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City of Boston workers clear encampments in the area known as Mass and Cass.

Craig F. Walker/The Boston Globe via Getty Images

Alvin Powell

Harvard Staff Writer

Experts cite complexity of problem, which is rooted in poverty, lack of affordable housing but includes medical, psychiatric, substance-use issues

It took seven years for Abigail Judge to see what success looked like for one Boston homeless woman.

The woman had been sex trafficked since she was young, was a drug user, and had been abused, neglected, or exploited in just about every relationship she’d had. If Judge was going to help her, trust had to come first. Everything else — recovery, healing, employment, rejoining society’s mainstream — might be impossible without it. That meant patience despite the daily urgency of the woman’s situation.

“It’s nonlinear. She gets better, stops, gets re-engaged with the trafficker and pulled back into the lifestyle. She does time because she was literally holding the bag of fentanyl for these guys,” said Judge, a psychology instructor at Harvard Medical School whose outreach program, Boston Human Exploitation and Sex Trafficking (HEAT), is supported by Massachusetts General Hospital and the Boston Police Department. “This is someone who’d been initially trafficked as a kid and when I met her was 23 or 24. She turned 30 last year, and now she’s housed, she’s abstinent, she’s on suboxone. And she’s super involved in her community.”

It’s a success story, but one that illustrates some of the difficulties of finding solutions to the nation’s homeless problem. And it’s not a small problem. A  December 2023 report  by the U.S. Department of Housing and Urban Development said 653,104 Americans experienced homelessness, tallied on a single night in January last year. That figure was the highest since HUD began reporting on the issue to Congress in 2007 .

Abigail Judge of the Medical School (from left) and Sandra Andrade of Massachusetts General Hospital run the outreach program Boston HEAT (Human Exploitation and Sex Trafficking).

Niles Singer/Harvard Staff Photographer

Scholars, healthcare workers, and homeless advocates agree that two major contributing factors are poverty and a lack of affordable housing, both stubbornly intractable societal challenges. But they add that hard-to-treat psychiatric issues and substance-use disorders also often underlie chronic homelessness. All of which explains why those who work with the unhoused refer to what they do as “the long game,” “the long walk,” or “the five-year-plan” as they seek to address the traumas underlying life on the street.

“As a society, we’re looking for a quick fix, but there’s no quick fix for this,” said Stephen Wood, a visiting fellow at Harvard Law School’s Petrie-Flom Center for Health Law Policy, Biotechnology and Bioethics and a nurse practitioner in the emergency room at Carney Hospital in the Dorchester neighborhood of Boston. “It takes a lot of time to fix this. There will be relapses; there’ll be problems. It requires an interdisciplinary effort for success.”

A recent study of 60,000 homeless people in Boston found the average age of death was decades earlier than the nation’s 2017 life expectancy of 78.8 years.

Illustration by Liz Zonarich/Harvard Staff

Katherine Koh, an assistant professor of psychiatry at HMS and psychiatrist at MGH on the street team for Boston Health Care for the Homeless Program, traced the rise of homelessness in recent decades to a combination of factors, including funding cuts for community-based care, affordable housing, and social services in the 1980s as well as deinstitutionalization of mental hospitals.

“Though we have grown anesthetized to seeing people living on the street in the U.S., homelessness is not inevitable,” said Koh, who sees patients where they feel most comfortable — on the street, in church basements, public libraries. “For most of U.S. history, it has not been nearly as visible as it is now. There are a number of countries with more robust social services but similar prevalence of mental illness, for example, where homelessness rates are significantly lower. We do not have to accept current rates of homelessness as the way it has to be.”

“As a society, we’re looking for a quick fix, but there’s no quick fix for this.” Stephen Wood, visiting fellow, Petrie-Flom Center for Health Law Policy, Biotechnology and Bioethics

Success stories exist and illustrate that strong leadership, multidisciplinary collaboration, and adequate resources can significantly reduce the problem. Prevention, meanwhile, in the form of interventions focused on transition periods like military discharge, aging out of foster care, and release from prison, has the potential to vastly reduce the numbers of the newly homeless.

Recognition is also growing — at Harvard and elsewhere — that homelessness is not merely a byproduct of other issues, like drug use or high housing costs, but is itself one of the most difficult problems facing the nation’s cities. Experts say that means interventions have to be multidisciplinary yet focused on the problem; funding for research has to rise; and education of the next generation of leaders on the issue must improve.

