Homelessness in the United States
Homelessness in the United States is an area of concern for social service providers, government officials, policy professionals, and humanity. The number of homeless people grew in the 1980s, as housing and social service cuts increased and the economy deteriorated. The United States government determined that somewhere between 200,000 and 500,000 Americans were then homeless. There are some U.S. federal programs that could be said to help to end and prevent homelessness, although there are no homeless-related programs in the Office of Management and Budget.
There were about 643,000 sheltered and unsheltered homeless persons nationwide in January 2009. Almost two-thirds stayed in an emergency shelter or transitional housing program and the other third were living on the street, in an abandoned building, or another place not meant for human habitation. About 1.56 million people, or about 0.5% of the U.S. population, used an emergency shelter or a transitional housing program between October 1, 2008 and September 30, 2009.
According to the United States Conference of Mayors, in 2008 the three most commonly cited causes of homelessness for persons in families were lack of affordable housing, cited by 72 percent of cities, poverty (52%), and unemployment (44%), and top ideas to stop homelessness were more housing for persons with disabilities (72%), more or better paying employment opportunities (68%), and more mainstream assisted housing (64%).
Over the past decades or so, the availability and quality of data on homelessness has improved considerably, due in part to initiatives by the US Department of Housing and Urban Development (HUD), the US Department of Health and Human Services, the US Department of Veterans Affairs, and several nongovernmental organizations working with homeless populations. Since 2007, the US Department of Housing and Urban Development has issued an Annual Homeless Assessment Report, which reports to Congress the number of individuals and families who are homeless in the previous year, both sheltered and unsheltered, in order to standardize data and collection processes for government officials and service providers.
- An individual who lacks a fixed, regular, and adequate nighttime residence;
- An individual who has a primary nighttime residence that is--
- A supervised publicly or privately operated shelter designed to provide temporary living accommodations (including welfare hotels, congregate shelters, and transitional housing for the mentally ill);
- An institution that provides a temporary residence for individuals intended to be institutionalized; or
- A public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human
- The deinstitutionalization movement from the 1950s onwards in state mental health systems, to shift towards 'community-based' treatment of the mentally ill, as opposed to long-term commitment in institutions.
- Redevelopment and gentrification activities instituted by cities across the country through which low-income neighborhoods are declared blighted and demolished to make way for projects that generate higher property taxes and other revenue, creating a shortage of housing affordable to low-income working families, the elderly poor, and the disabled.
- The failure of urban housing projects to provide safe, secure, and affordable housing to the poor.
- The economic crises and "stagflation" of the 1970s, which caused high unemployment. Unlike European countries, US unemployment insurance does not allow unemployed insurance recipients to obtain job training/education while receiving benefits except under very limited situations.
- The failure of the U.S. Department of Veterans Affairs to provide effective mental health care and meaningful job training for many homeless veterans, particularly those of the Vietnam War.
- Deprived of normal childhoods, nearly half of foster children in the United States become homeless when they are released from foster care at age 18.
- Natural disasters that destroy homes: hurricanes, floods, earthquakes, etc. Places of employment are often destroyed too, causing unemployment and transience.
- People who have served time in prison, have abused drugs and alcohol, or have a history of mental illness find it difficult to impossible to find employment for years at a time because of the use of computer background checks by potential employers.
- According to the Institution of Housing in 2005, the U.S. Government has focused 42% more on foreign countries rather than homeless Americans, including homeless veterans.
- People who are hiding in order to evade law enforcement.
- Women and children who flee domestic violence.
- Teenagers who flee or are thrown out by parents who disapprove of their child's sexual orientation or gender identity. A 2010 study by the left wing Center for American Progress shows that a disproportionately high number of homeless youth (between 20–40%) identify as LGBTQ.
- Overly complex building code that makes it difficult for most people to build. Traditional huts, cars, and tents are illegal, classified as substandard and may be removed by government, even though the occupant may own the land. Land owner cannot live on the land cheaply, and so sells the land and becomes homeless.
- Foreclosures of homes (properties)
- Evictions from apartments
- Lack of support from friends or family
- Lack of resources in place in the communities to help aid in prevention of homelessness before it becomes a crisis.
According to the U.S. Conference of Mayors, the demand for emergency shelter in 270 U.S. cities increased 13% in 2001 and 25% in 2005. 22 percent of those requesting emergency shelter were turned away. Traditionally single men have constituted the majority of the homeless. In the 1980s there was a sharp rise in the number of homeless families in certain parts of the United States; notably New York City. Most homeless families consist of a single mother and children. A significant number of homeless people are teenagers and young adults, mostly runaways or street children. A 1960 survey by Temple University of Philadelphia's poor neighborhoods found that 75% of the homeless were over 45 years old, and 87% were white. In 1986, 86% were under age 45, and 87% were minorities.
According to the US Department of Housing and Urban Development's 2008 Annual Homeless Assessment Report, the most common demographic features of all sheltered homeless people are: male, members of minority groups, older than age 31, and alone. More than two-fifths of sheltered homeless people have a disability. At the same time, sizable segments of the sheltered homeless population are white, non-Hispanic (38 percent), children (20 percent), or part of multi-person households (33 percent). Approximately 68 percent of the 1.6 million sheltered homeless people were homeless as individuals and 32 percent were persons in families.
In 2008 more than two-thirds of all sheltered homeless people were located in principal cities, with 32 percent located in suburban or rural jurisdictions. About two-fifths of people entering an emergency shelter or transitional housing program during 2008 came from another homeless situation (sheltered or unsheltered), two-fifths came from a housed situation (in their own or someone else's home), and the remaining one-fifth were split between institutional settings or other situations such as hotels or motels. Most people had relatively short lengths of stay in emergency shelters: three-fifths stayed less than a month, and a third stayed a week or less.
Statistics and demographics 
Completely accurate and comprehensive statistics are difficult to acquire for any social study, but especially so when measuring the ambiguous hidden, and erratic reality of homelessness. All figures given are estimates. In addition, these estimates represent overall national averages; the proportions of specific homeless communities can vary substantially depending on local geography.
2009 Annual Homeless Assessment Report to Congress 
Perhaps the most accurate, comprehensive, and current data on homelessness in the United States is reported annually by the Department of Housing and Urban Development (HUD) in the Annual Homeless Assessment Report to Congress (AHAR), released in June of every year since 2007. The AHAR report relies on data from two sources: single-night, point-in-time counts of both sheltered and unsheltered homeless populations reported on the Continuum of Care applications to HUD; and counts of the sheltered homeless population over a full year provided by a sample of communities based on data in their local Homeless Management Information Systems (HMIS).
International context 
The United States HUD estimated 650,000 absolute homeless (on the street or in temporary shelters) on a given night in 2009 out of a population of approximately 300 million.
Canada has no official data on the total number of homeless nationwide, but Statistics Canada put the number in homeless shelters at 20,000 in 2006. The number of Canadians living in absolute homelessness or "in over crowded or unsuitable accommodations" was estimated to be 150,000, although the criteria used are more broad than that used by the U.S. HUD. A homeless advocacy group estimated the number of Canadians in absolute homelessness in 2000 at 35,000 to 40,000 out of a population of 35 million.
Australia estimated 105,000 homeless in the 2006 census out of a population of ~20 million, however criteria used differ greatly from that used by the U.S. HUD, and only 36% of the total were on the street or in temporary shelters. (the rest were housed with friends & family or in long-term boarding houses)
Other statistics 
Some estimates from various sources on the characteristics and number of homeless people:
- Total Number
- As many as 3.5 million people experience homelessness in a given year (1% of the entire U.S. population or 10% of its poor), and about 842,000 people in any given week. Most were homeless temporarily. The chronically homeless population (those with repeated episodes or who have been homeless for long periods) fell from 175,914 in 2005 to 123,833 in 2007.
- Familial composition
- 23% are families with children—the fastest growing segment.
- 51.3% are single males.
- 24.7% are single females.
- 5% are minors unaccompanied by adults.
1.37 million (or 39%) of the total homeless population are children under the age of 18.
- Marital status
- 24% are married.
- 76% are single.
- 67.5% are single males within the single percentage.
- 32.5% are single females within the single percentage.
- 42% are African American (over-represented 3.23x compared to 13% of general population).
- 38% are Caucasian (under-represented 0.53x compared to 72% of general population).
- 20% are Hispanic (over-represented 1.25x compared to 16% of general population).
- 4% are Native American (over-represented 4x compared to 1% of general population).
- 2% are Asian-American (under-represented 0.4x compared to 5% of general population).
- 39% report some form of mental health problems
- 22% are considered to have serious mental illnesses, or are disabled.
- 38% have alcohol abuse problems.
- 26% have other substance abuse problems.
- 3% report having HIV/AIDS.
- 26% report acute health problems other than HIV/AIDS such as tuberculosis, pneumonia, or sexually transmitted infections.
- 46% report chronic health conditions such as high blood pressure, diabetes, or cancer.
- 55% report having no health insurance (compared to 27% of general population).
- 58% report having trouble getting enough food to eat.
- 38% have less than a High School diploma.
- 34% have a High School diploma or equivalent (G.E.D.).
- 28% have more than a High School education.
- 44% report having worked in the past week.
