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File:P7032101 small2.jpg
A homeless person in Paris.

Homelessness refers to the condition and societal category of people who lack housing, or live in transitional housing, or who spend most nights in a supervised public or private facility providing temporary living quarters, or in a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings.

History of homelessness

In the sixteenth century in England, the state first tried to give housing to vagrants instead of punishing them, by introducing bridewells to take vagrants and train them for a profession. In the eighteenth century, these were replaced by workhouses but these were intended to discourage too much reliance on state help. These were later replaced by dormitory housing ("spikes") provided by local boroughs, and these were researched by the writer George Orwell. By the 1930s in England, there were 30,000 people living in these facilities. In the 1960s, the nature and growing problem of homelessness changed for the worse in England, with public concern growing. The number of people living "rough" in the streets had increased dramatically. However, beginning with the Conservative administration's Rough Sleeper Initiative, the number of people sleeping rough in London has fallen from over 1,000 in 1990 to less than 200 in 2006. This initiative was supported further by the incoming Labour administration from 1997 onwards with the publication of the 'Coming in from the Cold' strategy published by the Rough Sleepers Unit, which proposed and delivered a massive increase in the number of hostel bed spaces in the capital and an increase in funding for street outreach teams, who work with rough sleepers to enable them to access services.


In general, in most countries, 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. This resulted in rescue missions, such as the oldest homeless shelter in New York City, The Bowery Mission, founded in 1879 by the Rev. and Mrs. A.G. Ruliffson.

The Bowery Mission in New York City in the 1800s

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.

Although not specifically about the homeless, Jacob Riis wrote about, documented, and photographed the poor and destitute in New York City tenements in the late 1800s. He wrote a ground-breaking book including such material in "How the Other Half Lives" in 1890, which inspired Jack London's The People of the Abyss (1903). Public awareness was raised by this, causing some changes in building codes and some social conditions.

However, modern homelessness as we know it, started as a result of the economic stresses in society, reduction in the availability of affordable housing, such as SROs, for poorer people. In the United States, in the late 1970s, the deinstitutionalisation 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 SROs 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.

Also, as real estate prices and neighborhood pressure increased to move these people out of their areas, the SROs diminished in number, putting most of their residents in the streets.

Other populations were mixed in later, such as people losing their homes for economic reasons, and those with addictions, the elderly, and others.

Homeless person with a collection of possessions, living under a bridge in Rome.

Many places where people were once allowed freely to loiter, or purposefully be present, such as churches, public libraries and public atriums, became more strict as the homeless population grew larger and congregated in these places more than ever. As a result, many churches closed their doors when services were not being held, libraries enforced a "no eyes shut" and sometimes a dress policy, and most places hired private security guards to carry out these policies, creating a social tension. Many public toilets were closed.

This banished the homeless population to sidewalks, parks, under bridges, and the like. They also lived in the subway and railroad tunnels in New York City. They seemingly became socially invisible, which was the intention of many of the enforcement policies.

The homeless shelters, which were generally night shelters, made the homeless leave in the morning to whatever they could manage and return in the evening when the beds in the shelters opened up again for sleeping. There were some daytime shelters where the homeless could go, instead of being stranded on the streets, and they could be helped, get counseling, avail themselves of resources, meals, and otherwise spend their day until returning to their overnight sleeping arrangements. An example of such a day center shelter model is Saint Francis House in Boston, Massachusetts, founded in the early 1980s, which opens for the homeless all year long during the daytime hours.

There was also the reality of the "bag" people, the shopping cart people, and the soda can collectors. These people carried around all their possessions with them all the time since they had no place to store them. If they had no access to or capability to get to a shelter and possible bathing, or access to toilets and laundry facilities, their hygiene was lacking. This again created social tensions in public places.

These conditions created an upsurge in tuberculosis and other diseases in urban areas.

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.

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.

Also, in the 1980s, in the United States, some federal legislation was introduced for the homeless as a result of the work of Congressman Stewart B. McKinney. In 1987, the McKinney-Vento Homeless Assistance Act was enacted.

Several organisations in some cities, such as New York and Boston, tried to be inventive about help to the swelling number of homeless people. In New York City, for example, in 1989, the first street newspaper was created called "Street News" which put some homeless to work, some writing, producing, and mostly selling the paper on streets and trains. It was written pro bono by a combination of homeless, celebrities, and established writers. In 1991, in England, a street newspaper, following on the New York model was established, called "The Big Issue" and was published weekly. Its circulation grew to 300,000. Chicago has "StreetWise" which has the largest circulation of its kind in the United States, thirty thousand. Boston has a "Spare Change" newspaper built on the same model as the others: homeless helping themselves. More recently, Street Sense, in Washington, D.C. has gained a lot of popularity and helped many make the move out of homelessness. Students in Baltimore, M.D. have opened a satellite office for that street paper as well (www.streetsense.org).

