Dictionary:
home·less (hōm'lĭs) ![]() |
| Antonyms: homeless |
| Encyclopedia of Public Health: Homelessness |
One of the most characteristic and consistent human behaviors over thousands of years is that humans build shelters. Homes offer protection from the elements and from a variety of health hazards and provide basic amenities such as a secure place to eat and sleep, to keep one's possessions, to raise a family, and be part of a community. Housing is a basic human need, yet the 1997 Human Development Report notes that more than 1 billion people—one-quarter of the world's population—live without shelter or in unhealthy and unacceptable conditions. Over 100 million people around the world have no shelter whatsoever. The health consequences of this level of homelessness are profound.
Homelessness in North America
Homelessness is a matter of concern anywhere in the world, but it is a particular cause for concern—and shame—when it occurs in the richest nations in the world. Sadly, homelessness is a significant problem in both the United States and Canada. Accurate statistics on the level of homelessness are hard to come by. In part, this is because definitions of homelessness vary. It includes not only those who are living on the streets or in shelters and hostels but also those who are living in temporary accommodation or in housing that is unfit for human habitation. Estimates of the number of people without homes in the United States vary from 230,000 to 3 million, including between 50,000 and 500,000 children. The U.S. Department of Housing and Urban Development estimated in 1999 that "there are at least 600,000 homeless men, women, and children in the United States on any given night," adding that roughly one-third of this population is composed of families with children. In its 1997 position paper on eliminating homelessness, the American Public Health Association (APHA) noted that "as many as 7.4 percent of Americans (13.5 million people) may have experienced homelessness at some time in their lives." Homelessness increased in the 1990s, and the fastest growing segment of the homeless population was homeless families.
In Canada, it was estimated in 1986 that 130,000 to 250,000 Canadians were homeless or living in substandard housing, while a one-night census by the Canadian Council for Social Development in 1987 found 10,672 people in emergency shelters—undoubtedly an undercounting of the true homeless. Up to half of the homeless in Canada now are believed to be families with children.
A wide array of factors contribute to homelessness, but they can be thought of as falling into one of two categories: structural problems and individual factors that increase vulnerability. Structural problems include a lack of affordable housing, changes in the industrial economy leading to unemployment, inadequate income supports, the deinstitutionalization of patients with mental health problems, and the erosion of family and social support. Added to this are factors that increase an individual's vulnerability, such as physical or mental illness, disability, substance abuse, domestic violence, or job loss. Reducing homelessness will mean addressing issues such as these.
The Health Effects of Homelessness
The health effects of homelessness include higher rates of infectious diseases, mental health problems, physical disorders, disability, and premature death. A United Kingdom report noted that those sleeping on the street on average lived only to their mid-to-late forties. Higher rates of infectious disease result from overcrowding, damp and cold living conditions, poor nutrition, lack of immunization, and inadequate access to health care services. There has been a particular concern with increased rates of tuberculosis (TB), particularly multiple drug-resistant TB. It has been reported, for example, that 48 percent of the homeless in Toronto test positive for TB. Another factor leading to increases in TB and other infectious diseases is the higher prevalence of AIDS (acquired immunodeficiency syndrome) in those segments of the homeless population involved in drug abuse and prostitution.
The conditions in which homeless people live also make them more prone to trauma. A study of street people in Toronto found that 40 percent had been the victims of assault in the previous year, while 43 percent of the women reported sexual harassment and 21 percent reported they had been raped in the previous year. These street people were also more than five times more likely to have been involved (as pedestrians) in a motor vehicle accident than the general population, and one in twelve of them had suffered frostbite in the previous year.
Homeless people are also more likely to suffer from cardiovascular, respiratory, arthritic, gastrointestinal, and skin disorders. The Toronto study found that arthritis and rheumatism were twice as frequent, emphysema and bronchitis five times as frequent, asthma two and one-half times as frequent, gastrointestinal problems twice as frequent, and epilepsy six times as frequent as in the general population.
Mental health problems contribute to and result from homelessness. The United Kingdom report noted that 9 to 26 percent of those living on the street have serious mental health problems (compared to 0.5 to 2% in the general population), while Canadian estimates are that 20 to 40 percent of those using shelters have substance abuse or psychiatric problems. Alcohol abuse and dependency is also very common in this population. But while such substance abuse and mental health problems contribute to homelessness, homelessness also contributes to these problems. The Toronto study, for example, found that one-third of the street people interviewed had feelings of worthlessness, that more than one in four (and almost two-thirds of the women) had contemplated suicide in the past year, and that one in twelve (and almost one in three of the women) had attempted suicide in that same period.