“This is an extremely complex problem that is really the physical and most visible embodiment of a lot of the public health challenges that have been happening in this country,” said Carmel Shachar, faculty director of Harvard Law School’s Center for Health Law and Policy Innovation. “The public health infrastructure has always been the poor Cinderella, compared to the healthcare system, in terms of funding. We need increased investment in public health services, in the public health workforce, such that, for people who are unhoused, are unsheltered, who are struggling with substance use, we have a meaningful answer for them.”

“You can either be admitted to a hospital with a substance-use disorder, or you can be admitted with a psychiatric disorder, but very, very rarely will you be admitted to what’s called a dual-diagnosis bed,” said Wood, a nurse practitioner in the emergency room at Carney Hospital.

Kris Snibbe/Harvard Staff Photographer

Experts say that the nation’s unhoused population not only experiences poverty and exposure to the elements, but also suffers from a lack of basic health care, and so tend to get hit earlier and harder than the general population by various ills — from the flu to opioid dependency to COVID-19.

A recent study of 60,000 homeless people in Boston recorded 7,130 deaths over the 14-year study period. The average age of death was 53.7, decades earlier than the nation’s 2017 life expectancy of 78.8 years. The leading cause of death was drug overdose, which increased 9.35 percent annually, reflecting the track of the nation’s opioid epidemic, though rising more quickly than in the general population.

A closer look at the data shows that impacts vary depending on age, sex, race, and ethnicity. All-cause mortality was highest among white men, age 65 to 79, while suicide was a particular problem among the young. HIV infection and homicide, meanwhile, disproportionately affected Black and Latinx individuals. Together, those results highlight the importance of tailoring interventions to background and circumstances, according to Danielle Fine, instructor in medicine at HMS and MGH and an author of two analyses of the study’s data.

“The takeaway is that the mortality gap between the homeless population and the general population is widening over time,” Fine said. “And this is likely driven in part by a disproportionate number of drug-related overdose deaths in the homeless population compared to the general population.”

Inadequate supplies of housing

Though homelessness has roots in poverty and a lack of affordable housing, it also can be traced to early life issues, Koh said. The journey to the streets often starts in childhood, when neglect and abuse leave their marks, interfering with education, acquisition of work skills, and the ability to maintain healthy relationships.

“A major unaddressed pathway to homelessness, from my vantage point, is childhood trauma. It can ravage people’s lives and minds, until old age,” Koh said. “For example, some of my patients in their 70s still talk about the trauma that their parents inflicted on them. The lack of affordable housing is a key factor, though there are other drivers of homelessness we must also tackle.”

The number was the highest since the U.S. Department of Housing and Urban Development began reporting on the issue to Congress in 2007 .

Most advocates embrace a “housing first” approach, prioritizing it as a first step to obtaining other vital services. But they say the type of housing also matters. Temporary shelters are a key part of the response, but many of the unhoused avoid them because of fears of theft, assault, and sexual assault. Instead, long-term beds, including those designated for people struggling with substance use and mental health issues, are needed.

“You can either be admitted to a hospital with a substance-use disorder, or you can be admitted with a psychiatric disorder, but very, very rarely will you be admitted to what’s called a dual-diagnosis bed,” said Petrie-Flom’s Wood. “The data is pretty solid on this issue: If you have a substance-use disorder there’s likely some underlying, severe trauma. Yet, when we go to treat them, we address one but not the other. You’re never going to find success in the system that we currently have if you don’t recognize that dual diagnosis.”

Services offered to those in housing should avoid what Koh describes as a “one-size-fits-none” approach. Some might need monthly visits from a caseworker to ensure they’re getting the support they need, she said. But others struggle once off the streets. They need weekly — even daily — support from counselors, caseworkers, and other service providers.

“I have seen, sadly, people who get housed and move very quickly back out on the streets or, even more tragically, lose their life from an unwitnessed overdose in housing,” Koh said. “There’s a community that’s formed on the street so if you overdose, somebody can give you Narcan or call 911. If you don’t have the safety of peers around, people can die. We had a patient who literally died just a few days after being housed, from an overdose. We really cannot just house people and expect their problems to be solved. We need to continue to provide the best care we can to help people succeed once in housing.”

“We really cannot just house people and expect their problems to be solved.”  Katherine Koh, Mass. General psychiatrist

Koh works on the street team for Boston Health Care for the Homeless Program.

Photo by Dylan Goodman

The nation’s failure to address the causes of homelessness has led to the rise of informal encampments from Portland, Maine, to the large cities of the West Coast. In Boston, an informal settlement of tents and tarps near the intersection of Massachusetts Avenue and Melnea Cass Boulevard was a point of controversy before it was cleared in November.

