The Problem of Homelessness in the United States

Homelessness in America
Homelessness is one of the major issues in the United States given its significant social and economic impacts. As a result, homelessness has been the subject of epidemiological studies, public debates, and policy initiatives. These efforts have sought to examine different aspects relating to the problem of homelessness including its prevalence, causes or contributing factors, and potential solutions to address it. Over the past few decades, various policies and programs have been developed to help address the problem of homelessness. However, these policies and programs have failed to address the issue of homelessness in a conclusive manner. Despite the adoption of these policies and programs, the prevalence rate of homelessness is still high. Homelessness in America is a big problem and it is time to review homelessness, allocate more resources and funding to address the problem.
Background Information on Homelessness
Homelessness is defined as the lack of a stable, safe and permanent housing due to lack of income, poor housing policies, and neighborhood gentrification (Dreyer, 2018). Homelessness is an complex, interdisciplinary problem that seemingly requires a multidisciplinary approach to address. While it is regarded as the lack of a stable, safe and permanent housing, the interdisciplinary nature and complexity of homelessness contributes to the lack of a universal definition of the issue. According to Yousey & Samudra (2018), a comprehensive, broad-based definition that can be used consistently for homelessness initiatives does not exist. The lack of a broad-based definition of homelessness is also attributable to the fact that it impacts different population groups and have varying outcomes on these groups. Therefore, existing homelessness initiatives are seemingly based on the specific groups affected by the problem. Dreyer (2018) suggests that homelessness can be classified into family homelessness, homeless children, and youth homelessness. Yousey & Samudra suggests that homelessness occur in urban and rural settings though rural homelessness is an understudied phenomenon that is not usually incorporated in public perceptions regarding the issue.
Despite the lack of a broad-based definition, homelessness is an egregious problem that has existed in the United States since 1980s and attributable to various factors and causes (Dreyer, 2018). It has attracted the attention of clinicians, administrators, policy makers and researchers in the last few years. Recent studies have shown that homelessness has grown to become a complex public health and social problem. This social and public health problem is a complex phenomenon than simply the lack of a place to live. As a result, a paradigm shift regarding homelessness has occurred as it is no longer viewed as simply the absence of a place to live, but in terms of its social context. While a paradigm shift on homelessness has occurred as it continues to increase, epidemiology of the issue in the general population is increasingly difficult to study (Tsai, 2018). Current interventions for homelessness need to incorporate its social context and diverse nature in order to be effective. Given these factors, multifaceted and multisectoral approaches are the most suitable interventions to address the growing problem of homelessness in the United States.
Statistics on Homelessness
As previously indicated, homelessness in the United States has continued to be an egregious problem since the 1980s. The gravity of this problem is evident in its prevalence rates in different populations and settings throughout the country. The prevalence rates of homelessness have been the subject of numerous studies in recent years. Tsai (2018) conducted a study to examine the lifetime and 1-year prevalence of this issue based on findings of the National Epidemiologic Survey on Alcohol and Related Conditions – III. Based on the findings of this study, the lifetime prevalence of homelessness in the United States population is approximately 4.2% (Tsai, 2018). On the other hand, the 1-year prevalence rate of homelessness in the U.S. population is estimated at 1.5% (Tsai, 2018). The 1-year prevalence rate of homelessness is attributable to various factors strongly associated with the issue. These factors include low income, past-year tobacco use disorder, borderline personality disorder, history of incarceration, and debt history. These factors also contribute to lifetime prevalence of homeless in addition to history of suicidal attempts and antisocial personality disorder. Therefore, the study concludes that lifetime homelessness has seemingly increased from 2.7% to 4.2% over the past decade.