The increase in homelessness among families in recent years has focused increasing attention on the serious health problems faced by children living in hostels and temporary accommodation. These problems include disturbed sleep, mood swings, depression, and developmental delays, as well as increased rates of obesity, anemia, infections, injuries, and other health problems.
Health Services for the Homeless
Not surprisingly, given all their health problems, homeless people make significant demands on the health care system. The Toronto study found that in the previous year, two-thirds of street people had seen a physician, more than half had used emergency rooms, and one-quarter of them had been admitted to hospital. But at the same time, homeless people—both those living on the street and those living in hostels and temporary shelters— experience significant barriers in accessing care. These barriers include procedural barriers such as the need to have a home address or a health card, economic barriers in terms of purchasing necessary medications, medical supplies, or appropriate foods, and—perhaps worst of all—prejudice and rude treatment on the part of health care providers. It is particularly unfortunate that a group that is so vulnerable and has such high needs should suffer further indignity and prejudice from what are supposed to be the caring professions.
Homelessness is a significant public health and health care issue. But more than that, as the APHA position paper concludes, "The persisting numbers of homeless people in America are an indictment of our collective failure to make basic ingredients of civilized society accessible to all citizens."
(SEE ALSO: Built Environment; Economics of Health; Healthy Communities; Social Health)
Bibliography
Ambrosio, E. et al. (1992). The Street Health Report: A Study of the Health Status and Barriers to Health Care of Homeless Women and Men in the City of Toronto. Toronto: Street Health.
American Public Health Association (1997). Supporting a National Priority to Eliminate Homelessness. Policy paper 9718.
Canadian Public Health Association (1997). Homelessness and Health. Ottawa: Author.
Institute of Medicine (1998). Homelessness, Health and Human Needs. Washington, DC: National Academy Press.
Pleace, N., and Quilgors, D. (1996). Health and Homelessness in London. London: King's Fund.
Plumb, J. D. (1997). "Homelessness: Care, Prevention and Public Policy." Annals of Internal Medicine 126(12):973–975.
World Health Organization (1987). Shelter and Health. Geneva: Author.
Yeich, S. (1994). The Politics of Ending Homelessness. Lanham, MD: University Press of America.
— TREVOR HANCOCK
| Columbia Encyclopedia: homelessness |
| Food & Culture Encyclopedia: Homelessness |
No nation is without its homeless. In the United States alone, between 280,000 and 600,000 men, women, and children are homeless each night, according to differing estimates. They are without permanent lodging because of poverty, lack of affordable housing, low wages, substance abuse, mental illness, or domestic violence. In many other countries, however, civil unrest, war, and famines bring about homelessness. At the beginning of the twenty-first century, there were more than eleven million homeless worldwide.
Paramount among the problems facing the homeless are poor nutrition and hunger. They can be life-threatening, especially among refugees. Protein-energy malnutrition is a major contributory cause of death among newly displaced refugees. International relief organizations and the United Nations set up refugee camps and make the distribution of nutritionally adequate food rations a high priority. The homeless in the United States often do not experience such extreme food deprivations. However, many are often chronically undernourished. Compared to other groups at risk for hunger, the homeless are at greatest risk, being ten times more likely to go without food for a day compared to the poor. Few are able to obtain three meals a day, and many go at least one day a month without any food. Scant research indicates that many have caloric intakes far below recommended levels and may have inadequate intakes of calcium, folacin, iron, magnesium, or zinc. Their low-calorie diets, which tend to be high in fat, cholesterol, and sodium and inadequate in essential nutrients, may further compromise the already poor health status of the homeless.
While many rely on homeless shelters, especially in winter months, a large number find refuge in cars, abandoned buildings, on grates, in parks, or, other outdoor places. Most have been without a fixed and regular nighttime residence for more than one year. Lacking a stable home environment and cooking and storage facilities exacerbates their inability to obtain an adequate, varied, and healthy diet. While it is not uncommon to see a homeless person panhandling or scavenging for food through trash cans, most depend on soup kitchens and shelters for the major portion of their daily nourishment. Soup kitchens and shelters typically serve one meal a day on-site, although some shelters permit their residents to prepare and cook their own meals. Those who are substance abusers or have mental health problems are more likely to resort to obtaining food from trash cans or begging, compared to those without these health conditions.
