178-186 Homeslessness 12/29/11 2:25 AM Page 178
Home lessness
BACKGROUND
The plight of children, women, men, and
families who are without residence continues
to befuddle social workers in their recent ef
forts, reaching back nearly three decades, to
both serve people who are homeless and to
find policy solutions. Indeed, scholars working
in this area have suggested that the persistence
of homelessness in the richest country in the
world at the beginning of the 21st century is a
consequence of massive policy failure (Stretch,
2004). Although sources disagree as to the exact
strategies for determining the extent of the
problem (Dworsky & Piliavin, 2002), on any
given night, point prevalence estimates indicate
that as many as 800,000 people are without
shelter and are homeless in the United States.
Furthermore, period prevalence estimates of
the number of people who are homeless over
a given year have been as high as 3.5 million
(National Alliance to End Homelessness, 1999).
Considerable literature has accumulated in
social work and related professions covering a
myriad of strategies for both better under
standing and better serving people who are
homeless (First Rife, & Toomey, 1999). Home
lessness has been addressed broadly as a hous
ing policy problem of largely political and eco
nomic origins, and more narrowly it has been
discussed as a mental health issue often related
to deinstitutionalization. It has been studied as
a domestic violence concern, a veterans issue, a
disability issue, a welfare reform dilemma, a
teenage runway or “throwaway” problem, and
a transitional or temporary housing situation.
It has been investigated as a migrant and immi
grant problem, and a concern for people with
communicable diseases. The problem for the
consumer of this literature has been to decide
exactly how a particular contribution fits into
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SOCIAL WORK SPEAKS
this vast pool of data, dimensions of practice,
and policy recommendations. Fortunately, a
variety of summary resources has recently be
come available, both in the traditional published
record (see for example, Levinson, 2004) and
from more diffuse electronic sources (Table 1).
No matter what the practice, policy or theo
retical orientation of practitioners, researchers,
and policy advocates, it is routinely recognized
that the persistence of homelessness is evi
dence that poverty and the lack of affordable
housing in the United States still persist and
are likely to remain critical policy issues for
this next century. Homelessness is a complex
problem that cannot be ameliorated until the
shortcomings of past policies are recognized
and the causes and consequences of persistent
poverty combined with a lack of affordable
housing are a matter of public record. The
plight of people who are homeless must be bet
ter understood from the perspectives of those
who suffer, and it can be seen in
1. people with psychiatric disorders who
lack the social networks, health care, and other
program supports to live independently in the
community (North, Fyrich, Pollio, & Spitz
nagel, 2004; Wong, 2002);
2. individuals with physical disabilities,
whose mobility limitations compound service
inaccessibility (Pardeck & Rollinson, 2002);
3. women and children who are victims of
domestic violence fleeing abusive domiciles
(Bufkin & Bray, 1998; Danis, 2003);
4. asthmatic children in shelters who are
not receiving adequate medical attention
(Holden, Wade, Mitchell, Ewart, & Islam, 1998;
McLean et al., 2004; Stretch & Kreuger, 1990);
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Table 1. Sources of Information on Homelessness in the United States
Site
URL
National Coalition for the Homeless
National Alliance to End Homelessness
National Law Center on Homelessness & Poverty
National Health Care for the Homeless Council
National Coalition for Homeless Veterans
National Low Income Housing Coalition
National Resource Center on Homelessness and Mental Illness
HUD Homelessness Website
www.nationalhomeless.org
www.endhomelessness.org
www.nlchp.org/
www.nhchc.org/
www.nchv.org/
www.nlihc.org
www.nrchmi.saml-isa.gov/
www.hud.gov/homeless/
5. individuals currently employed either
full- or part-time, with too little income to
afford adequate housing (Hutchison, Searight,
& Stretch, 1986; Johnson, 1999), or food (Big
gerstaff, Morris, & Nichols-Casebolt, 2002);
+
6. single mothers unable to work because
of child care responsibilities or the lack of skills
to meet the demands of a rapidly changing
economy (Fogel, 1997; Johnson & Kreuger,
1989; North & Smith, 1993; Rivera, 2003);
7. runaway youths who are without access
to adequate services (Baker, McKay, Lynn,
Schlange, & Auville, 2003; Thompson, Safyer,
& Pollio, 2001);
8. rural families who have been forced to
abandon family farms or small towns due to
economic crises in regional, national, and
global markets (Coodfellow, 1999);
9. men, many of whom are veterans, who
have only the life of the street for economic and
social supports (Benda, 2002);
10. people with chemical dependencies,
who are unable to maintain a stable residence
(Bride & Real, 2003);
11. refugees, asylees, and migrants who have
no place to turn to (Kobli, 2003);
12. individuals and families excluded be
cause of their criminal history (Center for Law
and Policy, 2003)
13. those displaced by disasters, whether
natural, human-made or both (Zakour, 2000).
