(Re)Defining Homelessness – A Synthesis of Thoughts
Homelessness is a temporary condition that people fall into when they cannot afford to pay for a place to live, or when their current home is unsafe or unstable. Other factors, such as job loss, physical and mental disability, various hardships—including personal, and drug addiction can accelerate people’s slide into poverty, and for some, eventual homelessness, especially in the absence of proper social services. The lack of housing, access to healthcare, and supportive services, then act as others barriers that keep individuals from moving into homefullnesss.
Homelessness is also a state of vulnerability – to health risks, violence, and harassment by police; heightened exposure to the elements; and the absence of privacy. Homelessness can turn into a more permanent condition when people become alienated from society and/or it becomes increasingly difficult and frustrating to reintegrate into the “mainstream”. However, homelessness is not an inherent quality of trait and it is not linked with any particular identity, nor does it define the people experiencing it. Each individual is unique and must be addressed in that way, and each person is worthy of being treated equally in society and should be given the utmost opportunity to succeed and transition out of a state of homelessness. Homeless people are also not a “population” of their own; they are individuals who have every right to the access afforded to people in society. Thus, it is important that we recognize that the greatest contribution one can make towards ending homelessness is acknowledging someone with a smile or a nod and showing that we recognize them—most importantly, that we recognize them as human beings.
Here, it is imperative that we think and talk different about his multifaceted and complex issue. To start, it is important to talk more positively about homelessness. We should refer to people experiencing homelessness as ‘un-housed’ individuals in a state of homelessness. It is also important to highlight common misconceptions about homeless men and women; a frequent one is equating substance use/abuse with un-housed individuals. Although there is a large number of un-housed individuals, who may suffer from substance use/abuse, we cannot equate the two. This is also true when it comes to attributing mental illness.
The following are quotes that reinforce the aforementioned ideas about thinking differently:
Getting people of the streets is such a negative stereotype, that I would probably use the paradigm of getting them housed. If they are homeless we want them to be housed, if they are penniless we want them to have money, if they are hungry we want them to fed, if they are cold we want them to be warm, if they are wet we want them to be dry. So, rather than ever getting into a negative, we want to accomplish something that is the removal of this.
I am not homeless, I’ve been living homeless in Palo Alto for 20 years, on the streets, I was never homeless, I just didn’t have a house,
Our hope is that this definition will be able to shed a new and positive light on people experiencing homelessness and help to see the importance of promoting the need to afford utmost access and assistance to homeless men, women, and children to help them in their current situations and move them to homefullness.
- The homeless are not just the people you see on Telegraph Avenue. To be homeless simply means to not have your own home and includes people living on their friend’s couches or in their cars. It could be the guy or gal waiting your table. It is important not to assume that anyone does or doesn’t have a home, particularly based on their appearance.
- Not all homeless are jobless. In 2000 a survey of 27 U.S. cities found that over one in four people in homeless situations are employed.
- In the past 20-25 a growing shortage of affordable rental housing and a simultaneous increase in poverty have led to a rise in homelessness.
- Living in poverty often means being an illness, an accident, or a paycheck away from having to choose between housing, food, child care, health care, and education. Often housing is the first to be relinquished, as it absorbs a high proportion of income is dropped first. In 2000, 11.3% of the U.S. population, or over 31 million people, lived in poverty. 39% of all people living in poverty had incomes less than half that of the poverty line.
- Two factors help account for increasing poverty. First – eroding employment opportunities: falling incomes, fewer benefits, less secure jobs, lessening of union power, erosion of the real value of minimum wage, increased temporary and part-time employment, and outsourcing of non-service sector positions. Second – the continuing decline in the value and availability of public assistance, most recently with Welfare reform and budget cuts. Other factors include a lack of affordable health care (38.7 million Americans), domestic violence (over 22% of the homeless population are victims), mental illness (22% of the homeless population are afflicted), and addiction disorders (complex + controversial)
10 Homelessness Myths
- Homeless people are lazy. In fact, over 45% of people who are homeless have a job(s) while they are homeless. Joblessness also exists as many times wages do not translate into livable earnings.
- Homeless people are alcoholics/drug addicts. In fact, about 35-45% of people who are homeless do have a substance abuse problem; however the relationship between homelessness and alcohol and drug addiction is quite controversial. While addiction and drug use is prevalent, many homeless individuals use substances in order to self-medicate, exposing a fundamental problem in our nation’s lack of healthcare provision for the poor and homeless.
- Homeless people are crazy. In fact, 20-25% of the single adult homeless population suffers from some form of severe and persistent mental illness, the most common of which is depression. Consequently, many people develop mental illnesses while on the street.