- 13% have regular jobs.
- 50% receive less than $300 per month as income.
- 70% work on street corners, pan-handling or prostituting themselves.
- 80% of those who experience homelessness do so for less than 3 weeks. They typically have more personal, social, or economic resources to draw upon.
- 10% are homeless for up to two months. They cite lack of available or affordable housing as responsible for the delay.
- 10% are so called "chronic" and remain without housing for extended periods of time on a frequent basis. They typically struggle with mental illness, substance abuse, or both.
Historical background 
Many towns and cities had an area which contained the poor, transients, and afflicted, such as a "skid row". In New York City, for example, there was an area known as "the Bowery", traditionally, where alcoholics were to be found sleeping on the streets, bottle in hand. Rescue missions offering "soup, soap, and salvation", a phrase introduced by The Salvation Army, sprang up along the Bowery thoroughfare, including the oldest one, The Bowery Mission. The mission was founded in 1879 by the Rev. and Mrs. A.G. Ruliffson.
The mission's parent organization, Christian Herald, once published Christian Herald And Signs of Our Times. In relating the formation and origin of the mission in its March 27, 1895 edition a chronology is given: "Fifteen years ago, Rev. A.G. Ruliffson and Mrs. Ruliffson, long engaged in mission work in New York, decided to open an eastside mission for men." Thus, based on this chronology, the time frame is 1880 rather than 1879.
At the time the Bowery Mission was established it was located at 36 Bowery, a location that in an earlier time in New York City, played a role in the New York City Draft Riots, when the building was used as a saloon. An examination of the Annual Reports for the first decade of the mission, and period New York City newspapers starting in 1881, suggest that an 1880 date for the mission is more likely than 1879. To cite examples from period newspapers, The New York Tribune's article, "The Bowery Mission, A Sketch of its Career", dated March 14, 1898 opens with "The Bowery Mission was started in 1880 at No.36 Bowery by a number of men who were interested in mission work." An even earlier article appearing in The New York Tribune on November 8, 1880, "A Bright Spot In The Darkness", declared "The Bowery Evangelical Mission, at No.36 Bowery, was opened yesterday afternoon with a prayer-meeting, at which some 150 persons were present." The present location of the Bowery Mission at 227–229 Bowery dates to 1909 when an abandoned coffin factory was converted to a mission.
In smaller towns, there were hobos, who temporarily lived near train tracks and hopped onto trains to various destinations. Especially following the American Civil War, a large number of homeless men formed part of a counterculture known as "hobohemia" all over America.
Jacob Riis wrote about, documented, and photographed the poor and destitute, although not specifically the homeless, in New York City tenements in the late 19th century. His ground-breaking book, How the Other Half Lives, published in 1890, raised public awareness of living conditions in the slums, causing some changes in building codes and some social conditions.
In the 1930s, the Great Depression caused the return of hobos. There were two million homeless people migrating around the country. One visible effect of the depression was the advent of Hoovervilles. Residents lived in shacks and begged for food or went to soup kitchens. Authorities did not officially recognize these Hoovervilles and occasionally removed the occupants for technically trespassing on private lands, but they were frequently tolerated out of necessity.
1960s, 1970s 
In the United States, during the late 1970s, the deinstitutionalization of patients from state psychiatric hospitals was a precipitating factor which seeded the homeless population, especially in urban areas such as New York City.
The Community Mental Health Act of 1963 was a pre-disposing factor in setting the stage for homelessness in the United States. Long term psychiatric patients were released from state hospitals into Single Room Occupancies and sent to community health centers for treatment and follow-up. It never quite worked out properly and this population largely was found living in the streets soon thereafter with no sustainable support system.
In 1965, The Diggers, a community-action group dedicated to the concept of everything being free of charge, established soup kitchens and free health-care facilities in the Haight-Ashbury district of San Francisco. This also began a movement of people that began to travel for political reasons as well as for personal choices. This is where the beginnings of the American nomadic caravans became popular, living homelessly, but happily.
In 1969 the Pine Street Inn was founded by Paul Sullivan on Pine Street in Boston's Chinatown district and began caring for homeless destitute alcoholics. In 1980, it moved to larger facilities on Harrison Avenue in Boston due to growing needs of the homeless population.
In 1974, Kip Tiernan founded Rosie's Place in Boston, the first drop-in and emergency shelter for women in the United States, in response to the increasing numbers of needy women throughout the country.
In 1979, a New York City lawyer, Robert Hayes, brought a class action suit before the courts, Callahan v. Carey, against the City and State, arguing for a person's state constitutional "right to shelter". It was settled as a consent decree in August 1981. The City and State agreed to provide board and shelter to all homeless men who met the need standard for welfare or who were homeless by certain other standards. By 1983 this right was extended to homeless women.
||The neutrality of this section is disputed. (November 2012)|
The History of the United States (1980–1991) illustrates that this was a time when there was economic distress, high unemployment, and was the period when chronic homelessness became a modern problem. In 1980 federal funds accounted for 22% of big city budgets, but by 1989 the same such aid composed only 6% of urban revenue (part of a larger 60% decrease in federal spending to support local governments). It is largely (although not exclusively) in these urban areas that homelessness became widespread and reached unprecedented numbers.
Most notable were cuts to federal low-income housing programs. An advocacy group claims that Congress halved the budget for public housing and Section 8 (the government's housing voucher subsidization program) and that between the years of 1980 and 1989 HUD's budget authority was reduced from $74 billion to $19 billion. Such alleged changes is claimed to have resulted in an inadequate supply of affordable housing to meet the growing demand of low-income populations. In 1970 there were 300,000 more low-cost rental units (6.5 million) than low-income renter households (6.2 million). By 1985 the advocacy group claimed that the number of low-cost units had fallen to 5.6 million, and the number of low-income renter households had grown to 8.9 million, a disparity of 3.3 million units
The 1980s also saw a continuing trend of deinstitutionalizing mental-health hospitals. It is believed[who?] that a large percentage of these released patients ended up in the homeless system.
Many existing shelters and soup kitchens had to expand their facilities to accommodate the larger number of homeless. For example, in 1980, the Pine Street Inn had to move to larger facilities on Harrison Avenue in Boston and in 1984, Saint Francis House had to move its operation from the St. Anthony Shrine on Arch Street to an entire ten-floor building on Boylston Street.
The January 2, 1984 issue of Newsweek magazine had a front cover of the Reynolds family in Galveston, Texas, with the cover title, "Homeless in America", thereby bringing the homelessness issue to continued national attention.
In response to the ensuing homelessness crisis of the 1980s, concerned citizens across the country[who?] demanded that the federal government provide assistance. After many years of advocacy and numerous revisions, President Reagan signed into law the McKinney-Vento Homeless Assistance Act in 1987—this remains the only piece of federal legislation that allocates funding to the direct service of homeless people.
By the mid-1980s, there was also a dramatic increase in family homelessness. Tied into this was an increasing number of impoverished and runaway children, teenagers, and young adults, which created a new sub-stratum of the homeless population.
The McKinney-Vento Act paved the way for service providers in the coming years. During the 1990s homeless shelters, soup kitchens, and other supportive services sprouted up in cities and towns across the nation. However, despite these efforts and the dramatic economic growth marked by this decade, homeless numbers remained stubbornly high. It became increasingly apparent that simply providing services to alleviate the symptoms of homelessness (i.e. shelter beds, hot meals, psychiatric counseling, etc.), although needed, were not successful at solving the root causes of homelessness.
Throughout this decade, homeless service providers and the Federal government have been able to reduce chronic homelessness and homelessness among Veterans with targeted efforts and interagency cooperation on initiatives like the HUD-VASH program. The 2000s, however, saw a new population of those experiencing homelessness: families with children. While an emerging problem at the beginning of the decade, the problem continued to persist through 2010. At the close of the decade the trend continued unabated, with the number of individuals in homeless families increasing from 431,541 in 2007 to 535,447 in 2009.
Another emerging concern at the onset of this decade was the disproportionate representation of the LGBTQ community among the population of unaccompanied youth experiencing homelessness. In 2002, activist and youth advocate Carl Siciliano founded the Ali Forney Center—a homeless shelter in New York City that is dedicated specifically to providing aid and shelter to homeless and at-risk LGBTQ youth. The center takes its name from a homosexual teenager who lived on the streets for much of the 1990s. While homeless, Ali Forney protected other LGBTQ homeless youth by performing HIV prevention and awareness work. He also urged the NYPD to investigate the murders of several homosexual homeless youth whom he had befriended during his time on the street. In 1997, Ali Forney was himself murdered by an attacker who has not yet been identified. However, Ali's outreach and advocacy work inspired Carl Siciliano to found an organization dedicated to improving the lives of LGBTQ homeless youth in New York. The Ali Forney Center provides both emergency and transitional housing for homosexual homeless youth, whose numbers account for anywhere between 20–40% of the 2.1 million homeless youth in America. The percentage of LGBTQ homeless youth is much higher than that of the general population, which runs between 5–10%. The work of the Ali Forney Center is one example of the ways that the social service community has responded to the needs of growing sub-populations of those experiencing homelessness.