Past and Prologue
Throughout U.S. history policy on homelessness has tended to mirror societal responses to
the conditions of the poorest of the poor popu
lation. At the beginning of the 20th century,
policy focused on either homeless men or
dependent children in need of care. Men were
often immigrants and lived in boarding houses
during the winter months until seasonal jobs
resumed. Those who were classified as tran
sients were given aid through such practices as
“passing on,” the forerunner to the “bus ther
apy” of today (Menzies & Webster, 1987). Inter
ventions by the Charity Organization Society,
the settlement house movement, and faithbased groups focused on encouraging moral
treatment for worthy poor people and work for
unworthy poor people.
During the Creat Depression, policy focused
on families with children standing in soup
lines and newly caught in the web of abject
poverty. These new poor populations joined
together with the transients and older beggars
of the 1930s. Policy efforts were numerous and
focused on structural causes rather than the
personal deficits of poor people.
In the 1950s the focus shifted to skid row,
downtown areas populated by single adult
men in cheap single room hotels. Policymak
ing focused on the housing crisis through new
construction and loan programs; however,
after urban renewal, residents were displaced
and when they could no longer pay rent, they
turned to the only available temporary services
HOMELESSNESS
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provided by organizations such as the Salva
tion Army.
From the mid-1960s to the early 1970s, the
War on Poverty and the Great Society began to
illuminate what had been a private problem
and helped the nation to see that it required a
public response. Welfare programs provided
economic opportunity for poor people, but fed
eral policy initiatives failed to give adequate
attention to extreme poverty and the growing
crisis in low-income housing (Blasi, 1994). The
scope of the crisis in affordable housing was
not well recognized or completely understood.
It was generally assumed that homelessness
had diminished or could be eliminated through
other reform efforts.
The Past 25 Years
Beginning in the early 1980s, homelessness
exploded as a social issue providing a sharp
contrast to the values of opportunity for all.
Before the public rediscovery of homelessness
in the 1980s (Segal & Baumohl, 1980), it was
widely assumed that homelessness was a social
problem found either in Third World countries
(now more accurately described as “dedevel
oped nations,” Crotty [2001]), or in an earlier
and less enlightened era in the United States.
However, by the mid-1980s, rising housing
costs, changes in labor markets, deinstitution
alization of people with psychological or devel
opmental disabilities (Bachrach, 1996; Fisk,
Rowe, Laub, Calvocoressi, & DeMino, 2000;
Segal & Baumhol, 1985), inadequate response
to the needs of veterans, and related social
forces cried out for greater response in the form
of public policy. As this population grew, the
estimated number of shelter accommodations
rose from 275,000 beds in 1988 to almost
608,000 in 1996 (Blau & Abramovitz, 2004).
As U.S. communities began to face the chal
lenge of increasing numbers of people who
were homeless in shelters or living in public
spaces in the 1980s, research efforts in social
work and related disciplines began to better
document the nature and scope of the problem.
Charitable organizations such as the Robert
Wood Johnson Foundation funded health care
for the homeless coalitions around the nation.
Fundraising for these new public—private part180
SOCIAL WORK SPEAKS
nerships and media focus increased national
attention to homelessness as an ever-present
problem. Debates about the numbers, charac
teristics, causes, and consequences revolved
around the definition of the problem as a per
sonal crisis in the lives of individuals and fam
ilies who were unable to afford housing or
to benefit from job opportunities in the emerg
ing postindustrial economy. Media coverage
focused on the plight of people who were home
less, and old myths about personal responsibil
ity, worthy and unworthy poor people, and
work continued to be perpetuated by conserv
ative policy shapers and others as a part of the
public debate. Advocacy groups were formed
and focused on the need for affordable hous
ing. Faith-based organizations set up commu
nity kitchens and other services; missions, pub
lic shelters, and local action groups grew in
numbers and zeal.