Morton et al. (2017) conducted a study to examine the prevalence and correlates of homelessness in the youth. Based on this study, explicit youth homelessness is likely to occur in 3% of households with 13- to-17 year olds (Morton et al., 2017). However, for young people aged between 18 to 25 years, household prevalence estimates for homelessness is 5.9% for explicitly reported homelessness. Additionally, incidence rates of youth homelessness are approximately 50% as high as prevalence rates (Morton et al., 2017). These prevalence rates for youth homelessness were found to be similar in both rural and non-rural counties. Therefore, these researchers suggest that there is a significant need for prevention and youth-centered systems and services because of the high prevalence and incidence rates. Moreover, homelessness initiatives should also address the disproportionate risks of some subpopulations.
Causes/Contributing Factors to Homelessness
Policy makers, clinicians, researchers and administrators have examined the causes or contributing factors to homelessness with a view of developing a suitable solution to address the problem. Recent studies have shown that homelessness is a complex, interdisciplinary problem that occurs in different contexts. Tsai, O’Toole & Kearney (2017) contend that an understanding of the social, behavioral and public health context with which homelessness occurs is required in the development of appropriate solutions for the problem. The causes and contributing factors to homelessness can be identified through examining these contexts and its impacts.
Mabhala, Yohannes & Griffith (2017) state that social conditions and maladaptive behaviors contribute to the problem of homelessness. Homelessness is essentially a social problem that is linked to social conditions and risk factors. Additionally, the problem is brought by some behavioral risk factors that affects one’s living conditions. A significant percentage of homeless people have experienced extreme social disadvantage such as poverty, dysfunctional family, shortage of social housing stocks, unstable family structures, and disrupted schooling. Lack of social and psychological support, neglect as well as physical, emotional and sexual abuse are social factors that also contribute to the problem of homelessness. Social factors and childhood experiences cluster together to influence behavior that leads to homelessness such as adult criminal activities and substance abuse. In essence, alcoholism, substance abuse, self-harm and disruptive behaviors, and criminal activities are maladaptive behaviors contributing to homelessness. According to Dreyer (2018), homelessness in the United States is also brought or exacerbated by income inequality, poor housing policies, and neighborhood gentrification.
Homelessness is also linked to racial stereotyping, which creates significant psychological distress that in turn contribute to homelessness (Weisz & Quinn, 2017; Morton et al., 2017).Weisz & Quinn (2017) argue that homelessness is an intensely stigmatized identity despite the negative impacts of stigmatization on health outcomes. Racial stereotyping is the premise for stigmatization, which in turn influences homelessness. Racial/ethnic minority groups have high numbers of homeless people due to racial stereotyping unlike other race/ethnic groups. Morton et al. (2017) found that black and Hispanic races are at higher risks of homelessness, especially youth homelessness in comparison to other racial/ethnic groups. This shows that there is a strong link between race and homeless resulting in the idea that racial stereotyping is a contributing factor to this issue.
Effects/Outcomes of Homelessness
Homelessness is a growing problem occurring within the social, behavioral and public health contexts. Since the issue is brought by various contributing factors within the social and behavioral contexts, it has significant impacts. One of the major effects or outcomes of homelessness is disruption of education and poor health outcomes. Homelessness significantly interrupt critical areas of life like education, psychosocial functioning, and health (Oppenheimer, Nurius & Green, 2018). Existing evidence shows health disparities among homeless people and the significant impact of homelessness on public health. Homelessness is linked to negative outcomes in various domains of health. Homeless people are at high risks of severe acute and chronic illness and death at earlier ages and of preventable conditions in comparison to low-income but housed people. The high risks of negative health outcomes among homeless people is attributable to unmet health needs. Additionally, existing research shows that homeless people are at high risks of behavioral health conditions and mental illnesses. Therefore, homelessness is a deadly stressor characterized with unique and enduring impacts on mental and physical health outcomes.
