —which, if I can translate, means allowing residents to block new housing more easily. (After her victory, Bass nodded at the need to house more people in wealthier neighborhoods—a tepid commitment that reveals NIMBYism’s continuing hold on liberal politicians.)

“We’ve been digging ourselves into this situation for 40 years, and it’s likely going to take us 40 years to get out,” Eric Tars, the legal director at the National Homelessness Law Center, told me.

Building the amount of affordable housing necessary to stanch the daily flow of new people becoming homeless is not the project of a single election cycle, or even several. What can be done in the meantime is a hard question, and one that will require investment in temporary housing. Better models for homeless shelters arose out of necessity during the pandemic. Using hotel space as shelter allowed the unhoused to have their own rooms; this meant families could usually stay together (many shelters are gender-segregated, ban pets, and lack privacy). Houston’s success in combatting homelessness — down 62 percent since 2011—suggests that a focus on moving people into permanent supportive housing provides a road map to success. (Houston is less encumbered by the sorts of regulations that make building housing so difficult elsewhere.)

The political dangers to Democrats in those cities where the homelessness crisis is metastasizing into public disorder are clear. But Democratic inaction risks sparking a broader political revolt—especially as housing prices leave even many middle- and upper-middle-class renters outside the hallowed gates of homeownership. We should harbor no illusions that such a revolt will lead to humane policy change.

Simply making homelessness less visible has come to be what constitutes “success.” New York City consistently has the nation’s highest homelessness rate, but it’s not as much of an Election Day issue as it is on the West Coast. That’s because its displaced population is largely hidden in shelters. Yet since 2012, the number of households in shelters has grown by more than 30 percent—despite the city spending roughly $3 billion a year (as of 2021) trying to combat the problem. This is what policy failure looks like. At some point, someone’s going to have to own it.

This article has been updated to clarify the percentage of homeless people who reported having moved to California from out of state.

This article appears in the January/February 2023 print edition with the headline “The Looming Revolt Over Homelessness.” When you buy a book using a link on this page, we receive a commission. Thank you for supporting The Atlantic.

Homelessness in US cities and downtowns

Subscribe to transformative placemaking, the perception, the reality, and how to address both, hanna love and hanna love fellow - brookings metro , anne t. and robert m. bass center for transformative placemaking @hannamlove tracy hadden loh tracy hadden loh fellow - brookings metro , anne t. and robert m. bass center for transformative placemaking @lohplaces.

December 7, 2023

• Homelessness is not uniform. There are significant variations in the types, prevalence, and service delivery ecosystems of homelessness across U.S. cities and regions—requiring policies tailored to those people and places rather than a “one-size-fits-all” solution.
• Despite perceptions of rising homelessness in the aftermath of the COVID-19 pandemic, homelessness rates in three of the four cities studied (New York, Philadelphia, and Chicago) declined over the past decade, including through the pandemic. Seattle was the stark outlier.
• Above any other factor, regional housing market dynamics—particularly when rents rise by amounts that low-income residents cannot afford—drive geographic variations in the prevalence of homelessness and correlate with higher homelessness rates.
• Evidence-based policy recommendations for reducing homelessness require root cause approaches, including reforming housing plans, scaling alternative crisis response models, stopping the jail-to-homelessness cycle, leveraging the capacity of place governance organizations, and taking a regional, data-driven approach to homelessness.
• 26 min read

A rare bipartisan consensus is emerging in many U.S. cities on one key issue: the need to address homelessness, particularly in downtown central business districts . Many on both the right and the left are calling for strategies such as encampment sweeps , increased enforcement of quality-of-life offenses , and even scaling back federal dollars for evidence-based “housing first” policies to quell rising fears of public disorder, homelessness, and crime in “hollowed out” downtowns.

Related Content

Hanna Love, Tracy Hadden Loh

February 5, 2024

The problem with this growing consensus is that it has led many local leaders further away from proven root-cause solutions for reducing homelessness, and toward costly and ineffective punitive measures that pose significant risks to people experiencing homelessness, and, paradoxically, increase the general risk of making homelessness worse.

Rather than responding to this latest reactive, “complaint-based” push that tends to over-criminalize people experiencing homelessness, we argue that local leaders must double down on evidence-based policies that address where, why, and how homelessness actually occurs within U.S. cities to meaningfully reduce homelessness and achieve economic recovery in the nation’s downtowns.

With these goals in mind—while also remaining responsive to constituents’ growing concerns about homelessness—this report presents an overview of recent pandemic-era trends in homelessness, compares perceptions of homelessness with data from four large cities, and reviews the evidence about cost-effective, humane, and root-cause approaches to reducing homelessness.

Taken together, our research supports the need for U.S. cities to engage in both short- and long-term policymaking targeted at the structural challenges associated with homelessness spanning, from reentry services to affordable housing, rather than crafting reactive homelessness policies rooted solely in perceptions, stereotypes, and fear. By doing so, local leaders can not only help cities and their downtowns recover from current economic disruptions, but they can also cultivate a sustainable regional ecosystem in which access to housing, economic stability, and opportunity is a human right.

Brookings Metro’s Future of Downtowns Project: This report is part of the  Future of Downtowns mixed-methods research project   that seeks to understand the future of American cities and their downtowns through interviews, spatial data analysis, and direct engagement with local leaders in New York, Chicago, Seattle, and Philadelphia. To gauge perceptions of cities’ downtown health and recovery, we interviewed nearly 100 business leaders, major employers, public sector officials, and residents in these four cities in fall 2022, 1  then juxtaposed qualitative findings with spatial analysis of employment , transit and travel , real estate , crime , and homelessness data impacting downtown recovery. This report synthesizes findings related to homelessness.

Homelessness trends, types, and service delivery ecosystems vary considerably across US cities

Before diving into recent homelessness trends impacting U.S. cities and their downtowns, it is important to first distinguish between different types of homelessness that affect cities and regions, how the prevalence of homelessness varies considerably nationwide, and the vast differences in the local and regional ecosystems that coordinate homelessness services and funding (also known as “Continuums of Care” ) across U.S. metro areas.

The different types of homelessness affecting US cities and regions

Most fundamentally, the tenure of a city’s homelessness population (e.g., whether people are unsheltered or in other temporary housing situations such as emergency or transitional shelters) can hold significant and often underappreciated ramifications for local policymaking. For instance, the most visible form of homelessness—when people are unsheltered and live in public spaces like parks, subway stations, or streets—represents only one-third or less of the unhoused population in most cities, despite capturing the bulk of resident and media attention , as well as significant city resources .

In New York and Philadelphia, for instance, most homeless people are not unsheltered, but rather reside in temporary shelter or transitional housing (94% and 82%, respectively) (Figure 1). In Chicago, most of the homeless population resides in either emergency shelter (46%) or transitional housing (20%), with 33% living unsheltered. Seattle is the stark outlier in the sample: Over 57% of its homeless population is living without shelter. These variations matter because a city like Seattle that is struggling with over half of its homeless population living unsheltered will require a different set of policies than a city like New York, whose “right to shelter” mandate has helped secure temporary shelter for most people experiencing homelessness.

Variations in the prevalence of homelessness across the US cities and regions

Stark regional variations in the prevalence of homelessness across U.S. cities and regions also matter significantly for policymaking. As Table 1 demonstrates, cities on the West Coast have higher homelessness rates than other regions—representing seven of the 10 cities with the highest total homelessness rates per capita. San Francisco, for instance, has a total homelessness rate that is nearly 20 times higher than Houston’s. West Coast cities also stand out for higher shares of their homeless population living without shelter. In addition to Seattle, West Coast cities including San Francisco; Long Beach, Calif.; Los Angeles; Portland, Ore.; Oakland, Calif.; Sacramento, Calif.; San Jose, Calif.; and Fresno, Calif. all have unsheltered homelessness rates above 50%.

These findings generally align with research showing that above any other factor, regional housing market dynamics—particularly when rents rise by amounts that low-income residents cannot afford— drive geographic variations in the prevalence of homelessness across U.S. regions and correlate with higher homelessness rates (Figures 2 and 3). In Seattle, however, even pandemic-era reductions in asking rents were not enough to curb homelessness.

While these regional variations can make it difficult to adopt a “one-size-fits-all” approach to reducing homelessness in the U.S., they can provide insight into the local policies and socioeconomic conditions that work to facilitate homelessness reduction.

Different service delivery ecosystems for homelessness across US cities and regions

Finally, differences in regions’ Continuums of Care (CoCs) boundaries add another important layer to both understanding and solving the challenge. CoCs are the local or regional planning bodies that coordinate housing support, social services, funding, and reporting across service providers, hospitals, businesses, advocates, and government agencies (e.g., school districts, law enforcement, and public housing authorities).