After passage of the Stewart B. McKinney
Homeless Assistance Act of 1987 (P.L. 100-77),
initiatives and grant-in-aid structures began to
emerge. In addition to emergency shelter care,
local efforts in service delivery began to include
transitional housing, outreach, and case man
agement, particularly to people with mental
disabilities who were homeless. However, the
crisis of homelessness continued to grow, par
ticularly among people of color (Kreuger &
Stretch, 1987), women with children; people
living in overcrowded and poorly maintained
housing, people with psychiatric disabilities
(Segal, Silverman, & Temkin, 1995), and other
families who were unable to close the gap
between affordable housing and total family
income (Stretch & Kreuger, 1989).
Scholars such as Jahiel (1992) have identified
a number of reasons for the growth of shelterbased services during the 1980s and 1990s, in
cluding their obvious preferable value to sleep
ing in harsh or dangerous conditions under
bridges or in cardboard shacks. Shelters have
been seen as providing emergency living quar
ters for low-income families who suffer from
loss of residence as a result of random and un
predictable events such as fires and natural or
human-made disasters. Critics have pointed
out that shelters also developed partially in
response to more predictable political or eco
nomic pressures (Kreuger & Stretch, 1995). For
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example, condemnations that arose from the
demolition of low-cost housing because of gen
trification also contributed to the growth of
shelters. All too often, affordable housing was
replaced by shopping malls and entertainment
complexes. Shelters offer safe haven for vic
tims of domestic and street violence, ad they
provide security as stopping off points for tran
sients who otherwise would be stranded. Shel
ters have been seen as a mechanism for ob
taining access to improved housing through
residential placement networks and public
subsidies such as vouchers for Section 8 assis
tance. Finally, shelters may provide alterna
tive support for law enforcement officers who
respond to requests from sometimes hostile
city audiences to arrest people who are home
less. Shelters provide care for people who real
istically need a place to live rather than more
extreme alternatives such as hospitalization or
punitive incarceration. Evaluation studies have
assessed both shorter-term outcomes (Glisson,
Thyer, & Fischer, 2001) and longer-term effec
tiveness (Stretch & Kreuger, 1993) of shelter
services, with mixed conclusions.
In 1994 the federal government published
the first federal plan to break the cycle of
homelessness, entitled Priority: Home! (U.S.
Department of Housing and Urban Develop
ment [HUD), 1994). The plan stated that “for
the most part, homelessness relief efforts remain
locked in an ‘emergency register” (p. 18).
Homelessness is divided into two broad cate
gories of problems: crisis poverty and chronic
disability. The plan called for efforts to “rein
vent the approach” because the “current ap
proach is plainly not working and must be
changed” (HUD, p. 4). A number of factors
place people at risk of homelessness, including
alcoholism; drug abuse; low education and
illiteracy; sexual exploitation; chronic mental
disability, developmental disabilities, or mild
mental retardation; and HIV/AIDS. Our soci
ety systematically and traditionally viewed
those labeled as “worthy” poor people in these
situations as “unworthy” poor people.
On August 22, 1996, President Clinton ended
“welfare as we know it” by signing the Per
sonal Responsibility and Work Opportunity
Reconciliation Act. This act ended the existing
income maintenance system known as Aid to
Families with Dependent Children, the Job
Opportunities and Basic Skill Training Pro
gram, and Emergency Assistance. These pro
grams were replaced by the new federal block
grant program known as Temporary Assis
tance for Needy Families (TANF). Analysis by
Sard (2001) of these changes in welfare spend
ing indicates that some progress has been made
in accommodating homelessness in TANF ad
ministration. However, consistent cuts in pub
lic expenditures for housing have been noted
in the fact that HUD’s budget has decreased
from approximately $85 billion in 1978 to just
$29.4 billion in 2002, in inflation-adjusted terms
(Blau & Abramovitz, 2004).
Lessons from the Past
After a century of shifting definitions of the
problem, political denial, and policy neglect,
the core of the homelessness problem clearly is
extreme poverty and lack of affordable hous
ing. Policies on homelessness, with only a few
exceptions, have emphasized the alleviation of
individual need and have underestimated the
influence of systemic factors that would be sig
nificant in reversing or preventing the underly
ing conditions of homelessness (Jones & Crook,
2001). Past policy failures (Johnson, Kreuger, &
Stretch, 1989) together with reductions in pub
lic assistance, housing, health care, economic
opportunity, education, nutrition, and affirma
tive action do not offer much hope that society
is capable of learning from either past mistakes
or accomplishments.