Homelessness causes major social and public health issues/problems (Tsai, O’Toole & Kearney, 2017). Homelessness contributes to poor physical and mental health outcomes by affecting health seeking behaviors of homeless people. Homeless people are less likely to seek for primary care services resulting in poor health status and outcomes. Disparities in healthcare utilization patterns between homeless people and other low-income groups exist. In this case, homeless people are less likely to utilize existing healthcare services in comparison to low-income groups. The poor health seeking and utilization behaviors of this population generates significant burdens on public health. This is worsened by their poor living conditions, which is strongly linked to poor health outcomes. Dreyer (2018) states that homeless children have been found to have significant health problems and problems with academic achievement and behavior. The significant health problems in this population is linked to poor living conditions and nutritional deficiencies.
Interventions for Homelessness
Policy makers and other stakeholders have collaborated to help identify suitable interventions to address the issue of homelessness. Current interventions for homelessness have ranged from policy initiatives to human service programs. One of the human service programs adopted as an intervention for homelessness is Housing First programs. This program, which targets individuals who are chronically or episodically homeless, combines access to permanent housing with community-based approaches (Ly & Latimer, 2015). The community-based approaches incorporate integrated treatment, support services, and rehabilitation. As a result Housing First programs act as suitable alternatives to the conventional continuum of care models. The programs provide supported housing or supportive housing to help address the problem of homelessness. Supported housing include scattered-site or congregate, independent housing with external support. On the contrary, supportive housing entails congregate housing with internal or on-site supports. Existing studies show that Housing First programs substantially increase the time that individuals are stably housed. As human service programs, Housing First programs is an effective intervention that lessens the costs of shelter and emergency department through effective resource allocation (Ly & Latimer, 2015).
Housing policy initiatives have been developed by policy makers on the premise that housing is a critical social determinant of health (Willison, 2017). Housing policy is regarded critical in addressing the issue of homelessness as it enhances affordability and quality of housing and deals with inequality. While housing policy provides the framework for providing housing to homeless people, its effectiveness and success is affected by politics and existing governance strategies. In recent years, housing governance has contributed to the failures of housing policy in addressing homelessness because of political decentralization and expansion of the submerged state. Consequently, housing policies seem ineffective in addressing homelessness because of the growing increase in the number of Americans experiencing unstable housing i.e. couch surfing, doubling-up and intermittent homelessness (Willison, 2017; Dreyer, 2018). Due to special and complex issues surrounding homelessness, a multifaceted approach is required to address this problem (Tsai, O’Toole & Kearney, 2017).
In conclusion, homelessness is a major problem in the United States and has attracted the attention of policymakers, clinicians, researchers, and other stakeholders. While homelessness is largely viewed as the absence or lack of housing, it lacks a broad-based definition to steer effective initiatives to address it. Nonetheless, this issue occurs within the social and behavioral contexts. Homelessness is brought by various causes and contributing factors including social conditions and behavioral factors. The issue has significant impacts on people’ psychological functioning, physical and mental health, employment status, and academic achievements. Relevant stakeholders have attempted to address the problem through housing policy initiatives and human service programs. Given its high prevalence and incidence rates, multidisciplinary and multifaceted approaches should be adopted to address this growing problem.