As Figure 4 demonstrates, metropolitan areas such as Houston 2  and Seattle take a “regional approach” to homelessness , in which funding and service delivery are consolidated across an integrated CoC area that includes both cities and suburbs to eliminate redundancies across agencies, fill gaps for underserved populations, and match resources with the scale of the challenge. On the other hand, metro areas such as Chicago and Philadelphia divide their homelessness services across a more fragmented and localized patchwork of providers, which limits the potential for regional collaboration. Understanding these nuances in the resources and ecosystems for homelessness prevention and reduction is critical for crafting effective policy.

Why focus on homelessness downtown, specifically? Downtowns play a critical role in local economies—serving as regional job hubs for both high- and low-wage work, supplying an outsized share of tax assessable value that maintains city budgets, and supporting clusters of small businesses that represent opportunity for entrepreneurs, artists, and creatives. People experiencing homelessness concentrate in downtowns for many of the same reasons that others do: a combination of highly accessible transit services, great density of public spaces and other amenities, and the concentration of critical public-serving institutions. In many cities, downtowns represent the most visible hub for people experiencing homelessness to gather, and this uneven spatial distribution often places pressure on a small number of downtown leaders to “solve” homelessness—even when its causes are rooted in structural challenges that extend far beyond downtown boundaries.

Comparing perceptions and realities of homelessness trends in New York, Philadelphia, Chicago, and Seattle

When conducting qualitative interviews for the Future of Downtowns project in fall 2022, we asked nearly 100 residents, workers, visitors, and employers in four of the largest U.S. cities about the top barriers preventing them from returning downtown—spanning issues from the changing nature of office work to different preferences for commuting and in-person interaction. To our surprise, we heard remarkably consistent results across the four cities: Interviewees told us that increased fear of public disorder, crime, and homelessness in the wake of the pandemic was the primary barrier preventing them from returning downtown—not changing office or residential patterns. This section compares these perceptions with quantitative analysis of pandemic-era homelessness trends in each city.

Respondents across all four cities perceived significant increases in homelessness since the pandemic, often describing “new negotiations” in public spaces with unhoused people and rates of public disorder not seen since the late 20th century. They frequently made statements such as:

Homelessness wasn't even like this during the crack cocaine 80s. It is terrible. Interview Respondent in Philadelphia

There are more homeless people in more places now than there were pre-pandemic. I would say that's true of every city I've been in. Interview Respondent in Chicago

The top thing we hear from employers is about the experience on the street with safety and chronic homelessness. Interview Respondent in Seattle

In the pandemic, my neighborhood changed meaningfully in terms of the crime rate and just the level of homelessness Interview Respondent in New York

Yet when we crunched the numbers to determine how perceptions of rising homelessness during the pandemic bore out in data, we found a significant mismatch between perception and reality in three of the four study cities. Interview respondents in Chicago, Philadelphia, and New York perceived that homelessness was increasing exponentially and leading to a level of public disorder not seen since the 1990s. However, total homelessness rates in these cities actually significantly declined in the past decade (by 42%, 25%, and 16%, respectively). And it continued this decline during the pandemic (Figure 5). Seattle remained the stark outlier, with total homelessness increasing by 23% since 2015. 

In New York, Chicago, and Philadelphia, we found a similar pattern with trends of unsheltered homelessness. They had not “ballooned” during the pandemic, as most interviewees supposed, but rather remained steady for the past decade and declined between 2020 and 2021 (Figure 6). Seattle, again, was a stark outlier—seeing an 88% jump in unsheltered homelessness since 2015, which continued during the pandemic.

Our findings from Chicago, Philadelphia, and New York generally align with recent research from the U.S. Department of Housing and Urban Development , which found that the nation was able to hold off a spike in homelessness during the pandemic due to federal relief authorized between 2020 and 2021, including eviction moratorium orders, emergency rental assistance, boosted unemployment benefits, and the expanded child tax credit. Seattle, however, demonstrates that even these vital federal supports were not always sufficient to reverse a decade-long spike in homelessness. The gap between perception and reality may in part be explained by significant changes in downtown foot traffic , which made unsheltered homelessness more visible given the relative reduction in other foot traffic.

Why fluctuations in homelessness—such as recent increases in unsheltered asylum seekers in cities like New York—can be difficult to capture: Because most CoCs conduct and report “point-in-time” counts annually or every other year, it can be difficult to measure temporary or seasonal changes in cities’ homelessness rates. Recently, this has presented a challenge in understanding the impact of new waves of migrants and asylum seekers arriving from Latin America on homelessness in cities such as Chicago, New York, and Washington, D.C. 3 For these data availability reasons and other more substantive ones—including the unique circumstances surrounding recent migration and its toll on a limited set of large U.S. cities —this report does not seek to respond to the intersection between homelessness and asylum seekers’ migration. Instead, we focus on the long-standing structural drivers of and evidence-based tools to address the persistent challenge of homelessness that cities have been wrestling with, even absent acute changes in global migration and asylum policies.

In addition to the fact that respondents perceived significant increases in homelessness during the pandemic, they also overwhelmingly conveyed a strong sense that homelessness was linked to criminality. Rather than discussing the challenge as one rooted in larger economic and regional market forces, respondents tended to focus on the behaviors of individual homeless people that made them uncomfortable (such as sleeping outside or public drug use), and thus were drawn toward interventions directed at individual behavior through the criminal legal system.

In fact, respondents often described crime and homelessness in the same breath, with statements such as:

There’s just lawlessness in the public realm. There’s garbage, there's a guy smoking pot, there's a homeless person I just stepped over, there's somebody who's crazy following me, there are vendors everywhere. Interview Respondent in New York

The homeless population has ballooned here, which makes people feel uneasy and unsafe. Crime has always existed in Chicago, but this is different. Interview Respondent in Chicago

There is a fair amount of violent crime that kind of emanates from those encampments. We see a lot more people unsheltered, a lot more drug use, a lot more organized retail theft. Interview Respondent in Seattle

There's a lady over there…She sits there all day. We tell her you can't sleep on a bench. She just sits on the bench. That's criminal. Interview Respondent in Philadelphia

It is notoriously difficult to determine whether a criminal offense involves a person experiencing homelessness (either as a victim or perpetrator), since most police departments do not track or report that data. However, research does suggest that the criminalization of homelessness is costly and counterproductive, as arrests make it more difficult for homeless people to get back on their feet and access housing due to the heightened barriers navigating employment, services, and housing with a criminal record.

Taken together, our analysis and existing evidence indicate that perceptions alone are insufficient to inform local decisionmaking on homelessness, and that a clear understanding of data, regional market variations, and local service delivery ecosystems is necessary to craft effective policy. The next section presents five recommendations to better align data and evidence and reduce homelessness through root-cause approaches.

An evidence-based policy framework for reducing homelessness and strengthening regional economies

The ability to spend time downtown without encountering public disorder such as visible drug use or harassment is a basic necessity of city life—as is the desire to have a safe place to sleep, bathe, and eat. Fortunately, there are evidence-based policies that can bring cities closer to this dual imperative in a humane, cost-effective, and sustainable manner. We offer five key recommendations below:

Ensure that housing policy is homelessness policy

Inadequate housing supply, particularly of affordable units, is consistently shown to be the primary driver of homelessness in the U.S.—significantly outweighing factors such as substance use, poverty, and mental health. Zoning and land use restrictions are examples of local governments’ dysfunctional fiscal and regulatory structures that disincentivize or prevent housing production and contribute to a widespread structural challenge in which the poorest people within cities cannot afford average asking rents for available apartments. Despite this evidence, a study from Community Solutions found that of the nation’s 100 largest cities, only 54% had homelessness plans, and of those, only 30% mentioned zoning and land use changes.

To craft policy that addresses the root causes of homelessness, we recommend that local governments align their long-term housing, land use, and homelessness plans to increase the supply of all types of housing, remove barriers to affordability and shelter construction (such as single-family-only zoning, parking minimums, and parcel shape regulations), and adopt evidence-based “housing first” models. For shorter-term solutions, cities should adopt and scale the pandemic-era preventative measures that helped avoid a spike in homelessness, including investments in emergency rental assistance, eviction defense, tenants’ rights, and economic stimulus, as well as mitigation measures such as converting hotels into temporary housing. For cities such as Seattle, where shelter bed capacity is incredibly overburdened (Figure 7), the need for these measures is particularly acute.

Case study from New York: How ‘housing first’ programs can be a proven, humane, and cost-effective strategy for reducing homelessness

New York’s Housing First program has been in place for over three decades to provide housing supports for people experiencing chronic street homelessness without preconditions—a recognition that stable housing is a critical foundation for individuals struggling with psychiatric and substance use disorders to transition from homelessness. The program has a 70% to 90% success rate in maintaining stable housing for participants over two to three years, outperforming traditional housing programs. Additionally, it has proven to be a cost-effective strategy (Table 2) that reduces public expenditures in the criminal justice and health care systems associated with homelessness.

