Changing the conventional rules: Surveying homeless people in nonconventional locations

Abstract

This paper describes the feasibility, validity, and cost‐effectiveness of supplementing surveys of shelter clients with surveys of people from nondwelling places (e.g., public places such as bus stations, parked cars and trucks, and abandoned buildings), nonresidential service locations (e.g., soup kitchens, day programs, health clinics), and other residential settings (e.g., jails, hospitals, group homes). The purpose of these supplements is to develop a more accurate estimate of how many homeless people there are, what their needs are, and the extent to which their needs are being met. The essential feature of these attempts involves systematic searches on a sample basis for homeless persons in these places. Reviewing ten studies that have attempted such surveys in the past decade and four that are now attempting to do so, this paper examines the comparative advantages and disadvantages of each approach and when each would be most appropriate. Particular attention is paid to the feasibility and desirability of surveying nondwelling or street locations.     

The physical and mental health status of homeless adults

Abstract

This paper reviews recent research on the physical and mental health status of homeless single adults and briefly summarizes definitional, sampling, and measurement problems. It presents findings from research examining the physical health status of homeless adults; the data suggest that homelessness places people at greater risk for specific health problems and also complicates treatment. The authors then review findings on the mental health status of homeless adults from several methodologically rigorous studies that carefully define and measure mental illness among the homeless population. The final section discusses what is known about the short‐ and long‐term service needs of the physically and mentally disabled homeless population.

The studies reviewed suggest that individuals with chronic physical or severe mental illnesses are more vulnerable than others to homelessness. Homelessness exacerbates physical and/or mental conditions and complicates their treatment. Despite myths to the contrary, research and demonstration programs have shown that most homeless individuals are willing to receive assistance. By linking health and mental health services to appropriate housing, such individuals can be treated and cared for in community settings. However, local communities often do not have the necessary resources to meet the long‐term needs of severely mentally ill or physically disabled homeless people.     

Toward a comprehensive homelessness‐prevention strategy

Abstract

Because of the misery and deprivation suffered by homeless persons, the initial response to homelessness in the United States focused first on quickly addressing the dire need for emergency food and shelter, and then on providing additional assistance to already homeless persons—ideally to help them move out of homelessness. New preventive measures to help people avoid becoming homeless were largely ignored or put off.¹ But now that efforts to provide emergency food and shelter are well under way throughout the country, many more experts, policymakers, and service organizations have begun focusing on homelessness prevention.² Nevertheless, actual prevention efforts are still tentative and somewhat haphazard. In support of a more rapid expansion of effective homelessness‐prevention activities, this paper discusses the benefits of prevention, develops an initial framework for a comprehensive homelessness‐prevention strategy, and, using this framework, evaluates existing prevention efforts and suggests new initiatives.     

Public shelter admission rates in Philadelphia and New York City: The implications of turnover for sheltered population counts

Abstract

Previous estimates of the size and composition of the U.S. homeless population have been based on cross‐sectional survey methodologies. National enumeration efforts have yielded point‐prevalence estimates ranging from 0.11 to 0.25 percent of the population. This study reports data from shelter databases in Philadelphia and New York City that record identifiers for all persons admitted and so make possible unduplicated counts of users.

Unduplicated counts of shelter users yield annual rates for 1992 of about 1 percent for both cities and rates near 3 percent over three years in Philadelphia (1990–92) and over five years (1988–92) in New York City. The annual rates are three times greater than rates documented by point‐prevalence studies. Shelter bed turnover rates are reported, as are average monthly first admission and readmission counts over a two‐year period. Implications for future research and public policy are discussed.     