Participation in the Food Stamp Program, the government's largest antihunger program, is unusually low among the homeless. While homeless advocates speculate that most of the homeless are eligible, they argue that barriers such as documentation of identity or administrative burdens prevent many from participating. The difficulty of making effective use of food stamp benefits without adequate cooking and storage facilities is also a barrier. While the Food Stamp Program does permit states to contract with restaurants to serve meals at concessional prices to the homeless, such authorizations are uncommon among states.
Bibliography
Burt, M. R., et al.. Homelessness: Programs and the People TheyServe. Washington, D.C.: U.S. Department of Housing and Urban Development, Office of Policy Development and Research, 1999.
Lindsey, A. T. Food and Nutrition Resource Guide for HomelessShelters, Soup Kitchens and Food Banks. Washington, D.C.: United States Department of Agriculture, 1998.
—Patricia McGrath Morris
| Word Tutor: homeless |
It is a homeless wind, forever on the move.
— Hal Borland (1900-1978)
| Wikipedia: Homelessness |
| The examples and perspective in this article may not represent a worldwide view of the subject. Please improve this article and discuss the issue on the talk page. |
Homelessness (UK: rough sleeping) is the condition of and social category of people who don't have a regular house or dwelling because they cannot afford, pay for, or are otherwise unable to maintain regular, safe, and adequate housing, or they lack, "fixed, regular, and adequate nighttime residence" [1] The actual legal definition varies from country to country, or among different entities or institutions in the same country or region.[2]
The term homelessness may also include people whose primary nighttime residence is in a homeless shelter, in an institution that provides a temporary residence for individuals intended to be institutionalized, or in a public or private place not designed for use as a regular sleeping accommodation for human beings.[3][4]
An estimated 100 million people worldwide are homeless.[5]
The United States Department of Housing and Urban Development (HUD) defines a "chronically homeless" person as "an unaccompanied homeless individual with a disabling condition who has either been continuously homeless for a year or more, or has had at least four episodes of homelessness in the past three years."[6]
Following the Peasants' Revolt, British constables were authorised under a 1383 statute to collar vagabonds and force them to show their means of support; if they could not, the penalty was gaol.[7] Vagabonds could be sentenced to the stocks for three days and nights; in 1530, whipping was added. The presumption was that vagabonds were unlicensed beggars.[7] In 1547, a bill was passed that subjected vagrants to some of the more extreme provisions of the criminal law, namely two years servitude and branding with a "V" as the penalty for the first offense and death for the second. One arriving in the American colonies in the 18th century were transported convicts. Large numbers of vagabonds were transported along with ordinary criminals.[8]
During the 16th 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 17th and 18th centuries, these were replaced by workhouses but these were intended to discourage too much reliance on state help.
Although not specifically about the homeless, Jacob Riis wrote documented the poor and destitute in New York City tenements in the late 1800s, authoring the work How the Other Half Lives.
The growing movement toward social concern sparked the development of rescue missions, such as America's first rescue mission, the New York City Rescue Mission, founded in 1872 by Jerry and Maria McAuley.[9]
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.[10]
How the Other Half Lives later inspired Jack London's The People of the Abyss (1903). This raised public awareness, causing some changes in building codes and some social conditions.
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 1933, George Orwell wrote about poverty in London and Paris, in his book Down and Out in Paris and London.
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.
The Great Depression of the 1930s caused a devastating epidemic of poverty, hunger, and homelessness. There were two million homeless people migrating across the United States.[11]
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 fell dramatically. This initiative was supported further by the incoming Labour administration from 2009 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.
However, modern homelessness, started as a result of the economic stresses in society, reduction in the availability of affordable housing, such as single room occupancies (SROs), for poorer people. In the United States, in the 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.[12]
The Community Mental Health Act of 1963 was a pre-disposing factor in setting the stage for homelessness in the United States.[13] Long term psychiatric patients were released from state hospitals into SROs and supposed to be sent to community mental health centers for treatment and follow-up. It never quite worked out properly, the community mental health centers mostly did not materialize, and this population largely was found living in the streets soon thereafter with no sustainable support system.[14][15]
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 (although alcoholic hobos had been visible as homeless people since the 1890s, and those stereotypes fueled public perceptions of homeless people in general), the elderly, and others.