The Housing First program’s effectiveness can be seen in its Frequent Users Service Enhancement (FUSE) initiative , which has been successful in breaking the homelessness-to-jail cycle. FUSE provides long-term rental assistance and supportive services, resulting in 86% of participants remaining stably housed after two years and a 40% reduction in jail time , while also achieving significant cost savings in annual jail, shelter, and crisis health care costs.

Scale alternative crisis response models to better respond to people with behavioral health and substance use emergencies while improving public safety

Research indicates that punitive approaches to policing homelessness—such as criminal arrests or fees for public behaviors associated with homelessness (e.g., camping, sleeping in public, eating in public, sitting on sidewalks, etc.) or mental health episodes—make it more difficult to solve homelessness. These approaches heap a criminal record onto people experiencing homelessness, making it difficult for them to rent an apartment or get a job on top of other challenges, while also straining police resources.

Instead, an emergent and promising body of research demonstrates that non-police crisis responders—alternatives to 911 with trained mental health professionals—can better respond to lesser infractions involving homeless people. In places such as Denver, non-police crisis responders were more effective than even alternative crisis response models that deploy both social workers and the police together (sometimes referred to as “co-responder models”). Moreover, supportive housing programs such as those mentioned above have successfully reduced arrests and jail stays for people experiencing homelessness; for example, New York’s FUSE initiative lead to an average of 95 fewer days spent in jail for homeless New Yorkers.

Despite this evidence, a Community Solutions survey of mayors found that homelessness policy is intertwined with police enforcement in most cities. For instance, 78% of survey respondents said that police have influence over shaping homelessness policy in their city, 59% said police enforce quality-of-life charges against homelessness people, and 22% had their homelessness staff co-located in police departments. This has led to a phenomenon in which jurisdictions are using jails as substitute shelters. For example, in Atlanta, one in eight of all city jail bookings  in 2022 involved a person experiencing homelessness.

To better address safety concerns surrounding homelessness, mental health, and quality-of-life offenses, local leaders should act on evidence from Denver , Eugene, Ore. , and other cities to adopt and scale non-police alternative crisis response models. In doing so, they should take care to not only prioritize crisis response models that provide an alternative for low-level offenses (such as substance use or homelessness), but also include models that address intimate partner violence—another area where victims are disproportionately likely to experience homelessness as a result of the circumstances surrounding victimization .

Case study from Denver: How ‘alternative response models’ can reduce the homelessness-to-jail pipeline

In June 2020, Denver launched its Support Team Assisted Response (STAR) program to redirect nonviolent 911 emergency calls from police to a team of mental health specialists and paramedics. Inspired by the evidence-based CAHOOTS model in Eugene, Ore., the STAR program focuses on providing appropriate care and resources to individuals facing mental health crises, substance use issues, or homelessness—particularly in low-income and at-risk communities. Funded through the city’s general fund and a grant from the Caring for Denver Foundation , the STAR program aims to alleviate the burden on police resources, ensuring law enforcement can concentrate on more serious crimes.

The model has been found to produce effective results , with a 34% reduction in lower-level crimes in areas served by STAR, leading to 1,400 fewer criminal offenses. Furthermore, the direct costs associated with the STAR responses were found to be four times lower than those incurred with police-only responses, with the average direct cost per response being $151—significantly less than the $646 typically incurred for minor criminal offenses handled by the police.

Strengthen housing and employment supports for those reentering from incarceration

It is well established that homelessness and incarceration are inextricably linked in the U.S., with many people cycling between jails and prisons and homelessness on the front end (due to the criminalization of low-level “survival” crimes) and on the back end (due to the lack of support for returning citizens to access employment and housing because of the significant barriers that criminal records pose). But often, less attention is paid to preventing those being released from jail or prison from entering into homelessness.

In New York, for instance, over half of people released from prison move directly into the shelter system . In California , which does not require returning citizens to have a place to live upon release, many move directly into street homelessness. Nationwide, formerly incarcerated people are nearly  10 times more likely  to experience homelessness than the general population.

To better address the pipeline between incarceration and homelessness, study after study shows that bolstering reentry supports—particularly access to housing and employment—is critical to reducing recidivism and homelessness, while also improving public safety. Effective policies include reducing barriers for returning citizens to enter public housing , providing tailored services for those most at risk for homelessness prior to release (including workforce and housing supports), and explicitly addressing the unique needs of returning citizens in regional housing and homelessness plans, among other reforms .

Case study: How Cuyahoga County and Houston are curbing the prison-to-homelessness-pipeline through new supports for returning citizens

In response to growing evidence indicating the need to reduce the prison-to-homelessness pipeline, in 2023, Cuyahoga County, Ohio (where Cleveland is located) launched a  $37-million Housing Justice Plan that seeks to develop 105 housing units available to individuals with criminal backgrounds, provide short-term funding to subsidize housing costs for those leaving prison, and pilot a program to provide down-payment assistance or lease-to-own opportunities. For those in jail, Houston is operating a  Healthcare for the Homeless  jail in-reach program that provides intensive medical case management to incarcerated people, as well as counseling, psychiatry, substance use treatment, dental care, housing, employment, help with navigating public health benefits, and help obtaining identification.

Leverage the capacity of place governance organizations to humanely address homelessness, particularly in central business districts

While public sector officials hold the bulk of the power to address the structural causes of homelessness, downtown place governance organizations (such as business improvement districts and other special-purpose districts) also play an outsized role. 4 The International Downtown Association estimates that there are over 2,500 place management organizations in North America with the capacity to leverage millions of dollars in special tax assessments. Many of these organizations have high exposure to challenges associated with homelessness.

Special districts such as business improvement districts (BIDs) have at times been complicit in the act of displacing homeless people and embracing hostile architecture . However, they have also been pragmatic, effective leaders in innovating and implementing inclusive management practices aligned with a public health approach by employing community ambassadors; providing access to drinking water and public restrooms; supporting placemaking activities and other built environment improvements that enhance safety, vibrancy, and belonging in the public realm; and connecting residents to social services, employers, and workforce development providers.

Case study from Philadelphia: How place-based partnerships and place governance organizations can support and bolster city services for homelessness reduction and care

Most emergency shelters in Philadelphia are closed during the day, meaning that the homeless population transitions from being sheltered to unsheltered and back again on a daily basis. In 2011, Project HOME , a nonprofit homelessness service provider in Philadelphia, sought to tackle this challenge by creating a drop-in day center for homeless people close to transit and City Hall.

Through place-based, cross-sector partnerships with city government and the regional transit authority, Project HOME was able to open the day center, Hub of Hope , for people to access food, health care, social services, laundry, showers, and fresh coffee provided by Wawa. It is the only drop-in center on transit property in the U.S. and currently serves approximately 200 people per day .

As part of its cross-sectoral approach, Project HOME also collaborates with Center City District (Philadelphia’s downtown place governance organization) and other private and public sector partners on a street outreach effort, the Ambassadors of Hope , which fields interdisciplinary outreach teams on the streets of Center City Philadelphia to engage chronically homeless people and connect them to help customized to their needs. Since 2018, over 700 people experiencing homelessness have received services and transportation off the street.

Philadelphia, Penn. / Authors’ original photo

Take a regional, data-driven approach to homelessness

There is growing consensus among homelessness service providers and city and regional officials that no one institution, organization, funding source, or level of government can solve homelessness alone. To respond to the structural challenges that prevent people across a region—not just within city boundaries—from accessing affordable housing, there is a movement to establish regional homelessness authorities that correspond to merged, regional Continuums of Care and align resources and service delivery programs across a region.

Cities and counties from the East Bay area to Spokane, Wash. to Houston have adopted a “regional approach” to homelessness to coordinate on cross-jurisdictional challenges to addressing homelessness by aligning regional funding, communications, coordination, social delivery infrastructure, data collection, performance management, and training and capacity-building. This helps regions understand the extent of homelessness in their region and transparently report performance metrics, which are critical to assembling the collective will and funding necessary to end it.

Case study: How cities and counties are working together on a regional approach to homelessness

Since 1994, the Metro Denver Homeless Initiative has coordinated data and services regionally—an early national leader on the regional approach that includes building, maintaining, and using a single “Coordinated Entry System” with real-time rather than annual data. Similarly, service providers, governments, philanthropy, and more came together in the Houston metro area in 2011 to form the Way Home —another regional approach that has successfully implemented the “housing first” model. Recently, the King County Regional Homelessness Authority (KCRHA) was established in December 2019 through an inter-local agreement between King County and the city of Seattle—representing a consolidated and regional approach to tackle a critical homelessness challenge that has spiked in the last decade. Even in places with less jurisdictional fragmentation, Continuum of Care participants can come together in more collaborative ways to create a regional approach. For example, in 2015, Strategies to End Homelessness was named the “Unified Funding Agency” for the Cincinnati/Hamilton County CoC.