Patterns and determinants of public shelter utilization among homeless adults in New York City and Philadelphia

Administrative data on public shelter utilization among homeless adults from New York City (1987–1994) and Philadelphia (1991–1994) are analyzed to identify the relative proportion of shelter users by length of stay and rate of readmission, and to identify the characteristics that predict an exit from shelter. Survival analyses reveal that half of adult shelter users will stay fewer than 45 days over a two-year period (combined stays), and that approximately one half of men and one third of women will experience a readmission within two years of the first admission. Results also document the size and relative resource consumption of a long-term sheltered population, finding that 18.2 percent of New York shelter users stay 180 days or more in their first year, consuming 53.4 percent of the system days for first-time shelter users. Discrete-time logistic hazard regression analyses reveal that, in general, being older, of black race, having a substance abuse or mental health problem, or having a physical disability, significantly reduces the likelihood of exiting shelter. In both cities, people entering shelter in later years are staying longer, although individuals have shorter episodes on subsequent admissions. The implications of this study for the analysis and management of emergency shelter system utilization are discussed.     

Federal homeless social policies for the 1990s

Abstract

While numbers are important, a substantial part of the disagreement concerning the number of homeless people and their characteristics derives from differing defi‐nitionsof homelessness. However, there is a consensus on basic needs to proceed with social policies that address homelessness, with the aim of ending it. Housing assistance is essential to ending homelessness and will need to be provided, at least in the short run, to all homeless and at‐risk households to enable them to obtain decent housing. The attrition in the number of unsubsidized low‐rent units and the loss of the single‐room occupancy(SRO) stock have been major causes of homelessness in the 1980s. Permanent housing must be coupled with other services to address the additional, nonhousing problems of a substantial portion of homeless people. The federal plan to end homelessness offers promise of developing a viable, coherent set of programs and policies, particularly if mainstream programs are improved and made accessible to homeless people. But carrying out a meaningful plan to end homelessness will require both committed and sustained political leadership and substantial increases in funding.     

Seasonal Variation in Family Homeless Shelter Usage

Seasonal surges in family homeless shelter usage occur in numerous communities around the United States. These surges are significant because they may place demands on shelter systems, require families to use lower quality shelter facilities, or impose significant costs on the municipalities that provide shelter services. This study uses empirical data from Hennepin County, Minnesota, to provide explanations for the seasonality of family homeless shelter usage. The results suggest that multiple factors may contribute to the surge, but that families with school-age children are the primary driver of seasonal increases in the family shelter population. This study provides initial findings that may help to improve the targeting of homelessness prevention resources.     

Using local longitudinal records to estimate transient and resident homeless populations

Abstract

Many local agencies that provide services to the homeless have only limited data and resources to estimate the extent of need or the size of the local population at risk of requiring the services they provide. Methods exist, however, that are capable of providing reasonable estimates of underlying service populations with minimal record keeping. In this paper one group of such models, first‐capture models, is discussed as a resource‐efficient technique for estimating the underlying population consistently at risk ("residents") and those occasionally at risk ("transients") of requiring agency services.     

Where the homeless come from: A study of the prior address distribution of families admitted to public shelters in New York City and Philadelphia

Abstract

This study investigates hypotheses regarding the association of census tract variables with the risk for homelessness. We used prior address information reported by families entering emergency shelters in two large U.S. cities to characterize the nature ofthat distribution.

Three dense clusters of homeless origins were found in Philadelphia and three in New York City, accounting for 67 percent and 61 percent of shelter admissions and revealing that homeless families’ prior addresses are more highly concentrated than the poverty distribution in both cities. The rate of shelter admission is strongly and positively related to the concentration of poor, African‐American, and female‐headed households with young children in a neighborhood. It is also correlated with fewer youth, elderly, and immigrants. Such areas have higher rates of unemployment and labor force nonpartici‐pation, more housing crowding, more abandonment, higher rates of vacancy, and higher rent‐to‐income ratios than other areas.     

Federal homeless information needs and local practice

Abstract

What would be required to produce a national homeless needs assessment? Information on the size and characteristics of the homeless population, evaluations of the effectiveness of interventions, and evaluations of the program and financial resources available nationwide would play pivotal roles in developing a comprehensive assessment. Estimates of the size of the homeless population are far less useful than evaluations of treatment and program delivery. There is no reason to focus attention on counts of the homeless nationwide.