References
Dreyer, B.P. (2018), A Shelter is not a Home: The Crisis of Family Homelessness in the United States, Pediatrics, 142(5) 1-3, httpps://doi.org10.1542/peds.2018-2695
Ly, A. & Latimer, E., (2015), Housing First Impact on Cost and Associated Cost Offsets A review of literature, Canadian Journal of Psychiatry, 60(11) 475-487,
doi: 10.1177/070674371506001103
Mabhala, M.A., Yohannes, A. & , Griffith, M. (2017), Social Conditions of Becoming Homelessness, Qualitative Analysis of Life Stories of Homelessness People, International Journal for Equity in Health, 16(150), Doi:10.1186/s12939-017-0646-3
Morton et al, (2017), Prevalence and Correlates of Youth Homelessness in the United States, Journal of Adolescent Health, 62, 14-21 Doi:10.1016/j.jadohealth.2017.10.006
Oppenheimer, S.C., Nurius, P.S. & Green, S. (2018) Homeless History Impact on Health Outcome and Economics and Risk Behaviors Intermediaries: New Insight from Population Data, Families in Society, 97(3), 230-242, Doi:10.1606/1044-3894.2016.97.21
Tsai, J., O’Toole, T. & Kearney, L. K. (2017), Homelessness as a Public Mental Health and Social Problem, New Knowledge and Solution, Psychological Services, 14(2), 113-117, http://dx.doi.org/10.1037/ser0000164
Tsai, J. (2018), Lifetime and 1-year Prevalence of Homelessness in the U.S. Population: Results from the National Epidemiologic Survey on Alcohol and Related Conditions-111, Journal of Public Health 40(1), 65-78, https://doi.org/10.1093/pubmed/fdx034
Yousey, A. & Samundra, R. (2018) Defining Homelessness in the Rural United States,
Online Journal of Rural Research & Policy, 13(4),
http://doi.org/10.4148/1936-0487.1094
Weisz, C. & Quinn, D.M. (2017), Stigmatized and identities Psychological Distress and Physical Health, Intersection of homelessness and Race, Stigma and Health 1-6,
http://dx.doi.org/10.1037/sah0000093
Willison, C. (2017), Shelter from the Storm: Roles, Responsibilities, and Challenges in the United States Housing Policy Governance, Healthy policy 121(111) 113-1123, https//doi.org/10.1016/j.healthpol.2017.08.002
Annotated Bibliography
Dreyer, B.P. (2018), A Shelter is not a Home: The Crisis of Family Homelessness in the United States, Pediatrics, 142(5) 1-3, httpps://doi.org10.1542/peds.2018-2695
This research takes a look at devastation of homelessness in the United States. This has been a big problem since the 80’s. The article talked about various factors that lead to homelessness such as income inequality, poor housing policies across the country and neighborhood gentrification. These factors combine to decrease the affordable housing for vulnerable population and low income families. Alternative housing does not solve this problem; the living condition along with the healthcare needs makes the problem worse.
Ly, A. & Latimer, E., (2015), Housing First Impact on Cost and Associated Cost Offsets A review of literature, Canadian Journal of Psychiatry, 60(11) 475-487,
doi: 10.1177/070674371506001103
This literature examines the effectiveness of Housing First programs, which are human service programs established by the U.S. Department of Housing and Urban Development to help address homelessness and housing issues. The study found that these programs are rapidly expanding in the U.S. as they combine access to permanent housing with community base and support services. The program has been found effective in addressing the issue of homelessness and housing issues. The study found that these programs are rapidly expanding in the U.S. as they combine access to permanent housing with community based and support services. The program has found effectiveness in addressing the issue of homelessness as it represents an efficient way for resource allocation than conventional services. Housing First have found ways to lessen the cost of shelter and the emergency department.
Mabhala, M.A., Yohannes, A. & , Griffith, M. (2017), Social Conditions of Becoming Homelessness, Qualitative Analysis of Life Stories of Homelessness People, International Journal for Equity in Health, 16(150), Doi:10.1186/s12939-017-0646-3
The author stated that homelessness is more of a public health and social phenomenon than lack of a place to live. Through conducting interviews of homeless people and examining the wider social context the study outcome leads to homelessness. The social conditions and adapting to the homeless behaviors lead to homelessness. Poor education, low educating social connections, unemployment, less life opportunity is what the social condition leads to.
Morton et al, (2017), Prevalence and Correlates of Youth Homelessness in the United States, Journal of Adolescent Health, 62, 14-21 Doi:10.1016/j.jadohealth.2017.10.006
The Research talks about the prevalence of youth homelessness in the U.S., Which is a serious problem that is characterized by lack of credible data on the size and attributes of the population. The researchers used a national phone survey and followed up with an interview. They found an overall 4.3% household prevalence of any homelessness in the U.S. While incidence rates for youth homelessness are as high as prevalence rates, prevalence rates are the same in rural and non-rural counties. Hispanics, blacks and LGBT youth and those without college education are increasingly susceptible to homelessness.