In 2001, the NAEH along with the U.S. ICH encouraged communities to create and implement state and local strategic plans to prevent and end homelessness, focusing on Housing First initiatives to house the chronically homeless population who have many barriers to stability, a cost-benefit analysis of state- and local-level resources, best practice engagement and service innovations, and prevention. Many communities and states across the country have created these plans and have set up measurable goals and targets for the short- and long-term.
In February 2009, President Obama signed the American Recovery and Reinvestment Act of 2009, which was part of the President's effort to save or create 3.5 million jobs in the United States to mitigate the effects of the economic recession begun in 2008. Part of the Act addressed homelessness prevention, in which he allocated an additional $1.5 billion to HUD for the "Homelessness Prevention and Rapid Rehousing Program (HPRP)." The purpose of HPRP was to assist individuals and families who are otherwise healthy and not chronically homeless in escaping homelessness or preventing homelessness of the vulnerable population. HPRP grant monies were distributed to localities in the same formula used for Emergency Shelter Grants (ESG) in amounts not to exceed $500,000 and must be used within three years. Primary grantee activities include short-term and medium-term rental assistance and housing relocation and stabilization services, including mediation, credit counseling, security or utility deposits, utility payments, moving cost assistance, and case management.
On May 20, 2009, President Obama signed the Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act into Public Law (Public Law 111-22 or "PL 111-22"), reauthorizing HUD's Homeless Assistance programs. It was part of the Helping Families Save Their Homes Act of 2009. The HEARTH act allows for the prevention of homelessness, rapid re-housing, consolidation of housing programs, and new homeless categories. In the eighteen months after the bill's signing, HUD had to begin implementing the new McKinney-compliant programs. In late 2009, some homeless advocacy organizations, such as the National Coalition for the Homeless, reported and published perceived problems with the HEARTH Act of 2009 as a HUD McKinney-Vento Reauthorization bill, especially with regard to privacy, definitional ineligibility, community roles, and restrictions on eligibile activities. However, at the close of 2010 HUD reported that many communities had successfully used HPRP funds to assist those in need in their communities, and reported that the program prevented homelessness for nearly 750,000 Americans.
The Federal government contains one agency that focuses on the issue of homelessness in America, and it has had a much greater role in the policy community since its revitalization at the beginning of the decade and its continued appropriations in the HEARTH Act. The United States Interagency Council on Homelessness (USICH),a federal agency contained in the Executive Branch, was established in 1987 as a requirement of the McKinney-Vento Act of 1987. Since its revitalization in 2001 as an agency independent from the Executive Office of the President and reauthorization in 2009, USICH serves as the coordinating body of all 19 federal agencies and their programs and initiatives to serve the homeless population. Its mission is to, "coordinate the Federal response to homelessness and to create a national partnership at every lever of government and with the private sector to reduce and end homelessness in the nation while maximizing the effectiveness of the Federal Government in contributing to the end of homelessness." USICH has taken on a much greater role in Federal-level initiatives to end homelessness in the United States since exiting the Executive Office of the President and notably since the enactment of the HEARTH Act, in which it was mandated that USICH provide leadership in developing a national strategic plan to prevent and end homelessness. Since its authorization as an independent agency, USICH been able to work with stakeholders across all government sectors and at all levels to promote collaboration and best practices within the homeless service provider community.
The first year of the new decade saw a renewed commitment from the Federal government in its efforts to prevent and end homelessness with the creation and release of Opening Doors: The Federal Strategic Plan to Prevent and End Homelessness. Opening Doors is a publication of the U.S. Interagency Council on Homelessness, which worked with all Federal agencies and many state and local stakeholders on its creation and vision, setting a ten-year path for the nation on preventing and ending all types of homelessness. This Plan was presented to the President and Congress in a White House Ceremony on June 22, 2010.
The Vision of the Plan is: "No one should experience homelessness – no one should be without a safe, stable place to call home."
This document focuses on four main goals:
- Finish the job of ending chronic homelessness in the next five years (2015)
- Prevent and end homelessness among Veterans in five years (2015)
- Prevent and end homelessness for families, children and youth in ten years (2020)
- Set a path to ending all types of homelessness
The most recent Point-In-Time Count by HUD took place the second two weeks of January 2011, and data reported at that time and gathered from Continuum of Care providers in local communities will be used to compile the 2010 Annual Homelessness Assessment Report to be released in the middle of 2011.
"In 2004 the United States Conference of Mayors... surveyed the mayors of major cities on the extent and causes of urban homelessness and most of the mayors named the lack of affordable housing as a cause of homelessness.... The next three causes identified by mayors, in rank order, were mental illness or the lack of needed services, substance abuse and lack of needed services, and low-paying jobs. The lowest ranking cause, cited by five mayors, was prisoner reentry. Other causes cited were unemployment, domestic violence, and poverty."
- Housing opportunities
Many workers cannot afford to live where they work, and even in moderately priced communities housing costs require a large portion of household income.
Personal factors 
- Untreated mental illness, and disability can cause individuals to become paranoid, anxious, or depressed, making it difficult or impossible to maintain employment, pay bills, or keep supportive social relationships.
- Substance abuse can drain financial resources, cause job or housing loss, and erode supportive social relationships. Substance abuse is quite prevalent in the homeless population.
- Many people (especially women and often with children) who flee from domestic violence often must quickly adapt to massive life changes. Many find it extremely difficult to secure a new place of residence and/or a job.
- Institutional release. Most individuals being discharged from prison have few resources to "get back on their feet" and have eroded personal contacts that may provide support. Youths who "age out" of systems such as foster care often find themselves without needed support networks.
Lastly, it should be mentioned that some people find themselves homeless due to unexpected extenuating circumstances:
- Natural disasters: Many people lose their homes to any variety of natural catastrophes including but not limited to: floods, forest fires, storms, and earthquakes. In 2005 hurricanes Katrina and Rita displaced over 1 million Americans. Tornadoes destroyed entire towns in Tennessee in 2006.
- Unexpected emergencies: A variety of people find themselves unable to cope with any number of the following sudden tragedies: being laid off from a long-term place of employment; losing their place of residence to an accidental fire; serious bodily injuries; discovery of terminal illnesses or diseases; loss of family member(s). These situations usually result not only in significant monetary expenses, but also in severe psychological and emotional hardships.
- More affordable housing
Homeless individuals report a lack of affordable housing as the number one reason for becoming homeless. This inadequacy must be remedied in order to get people off the streets and out of shelters. Many non-profit organizations are in operation to serve this need—for example, the National Low Income Housing Coalition—but most lack the funding necessary to create enough housing. Several proposed policy measures are designed to secure such funding, such as the National Housing Trust Fund, but these have not been signed into law.
- Comprehensive health care
Homeless individuals report mental illness as being the number three reason for becoming or staying homeless. Such illnesses are often closely linked with the fourth reason—substance abuse—and therefore it is generally accepted that both of these issues should be treated simultaneously. Although many medical, psychiatric, and counseling services exist to address these needs, it is commonly believed that without the support of reliable and stable housing such treatments remain ineffective. Furthermore, in the absence of a universal health-care plan, many of those in need cannot afford such services. Legislation such as the Bringing America Home Act, if enacted, would provide comprehensive and available treatment for all.
- Paradigm shift
A significant paradigm has occurred in homeless services over the past five years which has begun to shift the emphasis from "managing the problem of homelessness" with emergency shelters, soup kitchens and health clinic to ending homelessness by housing individuals who are experiencing homelessness. In 2000, the National Alliance to End Homelessness released "A Plan, Not a Dream: How to End Homelessness in Ten Years" which encouraged communities to develop and implement 10 year plans to end homelessness in their communities.
Key effective programs include:
- Shelter Plus Care – a federal program that provides housing subsidies and are matched by local funds to provide long-term supportive services (typically case management). Experience demonstrated that many individuals who have been homeless for a significant time often lose their housing shortly after placement. The Shelter Plus Care program provides long-term supports including working with the landlord to keep the individual housed.
- Housing First – a service paradigm that assumes that individuals who are homeless are "ready" to be housed immediately and with appropriate supports can retain their housing. The Pathways to Housing project in New York demonstrated a five-year housing retention rate of 88 percent among formerly homeless individuals with serious mental illness. Homeless people seeking help are often required to participate in substance abuse, mental health, and life skills programs of a year or more regardless of whether those are factors in their case. Many people only need decent housing to get back on their feet. Central City Concern's (Portland, Oregon) Shoreline Project allows homeless unemployed men to move into SRO type single person studios and find a job within 70 days; it's been a great success with expected expansion of the program in 2007.
- Assertive Outreach – a form of engagement and outreach that emphasizes building a bond of trust between the case worker and the individual. Engagement is highly individualized with the pace dictated by the individual in need. Case workers do not force rules, regulations or program services until they are requested. Typically used to engage homeless, mentally ill individuals.
In Boston, Massachusetts, in September 2007, an outreach to the homeless was initiated in the Boston Common, after some arrests and shootings, and in anticipation of the cold winter ahead. This outreach targets homeless people who would normally spend their sleeping time on the Boston Common, and tries to get them into housing, trying to skip the step of an emergency shelter. Applications for Boston Housing Authority were being handed out and filled out and submitted. This is an attempt to enact by outreach the Housing First initiative, federally mandated. Boston's Mayor, Thomas Menino, was quoted as saying "The solution to homelessness is permanent housing". Still, this is a very controversial strategy, especially if the people are not able to sustain a house with proper community, health, substance counseling, and mental health supportive programs.