Much more needs to be done to evaluate the capacity of the nation's program delivery system and to estimate the level and type of financial resources that flow into this sector. These same considerations apply to possible changes in what information the federal government will require of localities if the McKinney Act is shifted to a block grant. Evaluative assessments, including assessments of the barriers to serving the homeless, would prove to be of greater value at the local and federal levels than an emphasis on counts. Nevertheless, there is an argument for requiring a periodic local reporting of numbers and characteristics among the sheltered population under a new block grant.     

Images of the homeless: Public views and media messages

Abstract

Despite its potential policy relevance, public opinion about homelessness has received little attention from researchers. This deficiency is addressed here by bringing together data obtained in four recent surveys. The survey results indicate that many Americans accurately perceive the characteristics of homeless people, consider homelessness a serious problem with structural roots, and support a variety of measures intended to solve it. Certain segments of the public— Democrats, liberals, blacks, and residents of communities that have homeless populations—are especially likely to hold these views. The extent to which the public's thoughts on homelessness have been shaped by the media is difficult to determine. However, an analysis of the volume and content of print and broadcast news coverage of the issue hints at a plausible causal connection.     

Politics,policy making,data, and the homeless

Abstract

It is often said that a major obstacle to crafting effective policies concerning home‐lessness is the large uncertainty associated with estimates of the extent of the problem. Such uncertainty is due largely to the difficulties of identifying a “hidden” population. But how true is it that effective policy making for the homeless depends upon counting their population accurately? This paper reviews some critical relationships among politics, policy making, and data; examines data requirements for policy making affecting the homeless; argues the case for relative rather than absolute measurement; and assesses the importance for public policy of data problems in this area.     

Public service reductions associated with placement of homeless persons with severe mental illness in supportive housing

Abstract

This article assesses the impact of public investment in supportive housing for homeless persons with severe mental disabilities. Data on 4,679 people placed in such housing in New York City between 1989 and 1997 were merged with data on the utilization of public shelters, public and private hospitals, and correctional facilities. A series of matched controls who were homeless but not placed in housing were similarly tracked.

Regression results reveal that persons placed in supportive housing experience marked reductions in shelter use, hospitalizations, length of stay per hospitalization, and time incarcerated. Before placement, homeless people with severe mental illness used about $40,451 per person per year in services (1999 dollars). Placement was associated with a reduction in services use of $16,281 per housing unit per year. Annual unit costs are estimated at $17,277, for a net cost of $995 per unit per year over the first two years.     

What's behind the numbers? Definitional issues in counting the homeless

Abstract

Any estimate of the number of homeless persons involves several definitional issues, including the underlying conceptual definition of “homelessness,” the intended use of and rationale for the count, how the conceptual definition is translated into operational procedures, and methodological choices. These issues are at least partially responsible for the variation in existing estimates of homeless individuals. To best serve multiple constituencies and demands for information, the adoption of a broad definition is recommended. Furthermore, it is necessary to develop and report estimates for specific policy‐relevant subgroups of homeless persons, as well as to develop a family of research studies that can yield an understanding of the conditions facing the homeless and identify “markers” for those who are at risk of becoming homeless.     

Impacts of Heading Home Hennepin's Housing First programs for long-term homeless adults

This paper evaluates the impact of Heading Home Hennepin’s Housing First programs for long-term homeless individuals with work-limiting disabilities. These programs combine subsidized housing and extensive case management services to help program participants maintain stable housing. Using a matched comparison of housing-first participants and nonparticipants residing in public shelters, this study finds that housing-first placement is associated with a substantial decrease in public shelter use, an increase in public health insurance coverage, and a decrease in arrests and incarceration. Most of the decline in arrests is due to decreases in arrests for livability and drug-related charges and not for violent or property crime.     