In 2002, research showed that children and families were the largest growing segment of the homeless in America, and this has presented new challenges, especially in services, to agencies. Back in the 1990s, a teenager from New York, Liz Murray, was homeless at fifteen years old, and overcame that and went on to study at Harvard University. Her story was made into an Emmy-winning film in 2003, "Homeless to Harvard".

File:Enfants de don quichotte.jpg
Tents for homeless people on the Canal Saint-Martin in Paris, December 2006-January 2007, put there by the Enfants de Don Quichotte NGO (videos available on site).

Some trends involving the plight of the homeless have provoked some thought, reflection and debate. One such phenomenon is paid physical advertising, colloquially known as "sandwich board men" and another specific type as "Bumvertising". Another trend is the side effect of unpaid free advertising of companies and organisations on shirts, clothing and bags, to be worn by the homeless and poor, given out and donated by companies to homeless shelters and charitable organisations for otherwise altruistic purposes. These trends are reminiscent of the "sandwich board signs" carried by poor people in the time of Charles Dickens in the Victorian 1800s in England and later during the Great Depression in the United States in the 1930s.

Terms for Homelessness

The term most often used in the late twentieth century is "homeless". However, other terms include: vagrant, tramp, hobo (U.S.), transient, bum (U.S.), bagman/bagwoman, sturdy beggar, or the wandering poor. The term '(of) No Fixed Abode' (NFA) is used in legal circumstances.

More recently, many advocates and individuals who have experienced homelessness prefer using the term “houseless” to reflect more accurately the fact that the problem resides not with the lack of a home, which carries with it connotations including propinquity to family and other meta-physical notions, but with the more concrete problem of not having a house or apartment in which to live.

In different languages, the term for homelessness reveals the cultural and societal perception and classification of a homeless person:

  • Spanish: "persona sin hogar" (person without a home)
  • French: "Sans domicile fixe" (SDF, without a fixed domicile)
  • German: "obdachlos" (without a roof above)
  • Italian: "Senzatetto" (without a roof)
  • Portuguese: "sem-teto" (without a roof) or "Pessoa sem abrigo" (person without a shelter)

Definition of homeless

The U.S. Department of Housing and Urban Development (HUD) defines the term "homeless" or "homeless individual or homeless person" as -- (1) an individual who lacks a fixed, regular, and adequate nighttime residence; and (2) 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); B) an institution that provides a temporary residence for individuals intended to be institutionalized; or C) a public or private place not designed for, or ordinarily used as, a regular sleeping accommodations for human beings.

Pre-disposing factors to homelessness

Skid Row in Los Angeles, CA

Most researchers attempt to make a distinction between: 1) why homelessness exists, in general, and 2) who is at-risk of homelessness, in specific. Homelessness has always existed since urbanization and industrialization.

Factors placing an individual at high-risk of homelessness include:

  • Poverty: People living in poverty are at a higher risk of becoming homeless.
  • Drug or alcohol misuse: It is not uncommon for homeless to suffer from a substance abuse problem. Debate exists about whether drug use is a cause or consequence of homelessness. However, regardless when it arises, an untreated addiction "makes moving beyond homelessness extremely difficult."
  • Serious Mental Illness and Disability: It has been estimated that approximately one-third of all adult homeless persons have some form of mental illness and/or disability. In previous eras, these individuals were institutionalized in state mental hospitals. According to the National Alliance for the Mentally Ill (NAMI), there are 50,000 mentally ill homeless people in California alone because of deinstitutionalization between 1957 and 1988 and a lack of adequate local service systems. Various assertive outreach approaches, including a mental health treatment approach known as Assertive Community Treatment and the Path Program, have shown promise in the prevention of homelessness among people with serious mental illness.
  • Foster Care background: This population experienced rates of homelessness nearly 8 times higher than the non-foster care population.
  • Escaping domestic abuse, including sexual, physical and mental abuse: Victims who flee from abuse often find themselves without a home. Abused children also have a higher chance of succumbing to a drug addiction, which contributes to difficulties in establishing a residence. In 1990 a study found that half of homeless women and children were fleeing abuse.
  • Prison discharge: Often the formerly incarcerated are socially isolated from friends and family and have few resources. Employment is often difficult for those with a criminal record. Untreated substance abuse and mental illness also may put them at high risk for homelessness onced discharged.
  • Civilian during war: Civilians during war or any armed conflict are also are at a higher risk for homelessness, because of possible military attacks on their property, and even after the war rebuilding their homes is often costly, and most commonly the government is overthrown or defeated which is then unable to help its citzens.