Effects on education/homeless students 
Homelessness has a tremendous effect on a child's education. Education of homeless youth is thought to be essential in breaking the cycle of poverty. The McKinney-Vento Homeless Assistance Act mandates equal opportunity to a free public education to homeless students. This act is supposed to break down the barriers homeless students have to receiving an education. These barriers include residency restriction, medical record verification, and transportation issues. Once a student surpasses these barriers, they are still subject to the stigma of being homeless, and the humiliation they feel because of their situation. Some families do not report their homelessness, while others are unaware of the opportunities available to them. Many report that maintaining a stable school environment helps the students because it's the only thing that remains normal. Many homeless students fall behind their peers in school due to behavioral disorders, and lack of attendance in school.
Since the housing market fall out there has been a rise in the number of homeless students. NAEHCY or the National Association for the Education of Homeless for Children and Youth, has reported a 99% increase in homeless students within a three-month period (San Diego).
Of 1,636 schools, 330 reported no increase, 847 reported an increase of half, and 459 reported an increase of 25% or more. Due to the provisions of the McKinney-Vento Act many school districts are struggling to provide the necessary services, such as rising transportation needs and the greater severity of services.
One of the biggest challenges our district faces is providing transportation to students who are experiencing homelessness. There are few approaches that our district can utilize to provide transportation for these students. Our city has only one taxi cab service and no public bus system. Our cab company is small and simply cannot fulfill all of our transportation requests. When it's possible, we add students to existing bus routes or set up a contractual agreement with the student's parent/guardian. However, there have been many situations where none of these options have worked. Another challenge our district faces is providing proper outer-wear for students who are homeless. Being that we live in central Wisconsin and have long, cold winters, all students need proper outerwear to go outside. Proper outerwear includes snow boots, hat, mittens, snow pants, and a winter jacket that has a working zipper or buttons on it. This expense adds up quickly and is hard to provide to the increasing number of homeless students.
This is especially worrisome since homeless students are 1) 1.5 times more likely to perform below grade level in reading; 2)1.5 times more likely to perform below grade level in spelling; and 3) 2.5 times more likely to perform below grade level in math. There are a few worries that there will be false reports of homeless students, but mostly it's not an issue.
Public attitudes 
Many advocates for the homeless contend that a key difficulty is the social stigma surrounding homelessness. There is anecdotal evidence that many Americans complain about the presence of homeless people, blame them for their situation, and feel that their requests for money or support (usually via begging) are unjustified. In the 1990s, particularly, many observers and media articles spoke of "compassion fatigue" a belief that the public had grown weary of this seemingly intractable problem.
Public opinion surveys show relatively little support for this view, however. A 1995 paper in the American Journal of Community Psychology concluded that "although the homeless are clearly stigmatized, there is little evidence to suggest that the public has lost compassion and is unwilling to support policies to help homeless people." A Penn State study in 2004 concluded that "familiarity breeds sympathy" and greater support for addressing the problem.
A 2007 survey of New Yorkers found 67 percent said most homeless people were without shelter because of "circumstances beyond their control." More than one-third (36 percent) said they worried about becoming homeless themselves, with 15 percent saying they were "very worried." The survey by the nonpartisan group Public Agenda found support for investments in prevention, rental assistance and permanent housing.
Public Agenda has also concluded, however, that the public's sympathy has limits. In a 2002 national survey, the organization found 74 percent say the police should leave a homeless person alone if he or she is not bothering anyone. Yet 71 percent say the police should move the homeless if they are keeping customers away from a shopping area and 51 percent say the homeless should be moved if they are driving other people away from a public park.
Homeless assistance programs 
The homeless community of the United States is aided in many ways from governmental and non-governmental organizations. Non-governmental organizations help the homeless by advocating or by physical and financial aid. Organizations like the [National Alliance to End homelessness] go to government officials and offices to speak on behalf of the homeless community calling for policy changes or for the creation of policy to help end homelessness. Government agencies respond. The following programs and policies acknowledge the phenomenon of homelessness, provide help to the homeless, and prevent further growth of the homeless population.
Many programs that are designed to assist the homeless population have incorporated some type of housing program for their clients. Whether it is a transitional, permanent or even emergency housing program, the assistance is often provided for a very low cost and maybe even free. In the United States each year, there are around 3.5 million people who live their lives without shelter or a stable occupation. For 2006 alone, $28.5 billion was allotted to homeless programs ran through HUD (Housing and Urban Development), $1 billion was given for Section 8 housing, and $1.4 billion was used for Homeless Assistance Grants. As one example, Volunteers of America is an agency that believes preventing family homelessness is a critical part of their organization. Through them, transitional housing and emergency shelters are available to those who are in desperate need.
The two main types of housing programs provided for homeless people are:
- Transitional housing programs are operated with one goal in mind – to help individuals and families obtain permanent housing as quickly as possible. Transitional housing programs assist homeless for a fixed amount of time or until they are able to obtain housing on their own and function successfully in the community, or whichever comes first.
- For a significant number of homeless Americans with mental or physical impairments, often coupled with drug and/or alcohol use issues, long-term homelessness can only be ended by providing permanent housing coupled with intensive supportive services. Permanent housing provides a "base" for people to move out of poverty.
Some shelters and associated charitable foundations have bought buildings and real estate to develop into permanent housing for the homeless in lieu of transitional Housing.
The United States Department of Housing and Urban Development and Veterans Administration have a special Section 8 housing voucher program called VASH (Veterans Administration Supported Housing), or HUD-VASH, which gives out a certain number of Section 8 subsidized housing vouchers to eligible homeless and otherwise vulnerable US armed forces veterans.
- Substance abuse prevention
Without supportive services, housing is not often enough to end homelessness. Various agencies, in fact all homeless prevention agencies and programs include substance abuse recovery and prevention programs. Objectives are to provide substance abuse counseling and access to treatment centers.
For a significant number of homeless Americans with mental or physical impairments, often coupled with drug and/or alcohol use issues, long-term homelessness can only be ended by providing permanent housing coupled with intensive supportive services.
There are several policies dealing with homelessness. In 1980 the government decided to start sending funding to the homeless, but it was not until 1984 that shelters were built to accommodate and feed them. As it was shown though seventy percent required the homeless to attend a religious ceremony and spend only a couple of nights there. In the 1987 McKinney Act the problem with homelessness became known as a huge social problem. Later on, the No Child Left Behind Act of 2001 (P.L. 107-110) amended the program explicitly to prohibit states that receive McKinney-Vento funds from segregating homeless students from non-homeless students, except for short periods of time for health and safety emergencies or to provide temporary, special, supplementary services. The Chronic Homelessness Initiative. The Bush Administration established a national goal of ending chronic homelessness in ten years, by 2012. The idea of a 10-year plan to end chronic homelessness began as a part of a 10-year plan to end homelessness in general adopted by the National Alliance to End Homelessness (NAEH) in 2000. The following year, then-Secretary Martinez announced HUD's commitment to ending chronic homelessness at the NAEH annual conference. In 2002, as a part of his FY2003 budget, President Bush made "ending chronic homelessness in the next decade a top objective." The bi-partisan, congressionally mandated, Millennial Housing Commission, in its Report to Congress in 2002, included ending chronic homelessness in 10 years among its principal recommendations. By 2003, the Interagency Council on Homelessness had been re-engaged and charged with pursuing the President's 10-year plan. The Administration has recently undertaken some collaborative efforts to reach its goal of ending chronic homelessness in 10 years. On October 1, 2003, the Administration announced the award of over $48 million in grants aimed at serving the needs of the chronically homeless through two initiatives. The "Ending Chronic Homelessness through Employment and Housing" initiative was a collaborative grant offered jointly by HUD and the Department of Labor (DOL). The initiative offered $10 million from HUD and $3.5 million from DOL to help the chronically homeless in five communities gain access to employment and permanent housing. Section 8 is the core housing program that helps extremely low-income families accommodate the gap between their incomes below 30 percent of the median income for each community. The government assists homeless families by awarding grants and vouchers. Vouchers are available to the families who are most needy and they are used to pay for housing found in the private market. Currently there are policy changes in who receives vouchers and there will be a reduction in the amount of vouchers granted to the homeless population.
On May 20, 2009, President Barack Obama signed the Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act of 2009. The HEARTH Act amends and reauthorizes the McKinney-Vento Homeless Assistance Act with substantial changes. The HEARTH Act of 2009 consolidated HUD's competitive grant programs, created a Rural Housing Stability Program, changed HUD's definition of homelessness and chronic homelessness, supplied a simplified match requirement, increased prevention resources and increased in the emphasis on performance. The primary purpose of the legislation was to provide principal definitions regarding homelessness. The following terms: "homeless," "homeless individual," "homeless person," and "homeless individual with a disability."