Oppenheimer, S.C., Nurius, P.S. & Green, S. (2018) Homeless History Impact on Health Outcome and Economics and Risk Behaviors Intermediaries: New Insight from Population Data, Families in Society, 97(3), 230-242, Doi:10.1606/1044-3894.2016.97.21
The researcher used data from the Washington Behavioral Risk Factor Surveillance system to assess the historical impact of homelessness on physical and mental health outcomes The new insight from the data shows that homelessness has significant impact on physical and mental health since it poses risk factors to their health. Homelessness disrupts education, obtaining employment. Homelessness disrupts critical areas of a person's life such as education, social functioning, and health.
Tsai, J., O’Toole, T. & Kearney, L. K. (2017), Homelessness as a Public Mental Health and Social Problem, New Knowledge and Solution, Psychological Services, 14(2), 113-117, http://dx.doi.org/10.1037/ser0000164
This article will discuss how homelessness has become a social and public health concern. The authors stated that recent statistics show that approximately 4.2% of the U.S. population is experiencing homelessness for more than a month throughout their lives. In 2017 about 1.5% of the American population experienced homelessness. Homelessness puts a strain on public health as it increases the demand and need for primary healthcare services. The authors concluded that a multifaceted approach is needed to deal with homelessness because of the special and complex issues surrounding it.
Tsai, J. (2018), Lifetime and 1-year Prevalence of Homelessness in the U.S. Population: Results from the National Epidemiologic Survey on Alcohol and Related Conditions-111, Journal of Public Health 40(1), 65-78, https://doi.org/10.1093/pubmed/fdx034
The research indicate that homelessness have become a public health problem Though there a few recent epidemiological studies. The researchers utilize data from structured interviews with national representative samples to examine lifetime and 1 year prevalence of the issue. The study found that the lifetime prevalence of homelessness is 4.2% while the 1 year rate is 1.5%. The prevalence of this problem is linked to various behavioral health and economic factors.
Yousey, A. & Samundra, R. (2018) Defining Homelessness in the Rural United States,
Online Journal of Rural Research & Policy, 13(4),
http://doi.org/10.4148/1936-0487.1094
The research study explores the homelessness in the United States, especially rural homelessness, which is understudied. The review of literature found that no consistent or uniform definition of rural homelessness exists. As a result of the researchers argue that definition and overview of homelessness should incorporate the wide range of needs periodically and population. However the authors contend that homelessness is classified into different levels depending on the spectrum of needs periodically and population it affects.
Weisz, C. & Quinn, D.M. (2017), Stigmatized and identities Psychological Distress and Physical Health, Intersection of homelessness and Race, Stigma and Health 1-6,
http://dx.doi.org/10.1037/sah0000093
This research was conducted on the premises that homelessness is an extremely stigmatized identity. The stigma that is associated with homelessness impairs the health and well-being of homeless people. Some of the effects of the problem of homelessness include: isolation, stress and mental health disorders unhealthy coping behaviors. Stigma associated with homelessness is linked to racial stereotyping. which in turn is linked to substantial psychological distress.
Willison, C. (2017), Shelter from the Storm: Roles, Responsibilities, and Challenges in the United States Housing Policy Governance, Healthy policy 121(111) 113-1123, https//doi.org/10.1016/j.healthpol.2017.08.002
This study housing policy in the U.S., which is utilized as one of the interventions to address the problem of homelessness. Housing policy is viewed as one of the critical social services toward addressing the issue of homelessness and enhancing public health. The authors say even though housing policies have been enacted, they are largely ineffective in addressing the problem of homelessness because of the widespread housing problem around the country. Despite the decrease in homelessness housing problems are seemingly ineffective because the number of Americans experiencing unstable housing has increased.