Main causes of homelessness

The major reasons and causes for homelessness as documented by many reports and studies include:

  • Lack of affordable housing
  • Low paying jobs
  • Substance abuse and lack of needed services
  • Mental illness and lack of needed services
  • Domestic violence
  • Unemployment
  • Poverty
  • Prison release and re-entry into society
  • Change and cuts in public assistance

The high cost of housing is a by-product of the general distribution of wealth and income. The rate of homelessness has also been impacted by the reduction of household size witnessed in the last half of the 20th century.

Individuals who are incapable of maintaining employment and managing their lives effectively due to prolonged and severe drug and/or alcohol abuse make up a substantial percentage of the U.S. homeless population. The link between substance abuse and homelessness is partially caused by the fact that the behavioral patterns associated with addiction can alienate an addicted individual's family and friends who could otherwise provide a safety net against homelessness during difficult economic times.

Increased wealth and income inequality have caused distortions in the housing market that push rent burdens higher, thereby decreasing the availability of affordable housing.

Some homeless individuals choose not to have a permanent residence, including travelers and those who have personal spiritual/religious convictions (as yogis in India). Most researchers feel the population of individuals who choose not to have a permanent residence is negligible. Many people who respond that they "prefer" the homeless lifestyle suffer from mental illness, trauma or have adapted to the lifestyle and the response reflects a socially-desirable response or justification rather than having no real desire for stable shelter.

Refuges for the Homeless

There are many places where a homeless person might seek refuge.

  • The Outdoors: Exposed or in a tent
  • Vehicles: such as a car or a motorhome. Some people who live nomadically in a motorhome or trailer are people of means who do so by choice and do not think of themselves as "homeless" in the sense it is usually used. For others a vehicle might serve as a temporary living refuge, for example those recently evicted from a home.
  • Public places: parks, bus or train stations, airports
  • Derelict structures: abandoned buildings, ruined cars, beached boats
  • Shelters
  • Boarding houses, or more specifically, flophouses which offer cheap temporary lodging and are often used by those trying to pull themselves out of homelessness or who are one step above homelessness.
  • Friends or family: This is distinguished from living with friends or family in that it is temporary. This is occasionally referred to as "couch surfing".
  • Hobo jungles: Ad hoc campsites usually near rail yards.
  • Hotels: Gaining temporary shelter by staying in hotels is common among the houseless. Though many lack the money to rent a room so they do not literally "stay" in a hotel, they rather sleep in the lobby.

Services

Homeless woman in Nice, France.

Homeless shelters operated by government, churches, or charities work to provide temporary housing to the homeless.

Types of shelters include overnight shelters, warming shelters, transitional shelters, and subsidized housing. There are also day shelters which give basic services during the daytime hours when many of the overnight shelters for sleeping are closed.

In the United Kingdom, the majority of services for single homeless people and couples are provided by the voluntary sector, usually through contracts paid for by local government through Supporting People. Services available to homeless people include night shelters, day centres, hostels, resettlement services and floating support.

While some shelters also provide food, others require people to turn to food banks and soup kitchens for nutrition. In the United Kingdom, these services are usually paid for by homeless people themselves in service charges in addition to the housing benefit which pays the rent.

Auxiliary services provided by some shelters include:

However, there are a number of complaints about the safety and quality of homeless shelters. Subsidized housing is a more expensive solution that some believe might end the cycle of homelessness. Homeless Link in the UK provides minimum standards and best practice advice on how agencies can best deal with their clients to ensure permanent change and solutions to homelessness.

An "outreach program" is a group that may include police officers, formerly homeless civilian outreach workers, or counselors. This team makes contact with homeless people and can provide assistance, or guide them to shelters for assistance. This can avoid unnecessary and costly arrests intended to displace the homeless.

Most homeless people have no means of communications with the outside world. Few have access to a phone to make or receive calls, get voice messages, send and receive a fax or email. Many support organisations provide some limited local phone access, voice mail, and internet computers with email. This is critical in a modern technological world for medical appointment verification, job and services searches.

Health care for the homeless

In general, health care for the homeless is a very important charitable issue and a public health issue.

The homeless are under-served for medical problems. State medical insurance is one possibility, but many homeless can't get access to it. Free-care clinics, especially for the homeless, exist and are usually over-burdened with patients.