Many places where people were once allowed freely to loiter, or purposefully be present, such as churches, public libraries and public atriums, became stricter 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 and was originally based on the settlement house model.[16]
Many homeless keep all their possessions with them since they have no access to storage. There was also the reality of the "bag" people, the shopping cart people, and the soda can collectors (known as binners or dumpster divers) who sort through garbage to find items to sell, trade and eat. 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 (street children or street youth).
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 organizations 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, a 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.[17]
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.[18] 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.
Seattle has Real Change, a $1 newsletter that directly benefits the homeless and also reports on economic issues in the area. Portland, Oregon has "Street Roots", with articles and poetry by homeless writers, sold on the street for a dollar. 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, MD 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,[19][20] and this has presented new challenges, especially in services, to agencies.
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"[21][22] and another specific type as "Bumvertising".
Another trend is the side effect of unpaid free advertising of companies and organizations on shirts, clothing and bags, to be worn by the homeless and poor, given out and donated by companies to homeless shelters and charitable organizations 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[23] and later during the Great Depression in the United States in the 1930s.
In the USA, the government asked many major cities to come up with a ten year plan to end homelessness. One of the results of this was a "Housing first" solution, rather than to have a homeless person remain in an emergency homeless shelter it was thought to be better to quickly get the person permanent housing of some sort and the necessary support services to sustain a new home. But there are many complications of this kind of program and these must be dealt with to make such an initiative work successfully in the middle to long term. [24][25]
It has been reported that some formerly homeless people, when they finally were able to get their housing and life straightened out and return to a normal lifestyle, have donated money and volunteer service to the organizations which helped them when they were homeless. [26] Alternatively, some social service entities that help the homeless now employ formerly homeless individuals to assist in the care process.
After the abolishment of serfdom in Russia in 1861, major cities experienced a large influx of former peasants who sought jobs as industrial workers in rapidly-developing Russian industry. These people often lived in harsh conditions, sometimes renting a room, shared between several families. There also was a large number of shelterless homeless.
Immediately after the October Revolution a special program of "compression" ("уплотнение") was enabled: people who had no own shelter were settled in flats of those who had large (4,5,6-livingroom) flats with only one room left to previous owners, with the flat was declared a state property. This led to a large number of shared flats where several families lived simultaneously. Nevertheless the problem of complete homelessness was mostly solved as anybody could apply for a room or a place in dormitory (the number of shared flats steadily decreased after large-scale residential building program was implemented starting in 1960s). By 1922 there were at least 7 million homeless children in Russia as a result of nearly a decade of devastation from World War I and the Russian Civil War.[27] This led to creation of a large number of orphanages. By 1930s the USSR declared that it has no homeless and any citizen was obliged to have a propiska - a place of permanent residency. Nobody could be stripped of propiska without substitution or refuse it without a confirmed permission (called "order") to register in another place. The right for shelter was secured in the Soviet constitution. Not having permanent residency was legally considered a crime.
There were also virtually no empty and unused apartments in the cities: any flat where nobody was registered was immediately lent by the state at symbolic price to others who needed better living conditions. If a person who had permanent registration could not pay for shelter, nobody had right to evict them, only to demand money through a court.
After the breakup of the USSR the problem of homelessness sharpened dramatically, partially because of the legal vacuum of early 1990s with some laws contradicting each other and partially because of a high rate of frauds in the realty market. In 1991 articles 198 and 209 of Russian criminal code which instituted criminal penalty for not having permanent residence were abolished. Since most flats had been privatized and many people sold their last shelter without success to buy another, there was a sharp increase of homeless. Renting apartments from a private owner became widespread (which usually only gives temporary registration and apartment owner could evict the leaser after the contract is over or if the money was not paid). In Moscow first overnight shelter for homeless was opened in 1992.[28]
Nevertheless, the state still obliged to give permanent shelter for free to anybody who needs better living conditions or has no permanent registration, since right for shelter still included in constitution. This may take many years, though. Nobody still has right to strip a person of permanent residency without their will, even the owner of the apartment. This makes problems for banks since mortgage loans became increasingly popular. Banks obliged to buy a new, cheaper flat to a person instead of the old one if the person fails to repay the loan, or wait until all people who live in the flat are dead. Several projects of special cheap 'social' flats for those who failed to repay mortgages were proposed to facilitate mortgage market.
