The context in which homelessness exists in America is a paradox. This issue is concurrently simple and complex. It illustrates how social intimacy, alienation and destitution escalates in America. Hopefully this post will make a positive contribution to current understandings of homelessness in the American context as well as provide alternative advocacy interventions for social work endeavors in the homeless sector.
Historically, a paradoxical relationship has appeared between legitimacy and guilt as it relates to homelessness. Buckrop (1992) examined seven congressional committee hearings and revealed that guilt was assigned to the homeless via ideas of choice and responsibility (e.g., individuals chose to be homeless. Opposition to this viewpoint essentially blamed the homeless population for their societal status, rather than the systemic issues that cause them to fall into homelessness. In these hearings, homeless people countered this claim by assigning guilt to the Reagan administration via claims that they were the victims of Reagan policies. Although this is only one study, it illustrates the convoluted context in which homelessness exists. This issue is important and timely, especially given the escalating scope of homelessness and the current economic crisis in America.
There are a vast amount of vulnerabilities that could lead an individual down a path to homelessness. According to the United States Conference of Mayors' Hunger and Homelessness Survey (Diaz et. al., 2008), cities identified the “three main causes of homelessness for persons in families and for single adults and unaccompanied youth” (pp.19). The three most commonly cited causes of homelessness are: lack of affordable housing for persons in families, which was cited by 72 percent of cities, poverty was cited by 52 percent of cities, and unemployment was cited by 44 percent of cities (Diaz et. al., 2008, pp.19). In a previous survey, the three main causes of family homelessness were cited as: lack of affordable housing, poverty, and domestic violence. The top three causes of homelessness for this particular study among singles were said to be substance abuse, which was cited by 68 percent of cities, lack of affordable housing was cited by 60 percent of cities, and mental illness was cited by 48 percent of cities (pp.19).
Fundamentally, homeless people have higher premature mortality than appropriately housed people. Injuries, unintentional overdose, and extreme weather events are significant drivers of this mortality. The homeless population also has poor quality of life, characterized by chronic pain associated with poor sleeping conditions and limited access to medications, in addition to other salutary resources. Skin and foot problems, dental hygiene, and other chronic infectious diseases are well described among the homeless (Galea, 2016). Also, in terms of demographic trends, the Bipartisan Policy Center believes “communities across the country must make meeting the needs of their older residents a priority consideration as they plan for the future” because over the next 15 years, an explosive growth of the nation’s senior population will occur and present unprecedented challenges ("Healthy Aging Begins at Home", 2016). Millions of Americans will find they lack savings to fund their retirements; some may struggle to find adequate and affordable housing, others may find their units are ill suited for “aging-in-place”. Many will soon need help with “activities of daily living,” such cooking, personal hygiene, and dressing, assistance that can be both costly and taxing on their family and community (e.g., increase in need for respite care; decline in workforce due to more caregiving responsibilities).
In terms of equity, the homeless have no unified voice. According to Stone (2012), “the equality of voice is the most important quality issue of all to the extent that government policies determine the distribution of resources (pp.62). At a 1990 committee hearing on homelessness and the elderly, the following comment was made by Carol Finnley of the Community for Creative Nonviolence: “the truth is that the homeless, poor people quite often don’t vote, they don’t fund campaigns, they don’t consume and they don’t count”. Stone (2012) defines efficiency as a political claim; a way of picturing a situation that makes some people or things look more important than others (pp.78) From this concept, the homelessness situation is based on whether the democratic governing structure can efficiently organize social activity around housing its members (e.g., societally value the existence of homeless people).
From a fiscal perspective, in regards to liberty, homelessness could induce economic and material harm on the community. An exacerbated homelessness problem in the area could lead toward activities that ultimately destroy the community’s reputation of being livable or conducive for business (e.g., bring the area’s property value down). The communal harm of homelessness can also be seen, in terms of amenity effects (e.g., impacts on landscape, aesthetics, lifestyle, peace and quiet). Psychic harms are an issue for the homeless to grapple with (e.g., persistent denigration of their identity plays into their self-doubt, making them believe negative stereotypes about themselves, which leads to devaluing their culture and lowering their aspirations). To prevent this, society must socially accept the homeless and treat them equally (e.g., offer day-to-day public acknowledgment and assistance).
Stone (2012) states that, “liberty means having the wealth, health, education, and political rights to exercise effective choice” (pp.125). Based on these prerequisites, liberty comes in degrees. Essentially more wealth, health, education, and political rights equal more freedom. Thus, inequalities in those areas also create inequalities of liberty. The central issue for homelessness is discovering what constraints are on individual freedom within the power of society to change (e.g., having area affordability and formal rights for housing; collecting data to adjust rents or mortgages to better reflect the current incomes of citizens).