In the aftermath, more than 100 former “Mass and Cass” residents have been moved into housing, according to media reports. But experts were cautious in their assessment of the city’s plans. They gave positive marks for features such as a guaranteed place to sleep, “low threshold” shelters that don’t require sobriety, and increased outreach to connect people with services. But they also said it’s clear that unintended consequences have arisen. and the city’s homelessness problem is far from solved.

Examples abound. Judge, who leads Boston HEAT in collaboration with Sandra Andrade of MGH, said that a woman she’d been working with for two years, who had been making positive strides despite fragile health, ongoing sexual exploitation, and severe substance use disorder, disappeared after Mass and Cass was cleared.

Mike Jellison, a peer counselor who works on Boston Health Care for the Homeless Program’s street team, said dismantling the encampment dispersed people around the city and set his team scrambling to find and reconnect people who had been receiving medical care with providers. It’s also clear, he said, that Boston Police are taking a hard line to prevent new encampments from popping up in other neighborhoods, quickly clearing tents and other structures.

“We were out there Wednesday morning on our usual route in Charlesgate,” Jellison said in early December. “And there was a really young couple who had all their stuff packed. And [the police] just told them, ‘You’ve got to leave, you can’t stay here.’ She was crying, ‘Where am I going to go?’ This was a couple who works; they’re employed and work out of a tent. It was like 20 degrees out there. It was heartbreaking.”

Prevention as cure?

Successes in reducing homelessness in the U.S. are scarce, but not unknown. The U.S. Department of Veterans Affairs, for example, has reduced veteran homelessness nationally by more than 50 percent since 2010.

Experts point out, however, that the agency has advantages in dealing with the problem. It is a single, nationwide, administrative entity so medical records follow patients when they move, offering continuity of care often absent for those without insurance or dealing with multiple private providers. Another advantage is that the VA’s push, begun during the Obama administration, benefited from both political will on the part of the White House and Congress and received support and resources from other federal agencies.

The city of Houston is another example. In 2011, Houston had the nation’s fifth-largest homeless population. Then-Mayor Annise Parker began a program that coordinated 100 regional nonprofits to provide needed services and boost the construction of low-cost housing in the relatively inexpensive Houston market.

Neither the VA nor Houston was able to eliminate homelessness, however.

To Koh, that highlights the importance of prevention. In 2022, she published research in which she and a team used an artificial-intelligence-driven model to identify those who could benefit from early intervention before they wound up on the streets. The researchers examined a group of U.S. service members and found that self-reported histories of depression, trauma due to a loved one’s murder, and post-traumatic stress disorder were the three strongest predictors of homelessness after discharge.

In April 2023, Koh, with co-author Benjamin Land Gorman, suggested in the Journal of the American Medical Association that using “Critical Time Intervention,” where help is focused on key transitions, such as military discharge or release from prison or the hospital, has the potential to head off homelessness.

“So much of the clinical research and policy focus is on housing those who are already homeless,” Koh said. “But even if we were to house everybody who’s homeless today, there are many more people coming down the line. We need sustainable policies that address these upstream determinants of homelessness, in order to truly solve this problem.”

The education imperative

Despite the obvious presence of people living and sleeping on city sidewalks, the topic of homelessness has been largely absent from the nation’s colleges and universities. Howard Koh, former Massachusetts commissioner of public health and former U.S. assistant secretary for Health and Human Services, is working to change that.

In 2019, Koh, who is also the Harvey V. Fineberg Professor of the Practice of Public Health Leadership, founded the Harvard T.H Chan School of Public Health’s pilot Initiative on Health and Homelessness. The program seeks to educate tomorrow’s leaders about homelessness and support research and interdisciplinary collaboration to create new knowledge on the topic. The Chan School’s course “Homelessness and Health: Lessons from Health Care, Public Health, and Research” is one of just a handful focused on homelessness offered by schools of public health nationwide.

“The topic remains an orphan,” said Koh. The national public health leader (who also happens to be Katherine’s father) traced his interest in the topic to a bitter winter while he was Massachusetts public health commissioner when 13 homeless people froze to death on Boston’s streets. “I’ve been haunted by this issue for several decades as a public health professional. We now want to motivate courageous and compassionate young leaders to step up and address the crisis, educate students, motivate researchers, and better inform policymakers about evidence-based studies. We want every student who walks through Harvard Yard and sees vulnerable people lying in Harvard Square to not accept their suffering as normal.”

