Homelessness has been one of the significant health and social issues in the United States. It emerged as a national issue shortly after the Civil War in the 1870s (“Permanent supportive housing,” 2018). Vagrants during this era were mainly foreigners who traversed the country in search of labor following the industrialization and urbanization process. Demographically, the hobos were young white men who deviated from the cultural norms of the Americans. The vagabonds preferred open roads and riding the rails as opposed to working as constrained workers in the industries (“Permanent supportive housing,” 2018). Due to this counterculture, being homeless had a negative connotation since they were mainly perceived as lazy, ill-conditioned, and irreclaimable tramps.
However, in the 1880s, the public perceptions of homelessness improved following the development of literature that appreciated their courage and willingness to deviate from monotony and oppression associated with industrial work. Additionally, factories started appreciating the value of company loyalty and longevity (“Permanent supportive housing,” 2018). This shift in the work culture, mediated by World War II, allowed migrant workers to take up temporary factory jobs. Until then, the homeless population was predominantly white and male.
After World War II, the demographics shifted to include older males (50 years old), the disabled, and those whose livelihood depended on social welfare. Ironically, those regarded as derelicts during that era do not meet the modern definitions of homelessness. The Housing and Urban Development (HUD) defines a homeless person as one living in an inhabitable place, lacks a nighttime residence, and is unstably housed and can continue living in that state (“Permanent supportive housing,” 2018). Vagrants in the 1980s resided in cheap hotels, single room occupancy hotels, and flophouses located in poor neighborhoods (“Permanent supportive housing,” 2018). Therefore, most of these people would be considered ‘housed’ by HUD’s current definition.
Modern-Era Homelessness
Modern homelessness was caused by high unemployment rates, budget cuts to the HUD, deinstitutionalization of the mentally sick, HIV/AIDs prevalence, and unaffordable housing plan. Economic recessions in the 1980s led to significant budgetary cuts for HUD, which provided subsidized housing and housing assistance to the poor (“Permanent supportive housing,” 2018). Following the civil rights movement activities, the number of institutionalized psychiatrically sick reduced significantly from 535,000 to 137,000 in two decades (“Permanent supportive housing,” 2018). Hospital beds in California decreased from 37,000 to 2,500 between 1555 and 1983 (“Permanent supportive housing,” 2018). Coupled with inadequate funding, housing assistance and community-based services for the mentally ill were eliminated, forcing the affected individuals to seek temporary shelters and move to the streets. These factors’ confluence changed the American vagrant populace’s demographics, deteriorated the derelicts’ living conditions, and increased the homelessness prevalence in the country.
Until the 1990s, the homeless were single, white males and alcoholics. However, due to the aforementioned factors, the vagrant population changed to include women, youths, families, and veterans (“Permanent supportive housing,” 2018). African Americans currently account for 41% of the nation-wide derelict populace, followed by Hispanic/Latinos, who account for 22% (“Permanent supportive housing,” 2018). Despite these communities being minority groups, they are significantly affected by homelessness. Studies attribute these high numbers to unemployment, poor educational outcomes, and crime involvement (“Permanent supportive housing,” 2018). As opposed to living in hotels and SROS, almost half of the modern homeless people live in unsheltered locations.
Housing Policies
In response to the increased homelessness rate, several state and local governments have developed housing policies to curb the problem. Rent control regulation is among the housing procedures adopted by several states to curb the homelessness debacle. Rental control proponents support this approach, positing that they protect tenants by restricting the landlord’s market power. An empirical study conducted by Rajasekaran et al. (2019) endorses this argument; the survey’s findings revealed that rent control strategies adopted in New York, San-Francisco, and Cambridge helped minimize state homelessness. The policies lowered rent for housing units and prevented forced evictions (Rajasekaran et al., 2019). However, these policies are not entirely effective in addressing the problem. Rajasekaran et al. (2019) demonstrated further that tenants living in rent-controlled units are unlikely to move out following a change in their income status. Such practices can lock out needy families from accessing affordable housing.
The federal government has also established several housing programs, including temporary housing, transitional housing, medical respite programs for the medically incapable of living alone, and permanent housing. The U.S housing bill also requires the federal government to fund the Housing First Approach and Continuums of Care (CoCs), which provide social services to the vagrants. A recent report by the National Alliance to End Homelessness demonstrated that public policies that fund homeless shelters have led to increased permanent housing beds by 20% and housing assistance by 87% (“State of homelessness,” 2020). Consequently, derelict families have reduced by 29%, the unsheltered vagabonds by 10%, and chronically hobos by 9% since 2007 (“State of homelessness,” 2020). Unfortunately, despite implementing these programs and interventions, homelessness continues to be a national issue. It is reported that individual men and women experiencing chronic homelessness have increased by 11% in the last three years (“State of homelessness,” 2020). Arguably, this data is reflective of the housing policies’ effectiveness in addressing the problem. Considering the annual input in managing the problem, homelessness should no longer be considered a national issue.