In terms of security, the government often punishes the homeless for basic arbitrary “quality-of-life” activities (e.g., camping in public, panhandling, storing personal property in public places, loitering, public urination and defecation, etc.). Increasing criminalization, marginalization and victimization of these activities undermines democracy, in the sense that the government often dictates basic decisions about livelihood to the people, rather than allowing them to choose what is best for their situation. The real prospect of imprisonment couldn’t be farther from a state of security for the homeless population. Furthermore, an influx in homeless inmates adds to the problem of mass incarceration in the country and the destabilization of communities (e.g., lack of rehabilitation, lack of jobs, lack of housing, lack of resources = recidivism). Lurie and Schuster (2015) recommend that policy makers repeal discriminatory criminal ordinances that ban life-sustaining activities for people experiencing homelessness.
Various Factors that Exacerbate the Homelessness Issue
Many DV (domestic violence) victims must choose between their abusive relationships and homelessness due to current poverty. It has been stated that, “50% of the cities surveyed by the U.S. Conference of Mayors identified domestic violence as a primary cause of homelessness” (National Coalition for the Homeless, 2014). Multiple relocations induced by DV can hinder children from establishing a secure foundation. Homelessness also suggests larger problems associated with DV on a macro level (e.g., social acceptance of maltreatment and violence).
Life course scenarios may also be helpful to understand factors that contribute to homelessness (See Appendix A). In terms of the elderly population, a senior is often on a fixed income (e.g., retirement, social security) and may have mobility issues that hinder them from keeping their house up to code, so many seniors prefer to rent but this poses a new problem (e.g., eviction from their residence due to rising rents in the area), which could leave them homeless if savings fall short. If a senior has family to rely on, then that may also create new imbalances between the senior’s needs and the new environment’s resources (e.g., role changes, disorientation). Using the ecological perspective, this illustrates a society’s bi-directional influence on their people (e.g., lack of affordable housing or rental subsidies). This instability could inadvertently result in accumulated stress and negative health outcomes for seniors.
Local Significance/Relevance of the issue
Los Angeles (LA) County’s median rent rose by 25% from 2000 to 2012, while the county's median income dropped by 9% (Khouri, 2014). This can be spotted across the country; nonetheless, it is an ever-growing trend in the LA area. Due to rent rising by 6.1% in June, LA renters found that a typical 2-bedroom apartment in LA was listed for approximately $2,350 (Romero, 2014). Rising rent and falling wages are of major concern to many, particularly young adults (e.g., college students). Moreover, this effects people such as veterans and the elderly in the area. According to the Center for Housing Policy and National Housing Conference, 39% of working households in the metropolitan LA area spend over half their incomes on rent (Viveiros & Brennan, 2013).
Lack of affordable housing is of foremost concern for non-renters in the LA area, as well. Real estate prices jumped 20% in LA last year (Romero, 2014), it’s been reported that half of the LA households also spend nearly 30% of their income on mortgage payments (Logan, 2014). Many potential owners and people with foreclosed homes are being forced into the renters market. This has exacerbated the number of poor income renters in the area. The supply of affordable housing has dropped constantly over the years while demand has risen dramatically, further illustrating the deplorability of housing affordability in LA County.
In 2007, California’s population reached 36.5 million and it is expected to jump to 49 million by the year 2025 (“LINC’s History”, 2014). At this rate, in conjunction with the declining value of public assistance, the lack of affordable housing in LA County is also likely to have negative impacts on the health and well being of its community. Unaffordable rent in the area has caused lower-income families and people on fixed incomes to spend even less on basic necessities (e.g., food). The affordable housing crisis has also made it even more challenging for lower and moderate income families to save money, thus they cannot build wealth, which hinders them from gaining stability or any type of true housing security for the future.
Much debate centers on whether or not the homeless population should receive government assistance (“Should the government help the homeless?, 2017). Arguments against government assistance for the homeless postulate it enables the homeless. Opponents to government assistance tend to view food stamps as incentives rather than an intervention to food instability. Arguing points in favor of government assistance for the homeless put forward that the government principally works for the people (e.g., proponents view tax payers as employers of officials). Therefore, the government is obligated to serve those they are elected to represent.
According to the National Community Renaissance website (2013), CORE is a non-profit affordable housing developer in the US. CORE has dealt with community revitalization for over 20 years. CORE has 63 developments in California, which equates to 6,659 units that house 13,971 residents. Single Room Occupancy Housing Corporation (SRO) is a community-based organization with over 30 years of experience in housing development. According to the SRO website (2011), they are the only organization in LA that provides a full continuum of housing; Emergency, Transitional, and Permanent Supportive Housing (PSH), all of which is in conjunction with supportive services including food provision, case management, referrals, transportation, community events, etc. Nevertheless, there are only a handful of other resources available in LA to specifically address housing affordability.