These leading and innovative regional approaches have more in common than just high levels of cooperation, data, and streamlined funding. These initiatives seek to address a spectrum of socioeconomic challenges associated with homelessness, including through homelessness prevention, particularly focusing on communities of color such as Black and American Indian/Alaska Native populations, which are disproportionately affected.

Their work is characterized by clear planning and performance metrics, such as the KCRHA inter-local agreement that provides a community-driven, racially equitable, and data-informed methodology and operates in alignment with the Regional Action Framework, which outlines clear visions, policies, strategies, and success metrics while striving to balance immediate actions with long-term solutions. Many emphasize the importance of input from individuals with lived experience of homelessness . These metro areas have shown that a “regional approach” requires system integration, coordinated service delivery, and performance management.

Public, private, and civic sector leaders have the evidence at their disposal to advance pragmatic solutions that can not only reduce visible homelessness in downtowns, but also chart a future in which all residents of a region have access to more effective and humane service delivery ecosystems for housing, employment, and reintegration. This holistic, place-based approach to homelessness creates a foundation for a strong labor market and vibrant regional economy. Understanding the why, where, and how of homelessness across and within regions is critical to not only respond effectively to the needs of people experiencing homelessness today, but also to prevent people from experiencing homelessness in the future.

While the state of homelessness in a city like Philadelphia is not the same as in Seattle, the recommendations provided within this report—from increasing the supply of all types of housing to strengthening organizations that provide holistic, place-based support to bolstering reentry services for returning citizens—provide a roadmap based on evidence and root-cause approaches that a jurisdiction of any size can adopt and scale, with the right support and resources, to come closer to the goal of solving homelessness . This will require sustained commitment and coordination from local, regional, state, and federal leaders. Initiatives such as the Biden-Harris administration’s “ALL INside” —which is accelerating local efforts to reduce homelessness in Los Angeles, Dallas, Phoenix, and several other cities—are promising examples of how federal funds can be leveraged to escalate the response.

A large, unsheltered homeless population is not an inevitable part of human or urban life, and there is real harm and risk involved when solutions are not implemented early or are underfunded: both the harm to individuals experiencing the profound traumas of homelessness and incarceration, as well as the damage to regional economies and institutions that is visible in downtowns, emergency rooms, transit systems, and courthouses every day. Allowing the root causes to continue unabated creates the real “doom loop” : a homelessness challenge that becomes harder to solve the longer we wait.

All residents of a region deserve to feel safe walking free of public disorder within their central business districts, but so too must all people within a region have access to the opportunity for stable housing, food, and services. To this end, federal, state, and local leaders must deploy investments and interventions in a manner that is most effective and humane in achieving that goal.

The authors would like to thank Jira Trinetkamol for his excellent research assistance on this piece. They also extend their sincere gratitude to Alan Berube, Annelies Goger, Glencora Haskins, Paul Levy, and Joy Moses for reviewing earlier drafts of this piece. Any errors that remain are solely those of the authors.

• All qualitative interviews capture respondents’ perceptions from fall 2022—reflecting a point in time that may not capture improvements or heightened challenges that have happened since.
• Houston was included in Figure 4 to provide an example from a city that has intentionally embraced a homelessness reduction framework rooted in coordinated service delivery for the past decade.
• While preliminary data from a supplemental PIT Count conducted by the city of Chicago in light of increased migration reports a significant recent increase in homelessness since the 2022 PIT Count, it will be difficult to gauge how sustained the impact will be moving forward.
• For more on place governance organizations and homelessness, see Madison, E. and J. Moses. (2022) “How Should Place Governance Support People Experiencing Homelessness?” in Hyperlocal: Place Governance in a Fragmented World. Washington, DC: Brookings Institution Press.

Placemaking

Brookings Metro

Anne T. and Robert M. Bass Center for Transformative Placemaking

Hanna Love, Glencora Haskins

June 28, 2023

April 3, 2023

DW Rowlands, Hanna Love

April 21, 2022

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Homelessness and Public Health: A Focus on Strategies and Solutions

David a. sleet.

1 School of Public Health, San Diego State University, San Diego, CA 92182, USA; moc.liamg@teelsadivad

2 Veritas Management, Inc., Atlanta, GA 30324, USA

Louis Hugo Francescutti

3 School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada

4 Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada

5 Royal Alexandra Hospital, Edmonton, AB T5H 3V9, Canada

On any given night, hundreds of thousands of people are homeless in the United States and Canada. Globally, the problem is many times worse, making homelessness a global public health and environmental problem. The facts [ 1 ] are staggering:

• On a single night in January 2020, 580,466 people (about 18 out of every 10,000 people) experienced homelessness across the United States—a 2.2% increase from 2019.
• While 61% percent of the homeless were staying in sheltered locations, the remainder—more than 226,000 people—were in unsheltered locations on the street, in abandoned buildings, or in other places not suitable for human habitation.
• Homelessness has increased in the last four consecutive years.
• The increase in unsheltered homelessness is driven largely by increases in California.
• In 2020, 171,575 people in families with children experienced homelessness on a single night.
• A total of 3598 homeless people were children under the age of 18 without an adult present.
• Veterans comprised 8% of all homeless adults (over 46,000 veterans struggle with homelessness).
• People of color are significantly over-represented among those experiencing homelessness.

A layman’s definition of homelessness is usually “a person that has no permanent home”. However, many scholars have divided the broad group of people characterized as homeless into three (or more) categories:

• - People without a place to reside;
• - People in persistent poverty, forced to move constantly, and who are homeless for even brief periods of time;
• - People who have lost their housing due to personal, social, or environmental circumstances.

While this definition refers specifically to homeless individuals, it is equally applicable to homeless families.

Homelessness is closely connected to declines in physical and mental health. Homeless persons experience high rates of health problems such as Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) and Hepatitis A infections, alcohol and drug addiction, mental illness, tuberculosis, and other serious conditions. The health problems facing homeless persons result from various factors, including a lack of housing, racism and discrimination, barriers to health care, a lack of access to adequate food and protection, limited resources for social services, and an inadequate public health infrastructure. Legal and policy interventions have often been used to attempt to address homelessness, although not always from a public health perspective.

In health care, for example, if someone experiencing homelessness comes to an emergency department for medical aid, once treated, the only alternative is to release the patient back onto the street. This creates an endless cycle of emergency department visits, increasing costs and expending resources in the health care system.

Recent work [ 2 ] has emphasized the important role of public health, the health care system, and health care providers in homelessness prevention. In this Special Issue of the International Journal of Environmental Research and Public Health (IJERPH), we have brought together researchers, practitioners, and community organizers to articulate the public health problem of homelessness and identify clear strategies to reduce homelessness and provide more adequate health care and housing for this population. We also explore solutions for important subpopulations, including adults, families with children, adolescents, women, transitional aged youth, and those suffering from mental illness, PTSD, alcohol dependency, mental illness, adverse childhood experiences, and chronic homelessness.

We address many of these issues in the context of public health and explore the public health implications and potential solutions to homelessness, focusing on contemporary and emerging research and innovative strategies, and highlighting best practices to address homelessness among key populations. The papers in this Special Issue attempt to answer several questions related to homelessness and public health, such as:

• What is the extent of homelessness and why do people become homeless?
• What are the public health and health services implications of homelessness?
• What role does housing play as a precursor to and potential solution for homelessness?
• What public health and health care interventions are being employed, and what effectiveness is being achieved?
• What long-term strategies can be developed to prevent homelessness?