Health Conditions of the Homeless
The underlying health conditions of the vagrants have been identified as a significant effect of homelessness. This view is supported by a particular study which distinguished the burden of health conditions as the primary reason for homelessness among vagabond families and women (“Permanent supportive housing,” 2018). Among the homeless, 37.5% have suicidal thoughts, 28% have a chronic mental disease, and 11.4% have major depression (“Permanent supportive housing,” 2018). About 30% – 49% of the vagrants have substance use disorders (“Permanent supportive housing,” 2018). Derelicts also have significantly higher mortality rates than non-homeless individuals (“Permanent supportive housing,” 2018). The leading causes of death among the homeless are drug-related (over 80% caused by opioid overdose), infectious diseases, hypothermia, and chronic diseases (“Permanent supportive housing,” 2018). Numerous studies have described these health conditions as critical barriers to accessing social and support services among the homeless.
Paradoxically, some traditional housing programs require individuals to demonstrate readiness or prove participation in substance abuse and mental health treatment to be eligible for housing assistance. Requiring individuals to provide proof of treatment can lock out eligible and vulnerable populaces from receiving help. Affected individuals may also engage in survival sex (exchanging sex for basic needs) (“Permanent supportive housing,” 2018). These deportments typically expose them to violence and abuse, further risking their physical and mental wellbeing. Taken together, the aforementioned factors have led to the emergence of mental health as a significant issue among homeless populations. Mental health is seen as a condition preceding homelessness and a health outcome of the condition.
Future Projections
Synonymous to past transformations, the demographics of the homeless will also change significantly. Emerging evidence shows that the aging vagrant population – individuals older than 65 years – will increase. A previous survey examining a 14-year trend of the homeless populace revealed that most derelicts were aging by two-thirds of every calendar year (“Permanent supportive housing,” 2018). Migrant workers, asylum seekers, and refugees will also constitute a considerable portion of the vagabond population. According to the World Bank projections, 140 million people living in Latin America, sub-Saharan Africa, and South Asia will be forced to migrate to developed countries due to inhabitable living conditions caused by climate change (Lassey & Turunen, 2019). Experts predict conflicts, marginalization, and stigmatization caused by the migrations.
As the pressure to provide affordable housing increases, governments will be forced to stabilize housing. It is presumed that similar to the 60s and 70s, individuals and families will spend only 25 % of their income on housing (Lassey & Turunen, 2019). The current political climate across North America and Europe provide little-to-no hope regarding the potential improvement of homelessness. Following the Chinese-American Covid-19 Conflict, the economy is expected to experience a negative turn. Unemployment, economic crises, and poverty are expected to rise due to these unprecedented changes, which will increase the prevalence of homelessness. It is also estimated that family homelessness will increase from 143,000 to 215,000 between 2016 and 2031 and then to 365,000 in 2041 (Lassey & Turunen, 2019). However, optimists predict an improvement in homelessness upon the implementation of integrated systems such as the Housing First program.
Housing First is a program that provides supportive services and housing assistance to homeless people without requiring proof of participation in treatment services. This strategy is guided by the notion that humans need fundamental necessities, including food and shelter before attending to other obligations. The U.S is already taking a preventive approach to protect at-risk individuals from being homeless. According to homelessness optimists, this preventative approach is a positive development towards improving the country’s homeless situation (Lassey & Turrunen, 2019). Support for homeless people will also include psychosocial support for vulnerable populations in addition to housing assistance. The government should take appropriate measures to address the structural and systematic needs for social and housing infrastructure.
References
Lassy, J., & Turunen, S. (2019). Homelessness in 2030. Y-Foundation [PDF file].
Rajasekaran, P., Treskon, M., & Greene, S. (2019). Rent control: What does the research tell us about the effectiveness of local action? Research to Action Lab: Urban Institute [PDF File].
Permanent supportive housing: Evaluating the evidence for improving health outcomes among people experiencing chronic homelessness (2018). National Academies Press (U.S.). State of homelessness: 2020 edition. (2020). National Alliance to End Homelessness. Web.