Most are non-profit agencies such as Housing California, which is an organization that has been working to prevent homelessness and increase the variety and supply of accessible and affordable places to live in LA. Housing California’s staff has accomplished its goals through education, advocacy, and outreach. “A Community of Friends” (ACOF), specifically provides affordable housing developments for people with special needs, namely mental illnesses. Their website (n.d.) states that ACOF has 1,700 units in 43 properties. According to Project New Hope’s website (2008), they provide affordable housing (over 50 units) and supportive services to low and moderate-income families with disabilities (e.g., HIV/AIDS) and seniors, in LA.
Three Evidence Based Practices Addressing Homelessness
“Housing First” is a program that affords permanent housing to all homeless individuals as an alternative to criminalization, marginalization and victimization. According to Tsemberis (2010), the Housing First is an EBP “with well-established efficacy in reducing homelessness for a particular group of individuals” (pp. 235). Housing First is “certified through the Interagency Council on Homelessness as an evidence based practice, in working with individuals who are chronically homeless“ (Pearson, et. al., 2007). It provides quick, permanent and independent housing to homeless people (National Alliance to End Homelessness, 2006). Housing First recognizes the importance of providing housing prior to case-management or wraparound services (e.g., substance abuse or job training). Services are readily available and it is more interesting to note that the Housing First model does not require participation to maintain housing. Housing First programs are also relatively stable from a financial standpoint because they are funded through Housing and Urban Development (HUD).
Harm Reduction models benefit the individual, the community and society-at-large because it builds a relationship as a means of encouragement and support (Russell, 2008, pp. 66). This model deals with the stages of change, and the concept of accelerating an individual’s motivation toward continued change. Motivational interviewing and/or psyhcoeducation methods are often used to build rapport and explore alternatives for means of shelter. Harm reduction models create a safe atmosphere in which people can connect to the program as a whole, which helps solve one of the most consistent problems of homeless services: client retention (e.g., aggressive interventions = high dropout rates). Lastly, Harm Reduction and Housing First models both acknowledge the additional struggles that co-occurring issues present.
Critical Time Intervention (CTI), expands senior housing efforts with federal funding (e.g., Older American’s Act, ACA, SSI, Medicare, Medicaid). CTI provides time-limited assistance and support (i.e., 9 months) and is designed to assist people with mental illness and multifaceted social needs, such as homelessness. CTI is intended to help mobilize support for society’s most vulnerable individuals during times of transition. It aims to facilitate community integration and continuity of care by insuring that people have lasting ties to the community and support systems during critical periods of change. This model has been widely used on four continents; it has been applied with veteran populations, those suffering from mental illnesses, homeless or incarcerated persons, and many other groups of people (“CTI model”, 2014).
Much of the literature suggests interventions that provide case management for substance use and mental illness. It also suggests critical time intervention approaches to mitigate the consequences of acute stressors, which can be effective in the reduction of homelessness. These approaches mostly rely on human services and interventions embedded in healthcare systems. However, they do not remove, nor replace, the importance of approaches that tackle social policies and structural factors, such as lack of affordable housing, which ultimately set the conditions for homelessness and housing instability of marginalized groups (Galea, 2016).
From a social work perspective, homelessness causes inconsistency in an individual’s life. Homelessness can cause a person to have no secure base or stable place of attachment. People need to have healthy attachments with their environments to formulate their identities. The National Association of Social Workers (NASW) Code of Ethics identifies social justice as one of their six core values of social work, which mandates all social workers to challenge social injustice (Workers, pp. 3). The homelessness crisis is a social injustice issue that needs to be challenged because systematic problems (e.g., lack of affordable housing, density bonus laws, etc.) block opportunities for low and moderate-income citizens inhibiting their power to exercise self-determination. Social workers need to critically examine the issue of homelessness and the concept of social exclusion with particular reference to American initiatives currently being developed under the government.
Areas of social change for homelessness include: housing entitlement, issuing legislation to provide affordable housing, investing in job development, proportionating distributions of resources, creating simpler pathways to housing options, and enforcing rent control (e.g., assess for rent burdens; offer direct rental subsidies to keep up with rising rent; have no individual pay more than 30% of income for housing). The author recommends breaking down the federal silos to expand reach (e.g., combining HHS and HUD), and more media exposure of homelessness to expose injustices and change social attitudes. Advocacy and community organizing is also recommendable to foster more political acknowledgment and create sustainable solutions for homelessness (e.g., relaxed ordinances). Presumably, the economic index (e.g., federal poverty line) should also be changed to accurately reflect U.S. aggregate household incomes. Summarily, more replication of successful interventions (e.g., EBPs) should be considered to move social change forward on homelessness. Hopefully this post will make a positive contribution to current understandings of homelessness in the American context as well as provide alternative advocacy interventions for social work endeavors in the homeless sector.