Too often policy-making processes at the
federal, state, and local levels have been lim
ited to local emergency measures, such as var
ious health care for the homeless coalitions that
began in the 1980s, rather than addressing the
long-term structural and preventive dimensions
of severe poverty and homelessness. Recurring
themes of individual rather than communal
responsibility and labels such as “bag ladies,”
“panhandlers,” “handouts,” “hobos,” and “tran
sients” have been the focus of public attention.
Somewhat analogous to blaming each individ
ual drop of rain for causing one to get wet,
rather than responding to the larger weather
system (structural foundations), policymakers
have tended to rely on compartmentalized
HOMELESSNESS
181
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solutions. Critics have pointed out that too
often people who are homeless are substance
dependent, illegal immigrants, or psychiatric
outpatients, whose conditions would seem to
justify narrower problem-focused solutions.
But according to Blau and Abramovitz (2004),
when homelessness is seen through the lens of
an inadequate supply of affordable housing,
who other than people in extreme situations
are likely to be left after competition for scarce
low-cost housing has run its course?
However, valuable lessons are there to be
learned. First, the scope of emergency mea
sures during the Depression Era had a measur
able effect in alleviating suffering and extreme
poverty. Second, long-term structural mea
sures such as social security and the indexing
of these benefits, Medicare, and services to
elderly citizens have been effective in protect
ing some low-income older Americans from
the risks of homelessness. Third, the failure to
adequately respond to the needs of individuals
who were homeless in the 1980s and 1990s led
to an even greater crisis in the 21st century. The
new chronic homelessness is recognized as a
more multifaceted and entrenched problem
than in earlier decades, one exacerbated by
new at-risk populations, including those with
communicable diseases. And far too often,
communities have responded with more puni
tive efforts to criminalize homelessness, rather
than to work to prevent it (“Illegal to be home
less,” 2003).
ISSUE STATEMENT
After three decades of disjointed efforts to
address the crisis of homelessness in the United
States, it remains a significant issue. The rea
sons for this are primarily systemic, and home
lessness and poverty are inextricably linked.
Being poor means living on the verge of being
an accident, an illness, a paycheck, a violent
event, or a condemnation away from living on
the streets. Being poor means having limited
resources to cover the necessities of housing,
nutrition, child care, health care, and education.
Affordable housing, which absorbs a large pro
portion of income for people who are poor, is
too often abandoned when economic resources
are insufficient to meet basic needs. The cost
182
SOC/AL WORK SPEAKS
and difficulty of trying to find low-income
housing once a domicile has been lost can pre
sent tremendous obstacles, and cogent policies
not supported by adequate resources exacer
bate this problem. Studies indicate that whereas
there were 6.5 million low-cost housing units
for 6.2 million renters in 1970, by 1995 there
were only 6.1 million low-cost units for 10.5 mil
lion renters (Blau & Abramovitz, 2004).
Policy making in relation to the problem of
homelessness illustrates a drastic reshaping of
the federal social welfare agenda in the United
States during the past 25 years, but no single
legislative answer has solved or significantly
reduced homelessness (Burt, 2000). The dilemma
of how to achieve this goal in a time of massive
federal budget deficits, narrowly focused pol
icy agendas, and the recent trend toward crim
inalization of people who are homeless, merits
our attention. In keeping with an empower
ment perspective, social workers can and must
join with people who are homeless to make sig
nificant changes in their lives and in the social
structures that surround them.
POLICY STATEMENT
To adequately address the problem of both
shorter duration and chronic homelessness in
the United States, policies should range from
strengthening the capacities of the many peo
ple who are homeless who are system victims,
to changing social and economic conditions
that foster extreme poverty and increase the
risk of homelessness. NASW advocates the fol
lowing as supportive and long-term solutions
to the problem of homelessness:
1. The goal of an affordable and adequate
home and a suitable living environment for
everyone in the United States (Housing Act of
1949) should be vigorously pursued (HUD,
2004).
2. Social workers need to be actively in
volved side by side with people who are home
less (see, for example, Busch-Ceertsema, 2002)
in national, state, and local coalitions to net
work with and create advocacy groups; to
identify significant problems in localities and
create linkages to address and alleviate these
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problems; and to encourage state and local
communities to use mainstream programs in
building a continuum of care that integrates
housing, income maintenance, and supportive
services.