The actual medical conditions affecting the homeless are somewhat specialized and has opened a newer area of medicine catering to this population. Skin diseases and conditions abound, as well as dental, personal hygiene and the like. Specialized medical textbooks have been written to address this for providers.

The effects of poor nutrition, substance abuse, and unmitigated exposure to the severe elements of weather are important considerations.

There are many organizations providing free care all over the world for the homeless, but the services are in great demand given the limited number of medical practitioners helping. For example, it might take months to get a minimal dental appointment in a free-care clinic.

Communicable diseases are of great concern, especially Tuberculosis in high density urban populations.

Income opportunities

Many non-profit organizations such as Goodwill Industries maintain a mission to "provide skill development and work opportunities to people with barriers to employment", though most of these organizations are not primarily geared toward homeless individuals. Many cities also have street newspapers or magazines: publications designed to provide employment opportunity to homeless people or others in need by their sale on the streets of their respective cities.

While some homeless have paying jobs, some must seek other methods to make money. Begging or panhandling is one option, but is becoming increasingly illegal in many cities. Despite the stereotype, not all homeless people panhandle, and not all panhandlers are homeless. Another option is busking: performing tricks, playing music, drawing on the sidewalk, or offering some other form of entertainment in exchange for donations. In cities where pharmaceutical companies still collect paid blood plasma, homeless people may generate income through frequent visits to these centers.

Homeless people have been known to commit crimes just to be sent to jail or prison for food and shelter. In police lingo, this is called "three hots and a cot." Similarly a homeless person may approach a hospital's emergency department and fake a mental illness in order to receive food and shelter.

Statistics for developed countries

The following statistics indicate the approximate average number of homeless people at any one time. Each country has a different approach to counting homeless people, and estimates of homelessness made by different organisations vary wildly, so comparisons should be made with caution.

European Union: 3,000,000 (UN-HABITAT 2004)
England: 10,459 rough sleepers, 98,750 households in temporary accommodation (Department for Communities and Local Government 2005)
Canada: 150,000 (National Homelessness Initiative - Government of Canada)
Australia: 99,000 (ABS: 2001 Census)
United States: Chronically homeless people (those with repeated episodes or who have been homeless for long periods) 150,000-200,000 (some sources say 847,000-3,470,000) though a report in January 2007 said 744,000.
Japan: 20,000-100,000 (some figures put it at 200,000-400,000)

Developing and undeveloped countries

The number of homeless people worldwide has grown steadily in recent years. In some Third World nations such as Brazil, India, Nigeria, and South Africa, homelessness is rampant, with millions of children living and working on the streets. Homelessness has become a problem in the cities of China, Thailand, Indonesia, and the Philippines despite their growing prosperity, mainly due to migrant workers who have trouble finding permanent homes and to rising income inequality between social classes.

Homelessness in the popular media

Popular films

Documentary films

TV documentaries

Homelessness in specific countries

Main article: Homelessness in the United States

Main article: Homelessness in Canada

Main article: Homelessness in Australia

Main article: Homelessness in the United Kingdom

Voluntary Homelessness

Voluntary Homelessness is also known as Nomadism. Some choose Homelessness as a lifestyle, preferring it to a settlement with society's norms. Nomads have existed throughout history.

