Homelessness in America: Causes, Effects, and Interventions

Introduction

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 of the problem, including its prevalence, causes or contributing factors, and potential solutions. Over the past few decades, various policies and programs have been developed to help address homelessness. However, these policies and programs have failed to resolve the issue in a conclusive manner, and the prevalence rate of homelessness remains high. Homelessness in America is a serious problem, and it is time to review existing approaches, and allocate more resources and funding to address it.

Background Information on Homelessness

Homelessness is defined as the lack of stable, safe, and permanent housing due to lack of income, poor housing policies, and neighborhood gentrification (Dreyer, 2018). It is a complex, interdisciplinary problem that seemingly requires a multidisciplinary approach to address. While it is regarded as the lack of stable, safe, and permanent housing, the interdisciplinary nature and complexity of homelessness contribute to the absence of a universal definition. According to Yousey and Samudra (2018), a comprehensive, broad-based definition that can be used consistently for homelessness initiatives does not exist. This definitional gap is also attributable to the fact that homelessness affects different population groups and produces varying outcomes across those groups. Existing homelessness initiatives are therefore largely 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 and Samudra further note that homelessness occurs in both urban and rural settings, though rural homelessness is an understudied phenomenon that is not usually incorporated into public perceptions of the issue.

Despite the lack of a broad-based definition, homelessness is an egregious problem that has existed in the United States since the 1980s and is attributable to various factors and causes (Dreyer, 2018). It has attracted the attention of clinicians, administrators, policymakers, and researchers in recent years. Recent studies have shown that homelessness has grown to become a complex public health and social problem — one that is more complex than simply the lack of a place to live. As a result, a paradigm shift regarding homelessness has occurred; it is no longer viewed as simply the absence of a place to live, but is increasingly understood in terms of its broader social context. While this paradigm shift has taken hold, the epidemiology of homelessness in the general population remains 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

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 across different populations and settings throughout the country. Tsai (2018) conducted a study to examine the lifetime and one-year prevalence of homelessness based on findings from the National Epidemiologic Survey on Alcohol and Related Conditions – III. Based on the findings of this study, the lifetime prevalence of homelessness in the U.S. population is approximately 4.2% (Tsai, 2018). The one-year prevalence rate is estimated at 1.5% (Tsai, 2018). This one-year prevalence is attributable to various factors strongly associated with homelessness, including low income, past-year tobacco use disorder, borderline personality disorder, history of incarceration, and debt history. Lifetime prevalence is further associated with a history of suicidal attempts and antisocial personality disorder. The study concludes that lifetime homelessness has increased from approximately 2.7% to 4.2% over the past decade.

Morton et al. (2017) conducted a study to examine the prevalence and correlates of homelessness among youth. Based on this research, explicit youth homelessness is likely to occur in 3% of households with 13- to 17-year-olds. For young people aged 18 to 25 years, household prevalence estimates for explicitly reported homelessness rise to 5.9%. Additionally, incidence rates of youth homelessness are approximately 50% as high as prevalence rates (Morton et al., 2017). These prevalence rates were found to be similar in both rural and non-rural counties. The researchers therefore suggest a significant need for prevention efforts and youth-centered systems and services, given the high prevalence and incidence rates. Moreover, homelessness initiatives should address the disproportionate risks facing certain subpopulations.

Causes and Contributing Factors to Homelessness

Policymakers, clinicians, researchers, and administrators have examined the causes and contributing factors of homelessness with a view to developing suitable solutions. Recent studies have confirmed that homelessness is a complex, interdisciplinary problem occurring in different contexts. Tsai, O'Toole, and Kearney (2017) contend that an understanding of the social, behavioral, and public health contexts in which homelessness occurs is required to develop appropriate solutions.

Mabhala, Yohannes, and Griffith (2017) state that social conditions and maladaptive behaviors contribute to the problem of homelessness. Homelessness is essentially a social problem linked to social conditions and risk factors, as well as behavioral risk factors that affect one's living conditions. A significant percentage of homeless people have experienced extreme social disadvantage such as poverty, dysfunctional family environments, shortages of social housing, unstable family structures, and disrupted schooling. Lack of social and psychological support, neglect, and physical, emotional, and sexual abuse are social factors that also contribute to homelessness. Social factors and childhood experiences cluster together to influence behaviors that lead to homelessness, such as adult criminal activity and substance abuse. Alcoholism, substance abuse, self-harm, disruptive behavior, and criminal activity are among the maladaptive behaviors contributing to homelessness. According to Dreyer (2018), homelessness in the United States is also caused or exacerbated by income inequality, poor housing policies, and neighborhood gentrification.

Homelessness is further linked to racial stereotyping, which creates significant psychological distress that in turn contributes to homelessness (Weisz & Quinn, 2017; Morton et al., 2017). Weisz and Quinn (2017) argue that homelessness is an intensely stigmatized identity, and that stigmatization has serious negative impacts on health outcomes. Racial stereotyping provides the basis for stigmatization, which in turn influences patterns of homelessness. Racial and ethnic minority groups have disproportionately high numbers of homeless individuals as a result of racial stereotyping. Morton et al. (2017) found that Black and Hispanic individuals are at higher risk of homelessness — particularly youth homelessness — compared to other racial and ethnic groups. This demonstrates a strong link between race and homelessness and supports the view that racial stereotyping is a contributing factor to the issue.