The 13 research papers and one commentary in this Special Issue are summarized as follows:

• Conceptualizing an Interdisciplinary Collective Impact Approach to Examine and Intervene in the Chronic Cycle of Homelessness. This study by Abdel–Samad et al. [ 3 ] focuses on a novel, interdisciplinary academic–practice partnership model for addressing the problem of homelessness. Whereas singular disciplinary approaches may fall short in substantially reducing homelessness, this approach draws from a collective impact model that integrates discipline-specific approaches through mutually reinforcing activities and shared metrics. The paper describes what is necessary for capacity-building at the institution and community levels, the complementary strengths and contributions of each discipline in the model, and future implementation goals to address homelessness in the Southern California region using a cross-disciplinary approach.
• Mental Illness and Youth-Onset Homelessness: A Retrospective Study among Adults Experiencing Homelessness . Iwundu et al. [ 4 ] conducted a retrospective study and evaluated the association between the timing of homelessness onset (youth versus adult) and mental illness. The results indicated that mental illness (as a reason for current homelessness) and severe mental illness comorbidities were each associated with increased odds of youth-onset homelessness, providing a basis for agencies that serve at-risk youth in order to address mental health precursors to youth homelessness.
• Well-Being without a Roof: Examining Well-Being among Unhoused Individuals Using Mixed Methods and Propensity Score Matching. Ahuja et al. [ 5 ] found that the mean overall well-being score of unhoused participants was significantly lower than that of matched housed participants, with unhoused participants reporting lower mean scores for social connectedness, lifestyle and daily practices, stress and resilience, emotions, physical health, and finances. The unhoused participants had a statistically significantly higher mean score for spirituality and religiosity than their matched housed counterparts. The qualitative interviews highlighted spirituality and religion as a coping mechanism for the unhoused.
• Combatting Homelessness in Canada: Applying Lessons Learned from Six Tiny Villages to the Edmonton Bridge Healing Program. Authors Wong et al. [ 6 ] discuss the Bridge Healing Program in Edmonton, Alberta, a novel approach to combatting homelessness by using hospital emergency departments (ED) as a gateway to temporary housing. The program provides residents with immediate temporary housing before transitioning them to permanent homes. The paper discusses effective strategies that underlie the Tiny Villages concept by analyzing six case studies and applying the lessons learned to improving the Bridge Healing Program and reducing repeat ED visits and ED lengths of stay among homeless individuals.
• Change in Housing Status among Homeless and Formerly Homeless Individuals in Quebec, Canada: A Profile Study. Kaltsidis et al. [ 7 ] used a cluster analysis to develop a typology of the housing status change for 270 currently or formerly homeless individuals who were residing in shelters and temporary or permanent housing. The findings suggest that the maintenance or improvement in the housing status requires the availability of suitable types and frequencies of service use (enabling factors) that are well-adapted to the complexity of health problems (needs factors) among homeless individuals. Specific interventions, such as outreach programs and case management, are prioritized as necessary services, especially for individuals at a higher risk of returning to homelessness.
• Urban Stress Indirectly Influences Psychological Symptoms through Its Association with Distress Tolerance and Perceived Social Support among Adults Experiencing Homelessness. To investigate the simultaneous impact of intrapersonal characteristics (distress tolerance) and interpersonal characteristics (social support) and their association with homelessness, Hernandez et al. [ 8 ] recruited homeless adults from six homeless shelters in Oklahoma City who self-reported urban life stress, distress tolerance, social support, major depressive disorder, and PTSD symptoms. Based on the resulting associations, their findings stress the importance of implementing interventions aimed at increasing social support for homeless persons, something that may also increase skill development for distress tolerance and indirectly lead to a reduction in depression and PTSD.
• “I Felt Safe”: The Role of the Rapid Rehousing Program in Supporting the Security of Families Experiencing Homelessness in Salt Lake County, Utah. Garcia and Kim [ 9 ] describe their research into The Road Home (TRH) program, which provides services to homeless individuals and families. TRH is known for their emergency shelters and also administers the Rapid Rehousing Program (RRHP), designed to help homeless families transition back into stable housing. After collecting qualitative data from focus groups with participants and families, landlords, case managers, and service providers, they make recommendations for program improvements that can increase the residential security of families experiencing homelessness.
• “It’s Just a Band-Aid on Something No One Really Wants to See or Acknowledge”: A Photovoice Study with Transitional Aged Youth Experiencing Homelessness to Examine the Roots of San Diego’s 2016–2018 Hepatitis A Outbreak. In this study, Felner et al. [ 10 ] examined the experiences and needs of transitional aged youth (TAY) aged 18–24 experiencing homelessness who may have been uniquely affected by an unprecedented outbreak of hepatitis A virus (HAV). The findings documented a stigmatization of TAY, interventions that failed to address root causes of the outbreak, and interactions with housing- and social support-related resources that limited rather than supported economic and social mobility. The findings have implications for understanding how media and public discourse, public health interventions, and the availability and delivery of resources can contribute to and perpetuate stigma and health inequities faced by TAY experiencing homelessness.
• Predictors of Overnight and Emergency Treatment among Homeless Adults. Iwundu et al. [ 11 ] aimed to identify the sociodemographic predictors associated with overnight and emergency hospital treatment among a sample of homeless adults. Participants were recruited from a shelter in Dallas, Texas and were predominantly uninsured, low-income men and women from various social and ethnic groups. In logistic regression models, gender emerged as the only predictor of overnight treatment in a hospital and treatment in an emergency department. Women were more likely than men to be treated overnight and use emergency care. The authors concluded that interventions and policies targeted toward homeless women’s primary health care needs would reduce health care costs.
• Association of Problematic Alcohol Use and Food Insecurity among Homeless Men and Women. In a study on alcohol use and food insecurity among homeless men and women, Reitzel et al. [ 12 ] investigated the link between problematic alcohol use and food insecurity among homeless adults in Oklahoma. Problematic alcohol use was measured using the Alcohol Quantity and Frequency Questionnaire and the Patient Health Questionnaire. Food insecurity was measured with the USDA Food Security Scale-Short Form. The results indicated that heavy drinking and probable alcohol dependence/abuse were each associated with increased odds of food insecurity. The results question whether alcohol may take precedence over eating or food purchases among this population of homeless individuals.
• Exploring Tiny Homes as an Affordable Housing Strategy to Ameliorate Homelessness: A Case Study of the Dwellings in Tallahassee, FL. “Tiny Homes” is an emerging strategy to combat homelessness, and Jackson et al. [ 13 ] raise a number of questions about the intentions, efficacy, and policy feasibility of this strategy. The paper seeks to understand the strategies used by stakeholders to plan, design, and implement a “Tiny Homes” strategy, and to assess their effectiveness. Using a case study, they examined how the community was planned, the experiences of residents, and the constraints to success. Their findings highlighted how funding constraints and NIMBYism (Not in My Backyard-ism) stymied stakeholder efforts to achieve equity and affordability, resulting in the inability to achieve project aims to develop affordable housing that served homeless populations.
• Predictors of Emergency Department Use among Individuals with Current or Previous Experience of Homelessness. The study by Gabet et al. [ 14 ] assessed the contributions of predisposing, enabling, and needs factors in predicting emergency department (ED) use among 270 individuals with a current or previous experience of homelessness. Participants were recruited from types of housing in Montreal, Quebec (Canada) and were interviewed about their ED use at baseline and again 12 months later. The findings revealed two needs factors associated with ED use: having a substance use disorder and low perceived physical health. Two enabling factors—the use of ambulatory specialized services and stigma—were also related to ED use. ED use was not associated with the type of housing. The authors suggest that improvements are needed to manage substance use disorders and the physical health of homeless individuals in order to reduce ED use.
• Being at the Bottom Rung of the Ladder in an Unequal Society: A Qualitative Analysis of Stories of People without a Home. The Mabhala and Yohannes article [ 15 ] examines the stories of homeless people and their perceptions of their social status using interviews in three centers for homeless people in Cheshire, in the English Northwest. Education, employment, and health were three domains that provided a theoretical explanation for the reasons that led to their homelessness. Participants catalogued their adverse childhood experiences, which they believe limited their capacity to meaningfully engage with social institutions for social goods, such as education, social services, and institutions of employment. They conclude that, although not all people who are poorly educated, in poor health, and unemployed end up being homeless, a combination of these together with multiple adverse childhood experiences may weaken resilience and contribute to homelessness.
• Commentary: Investing in Public Health Infrastructure to Address the Complexities of Homelessness. In a final commentary, Allegrante and Sleet [ 16 ] introduce the notion that investments in public health infrastructure are needed to address the complexities of homelessness, including the continued threats posed by SARS-CoV-2 (COVID-19) and its variants. The lack of affordable housing, widespread unemployment, poverty, addiction and mental illness, which all contribute to the risk of homelessness, would be well-served by improving the fundamental public health infrastructure. They argue that homelessness is exacerbated by system-wide infrastructure failures at the municipal, state and federal governments and from the neglect to invest in public infrastructure, including a modern public health system.

In conclusion, shelter is a basic human need. Thus far, we have an inadequate understanding of all the medical and nonmedical, public health, and infrastructural influences that drive homelessness and why so many people are living without adequate shelter. Housing is one of the most critical factors in addressing homelessness and one of the best-researched social determinants of health. Several articles here focus on innovative approaches to providing temporary or permanent housing for those who need it, and it is well known that selected housing interventions can improve health and decrease health care costs. From that perspective, some professionals in the field contend that housing equates to health [ 17 ] and that improved housing options for homeless individuals and families would advance population-level health.

Many of the articles in this Special Issue [ 18 ] focus on specific aspects of life, quality of life, and co-morbidities related to behavioral and social variables influencing homelessness. Explored in detail are factors such as lack of housing, distress, wellness, emergency department use, mental health, drug and alcohol addiction, poverty, low educational attainment, inadequate health care and social services, adverse childhood experiences, ongoing infections, unemployment, and public health infrastructure. In addition to highlighting the impact these factors can have on the likelihood that someone would become homeless, many of the articles also provide recommendations for relevant policies, practices, and interventions that could help reduce homelessness and improve overall well-being.

