Defining Homelessness

The US Department of Housing and Urban Development (HUD) defines an individual experiencing homelessness as someone who “lacks a fixed, regular, and adequate nighttime residence.” Homelessness is indiscriminate. It affects men and women, young and old, the educated and uneducated, straight and LGBTQ+, and people of any age, race, or walk of life. Homelessness occurs when extreme poverty is combined with unstable housing.

When we first think of an individual experiencing homelessness, we often picture what is referred to as the “visible homeless.” These are the people we see sleeping on the street, walking around the city, or asking for help. While these individuals are experiencing homelessness, they do not represent the homeless population as a whole.  In addition to the visible homeless, there are many more types of homelessness, such as the “hidden homeless.” This population consists of “couch surfers,” multiple families sharing the same house, or people “doubling up” with family and friends. Homelessness also includes those living in transitional housing, shelters, hotels, and people about to be released from prison. Another significant portion of the homeless population consists of people fleeing from domestic violence without another place to go.

Beyond those actively experiencing homelessness, we must consider the precariously housed. This term refers to people who would become homeless within three months if they suddenly lost their income. There are many more people in this category than we might initially think. Shawnee has a population of roughly 31,400 people and approximately 1,500-2,000 individuals experiencing homelessness. This translates to a homeless rate of roughly 5% or 1 out of every 20 people.

What Causes Homelessness?
Many factors may contribute to an individual becoming homeless. These include domestic violence, mental or physical disabilities, changes in family status, and incarceration. Many people believe that the majority of homeless people have lost their housing as a result of drug or alcohol abuse, but this is not the case. Substance abuse accounts for a very small percentage of cases and is typically a result of living for months with severe anxiety and desperation. The leading cause for homelessness is loss of job, usually as a result of an illness or disability.

Medical expenses are the leading cause of financial calamity preceding homelessness. An individual may suffer a serious injury or illness, making it difficult to hold a job. In turn, they face a major decline in income. This cycle can result in insurmountable expenses. The combination of unemployment and poor health can easily lead to serious financial ruin.

The common cycle into homelessness: 
  1. Sickness or injury leads to loss of work
  2. The individual has no money or insurance to pay for healthcare
  3. They must make choices between healthcare and other needs (food, shelter, children, etc.)
  4. The individual will use up their savings.
  5. They will use up money from family and friends.
  6. The person enters homelessness.

Health, Stress, and Homelessness
Many individuals fail to recognize the dangers that accompany living without a home. People experiencing homelessness face immense stress, malnutrition, much higher exposure to diseases, and have a significantly higher risk of developing anxiety, depression, and substance abuse. This does not include the severe violence, often housed on unhoused, and many other health-related issues. 

Homelessness is considered to be a public health issue. It is recognized as a serious medical condition, holding its own ICD-10 code in hospital settings. The sick and vulnerable are among the first to become homeless, where they continue to become increasingly sicker and more vulnerable. Unhoused people die an average of two decades sooner than the average person, are twenty-nine times more likely to develop Hepatitis C, twenty times more likely to have epilepsy, and are at a significantly higher risk of developing many more diseases.