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.
What Causes Homelessness?
If you ask people what causes homelessness, the most common responses are substance abuse and mental health problems. In reality, substance abuse and mental health problems account for only about 9% of the reasons why someone becomes homeless. Of course, substance abuse and mental health are issues at play within the homeless community, but they usually are a result of homelessness and come in down the line.
By far, the most common reason why a person becomes homeless is the loss of a job, which accounts for 35% of people entering homelessness. And for the majority of those, the loss of a job was preceded by an illness or injury. A serious illness or injury makes working difficult, which leads to a declining income. Ultimately, many end up losing their job as a result. On top of that, the illness or injury can cause insurmountable expenses. The combination of unemployment and poor health lead to financial ruin. Medical expenses are the leading cause of financial disaster that precedes homelessness. In fact, 57% of personal bankruptcies are due to medical bills.
There are a lot of reasons why a person might find themselves homeless, including job loss, illness, domestic violence, community and family failures, or just plain lack of affordable housing. In fact, many of us are just one illness or divorce away from being homeless.
The common cycle into homelessness:
- Sickness or injury leads to loss of work
- The individual has no money or insurance to pay for healthcare
- They must make choices between healthcare and other needs (food, shelter, children, etc.)
- The individual will use up their savings.
- They will use up money from family and friends.
- 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.