The major reasons and lack of causes for homelessness as documented by many reports and studies include:[29][30][31][32]
A substantial percentage of the U.S. homeless population are individuals who are chronically unemployed or have difficulty managing their lives effectively due to prolonged and severe drug and/or alcohol abuse.[36] Substance abuse can cause homelessness from behavioral patterns associated with addiction that alienate an addicted individual's family and friends who could otherwise provide support during difficult economic times.
Increased wealth disparity and income inequality causes distortions in the housing market that push rent burdens higher, making housing unaffordable.[37]
Dr. Paul Koegel of RAND Corporation, a seminal researcher in first generation homelessness studies and beyond, divided the causes of homelessness into structural aspects and then individual vulnerabilities.[32]
The basic problem of homelessness is the human need for personal shelter, warmth and safety, which can be literally vital. Other basic difficulties include:
Homeless people face many problems beyond the lack of a safe and suitable home. They are often faced with many social disadvantages and reduced access to private and public services such as:
Such difficulties will often be exacerbated by the circumstances in which someone has become homeless, and consequential vulnerabilities such as health problems or alcohol and drug dependence.
There have been many violent crimes committed against the homeless. [42] A 2007 study found that the rate of such crimes is increasing.[43][44]
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Most countries provide a variety of services to assist homeless people. They often provide food, shelter and clothing and may be organised and run by community organisations (often with the help of volunteers) or by government departments. These programs may be supported by government, charities, churches and individual donors.
In 1998, a study by Koegel and Schoeni of a homeless population in Los Angeles, California, reported that a significant number of homeless do not participate in government assistance programs, and the authors reported being puzzled as to why that was, with the only possible suggestion from the evidence being that transaction costs were perhaps too high.[45]
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 street sale.
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 plasmapheresis centers still exist, 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 slang, this is called "three hots and a cot" referring to the three hot daily meals and a cot to sleep on given to prisoners.
Invented in 2005, in Seattle, Bumvertising, an informal system of hiring the homeless to advertise by a young entrepreneur, is providing food, money, and bottles of water to sign-holding homeless in the Northwest. Homeless advocates accuse the founder, Ben Rogovy, and the process, of exploiting the poor and take particular offense to the use of the word "bum" which is generally considered pejorative.[46][47]
In October 2009, the Boston Globe carried a story on so-called cyberbegging, or Internet begging, which was reported to be a new trend worldwide.[48]
In Australia the Supported Accommodation Assistance Program (SAAP) is a joint Commonwealth and state government program which provides funding for more than 1,200 organisations which are aimed to assist homeless people or those in danger of becoming homeless, as well as women and children escaping domestic violence [21]. They provide accommodation such as refuges, shelters and half-way houses, and offer a range of supported services. The Commonwealth has assigned over $800 million between 2000-2005 for the continuation of SAAP.
The current program, governed by the Supported Assistance Act 1994, specifies that "the overall aim of SAAP is to provide transitional supported accommodation and related support services, in order to help people who are homeless to achieve the maximum possible degree of self-reliance and independence. This legislation has been established to help the homeless people of the nation and help rebuild the lives of those in need, the joining of the states also helps enhance the meaning of the legislation and demonstrates the collaboration of the states and their desire to improve the nation as best they can.
Housing First is an initiative to help the homeless get re-integrated into society, and out of homeless shelters. It was initiated by the federal government's Interagency Council on Homelessness. It asks cities to come up with a plan to end chronic homelessness. In this direction, there is the belief that if homeless people are given independent housing to start off with, with some proper social supports, then there would be no need for emergency homeless shelters, which it considers a good outcome. However this is a controversial position.[49][50]
Miami, Florida's Community Partnership for Homeless launched a national outreach program in 2008 to help other communities throughout the United States address homelessness. Since its inception in 1993, CPH has served nearly 76,000 residents with a successful outplacement rate of nearly 62 percent in Miami-Dade County, Florida. The number of homeless people in the county has declined by 83 percent. The national program shares CPH's model of Homeless Assistance Centers, job training programs, on-site childcare, housing assistance and more. The organization also provides background on its unique funding structure and partnerships within the community. [51]
In Boston, Massachusetts, in September 2007, an outreach to the homeless was initiated in the Boston Common, after some arrests and shootings, and in anticipation of the cold winter ahead. This outreach targets homeless people who would normally spend their sleeping time on the Boston Common, and tries to get them into housing, trying to skip the step of an emergency shelter.