The intersection of environmental, behavioral, and social factors, in addition to the lack of an adequate infrastructure, must also be considered when studying the determinants of homelessness and designing appropriate interventions. Our ultimate goal in producing this Special Issue of IJERPH is to encourage the development of better evidence to inform public health, social services, and medical care policies and practices that will result in better health for homeless populations.

Acknowledgments

We thank the authors and reviewers for their commitment to preparing and editing these manuscripts and for adding to the knowledge base of this important public health problem.

Conflicts of Interest

The authors declare no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The Causes of Homelessness

This essay will examine the various causes of homelessness. It will explore factors such as economic hardship, mental health, substance abuse, and systemic issues that contribute to the phenomenon of homelessness. At PapersOwl too, you can discover numerous free essay illustrations related to Disability.

How it works

Homelessness has been a problem in American society for many generations. There are countless amounts of people who live without a permanent home and lack the basic essentials of life, such as food,wds `1ater, and clothes. It is likely when you walk or drive in your city that you will encounter a homeless person. Often when you are passing by a homeless individual or group, the thought comes to your mind, how did the end up here? Or why or how did they become homeless.

There are many factors that can lead to a individual or group of people to become homeless. These factors can be based off of one’s poor decision making, or just pure bad luck. The reasons a person may become or end up homeless are endless from unemployment to abuse at home.

Homeless. When you hear this word what comes to your mind? What do you see? Homelessness doesn’t exactly mean to not just have a permanent shelter it can also mean, It often means doubling or tripling up, camping or staying in places that would not (should not) be considered sufficient for human habitation(downing 7). The homeless are people just like everyone else, just people who have lost sight of what their lives use to be. Before they became homeless they probably had a good job, a nice house, friends, and a family. No one knows what their life was before they became homeless, or how they ended up homeless. They usually go off Baker 2 of their assumptions that the homeless led themselves to become homeless and its their fault that they ended up homeless. Homelessness can happen to anyone at any time regardless of the type of job you have or whether you have alot of money or not. A person can become homeless if there jobs lay people off the job, if a family member dies, or because a natural disatser that destroys most of one’s belongings.

What is homelessness? Homelessness is the product of decades of failed social policy, lack of affordable or subsidized housing, entry level wages that have not kept pace with the cost of living, and the lack of opportunity to create something better by dint of simple hard work(Downing 8). Homelessness has been around for many centuries. It is still an ongoing problem and seems to increase every year. Homelessnes is when someone

There are many different types of homeless, all homeless just for different reasons or time periods. The types of homeless is hidden homeless, transitional,chronic,episodic, and , Some people that are homeless are only homeless for a short term period

The hidden homeless are the homless that are the one sthat do not have a physical shelter. Most hidden homeless are working class families who became unable to keep up with expenses and have moved in with family members.( Fulton.Kut,Morianos, Spencer 6). The hidden homeless possibly live with their family members, which can lead to a cramp house. Which can be difficult for the family to adjust to and can lead to more problems in the home.

The next type of homeless is the seasonal homeless. They are the homeless who are homeless for only a certain time period or season.

The last type of homeless is:

The most commonly know reasons for an individual or family to end up without a permanent home is unemployment,low wages, drug and alcohol abuse, health issues, and lack of affordable housing. Homelessness is, in fact, caused by tragic life occurrences like the loss of loved ones, job loss, domestic violence, divorce and family disputes. Other impairments such as depression, untreated mental illness, post traumatic stress disorder, and physical disabilities are also responsible for a large portion of the homeless. Many factors push people into living on the street. Acknowledging these can help facilitate the end of homelessness in America( home aid 3).

Beside the most common reasons a person can become homeless by natural disasters like hurricanes, floods and tornadoes. Events like this can cause a family or individual to end up without a home and expenses can be costly. It can be very difficult especially with the rising cost like if you miss paying a bill or Due to the storm families are now stuck in a difficult situation

The types of people who can become homeless are endless. Walking the streets of your city you won’t see one specific race of homelessness or gender but a variety of people ranging from young to old, male to female, and ill to health.

Homelessness is a very serious issue but, it is even more serious when it involves youth. Homeless youth are more at risk then adults they can be physically and emotionally abused. As many as 3.5 million Americans are homeless each year.(homeaid 1). graph

For some people they are unfortunately homeless due to society that doesn’t do enough to to ensure that jobs have a high enough wages, in order for that worker to be able to pay their bills provide for themselves and afford housing. There are many ways to prevent homelessness or at least stop an individual from going down the dark rode of constantly worrying about where they are going to be sleeping the next day.

There are various amounts of reasons in which a person may end up homeless. Either because of their own doing or due to unfortunate circumstances that has resulted in that individual or family becoming homeless. It doesn’t matter who you are or what you have. That can all be taken away from you in a matter of time. Homelessness does not have to be a way of life but for many it has become a way of life for the unfortunate ones who can not find the help or support they need.

Works Cited Page

A Study of Homelessness – Worcester Polytechnic Institute. Margaret Fulton, Lindsey Kut Melissa Morianos, Lindsay Spencer. March 16,2010. Web. October 2, 2018.

Downing Sherri, Homelessness a problem that can be solved. Nov 19,2009. Web. October 2, 2018.

Homeaid.org, homeaid.Top causes of homelessness.web. October 1, 2018.

NCSL, Homeless and runaway youth. April 14,2016. Web. October 2, 2018.

Weebly. Three types of homeless. Web. October 4, 2018.

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What Causes Homelessness?

When Housing is Out of Reach

More than at any other time, there is a lack of housing that low income people can afford. Without housing options, people face eviction, instability and homelessness.

Income and Housing Affordability

Low income households often do not earn enough to pay for food, clothing, transportation and a place they can call home.

Connecting Homelessness and Health

Health and homelessness are inextricably linked. Health problems can cause a person’s homelessness as well as be exacerbated by the experience. Housing is key to addressing the health needs of people experiencing homelessness.

Escaping Violence

Many survivors of domestic violence become homeless when leaving an abusive relationship.

Impact of Racial Disparities

Most minority groups in the United States experience homelessness at higher rates than Whites, and therefore make up a disproportionate share of the homeless population.

Privacy Overview

Why mental health and social services are as crucial as physical shelter to address the homelessness crisis

• Paul Constant is a writer at Civic Ventures and cohost of the " Pitchfork Economics " podcast.
• He spoke with Josephine Ensign, a professor and former policy worker, about the homelessness crisis.
• Ensign says social services are critical to address the mental health needs of unhoused people.

It's difficult to even begin to have a conversation about homelessness in America anymore.

Even in progressive cities like Seattle and San Francisco, coverage of our historically high levels of homelessness has become so hyperpartisanized that it's impossible for people to agree on the causes of the housing crisis, let alone work together to find solutions. Where some people see homelessness as strictly an economic failure, others position each case of homelessness as an individual failure, blaming it on untreated mental illness or a drug addiction problem. 

Let's be clear that simply building large amounts of housing will not solve our housing crisis, as some urbanists claim. But neither is homelessness a personal failing free from systemic economic pressures. A Zillow study from 2017 found that homelessness increases in cities where rents exceed a third of the average income, and each rent increase of $100 is associated with a corresponding jump in homelessness of anywhere from 6% to 32%. Given that median rents in some cities have skyrocketed by up to 91% over the past decade, that's a minimum of tens of thousands of Americans who are being pushed out into the street for the first time every year. 

Related stories

University of Washington Professor Josephine Ensign joined the "Pitchfork Economics" podcast to discuss her 40-year career working with homeless populations around the world as a researcher, nurse, and policy worker. Her latest book, " Skid Road: On the Frontier of Health and Homelessness in an American City ," specifically explores the history of homelessness in Seattle.

How did we get to a point when nearly every American city is dotted with tent encampments? Ensign cites the "steady defunding of [Department of Housing and Urban Development] services, in terms of support for low-income housing redevelopments" that has taken place through the latter half of the 20th century, as well as "the gentrification of inner city areas that have displaced, especially, persons of color and people living intergenerationally in poverty," and the "deinstitutionalization of people with pretty severe mental health issues and developmental issues" that took place in the late '70s and throughout the '80s.

In short, there's no one smoking gun to point to as the root cause of America's homelessness crisis. Instead, a wide array of policy failures, worsened by American leaders' 40-year love affair with trickle-down austerity, have led to this moment. (For proof, consider the fact that European nations with robust social safety nets don't have the same growing number of unhoused people as we do.)

A universal healthcare system alone would resolve many of the issues that push Americans onto the streets, and which exacerbate their problems once they're on the street.