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Essays About Homelessness: Top 8 Examples Plus Prompts

Everyone has heard of homeless people at some point in their lives; if you are writing essays about homelessness, read our top essay examples and prompts.

Poverty is one of the greatest evils in the world. Its effects are seen daily, from people begging on the streets to stealing to support their families. But unfortunately, one of the most prominent and upsetting diversity is homelessness. Homelessness is a significant problem in even the most developed nations, including the U.S. and Canada. Despite all the resources used to fight this issue, countries often lack the means to reduce homelessness significantly. With the proper aid, homelessness can be entirely eradicated in the future. 

If you want to write essays about homelessness, keep reading to see our essay examples and helpful writing prompts.

2. A journey with the homeless by Sujata Jena

3. i chose to be homeless: reflections on the homeless challenge by emily kvalheim, 4. my experience being homeless by scott benner, 5. what people get wrong when they try to end homelessness by james abro, 1. causes of homelessness , 2. how can homelessness be reduced, 3. mental illness and homelessness, 4. reflection on homelessness, 5. is homelessness a “personal problem”.

Are you looking for more? Check out our guide packed full of transition words for essays

1. That Homeless Man is My Brother by Megan Regnerus

“But the subtext of my friend’s statement is really Why should I give money to someone who’s lazy; who isn’t willing to work for money like I do?’ And to that I say, her opinion that people who ask for money are freeloaders who could work but choose not to, is based on assumption. It relies on the notion that the two things that shape us into able-bodied adults who can hold down a regular job, nature and nurture, are level playing fields. And they’re not.”

Regnerus writes about a friend’s claim that the homeless are “lazy,” reminding her of her homeless brother. She cites genetics and circumstance as contributing factors to homelessness. Despite the other woman being her friend, Regnerus strongly refutes her belief that the homeless are non-disabled freeloaders- they should be treated with empathy. For more, check out these articles about homelessness .

“I realize that the situation of poverty and homelessness is a huge social problem around the world. But when I meet them, I face fellow human beings, not some abstract “social problem.” The very phrase, “What would Jesus do at this scene?” haunted me.  I ventured to ask their names, age, where they came from, where they live (street, bridges, cemetery) and the reason they are on the streets. Their stories are poignant. Each one has a unique story to tell about his/her reason to be homeless, how they were forced to leave distant rural villages to live on the city streets. I tried to listen to them with empathy.”

In her essay, Jena remembers the homeless people in Manila, Philippines. She can see them beyond some “aspect of society” as human beings. She empathizes with them extensively and recalls the words of Jesus Christ about loving others, particularly the neediest.

“I, too, have not been compassionate enough, and I have allowed my prejudices to distort my view of the homeless. One woman, who sat across from me at a feeding program, talking to herself erratically, may have seemed strange to me before the Homeless Challenge. But when I really saw myself as her equal, and when I took the time to watch her get up and laugh as she danced to the music playing in the background, I thought she was beautiful. She had found her own happiness, amidst despair.”

Kvalheim details her experiences during an immersion challenge with the homeless. She recalls both the discrimination and generosity she experienced and her experiences with other homeless people. She was amazed to see how they could stay positive despite their terrible circumstances. We should be thankful for what we have and use it to help others in need. 

“As my funds dwindled, and the weather got colder, I sought shelter at Father Bill’s in Quincy Ma. When you are homeless, sometimes very small things mean a lot. A dry pair of socks, shoes without holes, a pocketful of change. You begin to realize how much you value your personal space. You begin to realize other people want space too. A lot of people have issues or have suffered in one way or another and you can see their pain. I think that there are people who for a variety of issue are chronically homeless and a larger portion of homeless are transitioning through a series of bad events.”

Benner’s essay, written for the company ArtLifting, reflects on his experience of being homeless for a brief while. Then, he and his wife grew ill, and Benner sought refuge at a homeless shelter after his company shut down. After that, he realized how his struggles were very different from those of others and the value of the more minor things he previously took for granted. Luckily, he escaped homelessness by making art with the help of ArtLifting. 

“The court denied my sister’s request and named me our mother’s legal guardian, but it appointed my sister as guardian of her property.  In 2009, when my mother passed away, my sister evicted me. The day I was scheduled to move out, I stood in a convenience store, dazed, as I stared at microwaveable meals.  These would be my new staple when I moved into the motel room. My phone rang—my sister.  She told me she needed me out of the house in a couple of hours—she was a real estate agent and a client wanted to see the house. ‘No hard feelings,’ she said.”