Housing First 
Housing First is a relatively recent innovation that has met with success in providing housing to homeless people with substance abuse problems or mental health issues. Housing First allows homeless men and women to be taken directly off the street into private community-based apartments, without requiring treatment first. This allows the homeless to return to some sense of normalcy, from which it is believed that they are better-poised to tackle their addictions or sicknesses. The relapse rate through these types of programs is lower than that of conventional homeless programs.
It was initiated by the federal government's Interagency Council on Homelessness. It asks cities to come up with a plan to end chronic homelessness. In this direction, there is the belief that if homeless people are given independent housing to start off with, with some proper social supports, then there would be no need for emergency homeless shelters, which it considers a good outcome. This is a very controversial position. There are many complications of this kind of program and these must be dealt with to make such an initiative work successfully in the middle to long term.
Criminalization of homelessness 
Measures passed "prohibit activities such as sleeping/camping, eating, sitting, and begging in public spaces, usually including criminal penalties for violation of these laws." Violators of such laws typically incur criminal penalties, which result in fines and/or incarceration.
In April 2006 the Court of Appeals for the Ninth Circuit ruled that "making it a crime to be homeless by charging them with a crime is in violation of the 8th and 14th Amendments." However, on October 15, 2007, the Court vacated its Opinion when, on appeal the parties settled the case out of court.
The City could not expressly criminalize the status of homelessness by making it a crime to be homeless without violating the Eighth Amendment, nor can it criminalize acts that are an integral aspect of that status. Because there is substantial and undisputed evidence that the number of homeless persons in Los Angeles far exceeds the number of available shelter beds at all times, including on the nights of their arrest or citation, Los Angeles has encroached upon Appellants' Eighth Amendment protections by criminalizing the unavoidable act of sitting, lying or sleeping at night while being involuntarily homeless.
… the Eighth Amendment prohibits the City from punishing involuntary sitting, lying, or sleeping on public sidewalks that is an unavoidable consequence of being human and homeless without shelter in the City of Los Angeles.… By our decision, we in no way dictate to the City that it must provide sufficient shelter for the homeless, or allow anyone who wishes to sit, lie, or sleep on the streets of Los Angeles at any time and at any place within the City. All we hold is that, so long as there is a greater number of homeless individuals in Los Angeles than the number of available beds, the City may not enforce section 41.18(d) at all times and places throughout the City against homeless individuals for involuntarily sitting, lying, and sleeping in public.
In August 2007, in Boston, Massachusetts, the city took action to keep loiterers, including the homeless, off the Boston Common overnight, after a series of violent crimes and drug arrests.
Sex offender registration 
Sex offender registration has been noted for its effect on homeless sex offenders. Georgia's sex offender registration law, which declared that the homeless could not register and was punishable by life imprisonment, was invalidated by the Georgia Supreme Court in October 2008 for not giving homeless fair notice of how they could comply with the statute's registration requirement.
Crimes against homeless people 
Recent years have seen a growing number of violent acts committed upon people experiencing homelessness—the rate of such documented crimes in 2005 was 30% higher than of those in 1999. 75% of all perpetrators are under the age of 25.
In recent years, largely due to the efforts of the National Coalition for the Homeless (NCH) and academic researchers, the problem of violence against the homeless has gained national attention. In their report: Hate, Violence, and Death on Mainstreet USA, the NCH reported 386 violent acts committed against homeless persons over the period, among which 155 were lethal. The NCH called those acts hate crimes (they retain the definition of the American Congress). They insist that so called bumfight videos disseminate hate against the homeless and dehumanize them.
The Center for the Study of Hate & Extremism (CSHE) at California State University, San Bernardino in conjunction with the NCH found that 155 homeless people were killed by non-homeless people in "hate killings", while 76 people were killed in all the other traditional hate crime homicide categories such as race and religion, combined. The CSHE contends that negative and degrading portrayals of the homeless contribute to a climate where violence takes place.
Various studies and surveys indicate that homeless people have a much higher criminal victimization rate than the non-homeless, but that most incidents never get reported to authorities. On October 1, 2006 CBS News 60 Minutes telecast a story on "thrill" violence against the homeless and "Bumfights" videos. A 2007 study found that the number of violent crimes against the homeless is increasing.
Homeless bills of rights legislation 
Situations in specific U.S. cities 
Los Angeles 
The Los Angeles region is thought to have the largest concentration of homeless persons in the country and is considered the homelessness capital of the USA, together with San Francisco. In its biennial census of 2011, the County counted more than 51,000 homeless persons living in the county at any given night. One hundred thousands persons are expected to be homeless at least one night during the year. A 50-block area in downtown Los Angeles called Skid Row (4,316) has a homeless population nearly as large as the homeless population of San Francisco (6,455). Hollywood and the city of Santa Monica also suffer from visible homelessness. Los Angeles, of course, has approximately 3.6 times the population of San Francisco,. Proportionately Los Angeles has more homeless than San Francisco.
In 2009, the author Geoffrey Neil wrote a novel, Dire Means, whose underlying premise was about the homeless situation in Santa Monica, California.
San Francisco 
The city of San Francisco, California, due to its mild climate and its social programs that have provided cash payments for homeless individuals, is often considered the homelessness capital of the United States, together with Los Angeles. The city's homeless population has been estimated at 7,000–10,000 people, of which approximately 3,000–5,000 refuse shelter. The city spends $200 million a year on homelessness related programs. On May 3, 2004, San Francisco officially began an attempt to scale back the scope of its homelessness problem by changing its strategy from cash payments to the "Care Not Cash" plan. At the same time, grassroots organizations within the Bay Area such as the Suitcase Clinic work to provide referrals for housing and employment to the homeless population. In 2010, a city ordinance was passed to disallow sitting and lying down on public sidewalks for most of the day, from 7 am until 11 pm.
The city of Chicago, Illinois is also noted for its number of homeless people. Over the years, Chicago has gained a reputation as the city with the most homeless people, rivaling Los Angeles and New York, although no statistical data have backed this up. The reputation stems primarily from the subjective number of beggars found on the streets rather than any sort of objective statistical census data. Indeed, from statistical data, Chicago has far less homeless per capita than peers New York, and Los Angeles, or other major cities such as Philadelphia, San Francisco, and Boston, among others, with only 5,922 homeless recorded in a one night count taken in 2007.
Denver, Colorado 
While Mayor of Denver, Colorado, Colorado Governor John Hickenlooper made dealing with the issues that underlie homelessness a top priority on his Mayoral agenda, speaking heavily on the issue during his first "State of the City" address in 2003. While Denver's homeless population is much lower than other major cities, the homeless residents have often suffered when without shelter during Denver's infamously cold winters. Now officials have said that this number has risen over the past few years.
Indianapolis, Indiana 
In Indianapolis, Indiana, as many as 2,200 people are homeless on any given night, and as many as 15,000 individuals over the course of a year. Indianapolis is notable among cities of similar size for having only faith-based shelters, such as the century-old Wheeler Mission. In 2001, Mayor Bart Peterson endorsed a 10-year plan, called the Blueprint to End Homelessness, and made it one of his administration's top priorities. The plan's main goals are for more affordable housing units, employment opportunities, and support services. The Blueprint notwithstanding, Indianapolis has criminalized aspects of homelessness, such as making panhandling a misdemeanor; and the City-County Council has twice (in April 2002, and August 2005) denied the zoning necessary to open a new shelter for homeless women.
Boston & Massachusetts 
In October 2008, Connie Paige of The Boston Globe reported that the number of homeless in Massachusetts had reached an all-time high, mostly due to mortgage foreclosures and the national economic crisis.
In October 2009, as part of the city's Leading the Way initiative, Mayor Thomas Menino of Boston dedicated and opened the Weintraub Day Center which is the first city-operated day center for chronically homeless persons. It is a multi-service center, providing shelter, counseling, health care, housing assistance, and other support services. It is a 3,400-square-foot (320 m2) facility located in the Woods Mullen Shelter. It is also meant to reduce the strain on the city's hospital emergency rooms by providing services and identifying health problems before they escalate into emergencies. It was funded by $3 million in grants from the American Recovery and Reinvestment Act of 2009, Massachusetts Department of Housing and Community Development (DHCD), the Massachusetts Medical Society and Alliance Charitable Foundation, and the United States Department of Health and Human Services Substance Abuse and Mental Health Services Administration (SAMHSA).
In 2010, there was a continued crackdown on panhandling, especially the aggressive type, in downtown Boston. Summonses were being handed out, with scheduled court appearances. The results were mixed and in one upscale neighborhood, Beacon Hill, the resolve of the Beacon Hill Civic Association, which has received only one complaint about panhandlers, was to try to solve the bigger problem not by criminal actions.
Due to economic constraints in 2010, Governor Deval Patrick had to cut the Commonwealth of Massachusetts 2011 budget so dental care for the majority of adults, including most homeless people, covered by MassHealth (Medicaid) would no longer be provided except for cleaning and extractions, with no fillings, dentures, or restorative care. This does not affect dental care for children. The measure took effect in July 2010 and affects an estimated 700,000 adults, including 130,000 seniors.
In September 2010, it was reported that the Housing First Initiative had significantly reduced the chronic homeless single person population in Boston, Massachusetts, although homeless families were still increasing in number. Some shelters were reducing the number of beds due to lowered numbers of homeless, and some emergency shelter facilities were closing, especially the emergency Boston Night Center.