- Homeless people are uneducated. In fact, many people who are homeless have high school diplomas or their GED, college degrees and even Masters Degrees.
- Homeless people want to be homeless. In fact, nobody in their right mind wants to become homeless. There are some people who are “chronically homeless” who have lost faith in society; they don’t think that there is another way out because of society’s treatment towards the homeless.
- Homeless people are dirty/smell. In fact, you would be unable to tell that many homeless people are as such. Many people living in shelters you would never know were homeless because they have a place to shower.
- It is your fault if you become homeless. In fact, people become homeless for a wide variety of circumstances such as: family problems, abuse, mental illness, lost job, can’t afford to pay rent (lack of affordable housing and lack of a living wage), no health insurance, substance abuse (alcohol or drugs), natural disaster (hurricane, earthquake, fire etc), etc.
- Homelessness can’t happen to you. In fact, it can happen to anybody at any time. 1 out of 3 people working today are one or two missed paychecks away from being homeless, especially the 37 million people currently living in poverty.
- Homelessness will never end. In fact, homelessness can end and will end once it is no longer acceptable in our society for another human being to be sleeping outside, in their car, in an abandoned building, or in a shelter.
- Homelessness is easy to get out of. In fact, it is not. It takes a lot of work for a person to move from homelessness to homefullness and obtain access to gainful employment based on a living wage, housing, healthcare, and networks of support are imperative.
The Basics (from National Health Care for the Homeless Council)
Homelessness inevitably means serious health problems. Illnesses that are closely associated with poverty – tuberculosis, AIDS, malnutrition, severe dental problems – ravage the homeless population. Health problems that exist quietly at other income levels – alcoholism, mental illnesses, diabetes, hypertension, physical disabilities – are prominent on the streets. Human beings without shelter fall prey to parasites, frostbite, infections and violence.
Each year, millions of Americans experience homelessness and are in desperate need of health care services. Most do not have health insurance of any sort, and none have cash to pay for medical care. Homeless people are concentrated in the nation’s urban centers and are dispersed throughout rural America, often not close to the health care facilities that they need. They don’t have transportation or any real control over their daily lives, since they depend on the routines of shelters, soup kitchens and marginal jobs to meet their most basic survival needs.
Finding health care is tough or impossible. For many homeless people, seeking health care takes a back seat to more immediate priorities for survival. For some, the symptoms of their illnesses or bad experiences with the health care system in their past cause them to actually avoid health care.
Unacceptable costs result from poor access to health care. Ultimately, as relatively minor problems develop into health care emergencies, most homeless people do get treated, but it is treatment of the most expensive sort, delivered in hospital emergency rooms and acute care wards. Through taxpayer support of public institutions and through the cost-shifting inherent in the health insurance system, we all pay the high costs of care deferred.
Undetected and untreated communicable diseases threaten the health of other homeless people in particular and of the public generally, and the bill increases as disease spreads. In the long run, perhaps the greatest costs are the moral and social results of neglecting the needs of dispossessed, seriously ill people in our midst.
A sensible and effective response to the health needs of homeless people has developed over the past ten years. In locations where homeless people congregate, health and social service workers have established clinics designed to overcome the access problems faced by homeless people, providing comprehensive care that improves people’s health and helps them to escape the trap of homelessness. These clinics are in shelters, soup kitchens, skid-row store fronts; medical vans visiting parks, underpasses and encampments; and contact with the homeless population is extended by outreach workers who aggressively seek out and patiently engage the most isolated of homeless people.
Multidisciplinary teams work to remedy the variety of problems that affect their clients’ health. Going beyond traditional medical care, these effective teams work with their clients to address issues of safe shelter and permanent housing, jobs and income, family relationships and substance abuse, all in an effort to help people get well and move out of homelessness.
Health Care for the Homeless Projects are successful because they are designed and controlled by local communities to fill significant gaps in existing health care delivery systems. Each project has well-established relationships with providers of shelter, mental health, substance abuse and hospital services in its community, and has developed considerable experience in managing the care of homeless people. Careful attention is paid to delivering high quality care in a cost-effective manner.
This model of care was developed through a 19-city demonstration program established in 1985 by The Robert Wood Johnson Foundation and the Pew Memorial Trust. In 1987, the Stewart B. McKinney Homeless Assistance Act replicated the foundations’ program and now 123 Health Care for the Homeless Projects are funded in part by the United States Public Health Service. The federal Health Care for the Homeless Program is widely recognized as one of the most effective McKinney Act programs, and is an indispensable, front-line component of our country’s struggle with homelessness.