Applications for Boston Housing Authority were being handed out and filled out and submitted. This is an attempt to enact by outreach the Housing First initiative, federally mandated. Boston's Mayor, Thomas Menino, was quoted as saying "The solution to homelessness is permanent housing". Still, this is a very controversial strategy, especially if the people are not able to sustain a house with proper community, health, substance counseling, and mental health supportive programs.[52]
In Louisiana former State Senator B.G. Dyess of Rapides Parish, an ordained Baptist minister, has been a leading advocate for the homeless through the Louisiana Integral Action Council for the Homeless.[53]
In October 2009, as part of the city's Leading the Way initiative, Mayor Thomas M. Menino of Boston dedicated and opened the Weintraub Day Center which is the first city-operated day center for chronically homeless persons. It is a multi-service center, providing shelter, counseling, healthcare, housing assistance, and other support services. It is a 3,400 square foot facility located in the Woods Mullen Shelter. It is also meant to reduce the strain on the city's hospital emergency rooms by providing services and identifying health problems before they escalate into emergencies. It was funded by $3 million in grants from the American Recovery and Reinvestment Act of 2009, Massachusetts Department of Housing and Community Development (DHCD), the Massachusetts Medical Society and Alliance Charitable Foundation[54], and the United States Department of Health and Human Services Substance Abuse and Mental Health Services Administration (SAMHSA).[55]
There are many places where a homeless person might seek refuge.
Health care for the homeless is a major public health challenge.[63][64][65][66][67][68][69][70][71][72][73]
Homeless people are more likely to suffer injuries and medical problems from their lifestyle on the street, which includes poor nutrition, substance abuse, exposure to the severe elements of weather, and a higher exposure to violence (robberies, beatings, and so on). Yet at the same time, they have little access to public medical services or clinics.
This is a particular problem in the US where many people lack health insurance: "Each year, millions of people in the United States experience homelessness and are in desperate need of health care services. Most do not have health insurance of any sort, and none have cash to pay for medical care." [74][75]
Homeless persons often find it difficult to document their date of birth or their address. Because homeless people usually have no place to store possessions, they often lose their belongings, including their identification and other documents, or find them destroyed by police or others. Without a photo ID, homeless persons cannot get a job or access many social services. They can be denied access to even the most basic assistance: clothing closets, food pantries, certain public benefits, and in some cases, emergency shelters.
Obtaining replacement identification is difficult. Without an address, birth certificates cannot be mailed. Fees may be cost-prohibitive for impoverished persons. And some states will not issue birth certificates unless the person has photo identification, creating a Catch-22.[76]
This problem is far less acute in countries which provide free-at-use health care, such as the UK, where hospitals are open-access day and night, and make no charges for treatment. In the US, free-care clinics, especially for the homeless do exist in major cities, but they are usually over-burdened with patients. [77]
The conditions affecting the homeless are somewhat specialized and have opened a new area of medicine tailored to this population. Skin conditions and diseases abound, because homeless people are exposed to extreme cold in the winter and they have little access to bathing facilities. They have problems caring for their feet[78] and have more severe dental problems than the general population.[79] Specialized medical textbooks have been written to address this for providers.[80]
There are many organizations providing free care to the homeless in countries which do not offer free medical treatment organised by the state, but the services are in great demand given the limited number of medical practitioners. 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, which spreads more easily in crowded homeless shelters in high density urban settings.[81]
In 1999, Dr. Susan Barrow of the Columbia University Center for Homelessness Prevention Studies reported in a study that the "age-adjusted death rates of homeless men and women were 4 times those of the general US population and 2 to 3 times those of the general population of New York City". [82]
In 2004, Boston Health Care for the Homeless in conjunction with the National Health Care for the Homeless Council published a medical manual called "The Health Care of Homeless Persons", edited by James J. O'Connell, M.D., specifically for the treatment of the homeless population.[83]
In June 2008, in Boston, Massachusetts, the Jean Yawkey Place, a four-story, 77,653 square-foot building, was opened by the Boston Health Care for the Homeless Program. It is an entire full service building on the Boston Medical Center campus dedicated to providing health care for the homeless. It also contains a long term care facility, the Barbara McInnis House, which expanded to 104 beds, which is the first and largest medical respite program for homeless people in the United States.[84][85]
In the USA, the federal government's HUD agency has required federally funded organizations to use a computer tracking system for the homeless and their statistics, called HMIS (Homeless Management Information System).[86][87][88] There has been some opposition to this kind of tracking by privacy advocacy groups, such as EPIC.[89] However, HUD considers its reporting techniques to be reasonably accurate for homeless in shelters and programs in its Annual Homeless Assessment Report to Congress.[90]
Actually determining and counting the number of homeless is very difficult in general due to their lifestyle habits.[91][92] There are so-called "hidden homeless" out of sight of the normal population and perhaps staying on private property.[93]
Various countries, states, and cities have come up with differing means and techniques to calculate an approximate count. For example, a one night "homeless census count", usually held in the early Winter, for the year is a technique used by a number of American cities, especially Boston, Massachusetts.[94][95] Los Angeles, California uses a mixed set of techniques for counting, including the point-in-time street count.[93][96]
In 2005, an estimated 100 million people worldwide were homeless.[97]
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 organizations vary wildly, so comparisons should be made with caution.