3. Federal, state, and local housing subsi
dies should be available as an entitlement for
all households with new emphasis on advo
cacy for McKinney-Vento Homeless Assistance
Programs; HOPWA (Housing Opportunities
for Persons with AIDS); Section 811 for Persons
with Disabilities; and programs for the Educa
tion for Homeless Children and Youth (EHCY).
4. The complex patchwork of housing
assistance programs (Mulroy & Ewalt, 1996)
for low-income families should be organized
into a more efficient and coordinated system
that targets very poor people and households
at highest risk of homelessness.
5. Efforts to encourage state and local com
munities to use mainstream programs in build
ing a continuum of care that integrates hous
ing, income maintenance, and supportive
services should be strengthened.
6. Education, job training, and related sup
port services should be expanded to serve as
key elements in the prevention of homelessness. Studies show that only 11 percent of peo
ple who are homeless receive SSI benefits,
whereas almost 40 percent experience mental
health problems, and 46 percent report having
at least one chronic health condition (Intera
gency Council on Homelessness, 1999).
7. Homeless children need to be identified
as a special population. They require proper
nutrition, adequate clothing and hygiene, and
continuous, appropriate education (including
a space to study). Services to homeless children
should be provided with an overall goal of
stopping the cycle of homelessness,
8. Treatment and supportive services for
special populations should be expanded and
be focused on innovative approaches.
9. Federal, state, and local proposals to cut
expenditures and restructure social welfare
programs should be studied to determine their
impact on homelessness.
10, The lack of bipartisan effort and consen
sus on policy goals to end mass homelessness
continues and is a major stumbling block to
federal leadership in agenda setting and ap
propriations. Political action strategies are
needed to reverse this trend.
11. Support for a living wage to help pre
vent homelessness should be widespread.
Short-term program and policy changes are
needed to cope with fiscal crises and the dis
jointed community system of emergency ser
vices for individuals and families who are
homeless. Fiscal and programmatic recommen
dations contained in new ventures, including
the development of a National Housing Trust
Fund and the Bringing America Home Act
(www. bringingamericahome.org), merit our
attention. State and local communities as well
as nonprofit and public agencies should rethink
the place of shelter care within a larger contin
uum of services for special at-risk populations
faced with crisis poverty and homelessness.
Shelters have become an institutional response,
but their presence should not be viewed as a
policy solution (Kreuger, Stretch, Hodges, &
Word, 2002). Social workers should be actively
involved, in the company of people who are
homeless, in the development of continuity of
services for children and families. School social
workers should work as advocates for the
needs of children who are members of families
who are homeless (Markward & Biros, 2001).
Excessive rent and other housing burdens on
poor people in urban and rural communities
must be alleviated. State and local resources,
including voluntary efforts, must be mobilized
to develop creative solutions and stopgap mea
sures for protecting people who are precari
ously housed. Misconceptions about the causes
of homelessness and severe poverty have con
tributed to the lack of public support for efforts
to alleviate homelessness. Social workers in
partnership with elected officials and others
must lead the fight in the interests of people
who are homeless. The impact of homelessness
on women and people of color in U.S. society is
an important national issue and for the social
work profession that must be translated into
more effective efforts at coalition building.
HOMELESSNESS
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Although more demands are being placed
on shelters and emergency services to help
people who are homeless, mainstream pro
grams for housing assistance, public assis
tance, and health care have been drastically cut
to fund other political priorities. As programs
are paralyzed by too many funding reductions,
poverty becomes more severe and homelessness emerges as a growing and chronic reality
for the poorest population.
After three decades of disjointed efforts to
address the crisis of homelessness in the
United States, gaps in federal and state policies
and inadequate funding are producing more
homeless individuals. The impact of homelessness necessitates immediate action on the part
of the social work profession.
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+
Policy statement approved by f/ic NASW Delegate Assembly, August 2005. This policij supersedes the policy statement on Home
less ness approved by the Delegate Assembly in 1996 and referred by tIme 2002 Delegate Assembly to the 2005 Delegate Assenthly for
revision. For further information, contact (lie National Association of social Wom-kers, 750 First Street, NE, Suite 700, Washington,
DC 20002-4241. Telephone: 202-408-8600 or 800-638-8799; e-mail: press@naswdc.org
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