There is sometimes corruption and theft by the employees of a shelter as evidenced by a 2011 investigative report by FOX 25 TV in Boston wherein a number of Boston public shelter employees were found stealing large amounts of food over a period of time from the shelter's kitchen for their private use and catering.
New York City 
On March 18, 2013, the New York City Department of Homeless Services reported that the sheltered homeless population consisted of:
- 27,844 adults
- 20,627 children
- 48,471 total individuals
According to the Coalition for the Homeless, the homeless population of New York rose to an all-time high in 2011. A reported 113,552 people slept in the city's emergency shelters last year, including over 40,000 children; marking an 8 percent increase from the previous year and a 37 percent increase from 2002. There was also a rise in the number of families relying on shelters, approximately 29,000. That is an increase of 80% from 2002. About half of the people who slept in shelter in 2010 returned for housing in 2011.
According to the NYC Department of Homeless Services, 64 percent of those applying for emergency shelter in 2010 were denied. Several were denied because they were said to have family who could house them when in actuality this might not have been the case. Applicants may have faced overcrowding, unsafe conditions, or may have had relatives unwilling to house them. According to Mary Brosnaham, spokeswoman for Coalition for the Homeless, the administration of Mayor Michael Bloomberg employs a deliberate policy of "active deterrence".
Part of the problem lies with long-term joblessness that characterizes the United States' economic crisis. According to the Center for an Urban Future about a third of the adult workers in New York City are low-wage earners, making under $11.54 an hour. Affordable rent rates considered to be no more than a third of the renter's wages. A family in New York City must earn at least over $54,000 to find an affordable home. The median household income for renters in the Bronx and Brooklyn is barely $30,000 and $35,000 respectively. According to the Community Service Society, "Two-thirds of poor New Yorkers and over one-third of near poor households—up to twice the poverty level—spend at least half of their incomes on rent…and place millions of low-income New Yorkers at risk of housing hardships and displacement."
The New York City Housing Authority is experiencing record demand for subsidized housing assistance. However, just 13,000 of the 29,000 families who applied were admitted into the public housing system or received federal housing vouchers known as [Section 8] in 2010. Due to budget cuts there have been no new applicants accepted to receive Section 8.
In March 2010, there were protests about the Governor's proposed cut of $65 million in annual funding to the homeless adult services system. The Bloomberg administration announced an immediate halt to the Advantage program, threatening to cast 15,000 families back into the shelters or onto the streets. A court has delayed the cut until May 2011 because there was doubt over the legality of cancelling the city's commitment. However, the Advantage program itself was consciously advanced by the Bloomberg administration as an alternative to providing long-term affordable housing opportunities for the poor and working class. The result, as the [Coalition for the Homeless] report points out, is that "Thousands of formerly-homeless children and families have been forced back into homelessness, In addition, Mayor Bloomberg proposed $37 million in cuts to the city's budget for homeless services this year.
Baltimore, Maryland 
A point in time census conducted on Jan 25, 2011 counted 4,088 homeless persons in the city. Word on the Street, a street newspaper written by the homeless in the Baltimore, MD area, was established in 2012.
Homeless advocate and urban designer Michael E. Arth proposed building a Pedestrian village for the adult homeless in Volusia County near Daytona Beach, Florida in 2007. As of 2009, Arth was still working toward trying to consolidate most of the scattered 19 local agencies into an attractive community that would be designed to more effectively address the needs of the chronically adult homeless and the temporarily adult homeless, as well as others who may be having difficulty fitting into the pervasive, automobile-dominated culture. He writes that the current "piecemeal approach" inefficiently spreads out services and work opportunities, and aggravates the problem by polarizing citizens who might otherwise be inclined to help. In response to critics who say that such a village would be like a concentration camp, Arth points out that the U.S. already concentrates their citizens into prisons at 7–8 times the rate of Canada or Europe. "There should be alternative between living on the street and being locked up that addresses the needs of the chronically and temporarily adult homeless." His proposed "Tiger Bay Village" would have a community garden and orchard, a place to hire certified workers, and a work crew to help build and maintain the village. "Little shops in the village center could process and rehabilitate donated clothes and furnishings to be sold to the public." Housing would range from multi-bed barracks to small Katrina cottages depending on a person's contributions to the village, special needs, and income. Arth claims that this would cost less and be far more effective than any of the other solutions tried elsewhere.
Income sources 
Many are employed intermittently. Begging and panhandling is another important income source for some, but not most, homeless people.
Internet begging 
Health concerns 
A 2011 study led by Dr. Rebecca T. Brown in Boston, Massachusetts conducted by the Institute for Aging Research (an affiliate of Harvard Medical School), Beth Israel Deaconess Medical Center, and the Boston Health Care for the Homeless Program found the elderly homeless population had "higher rates of geriatric syndromes, including functional decline, falls, frailty and depression, than seniors in the general population and that many of these conditions may be easily treated if detected". The report was published in the Journal of Geriatric Internal Medicine.
Mental Health 
There is disproportionally higher prevalence of mental disorders relative to other disease groups within homeless patient populations at both inpatient hospitals and hospital-based emergency departments.
In the last decades of the 20th century, the number of women in the homeless population had increased dramatically and grown faster than the number of men. In the early 21st century, the numbers of homeless women continued to grow. In 2008 in one sample, women represented 26% of the respondents surveyed, compared to 24% in 2007.
Homeless women between the ages of 18 and 44 are between 5 and 31 times more at risk of dying than those women who have homes. Homeless women over the age of 44, however, are healthier than homeless men of the same age, and are negligibly more at risk of dying than housed women. Psychologically, however, homeless women in their fifties suffer from troubles and chronic diseases from which their housed counterparts only begin to suffer in their seventies. Despite their comparable psychological condition, elderly housing assistance is not available to these homeless women. Between 3.1 and 4.4% of homeless women in the United States are veterans of the armed services. 57% of these have availed of the Veterans Affairs' healthcare services.
Adult partner abuse, foster care, and childhood sexual abuse are all more likely to have been experienced by homeless women than by their male counterparts. Domestic violence is the direct cause of homelessness for over half of all homeless women in the United States. Approximately three quarters of the women who attempt to avail of domestic violence shelter beds are turned away in major American cities. These victims of domestic violence are often excluded from homelessness studies, despite the lack of livable conditions in their homes.
See also 
- Back on My Feet
- Dignity Village
- Frontline Foundation
- Homeless ministry
- List of tent cities in the United States
- Mole People
- Poverty in the United States
- Tent city
- Vagrancy (people)
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- Burt, Martha R., "Characteristics of Transitional Housing for Homeless Families Final Report", Urban Institute, Washington, D.C., September 7, 2006,
- Dordick, Gwendolyn A. (March 2002). "Recovering from Homelessness: Determining the 'Quality of Sobriety' in a Transitional Housing Program". Journal Qualitative Sociology 25 (1).
- Karash, Robert L., "The Graduate", Spare Change News, Boston, March 11, 2010
- Kooker, Naomi R., "Pine St. adds to permanent housing holdings", Boston Business Journal, November 3, 2006.
- VHA Office of Mental Health. "The Department of Housing and Urban Development and VA's Supported Housing (HUD-VASH) Program". .va.gov. Retrieved 2012-06-19.
- Graves, Florence; Sayfan, Hadar, "First things first: 'Housing first,' a radical new approach to ending chronic homelessness, is gaining ground in Boston", Boston Globe, Sunday, June 24, 2007.
- Roncarati, Jill (June 2008). "Homeless, housed, and homeless again". Journal of the American Academy of Physician's Assistants.
- Abel, David, "For the homeless, keys to a home: Large-scale effort to keep many off street faces hurdles", Boston Globe, February 24, 2008.
- Karash, Robert L., "Housing Lost, Housing Regained, Housing Kept", Spare Change News, Boston, February 25, 2010.
- Barbara Ehrenreich (August 10, 2011) "How America criminalised poverty" The Guardian
- Baylen Linnekin (June 9, 2012) "Bans on Feeding the Homeless Are Discriminatory and Unconstitutional" Reason.org
- National Coalition for the Homeless: A Dream Denied.
- "Portal | LexisNexis". Lexisone.com. Retrieved 2012-06-19.
- L.A. Times: Justices Hand L.A.'s Homeless a Victory.
- "Portal | LexisNexis". Lexisone.com. Retrieved 2012-06-19.
- St. Martin, Greg, "Night watch: Police removing overnight loiterers on Common", Boston Metro newspaper, Wednesday, August 29, 2007.
- Isaiah Thompson (August 16, 2012) "City's homeless feeding ban takes a beating in judge's opinion" City Paper
- National Coalition for the Homeless, Hate, "Violence, and Death on Main Street USA: A report on Hate Crimes and Violence Against People Experiencing Homelessness, 2006", February 2007.
- Lewan, Todd, "Unprovoked Beatings of Homeless Soaring", Associated Press, April 8, 2007.
- Sennott, Adam, "Rhode Island Homeless Bill of Rights: Is Massachusetts Next?", Spare Change News, June 29, 2012 issue
- "San Francisco's homeless count reveals drop in chronic homelessness | Bay City News | Local | San Francisco Examiner". Sfexaminer.com. Retrieved 2012-06-19.