The number of homeless people worldwide has grown steadily in recent years.[104][105] In some Third World nations such as India, Nigeria, and South Africa, homelessness is rampant, with millions of children living and working on the streets.[106][107] Homelessness has become a problem in the countries of China, Thailand, Indonesia, and the Philippines despite their growing prosperity, mainly due to migrant workers who have trouble finding permanent homes.[108]
For people in Russia, especially the youth, alcoholism and substance abuse is a major cause and reason for becoming and continuing to be homeless.[109]
The United Nations, United Nations Centre for Human Settlements (UN-Habitat) wrote in its Global Report on Human Settlements in 1995: "Homelessness is a problem in developed as well as in developing countries. In London, for example, life expectancy among the homeless is more than 25 years lower than the national average.
Poor urban housing conditions are a global problem, but conditions are worst in developing countries. Habitat says that today 600 million people live in life- and health-threatening homes in Asia, Africa and Latin America. The threat of mass homelessness is greatest in those regions because that is where population is growing fastest.
By 2015, the 10 largest cities in the world will be in Asia, Latin America and Africa. Nine of them will be in developing countries: Bombay, India - 27.4 million; Lagos, Nigeria - 24.4; Shanghai, China - 23.4; Jakarta, Indonesia - 21.2; S o Paulo, Brazil - 20.8; Karachi, Pakistan - 20.6; Beijing, China - 19.4; Dhaka, Bangladesh - 19; Mexico City, Mexico - 18.8. The only city in a developed country that will be in the top ten is Tokyo, Japan - 28.7 million."[110]
In 2008, Dr. Anna Tibaijuka, Executive Director of UN-HABITAT, referring to the recent report "State of the World’s Cities Report 2008/2009"[111], said that the world economic crisis we are in should be viewed as a “housing finance crisis” in which the poorest of poor were left to fend for themselves.[112]
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| Translations: Homeless |
Dansk (Danish)
adj. - hjemløs, husvild
n. - hjemløs, husvild
Nederlands (Dutch)
dakloos, onbehuisd, daklozen
Français (French)
adj. - sans abri, sans logement, sinistré (après un tremblement de terre)
n. - les sans-abri
Deutsch (German)
adj. - obdachlos
n. - Obdachlose, %
Ελληνική (Greek)
adj. - άστεγος, ανέστιος
n. - (οι) άστεγοι
Italiano (Italian)
senza tetto
Português (Portuguese)
adj. - desabrigado
n. - indigente (m), sem-teto (m) (f)
Русский (Russian)
бездомный, бездомность
Español (Spanish)
adj. - sin hogar, sin techo
n. - persona sin hogar, persona sin techo
Svenska (Swedish)
adj. - hemlös
n. - hemlös person
中文(简体)(Chinese (Simplified))
无家的, 无养主的, 无家可归的人
中文(繁體)(Chinese (Traditional))
adj. - 無家的, 無養主的
n. - 無家可歸的人
한국어 (Korean)
adj. - 집 없는
n. - 집 없는 사람
日本語 (Japanese)
adj. - 家のない, 飼い主のない
العربيه (Arabic)
(صفه) شريد لا وطن أو مسكن له (الاسم) الشريد الشخص الذي لا وطن أو مسكن له
עברית (Hebrew)
adj. - חסר-בית
n. - חסר-בית
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