Similar to Benner, Abro narrates the circumstances surrounding his homelessness. After his mother’s death and a conflict with his sister led to his eviction, he ended up homeless. While his situation was unfortunate, he believes that there are many people worse off than him and that something must change to address the housing and poverty crises in America.

Top 5 Prompts On Essays about Homelessness

For your essay, it would be interesting to write about how people become homeless in the first place. Research the different causes of homelessness and elaborate on them, and be sure to provide sources such as statistics and anecdotes. 

What solutions to homelessness can you think of? In your essay, propose at least one way you think the homelessness problem can be solved or at least reduced. It must be concrete, realistic, and defensible; be sure to explain your solution well and defend its feasibility, backing up your claims with facts and logic. 

Homelessness and mental health can be linked—research into declining mental health and how homelessness can impact a person’s mental well-being. Make sure to use research data and statistics to show your findings. Conclude whether poor mental health can cause homelessness or if homelessness causes poor mental health.

You can write about what homelessness means to you in your essay. Perhaps you’ve heard stories of homeless people, or maybe you know someone who is or has been homeless. Use this essay to highly the effects of homelessness and how we can work together as a society to eradicate it.

Many say that homeless people “choose to be homeless” and are underachievers; otherwise, they would simply “get a job” and lift themselves out of poverty. Is this true? Research this topic and decide on your stance. Then, write about whether you agree with this topic for a compelling argumentative essay.

If you’re still stuck, check out our general resource of essay writing topics .

Martin is an avid writer specializing in editing and proofreading. He also enjoys literary analysis and writing about food and travel.

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Homelessness and Public Health: A Focus on Strategies and Solutions

David a. sleet.

1 School of Public Health, San Diego State University, San Diego, CA 92182, USA; moc.liamg@teelsadivad

2 Veritas Management, Inc., Atlanta, GA 30324, USA

Louis Hugo Francescutti

3 School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada

4 Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada

5 Royal Alexandra Hospital, Edmonton, AB T5H 3V9, Canada

On any given night, hundreds of thousands of people are homeless in the United States and Canada. Globally, the problem is many times worse, making homelessness a global public health and environmental problem. The facts [ 1 ] are staggering:

• On a single night in January 2020, 580,466 people (about 18 out of every 10,000 people) experienced homelessness across the United States—a 2.2% increase from 2019.
• While 61% percent of the homeless were staying in sheltered locations, the remainder—more than 226,000 people—were in unsheltered locations on the street, in abandoned buildings, or in other places not suitable for human habitation.
• Homelessness has increased in the last four consecutive years.
• The increase in unsheltered homelessness is driven largely by increases in California.
• In 2020, 171,575 people in families with children experienced homelessness on a single night.
• A total of 3598 homeless people were children under the age of 18 without an adult present.
• Veterans comprised 8% of all homeless adults (over 46,000 veterans struggle with homelessness).
• People of color are significantly over-represented among those experiencing homelessness.

A layman’s definition of homelessness is usually “a person that has no permanent home”. However, many scholars have divided the broad group of people characterized as homeless into three (or more) categories:

• - People without a place to reside;
• - People in persistent poverty, forced to move constantly, and who are homeless for even brief periods of time;
• - People who have lost their housing due to personal, social, or environmental circumstances.

While this definition refers specifically to homeless individuals, it is equally applicable to homeless families.

Homelessness is closely connected to declines in physical and mental health. Homeless persons experience high rates of health problems such as Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) and Hepatitis A infections, alcohol and drug addiction, mental illness, tuberculosis, and other serious conditions. The health problems facing homeless persons result from various factors, including a lack of housing, racism and discrimination, barriers to health care, a lack of access to adequate food and protection, limited resources for social services, and an inadequate public health infrastructure. Legal and policy interventions have often been used to attempt to address homelessness, although not always from a public health perspective.

In health care, for example, if someone experiencing homelessness comes to an emergency department for medical aid, once treated, the only alternative is to release the patient back onto the street. This creates an endless cycle of emergency department visits, increasing costs and expending resources in the health care system.

Recent work [ 2 ] has emphasized the important role of public health, the health care system, and health care providers in homelessness prevention. In this Special Issue of the International Journal of Environmental Research and Public Health (IJERPH), we have brought together researchers, practitioners, and community organizers to articulate the public health problem of homelessness and identify clear strategies to reduce homelessness and provide more adequate health care and housing for this population. We also explore solutions for important subpopulations, including adults, families with children, adolescents, women, transitional aged youth, and those suffering from mental illness, PTSD, alcohol dependency, mental illness, adverse childhood experiences, and chronic homelessness.