With rents and housing prices rising astronomically, we obviously need much more affordable housing in American cities right now. It's cheaper to house homeless people than it is to put them through the endless piecemeal cycle of homeless shelters and triage services that cost taxpayers somewhere between $30,000 and $80,000 per homeless person per year . But the fact is that physical shelter needs are only part of the problem. 

"It's not just a problem with inadequate low income and supportive housing," Ensign said. "It is also the sense of belonging, the sense of community, the community supports in terms of health and social services, that are needed for people to be safe and healthy and happy in low-income and long-term permanent housing." 

People experience trauma before they're forced into homelessness, and they experience trauma while they're homeless. If we don't have systems in place to address that emotional damage, homeless populations will continue to rise.

So what would Ensign do if she could establish policies to ameliorate homelessness in a major American city? "The biggest thing that I would fund is ongoing supportive services in shelters and day shelters and outreach programs," she said, including high-quality mental health and substance abuse programs for homeless families and individuals, "because if they're not quality, if they're not sustainable, it actually does more harm than good for people trying to become more stable in housing and health."

"With quick interventions and appropriate counseling and treatment for the child and for the family," Ensign said, those traumas "can be overcome and can actually become sources of strength." 

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Homelessness in the U.S. hit a record high last year as pandemic aid ran out

Jennifer Ludden

The latest national count taken in January found more than 650,000 people living in tents, cars and shelters. Business Wire Via AP hide caption

The latest national count taken in January found more than 650,000 people living in tents, cars and shelters.

Homelessness in America spiked last year, reaching a record high, according to an annual count that provides a snapshot of one night in January. The report, released today by the department of Housing and Urban development, found more than 650,000 people were living in shelters or outside in tents or cars. That's up a whopping 12% from the year before.

To advocates, it hardly comes as a surprise.

"We simply don't have enough homes that people can afford," says Jeff Olivet, executive director of the U.S. Interagency Council on Homelessness. "When you combine rapidly rising rent, that it just costs more per month for people to get into a place and keep a place, you get this vicious game of musical chairs."

Homelessness has been rising since 2017 in large part because of the country's massive shortage of affordable housing. There was a pause during the pandemic, and Biden administration officials say that's because of sweeping federal aid that kept people from getting evicted. But last year, in a triple whammy, that aid started running out . Inflation spiked to its highest level in a generation, and median rent hit a record high . Research has found that where rents rise, so does homelessness.

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This year's big jump was driven by people who lost housing for the first time, which Biden administration officials say reflects the sharp rise in rent. The largest increase was among families, and the count also finds a significant rise among Hispanics. Nearly 40% of the unhoused are Black or African-American, and a quarter are seniors. The annual count does not include the many people who couch surf with friends or family, and who may be at high risk of ending up on the street.

One family sleeps in a Walmart parking lot

In July, Takia Cheeks and her four children joined the surge in families losing housing for the first time.

They'd moved to Virginia so she could take a higher paying job at a corrections facility, and Cheeks was excited to no longer have to live "paycheck to paycheck." But it did not go well. Two of her children have disabilities, and she kept having to miss work to get them enrolled in school and set up with accommodations. After six days' absence, her employer let her go.

Meanwhile, the family's new apartment turned out to have no hot water or AC, not even screens to be able to open the windows. Cheeks had complained, and after losing her job she was evicted in a court hearing where she had no lawyer. She put the family's belongings in a storage unit and they all slept crammed into her Ford Fiesta in a Walmart parking lot.

"I'm not getting sleep because I'm watching over my children, because it's a lot of people walking around," she says. She would get everyone up at 6:00 in the morning to go to a Wawa across the street. "Therefore I know it's not that many people in the bathrooms, for my children just to wash up," she says.

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Medical debt nearly pushed this family into homelessness. millions more are at risk.

It was so hot in the car that Cheeks's daughter got first and second degree burns. "I had to take her to the hospital," she says. Their rescue dog Max was also suffering so she gave him up, even though he'd been an emotional support animal for her son with autism.

After a few weeks, Cheeks got another job making deliveries for Amazon, and that let the family stay in a motel for a couple months. In October, they finally moved into a house with rental assistance, but that aid is temporary.

Migrants likely added to the higher numbers in some places

The surge in migrants showing up at shelters around the country likely also helped push up the numbers, says Ann Oliva, CEO of the National Alliance to End Homelessness. It's not clear how many may have been included, because back in January the volunteers conducting the count did not ask whether someone was seeking asylum. But Oliva says homeless service providers who'd already been overwhelmed are now struggling with this added population.

"We saw it in the state of Maine, in Minneapolis, in Chicago," she says. "Our big concern is that there is a huge inflow of folks that are coming into these systems without any resources for these systems to serve them."

Oliva's group wants the Biden administration to make it easier for migrants to legally work, and to have their asylum cases heard more quickly. She also says the federal government needs to provide far more rental assistance. Unlike food and healthcare, housing aid is not an entitlement, and only a quarter of people eligible for it actually receive a subsidy.

A few places did see a decrease in homelessness

The annual count found homelessness numbers down from the previous year in Houston, Newark and Chattanooga. "Homelessness is solvable and should not exist in the United States," HUD Secretary Marcia Fudge said in a statement .

The Biden administration says it's stepped up funding and streamlined the process for housing vouchers, among other things, and that helped move more people into permanent housing this year. They also point out that a record number of new apartments — about a million — were under construction.

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To tackle homelessness faster, LA has a kind of real estate agency for the unhoused

Inflation has also eased, but housing and food remain much more expensive than just a few years ago. Food pantries say they continue to see large numbers of people. And while rents on luxury condos in some places may be coming down, the massive housing shortfall is worst for the lowest-income renters, many of whom pay more than half their income on rent .

To really bring down these numbers, advocates say there should be far more federally subsidized housing. Right now only one in four people who are eligible actually gets it, but expanding that would need more funding from Congress.

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• affordable housing
• homelessness

Record Numbers in the US Are Homeless. Can Cities Fine Them for Sleeping in Parks and on Sidewalks?

The most significant case in decades on homelessness has reached the Supreme Court as record numbers of people in America are without a permanent place to live

FILE - A woman gathers possessions to take before a homeless encampment was cleaned up in San Francisco, Aug. 29, 2023. The Supreme Court will hear its most significant case on homelessness in decades Monday, April 22, 2024, as record numbers of people in America are without a permanent place to live. The justices will consider a challenge to rulings from a California-based federal appeals court that found punishing people for sleeping outside when shelter space is lacking amounts to unconstitutional cruel and unusual punishment. (AP Photo/Jeff Chiu, File)

WASHINGTON (AP) — The most significant case in decades on homelessness has reached the Supreme Court as record numbers of people in America are without a permanent place to live.

The justices on Monday will consider a challenge to rulings from a California-based appeals court that found punishing people for sleeping outside when shelter space is lacking amounts to unconstitutional cruel and unusual punishment.

A political cross section of officials in the West and California, home to nearly one-third of the nation's homeless population, argue those decisions have restricted them from “common sense” measures intended to keep homeless encampments from taking over public parks and sidewalks.

Advocacy groups say the decisions provide essential legal protections, especially with an increasing number of people forced to sleep outdoors as the cost of housing soars.

The case before the Supreme Court comes from Grants Pass, a small city nestled in the mountains of southern Oregon, where rents are rising and there is just one overnight shelter for adults. As a growing number of tents clustered its parks, the city banned camping and set $295 fines for people sleeping there.

The 9th U.S. Circuit Court of Appeals largely blocked the camping ban under its finding that it is unconstitutional to punish people for sleeping outside when there is not adequate shelter space. Grants Pass appealed to the Supreme Court , arguing the ruling left it few good options.

Photos You Should See - April 2024

“It really has made it impossible for cities to address growing encampments, and they’re unsafe, unhealthy and problematic for everyone, especially those who are experiencing homelessness,” said lawyer Theane Evangelis, who is representing Grants Pass.

The city is also challenging a 2018 decision, known as Martin v. Boise, that first barred camping bans when shelter space is lacking. It was issued by the San Francisco-based 9th Circuit and applies to the nine Western states in its jurisdiction. The Supreme Court declined to take up a different challenge to the ruling in 2019, before the solidification of its current conservative majority.

If the decision is overturned, advocates say it would make it easier for cities deal with homelessness by arresting and fining people rather than helping them get shelter and housing.

“In Grants Pass and across America, homelessness has grown because more and more hardworking people struggle to pay rent, not because we lack ways to punish people sleeping outside," said Jesse Rabinowitz, campaign and communications director for the National Homeless Law Center. Local laws prohibiting sleeping in public spaces have increased at least 50% since 2006, he said.