- Neil, Geoffrey, Dire means, Reno, NV : Priorities Intact Pub., Ltd., 2009. ISBN 978-0-615-29249-6
- San Francisco Ten Year Planning Council, "The San Francisco Plan to Abolish Chronic Homelessness", c.2004, submitted to the federal Interagency Council on Homelessness. Quoting from the report: "San Francisco is Everyone's Favorite City. But San Francisco also has the dubious distinction of being the homeless capital of the United States"
- "Chronicle Homeless Special". SF Gate. January 16, 2004. Retrieved 2012-06-19.
- Cheng, Alexandra, "Are Peace and Love Dead in San Francisco?", Spare Change News, Boston, July 2, 2010.
- "Homeless in Chicago: 2007 Numbers and Demographics: Point-In-Time Analysis", The Chicago Alliance, 2007
- Loh, Christopher, "City experts predict drop in homeless numbers", Boston Now newspaper, December 20, 2007.
- Paige, Connie, Homelessness hits record high: Advocates expect numbers to grow amid economic downturn and ask for state aid, The Boston Globe, October 6, 2008
- "Massachusetts Medical Society and Alliance Charitable Foundation website". Massmed.org. Retrieved 2012-06-19.
- Mayor's Office, City of Boston, "Mayor Menino Dedicates New Day Center for the Homeless", Press Release, October 14, 2009.
- Sennott, Adam, "Panhandling on Beacon Hill: The Lowdown on a Reported Crackdown", Spare Change News, Boston, June 4, 2010
- Cunningham, Liam, "Cuts Extract Mass Health Dental Benefits From Budget", Spare Change News, July 16, 2010 issue.
- Commonwealth of Massachusetts, "Healthcare: Governor's FY2011 Budget". "The MassHealth adult dental benefit is restructured to cover preventative and emergency services only, excluding restorative dental services."
- Banda, Deborah, "AARP Alert: Seniors’ Prescriptions; MassHealth Dental Benefits at Risk", AARP, May 26, 2010.
- Brady-Myerov, Monica, "Homelessness On The Decline In Boston", WBUR Radio, Boston, September 29, 2010
- Beaudet, Mike, "FOX Undercover: Employees implicated in thefts from local homeless", FOX 25 TV, Boston, Tuesday, February 22, 2011
- Smith,Stephen, "Shelter kitchen theft prevalent, report says", The Boston Globe, February 23, 2011
- "NYC Department of Homeless Services". Nyc.gov. Retrieved 2012-03-24.
- "Council, Public Advocate, Department of Homeless Services, and Coalition for the Homeless unite to oppose State's $65 million cut to the Adult Shelter System", News Brief, NYC Department of Homeless Services, March 23, 2010
- Smith, Van (October 19, 2011). "MOBTOWN BEAT: Census shows striking growth in Baltimore homelessness Population swells nearly 20 percent in two years; ranks of homeless young people increase 50 percent". City Paper (Baltimore, MD). Retrieved December 8, 2012.
- Birdsong, Verinda (February 28, 2012). "What a dollar can mean 'Word on the Street' newspaper gives the homeless a chance at a living – and a chance to give voice to their experiences". Baltimore Sun. Retrieved December 8, 2012.
- Tom Leonard, "Daytona may give vagrants their own resort." Telegraph.co.uk, January 24, 2007 link to article
- Etan Horowitz, "Developer defends homeless-village concept", Orlando Sentinel, January 27, 2007
- Rebbecca Mahoney, "Homeless village or leper colony?" Orlando Sentinel, January 20, 2007
- Arth, Michael, "Why we should build a Pedestrian Village for the homeless in Volusia County." The Daytona beach News-Journal. April 1, 2009. p. 11 A.
- Karash, Robert L., "Spare Change?", Spare Change News, Boston, March 25, 2010
- Abel, David, "Panhandlers move from street to Internet: Online sites offer a fertile venue for some in need", Boston Globe, October 26, 2009.
- "Occupational Exposure to Tuberculosis" – OSHA notice, 1997.
- "Boston's Elderly Homeless Sicker Than Others, Research Finds", Science Daily, September 13, 2011.
- Karaca Z (AHRQ), Wong H (AHRQ), Mutter R (AHRQ). Characteristics of Homeless and Non-Homeless Individuals Using Inpatient and Emergency Department Services, 2008. HCUP Statistical Brief #152. March 2013. Agency for Healthcare Research and Quality, Rockville, MD.. Agency for Healthcare Research and Quality, Rockville, MD. Available at http://www.hcup-us.ahrq.gov/reports/statbriefs/sb152.pdf.
- Cf. Levinson, Encyclopedia of Homelessness, article entry on Women by Susan Barrow, pp. 598–606. Cited statistic from p.599
- Means, Roseanna H., Maryland, MSc (03/01/2001). "A primary care approach to treating women without homes". Medscape General Medicine. Medscape. Retrieved 2008-11-20. "Women constitute the fastest growing subgroup of the millions of Americans who are homeless"
- WMBB TV News, "Homelessness Up Among Women and Children", via Panama City Rescue Mission, Panama City, Florida, November 19, 2008. "The 20th annual snapshot survey of the Homeless, completed at 137 rescue missions across North America, recorded more women than ever before, 26 percent of those responding, as compared to 24 percent in 2007."
- Cheung, AM; SW Hwang (2004). "Risk of death among homeless women: a cohort study and review of the literature". Canadian Medical Association Journal 170 (8): 1243–7. doi:10.1503/cmaj.1031167. PMC 385354. PMID 15078846.
- The Women's and Children's Health Policy Center (WCHPC) at the Johns Hopkins Bloomberg School of Public Health, "The Health of Homeless Women: Information for State Maternal and Child Health Programs"
- Gamache, G; R Rosencheck, R Tessler (2003). "Overrepresentation of Women Veterans Among Homeless Women". Am J Public Health 93 (7): 1132–6. doi:10.2105/AJPH.93.7.1132. PMC 1447922. PMID 12835198.
- Robrecht, LC (1998). "Interpersonal violence and the pregnant homeless woman". Journal of Obstetric, Gynecologic, & Neonatal Nursing (27): 684–691.
- Ringwalt CL, Greene JM, Robertson M, McPheeters M (September 1998). "The prevalence of homelessness among adolescents in the United States". Am J Public Health 88 (9): 1325–9. doi:10.2105/AJPH.88.9.1325. PMC 1509094. PMID 9736871.
- Jensen, RH (1994). "Domestic violence facts". Ms. 2: 44–51.
- Donohoe, Martin (July 7, 2004). "Homelessness in the United States: History, Epidemiology, Health Issues, Women, and Public Policy". Medscape. Retrieved 2008-11-20.
- "The Continuing Crisis: Synopsis of 'Women’s Reality: Single Homeless Women in the City of Portland'", Transition Projects report, Portland, Oregon.
- "Women’s Reality: Single Homeless Women in the City of Portland", Transition Projects report, Portland, Oregon.
- "NEEDS AND RESOURCES: WHAT IS AND WHAT SHOULD BE: A Study of Single Homeless Women in Portland, Oregon". Homeless Women's Task Force, Transition Projects report, Portland, Oregon, 2004
- Aguirre, Adalberto; Brooks, Jonathan. (2001), "City redevelopment policies and the criminalization of homelessness: A narrative case study", in Kevin Fox Gotham (ed.) Critical Perspectives on Urban Redevelopment (Research in Urban Sociology, Volume 6), Emerald Group Publishing Limited, pp. 75–105
- Barry, Ellen, "A Refugee's Triumph Over Desolation", Boston Globe, December 28, 2003.
- Baumohl, Jim, (editor), "Homelessness in America", Oryx Press, Phoenix, 1996. ISBN 0-89774-869-7
- Booth, Brenda M., Sullivan, J. Greer, Koegel, Paul, Burnam, M. Audrey, "Vulnerability Factors for Homelessness Associated with Substance Dependence in a Community Sample of Homeless Adults", RAND Research Report. Originally published in: American Journal of Drug and Alcohol Abuse, v. 28, no. 3, 2002, pp. 429–452.
- Borchard, Kurt, Homeless in Las Vegas: Stories from the Street, University of Nevada Press, 2011
- Borchard, Kurt, The Word on the Street: Homeless Men in Las Vegas, University of Nevada Press, 2005
- Burke, Kerry, Fox, Alison, Martinez, Jose, "Hobo Madness hits Mad. Ave.: Bizman Sues Homeless for $", New York Daily News, January 18, 2007.
- Center for Social Policy, University of Massachusetts Boston, "Hard Numbers, Hard Times: Homeless Individuals in Massachusetts Emergency Shelters 1999–2003", July 2004.
- Coalition for the Homeless (New York), "A History of Modern Homelessness in New York City". 
- Crimaldi, Laura, "Cardinal spends time with homeless", Boston Herald, December 26, 2006.
- Crimaldi, Laura, "Homeless Advocates Urge no Diversion of Shelter Funds", Boston Herald, Wednesday, February 14, 2007.