Homelessness old and new: The matter of definition

Abstract

The contemporary emphasis on the pathologies of shelter denizens and street‐dwellers tends to conceal the great variety of makeshift ways of life that have characterized “homelessness” over the centuries. Diversity notwithstanding, those considered “vagrants” were historically marked as suspect members of a poor apart, even when their numbers increased sharply. Because kin ties have consistently proven to be the first line of defense against “literal homelessness,” skid row researchers thought their absence (along with the lack of associated ties to work and community) to be diagnostic of the condition. Indeed, earlier research tended to see as “homeless” any “disaffiliated” persons, housed or not, who lived alone in unconventional dwellings. Not only have the new homeless poor, by contrast, proven to be more diverse—their geographic locus, age, gender, ethnicity, and signal disabilities having all changed—but their common element is less often ascribed to faulty social connectedness than to sheer absence of shelter. This paper discusses such changes and reviews definitions of homelessness and several approaches to its social construction. The paper argues that, although definitions owe as much to political as to logical considerations, it makes both practical and historical sense to view the streets and shelters as but one variant of a class of informal or makeshift residential settings that increasingly characterizes the marginally situated.     

Strategies for homeless research in the 1990s

Abstract

Existing empirically based knowledge about homelessness is neither extensive nor well grounded. Proper policy formation and program design that address homelessness are badly served by knowledge deficiencies. This paper lays out a strategy that will develop appropriate research methodology and generate better empirically based knowledge. It proposes a program of technical research, as well as moditica‐tions to several national data collection programs, such as the Current Population Survey, to collect data on the literal homeless and the precariously housed. It also presents a rationale for starting longitudinal studies that focus on the processes that lead into and out of the homeless state. Finally, it proposes evaluation research to measure the effectiveness and efficiency of promising programs.     

Housing chronically homeless women: “Inside” a safe haven

Abstract

This case study of an innovative pilot project for chronically homeless, mentally ill women in Toronto exposes assumptions that professionals embarking on initiatives to house chronically homeless women may bring to the design of such facilities. The value of in‐depth ethnographic research in charting the effectiveness of initiatives to alleviate chronic homelessness for women and in understanding the barriers that hinder the development of effective programs is highlighted.

This article challenges conventional static understandings of the concepts of “private” and “public” and explores issues related to spatial privacy and communality, sense of ownership, ideas about the safe haven being both a home and a hostel, planning for flexibility, accountability to public flinders, and accommodation of individual needs.     

Homeless families,singles, and others: Findings from the 1996 national survey of homeless assistance providers and clients

Abstract

The first question people typically ask about homelessness is, “How many people are homeless?” After that, questions usually turn to characteristics: “What are they like?” Basic demographic characteristics such as sex, age, family status, and race have always been of interest, in part because the homeless population appears to be very different from the general public and even from most poor people who are housed with respect to these characteristics. Often, because these differences are so dramatic, demographic characteristics are overinterpreted as representing the reasons for homelessness.

But as various studies have documented, most demographic factors quickly disappear as proximate causes when other factors representing personal vulnerabilities are available for examination. The underlying causes of homelessness, the structural conditions of housing and labor markets that turn vulnerabilities into loss of housing, do not lie within individuals at all and are thus difficult to include in analyses based on individual data.     

Alcohol and other drug problems among the homeless: Research,practice, and future directions

Abstract

At least 50 percent of America's homeless people have significant current problems with alcohol and other drugs. These problems are important risk factors in the selection of the undomiciled from the larger population of extremely poor people. This paper reviews what is known about homeless people with alcohol and other drug problems; assesses the relationship between such individual problems and the larger phenomenon of homelessness; and describes selected aspects of projects funded through the National Institute on Alcohol Abuse and Alcoholism/National Institute on Drug Abuse Demonstration Program for Homeless Persons with Alcohol and Other Drug Problems. It concludes with observations about future directions for research and practice.