- A Community of Friends – Who We Are. (n.d.). Retrieved September 27, 2014, from http://www.acof.org/about/who-we-are/
- Buckrop, J. J. (1992). Homelessness in America: An analysis of the rhetorical relationship between legitimacy and guilt.add info
- CTI Model. (2014). Any title Retrieved January 28, 2017, from https://www.criticaltime.org/cti-model/
- Diaz, M.A., Nickels, G., Kautz, E. B., Newsom, G., Stultz, J. T., Cochran, T. (2008, December). A Status Report on Hunger and Homelessness in America's Cities: A 25-City Survey. The United States Conference of Mayors, 1620 Eye Street, NW, Washington, DC 20006. retrieved from http://usmayors.org/pressreleases/documents/hungerhomelessnessreport_121208.pdf
- Galea, S. (2016, February 28). Homelessness, Its Consequences, and Its Causes | |? Boston University. Retrieved January 26, 2017, from https://www.bu.edu/sph/2016/02/28/homelessness-its-consequences-and-its-causes/
- Healthy Aging Begins at Home. (2016, November 30). Retrieved January 28, 2017, from http://bipartisanpolicy.org/library/recommendations-for-healthy-aging/
- Khouri, A. (2014, May 28). Shortage of affordable housing is dire in L.A. County, advocates say. Retrieved September 14, 2014, from http://www.latimes.com/business/realestate/la-fi-re-affordable-housing-20140528-story.html
- LINC's History. (2014). Retrieved September 21, 2014? , from http://www.linchousing.org/about/history.html
- Logan, T. (2014, June 25). Housing costs are a greater burden in L.A. than elsewhere. Retrieved September 13, 2014, from http://www.latimes.com/business/realestate/la-fi-affordable-housing-20140626-story.html
- Lurie, K. & Schuster, B. (May 2015). Discrimination at the margins: The intersectionality of homelessness and other marginalized groups. pp, i-5. Seattle University: School of Law: Homeless Rights Advocacy Project
- National Alliance to End Homelessness. (2006). What is housing first? Retrieved on January 28, 2017, from http://www.endhomelessness.org/library/entry/what-is-housing-first
- National Coalition for the Homeless. (2014). Why are people homeless? Retrieved October 4, 2015, from http://nationalhomeless.org/about-homelessness/
- National CORE: About Us. (2013). Retrieved September 7, 2014, from http://nationalcore.org/about-us/
- Pearson, C. L., Locke, G., Montgomery, A.E., Buron, L. (2007). The applicability of Housing First models to homeless persons with serious mental illness: Final report. US Department of Housing and Urban Development, Office of Policy Development and Research.
- Project New Hope: Providing HOPE through Homes, Opportunities, Placement and Employment. (2008). Retrieved September 23, 2014, from http://www.projectnewhope.org/PNHjourney.html
- Romero, D. (2014, July 10). Maybe Now's the Time to Buy a House in L.A. Retrieved September 26, 2014, from http://www.laweekly.com/informer/2014/07/10/maybe-nows-the-time-to-buy-a-house-in-la
- Russell, A. (2010). Housing First and harm reduction: Effective models for substance abuse treatment with individuals who are homeless. Praxis, 10, 63-69.
- Should the government help the homeless? (2017). Retrieved January 27, 2017, from http://www.debate.org/opinions/should-the-government-help-the-homeless
- Single Room Occupancy (SRO) Housing Corporation: About. (2011). Retrieved September 26, 2014, from http://www.srohousing.org/about
- Stone, D (2012). Introduction. In Policy paradox: The art of political decision-making (3rd Ed., pp.1-15). New York: W.W. Norton & Company.
- Tsemberis, S. (2011). Housing first: The pathways model to end homelessness for people with mental illness and addiction manual. European Journal of Homelessness _ Volume, 5(2).
- Viveiros, J. & Brennan, M. (2013, May). An Annual Look at the Housing Affordability Challenges of America’s Working Households. Center for Housing Poilcy. Retrieved September 25, 2014 from http://www.nhc.org/media/files/Landscape2013.pdf
- Workers, N. A. (2008). NASW Code of Ethics (Guide to the Everyday Professional Conduct of Social Workers). Washington, DC: NASW