- Crimaldi, Laura, "Champion for homeless fights for life", Boston Herald, Sunday, September 21, 2008. About Richard Weintraub, Director of Homeless Services for Boston, Massachusetts. The article has some modern history of homelessness in Boston.
- CSPTech, University of Massachusetts, Boston, "Characteristics of Homeless Families Accessing Massachusetts Emergency Shelters 1999–2001", April 2003.
- Culhane, Dennis , "Responding to Homelessness: Policies and Politics", 2001. 
- deMause, Neil, "Out of the Shelter, Into the Fire: New city program for homeless: Keep your job or keep your apartment", The Village Voice, New York, June 20, 2006. 
- DePastino, Todd, "Citizen Hobo: How a Century of Homelessness Shaped America", 2003. ISBN 0-226-14378-3
- Desjarlais, Robert R., Shelter blues: sanity and selfhood among the homeless, University of Pennsylvania Press, 1997. A particular study of the homeless in the Boston area.
- Dreier, Peter; Appelbaum, Richard, "American Nightmare: Homelessness", Challenge: The Magazine of Economic Affairs, v.34, n.2, March/April 1991, pp. 46–52.
- Freeman, Richard B.; Hall, Brian, "PERMANENT HOMELESSNESS IN AMERICA?", Working Paper No. 2013, National Bureau of Economic Research, Cambridge, Massachusetts, September 1986
- Friedman, Donna Haig, et al., "Preventing Homelessness and Promoting Housing Stability : A Comparative Analysis", The Boston Foundation and UMASS/Boston Center for Social Policy, June 2007.
- Gatto, Nora, "Vincent", Niagara University, Eagle Alumni Magazine, Fall 2006, p. 12.
- Institute for Governmental Studies, Berkeley, "Urban Homelessness & Public Policy Solutions: A One-Day Conference", January 22, 2001 
- Hoch, Charles; Slayton, Robert A., New Homeless and Old: Community and the Skid Row Hotel, Philadelphia : Temple University Press, 1989. ISBN 0-87722-600-8
- Kahn, Ric, "Buried in obscurity: Found dead on Causeway Street in June, his body awaits a nameless final rest", Boston Globe, December 17, 2006. A story about a Beacon Hill church pausing to remember the recently departed homeless.
- Katz, Celeste, "Public Advocate Bill de Blasio To BBH Global: Keep Your "Homeless Hotspot" Stunt Out Of NYC", The New York Daily News, March 13, 2012
- Katz, Jessica Ilana, "Homelessness, Crime, Mental Illness, and Substance Abuse: A Core Population with Multiple Social Service Needs", Department of Urban Planning and Studies, Massachusetts Institute of Technology, June 2003
- Koebel, C. Theodore (1998). Shelter and Society: Theory, Research, and Policy for Nonprofit Housing. SUNY Press. ISBN 0-7914-3789-2.
- Kuhlman, Thomas L., Psychology on the streets : mental health practice with homeless persons, New York : J. Wiley & Sons, 1994. ISBN 0-471-55243-7
- Kusmer, Kenneth L., "Down and Out, On the Road: The Homeless in American History", Oxford University Press, 2003. ISBN 0-19-504778-8
- Levinson, David, [editor] (2004). Encyclopedia of Homelessness. Thousand Oaks, California: Sage Publications. ISBN 0-7619-2751-4.
- Massachusetts Coalition for the Homeless, "Down & Out Resource Manual", 2005. 
- The Massachusetts Commission to End Homelessness, "Report of the Special Commission Relative to Ending Homelessness in the Commonwealth", Boston, Massachusetts, December 28, 2007 (January 2008).
- Massachusetts, Commonwealth of, "Housing the Homeless: a more effective approach", Governor's Executive Commission for Homeless Services Coordination, November 2003.
- Morton, Margaret, "The Tunnel: The Underground Homeless of New York City", Yale University Press, 1995. ISBN 0-300-06559-0
- National Coalition for the Homeless, "American Nightmare: A Decade of Homelessness in the United States", December 1989
- Nieto G., Gittelman M., Abad A. (2008). "Homeless Mentally Ill Persons: A bibliography review", International Journal of Psychosocial Rehabilitation. 12(2)
- O'Flaherty, Brendan, "Making room : the economics of homelessness", Cambridge, Massachusetts : Harvard University Press, 1996. ISBN 0-674-54342-4
- Quigley, John M.; Raphael, Steven, "The Economics of Homelessness: The Evidence from North America", European Journal of Housing Policy 1(3), 2001, 323–336
- Radin, Charles A., "On the street, a quiet outreach of kindness: Little Brothers lift the less fortunate", Boston Globe, December 18, 2006.
- Riis, Jacob, How the Other Half Lives, 1890.
- Rossi, Peter H., Down and Out in America: The Origins of Homelessness, University of Chicago Press, 1991.
- Russell, Jenna, "In their shoes: To better understand the plight of the homeless, Harvard student takes to the streets", Boston Globe, August 9, 2009
- Ryan, Charles V., "Homes Within Reach: Springfield's 10-year plan to end long term homelessness", City of Springfield, Massachusetts, Mayor Charles V. Ryan, January 2007.
- Schutt, Russell K., PhD, Professor, University of Massachusetts Boston.
- Schutt, Russell K., et al., "Boston's Homeless, 1986–87: Change and Continuity", 1987.
- Schutt, Russell K., Working with the Homeless: the Backgrounds, Activities and Beliefs of Shelter Staff, 1988.
- Schutt, Russell, K., "Homeless Adults in Boston in 1990: A Two-Shelter Profile", 1990.
- Schutt, Russell K., Garrett, Gerald R., "Responding to the Homeless: Policy and Practice", Topics in Social Psychiatry, 1992. ISBN 0-306-44076-8
- Schutt, Russell K., Byrne, Francine, et al., "City of Boston Homeless Services: Employment & Training for Homeless Persons", 1995.
- Schutt, Russell K., Feldman, James, et al., "Homeless Persons’ Residential Preferences and Needs: A Pilot Survey of Persons with Severe Mental Illness in Boston Mental Health and Generic Shelters", 2004.
- Sommer, Heidi, "Homelessness in Urban America: a Review of the Literature", 2001
- St. Mungo's organisation (UK), "A Brief History of Homelessness"
- Stringer, Lee, Grand Central Winter: Stories from the Street, 1st ed., New York : Seven Stories Press, 1998. ISBN 1-888363-57-6
- Vissing, Yvonne "Out of Sight, Out of Mind: Homeless Children and Families in Small-Town America", 1996.
- Vissing, Yvonne, "The $ubtle War Against Children", Fellowship, March/April 2003
- Vladeck, Bruce, R., and the Committee on Health Care for Homeless People, Institute of Medicine, "Homelessness, Health, and Human needs", National Academies Press, 1988
- Toth, Jennifer, The Mole People: Life in the Tunnels Beneath New York City, 1993. ISBN 1-55652-190-1
- United States Conference of Mayors, "Hunger and Homelessness Survey", December 2005. 
- United States Department of Health and Human Services, "Ending Chronic Homelessness: Strategies for Action", Report from the Secretary's Work Group on Ending Chronic Homelessness, March 2003.
- University of Vermont, "It starts With a Bed: UVM alums Richard Weintraub & Lyndia Downie lead fight to break cycle of homelessness in Boston, Vermont Quarterly, Fall 2002.
- Wagner, David. Checkerboard Square: Culture and Resistance in a Homeless Community (Boulder: Westview Press), 1993. ISBN 0-8133-1585-9
- Woolhouse, Megan, "Homes for the holiday: Housing agency, nonprofit team up to help the homeless", Boston Globe, December 25, 2007.
- Wortham, Jenna, "Use of Homeless as Internet Hot Spots Backfires on Marketer", The New York Times, March 12, 2012
- Wright, James D., "Address Unknown: the homeless in America", New York : A. de Gruyter, Edition: 3, 1989
- Homelessness restrictions in Top 20 "meanest" U.S. cities. (Information for all U.S. cities)
- "Of No Fixed Address: A Collection of Voices from the Streets of Chicago"
- City Mayors Society – "Hunger and homelessness continues to rise in US cities"
- City Mayors Society – "Report accuses US cities of criminalising the homeless"
- City Mayors Society – "Big US cities report steep rise in hunger and homelessness"
- National Coalition for the Homeless
- National Alliance to End Homelessness
- Corporation for Supportive Housing
- National Coalition for Homeless Veterans
- National Low Income Housing Coalition
- U.S. Interagency Council on Homelessness – US Government
- City of Boston Homeless census reports
- Coalition for the Homeless (New York)
- United States Department of Housing and Urban Development site on Homelessness
- United States Department of Health and Human Services site on Homelessness
- History of Homeless Services – Boston Public Health Commission
- National Housing Institute – resources, information, and publisher of "Shelterforce", The Journal of Affordable Housing and Community Building.
- National Center on Family Homelessness
- "Homelessness in the City of Boston Winter 2003–2004" – Annual Census and Mayor's Report, Boston, Thomas M. Menino, Mayor
- State Auditor's Report on Public Housing in Massachusetts, 2006
- Center for the Homeless – Community Programs (South Bend, IN)
- TODAY show: More homeless families in LA
- National Policy and Advocacy Council on Homelessness (USA)