The case comes after homelessness in the United States grew by 12%, to its highest reported level as soaring rents and a decline in coronavirus pandemic assistance combined to put housing out of reach for more people, according to federal data. Four in 10 people experiencing homelessness sleep outside, a federal report found.

More than 650,000 people are estimated to be homeless, the most since the country began using the yearly point-in-time survey in 2007. People of color, LGBTQ+ people and seniors are disproportionately affected, advocates said.

Two of four states with the country's largest homeless populations, Washington and California, are in the West. Officials in cities such as Los Angeles and San Francisco say they do not want to punish people simply because they are forced to sleep outside, but that cities need the power to keep growing encampments in check.

“I never want to criminalize homelessness, but I want to be able to encourage people to accept services and shelter,” said Thien Ho, the district attorney in Sacramento, California, where homelessness has risen sharply in recent years.

San Francisco says it has been blocked from enforcing camping regulations because the city does not have enough shelter space for its full homeless population, something it estimates would cost $1.5 billion to provide.

“These encampments frequently block sidewalks, prevent employees from cleaning public thoroughfares, and create health and safety risks for both the unhoused and the public at large,” lawyers for the city wrote. City workers have also encountered knives, drug dealing and belligerent people at encampments, they said.

Several cities and Democratic California Gov. Gavin Newsom urged the high court to keep some legal protections in place while reining in “overreach” by lower courts. The Martin v. Boise ruling allows cities to regulate and “sweep” encampments, but not enforce total bans in communities without enough beds in shelters.

The Justice Department also backed the idea that people shouldn’t be punished for sleeping outside when they have no where else to go, but said the Grants Pass ruling should be tossed out because 9th Circuit went awry by not defining what it means to be “involuntarily homeless."

Evangelis, the lawyer for Grants Pass, argues that the Biden administration's position would not solve the problem for the Oregon city. “It would be impossible for cities to really address the homelessness crisis,” she said.

Public encampments are not good places for people to live, said Ed Johnson, who represents people living outside in Grants Pass as director of litigation at the Oregon Law Center. But enforcement of camping bans often makes homelessness worse by requiring people to spend money on fines rather than housing or creating an arrest record that makes it harder to get an apartment. Public officials should focus instead on addressing shortages of affordable housing so people have places to live, he said.

“It’s frustrating when people who have all the power throw up their hands and say, ‘there’s nothing we can do,’” he sad. “People have to go somewhere.”

The Supreme Court is expected to rule by the end of June.

Copyright 2024 The  Associated Press . All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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Criminalizing Homelessness Won’t Make It Go Away

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By Mark Horvath ,  Adam Westbrook and Lindsay Crouse

Mr. Horvath started the YouTube channel Invisible People. Mr. Westbrook is a producer and editor with Opinion Video. Ms. Crouse is a producer with Opinion Video.

If you live in one of America’s cities, you probably see homeless people all the time. You might pass them on your way to work. Maybe you avoid eye contact. If they ask you for money, maybe you pretend you didn’t hear, and walk on by.

But what if you stopped and listened to what they have to say?

As you’ll see in the Opinion video above, you might find their stories of landing on the streets strikingly relatable. Such accounts reveal a hard truth about our country: Amid an affordable housing crisis, where 70 percent of all extremely low-income families today pay more than half their income on rent, becoming homeless is easier than we’d like to think.

That’s what Mark Horvath discovered firsthand in 1995, when he lost his job and wound up homeless for eight years. He started interviewing people on the street in 2008, and began sharing those stories on his YouTube channel, Invisible People . He wanted to try to help viewers who might ignore their homeless neighbors see them not with scorn, or indifference, but empathy.

These stories are even more important today, as a record number of people experience homelessness and face increasing threats from the law. On April 22, the Supreme Court is set to hear the case of Johnson v. Grants Pass, the most significant case in decades about homeless people’s rights. The case will determine whether cities can arrest or fine the homeless — even if there’s no other shelter. As the homeless plaintiffs wrote, this would be “punishing the city’s involuntarily homeless residents for their existence.”

Every homeless person’s path is complicated, and in this video, we haven’t remotely captured anyone’s whole story. Yes, some are addicts, some are mentally ill, some have made unwise choices, and some are simply unlucky. Some are many of those things. But all of them argue that in the hardest moment of their lives, they have been largely abandoned, and even punished, by the rest of us. So we hope you’ll do more than dismiss, or judge, the people in this video, and instead listen to them.

Mark Horvath is the creator behind the Invisible People YouTube channel. Lindsay Crouse ( @lindsaycrouse ) is a writer and producer in Opinion. Adam Westbrook is a producer and editor with Opinion Video.

Opinion Video combines original reporting with creative storytelling to produce visually transformative commentary. Pitch a video Guest Essay here.

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Home — Essay Samples — Social Issues — Homelessness — The Problem Of Homelessness In America

The Problem of Homelessness in America

• Categories: Homelessness Poverty in America

About this sample

Words: 1222 |

Published: Apr 29, 2022

Words: 1222 | Pages: 3 | 7 min read

Works Cited

• National Alliance to End Homelessness. (2016). State of Homelessness in America. https://endhomelessness.org/homelessness-in-america/homelessness-statistics/state-of-homelessness-report-2016/
• National Center for Biotechnology Information. (n.d.). Who Are the Homeless? – NCBI Bookshelf.
• NPR. (n.d.). As Cities Grow, So Do the Numbers of Homeless. https://www.npr.org/2018/08/09/637056547/as-cities-grow-so-do-the-numbers-of-homeless
• Coalition for the Homeless. (n.d.). Homelessness & Poverty in New York City. https://www.coalitionforthehomeless.org/homelessness-in-new-york/
• National Alliance to End Homelessness. (2017). State of Homelessness.
• U.S. Department of Housing and Urban Development. (n.d.). The Impact of Homeless Encampments on the Environment.

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Main mental health conditions among children living in shelters, New York City, 2022

Number of behavioral health conditions among children living in homeless shelters in New York City in 2022 as reported by the head of household

Deaths among homeless people in New York City from 2005 to 2022, by reporting agency

Number of deaths among persons experiencing homelessness in New York City between 2005 and 2022, by reporting agency

Deaths among homeless people in New York City from 2021 to 2022, by location of death

Number of deaths among persons experiencing homelessness reported in New York City between 2021 and 2022, by location of death

Leading causes of death among homeless persons in New York City 2021-2022

Leading causes of death among persons experiencing homelessness in New York City between 2021 and 2022

• Basic Statistic Health-related reasons for homelessness in King County, Washington 2020
• Basic Statistic Health conditions among homeless persons in King County, Washington 2020
• Basic Statistic Health conditions among homeless veterans in King County, Washington, 2020
• Basic Statistic Health conditions among homeless youth and young adults, King County, Washington 2020
• Basic Statistic Health conditions among homeless persons in King County, Washington, 2020, by shelter
• Basic Statistic Number of deaths among homeless people in King County, Washington 2012-2021
• Basic Statistic Share of deaths among homeless in King County, Washington from 2012 to 2021, by age
• Basic Statistic Share of deaths among homeless in King County, Washington 2012-2021 by location
• Basic Statistic Share of deaths among homeless in King County, Washington 2012-2021, by cause
• Basic Statistic Share of overdose deaths in King County, Washington 2019-2024, by housing status

Health-related reasons for homelessness in King County, Washington 2020

Percentage of homeless people in King County, Washington who stated they were homeless for select health-related reasons from 2017 to 2020

Health conditions among homeless persons in King County, Washington 2020

Percentage of homeless persons in King County, Washington who stated they had select health conditions from 2017 to 2020

Health conditions among homeless veterans in King County, Washington, 2020

Percentage of veteran and non-veteran homeless persons in King County, Washington who stated they had select health conditions as of 2020

Health conditions among homeless youth and young adults, King County, Washington 2020

Percentage of homeless unaccompanied youth and young adults in King County, Washington who stated they had select health conditions as of 2020

Health conditions among homeless persons in King County, Washington, 2020, by shelter

Percentage of homeless persons in King County, Washington who stated they had select health conditions as of 2020, by sheltered status

Number of deaths among homeless people in King County, Washington 2012-2021

Number of deaths among those presumed to be homeless in King County, Washington from 2012 to 2021

Share of deaths among homeless in King County, Washington from 2012 to 2021, by age

Distribution of deaths among those presumed to be homeless in King County, Washington from 2012 to 2021, by age

Share of deaths among homeless in King County, Washington 2012-2021 by location

Distribution of deaths among those presumed to be homeless in King County, Washington from 2012 to 2021, by location

Share of deaths among homeless in King County, Washington 2012-2021, by cause

Distribution of deaths among those presumed to be homeless in King County, Washington from 2012 to 2021, by cause

Share of overdose deaths in King County, Washington 2019-2024, by housing status

Distribution of drug overdose deaths in King County, Washington between 2019 and 2024, by housing status

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