See also

References
  1. Office of Applied Studies, United States Department of Health and Human Services,"Terminology"
  2. United States Code, Title 42, Chapter 119, Subchapter I, § 11302. United States Code: General definition of a homeless individual.
  3. The Bowery Mission For a history see
  4. Depastino, Todd, "Citizen Hobo: How a Century of Homelessness Shaped America"
  5. Scherl D.J., Macht L.B., "Deinstitutionalization in the absence of consensus", Hospital and Community Psychiatry, 1979 Sep;30(9):599-604
  6. Rochefort, D.A., "Origins of the 'Third psychiatric revolution': the Community Mental Health Centers Act of 1963", Journal of Health Politics, Policy and Law, 1984 Spring;9(1):1-30.
  7. Feldman, S., "Out of the hospital, onto the streets: the overselling of benevolence", Hastings Center Report, 1983 Jun;13(3):5-7.
  8. Borus J.F., "Sounding Board. Deinstitutionalization of the chronically mentally ill", New England Journal of Medicine, 1981 6 August;305(6):339-42.
  9. Harman, Dana, "Read all about it: street papers flourish across the US", The Christian Science Monitor, November 17, 2003.
  10. http://www.bigissue.com/
  11. FACS, "Homeless Children, Poverty, Faith and Community: Understanding and Reporting the Local Story", March 26 2002 Akron, Ohio.
  12. National Coalition for the Homeless, "Homeless Youth" 2005
  13. Schreiber Cindy, "Sandwich men bring in the bread and butter", Columbia (University) News Service, May 08, 2002.
  14. Associated Press and CNN, "Pizza company hires homeless to hold ads", Tuesday, June 17 2003.
  15. Victorian London site, "Sandwich Men"
  16. Coalition on Homelessness and Housing in Ohio (2006-09-17). Homelessness: The Causes and Facts. Retrieved 2006-05-10.
  17. http://content.healthaffairs.org/cgi/content/full/hlthaff.w5.212/DC1
  18. Robert A. Rosenheck, MD; Deborah Dennis, MA, "Time-Limited Assertive Community Treatment for Homeless Persons With Severe Mental Illness", Archives of General Psychiatry. 2001;58:1073-1080.
  19. Dixon L, Weiden P, Torres M, Lehman A., "Assertive community treatment and medication compliance in the homeless mentally ill", American Journal of Psychiatry. 1997 Sep;154(9):1302-4.
  20. Meisler N, Blankertz L, Santos AB, McKay C., "Impact of assertive community treatment on homeless persons with co-occurring severe psychiatric and substance use disorders", Community Mental Health Journal, 1997 Apr;33(2):113-22.
  21. Homeless Agency. Facts about Homelessness: Causes of Homelessness. Retrieved 2006-05-10.
  22. National Coalition for the Homeless (June 2005). Often, more local resources are available to fleeing women and children as this group is easier to identify and improve their situation. Domestic Violence and Homelessness. Retrieved 2006-05-11.
  23. Chicago Coalition for the Homeless. Homelessness—Causes and Facts. Retrieved 2006-05-10.
  24. http://www.chicagohomeless.org/factsfigures/war.pdf#search=%22War%20and%20homelessness%22
  25. United States Conference of Mayors, "A Status Report on Hunger and Homelessness in America's Cities: a 27-city survey", December 2001.
  26. United States Conference of Mayors, "US Conference of Mayors/Sodexho Hunger and Homelessness Survey: 2005", December 2005, "Main Causes of Homelessness", p.63-64.
  27. Coalition on Homelessness and Housing in Ohio (2006-09-17). Homelessness: The Causes and Facts. Retrieved 2006-05-10.
  28. "Homeless advocates urge council to remember 'couch surfers'", Susan O'Neill, Inside Toronto, Canada, 7 July 2006
  29. Coalition on Homelessness and Housing in Ohio. Homelessness: The Causes and Facts. Retrieved 2006-05-10.
  30. Homeless Link
  31. National Coalition for the Homeless. A Dream Denied: The Criminalization of Homelessness in U.S. Cities. Retrieved 2006-05-11.
  32. Allis, Sam (May 14, 2006). "A port in the storm Center gives homeless a phone and a chance". The Boston Globe. Globe Newspaper Company.
  33. Aday, Lu Ann , "Health status of vulnerable populations", Annual Review of Public Health, 1994;15:487-509.
  34. Bibliography on Healthcare for the Homeless
  35. United States Department of Health and Human Services, "Healthcare for the Homeless".
  36. Ferguson, M., "Shelter for the Homeless", American Journal of Nursing, 1989, pp.1061-2.
  37. Lenehan, G., McInnis, B., O'Donnell, and M. Hennessey, "A Nurses' Clinic for the Homeless", American Journal of Nursing, 1985, pp.1237-40.
  38. Martin-Ashley, J., "In Celebration of Thirty Years of Caring: Pine Street Inn Nurses Clinic", Unpublished.
  39. Homeless Health Concerns - National Library of Medicine
  40. Wood, David, (editor), "Delivering Health Care to Homeless Persons: The Diagnosis and Management of Medical and Mental Health Conditions", Springer Publishing Company, March 1992, ISBN 0-8261-7780-8
  41. "No Angels Here: The Closing of the Pine Street Inn Nurses Clinic, 1972–2003", by Grace Elizabeth Moore, Harvard Divinity School, Center for the Study of World Religions
  42. O'Connell, James, J, M.D., editor, et al. "The Health Care of Homeless Persons: a Manual of Communicable Diseases & Common Problems in Shelters & On the Streets", Boston Health Care for the Homeless Program, 2004.
  43. Government of Canada, "National Homelessness Initiative: Working Together"
  44. Australian Bureau of Statistics, "Housing Arrangements: Homelessness", 2004.
  45. National Alliance to End Homelessness
  46. "Study: 744,000 homeless people in U.S.". Associated Press. Jan. 10, 2006. Article is here, too.
  47. "In pictures: Japan's homeless", BBC News.

Bibliography

External links

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