The Injustice and Dehumanization of Experiencing Homelessness

Note: the following piece was co-authored by Providence Associates Jane Fischer and Suzie Ray.

Homelessness touches every community and every person whether we admit it or not. Homelessness is personal, emotional and political. It is personal if it happens to you or someone you know. It is emotional if it happens to someone in your family. And it is political when people try to push for services and solutions. We all know that public opinion, attitudes, biases, prejudices, services and solutions vary. Let us bring in some facts and figures on this touchy subject. 

Forbes Advisor reports that 28 percent of Americans across four generations have less than $1,000 in personal savings. That includes emergency funds, non-workplace retirement accounts and other investments. With the average national rent price at or about $1,372, having less than a grand tucked away means 28 percent of Americans and their families are on the edge of financial instability, with little to absorb unexpected expenses. This is living on the margin. These 28 percent are without sufficient income or savings and are daily on the brink of homelessness. Not only is this frightening, it is emotionally, mentally and physically unhealthy. Their ability and/or privilege to relax and create a plan for success, with or without input from others, is jeopardized. Any type of car trouble, unforeseen medical expenses, job loss, illness, or family emergencies can bring on a housing crisis. 

Homelessness is an Economic Issue!

Providence Associate Maria Price has spent years working with people who are experiencing homelessness. When interviewed recently, she simply stated,  “Homelessness is an economic issue.”  And many others in the field agree. 

G. Robert Watts,  Editor of AMA Journal of Ethics, offers the following:  “As members of society and clinicians, [we] are ethically obligated to offer homeless [people] health care in the United States and to work to end homelessness: (1) homelessness harms people’s health and well-being; (2) homelessness harms the health system and health professionals; and, finally, (3) homelessness is a result of inequitable policies, practices, and choices our society has made.”

There are many schools of thought on how to help people experiencing homelessness. Below are the more common methodologies used in communities. However, there is a lot of debate about which is most effective. 

Approaches

• Housing First  provides immediate access to permanent housing with no housing readiness requirements. Transforms individual lives by ending homelessness and supporting recovery. Strong evidence exists that the Housing First model leads to quicker exits from homelessness and greater housing stability over time compared with treatment as usual. And moderate evidence points to “reduced use of emergency department services, fewer hospitalizations and less time hospitalized…”The Veterans Administration Housing First team has social workers, nurses, psychiatrists, vocational and substance abuse counselors available 7 days a week, 24 hours a day for those enrolled in the Housing First program.
• Treatment First prioritizes the value of addiction recovery, personal transformation and self-sufficiency. Treatment First requires clients to be “housing ready” — that is, in psychiatric treatment and substance-free—before and while receiving permanent housing. The National Low-Income Housing Coalition reported on 26 studies in the U.S. and Canada. The review findings are that the Treatment First approach has a greater impact on the lives of those experiencing homelessness. Treatment First: decreased homelessness by 88 percent, improved housing stability by 41 percent, reduced HIV clients experiencing homelessness by 37 percent and viral load by 22 percent, reduced depression by 13 percent, and decreased emergency department use, hospitalization and mortality.
• Permanent Supportive Housing is a solution for people who are chronically homeless frequently due to physical disability, serious mental illness, or substance use disorder. A group home is a living accommodation option for people with disabilities. Living in a group home may be a good option for those individuals who do not need advanced medical care but cannot safely live alone. The care in a group home setting allows residents to receive extra support without sacrificing their independence. Research has demonstrated that permanent supportive housing can increase housing stability and improve health. It is a cost-effective solution to lower public costs associated with crisis services such as shelters, hospitals, jails and prisons.
• Agencies and Homelessness HUD’s (United States Department of Housing and Urban Development) definition of homeless has four categories:  literally homeless, imminent risk of homelessness, homeless under other federal statutes and fleeing or attempting to flee domestic violence. HUD’s definition also includes people who are trading sex for housing and staying with friends (couch surfing) but cannot stay there for longer than 14 days. Their definition includes people being trafficked, and people who have left home because of physical, emotional and financial abuse and have no safe alternative housing. Together that makes up a large collective of people!  The perceived image or the social narrative of the “homeless” for most of us would be much narrower than that and look a lot different. United States Homeless Population by State Every January, HUD publishes the total U.S. Homeless population. As of January, 2023, there were 653,104 people reported as homeless.  The reports include individuals experiencing homelessness across the United States and also break it down by state. The counts are available at the following HUD exchange site:  Point-in-Time (PIT) figures. 

Homeless by the Numbers

• $3.16 Billion. On January 29, 2024, the HUD Continuum of Care Program, the backbone federal program supporting community homelessness, gave $3.16 billion in homeless assistance, funding over 7,000 projects nationwide.

• 46,552. The Department of Veterans Affairs announced that it provided permanent housing to 46,552 homeless Veterans in 2023.

• $7.25/hr minimum wage. As many as  40 percent-60 percent of homeless people are employed. However, they have minimum wage jobs. The U.S. minimum wage is $7.25 per hour for non-exempt workers. At minimum wage, it is extremely difficult to afford housing at $1,372 per month. A minimum wage earner would have to work 86 hours per week to afford a one-bedroom apartment. Basic math will tell you that It is hard to dig oneself out of a hole and maintain some semblance of self-sufficiency when living on the minimum wage.

We Need to Change the Narrative

When you began reading this newsletter, you had an image and an understanding of homelessness. Has that changed? Can you spend a few minutes reflecting on your implicit (unconscious) and explicit (conscious) bias? Then think about expressions such as “Gee, I look like I’m a homeless person.” When examining your own biases and the social narratives you have heard, do you say, “They are experiencing homelessness?” or do you label them by saying “they are homeless?” If you spoke about homelessness to a friend or acquaintance, what would you be able to share with them after reading this?