We address many of these issues in the context of public health and explore the public health implications and potential solutions to homelessness, focusing on contemporary and emerging research and innovative strategies, and highlighting best practices to address homelessness among key populations. The papers in this Special Issue attempt to answer several questions related to homelessness and public health, such as:

• What is the extent of homelessness and why do people become homeless?
• What are the public health and health services implications of homelessness?
• What role does housing play as a precursor to and potential solution for homelessness?
• What public health and health care interventions are being employed, and what effectiveness is being achieved?
• What long-term strategies can be developed to prevent homelessness?

The 13 research papers and one commentary in this Special Issue are summarized as follows:

• Conceptualizing an Interdisciplinary Collective Impact Approach to Examine and Intervene in the Chronic Cycle of Homelessness. This study by Abdel–Samad et al. [ 3 ] focuses on a novel, interdisciplinary academic–practice partnership model for addressing the problem of homelessness. Whereas singular disciplinary approaches may fall short in substantially reducing homelessness, this approach draws from a collective impact model that integrates discipline-specific approaches through mutually reinforcing activities and shared metrics. The paper describes what is necessary for capacity-building at the institution and community levels, the complementary strengths and contributions of each discipline in the model, and future implementation goals to address homelessness in the Southern California region using a cross-disciplinary approach.
• Mental Illness and Youth-Onset Homelessness: A Retrospective Study among Adults Experiencing Homelessness . Iwundu et al. [ 4 ] conducted a retrospective study and evaluated the association between the timing of homelessness onset (youth versus adult) and mental illness. The results indicated that mental illness (as a reason for current homelessness) and severe mental illness comorbidities were each associated with increased odds of youth-onset homelessness, providing a basis for agencies that serve at-risk youth in order to address mental health precursors to youth homelessness.
• Well-Being without a Roof: Examining Well-Being among Unhoused Individuals Using Mixed Methods and Propensity Score Matching. Ahuja et al. [ 5 ] found that the mean overall well-being score of unhoused participants was significantly lower than that of matched housed participants, with unhoused participants reporting lower mean scores for social connectedness, lifestyle and daily practices, stress and resilience, emotions, physical health, and finances. The unhoused participants had a statistically significantly higher mean score for spirituality and religiosity than their matched housed counterparts. The qualitative interviews highlighted spirituality and religion as a coping mechanism for the unhoused.
• Combatting Homelessness in Canada: Applying Lessons Learned from Six Tiny Villages to the Edmonton Bridge Healing Program. Authors Wong et al. [ 6 ] discuss the Bridge Healing Program in Edmonton, Alberta, a novel approach to combatting homelessness by using hospital emergency departments (ED) as a gateway to temporary housing. The program provides residents with immediate temporary housing before transitioning them to permanent homes. The paper discusses effective strategies that underlie the Tiny Villages concept by analyzing six case studies and applying the lessons learned to improving the Bridge Healing Program and reducing repeat ED visits and ED lengths of stay among homeless individuals.
• Change in Housing Status among Homeless and Formerly Homeless Individuals in Quebec, Canada: A Profile Study. Kaltsidis et al. [ 7 ] used a cluster analysis to develop a typology of the housing status change for 270 currently or formerly homeless individuals who were residing in shelters and temporary or permanent housing. The findings suggest that the maintenance or improvement in the housing status requires the availability of suitable types and frequencies of service use (enabling factors) that are well-adapted to the complexity of health problems (needs factors) among homeless individuals. Specific interventions, such as outreach programs and case management, are prioritized as necessary services, especially for individuals at a higher risk of returning to homelessness.
• Urban Stress Indirectly Influences Psychological Symptoms through Its Association with Distress Tolerance and Perceived Social Support among Adults Experiencing Homelessness. To investigate the simultaneous impact of intrapersonal characteristics (distress tolerance) and interpersonal characteristics (social support) and their association with homelessness, Hernandez et al. [ 8 ] recruited homeless adults from six homeless shelters in Oklahoma City who self-reported urban life stress, distress tolerance, social support, major depressive disorder, and PTSD symptoms. Based on the resulting associations, their findings stress the importance of implementing interventions aimed at increasing social support for homeless persons, something that may also increase skill development for distress tolerance and indirectly lead to a reduction in depression and PTSD.
• “I Felt Safe”: The Role of the Rapid Rehousing Program in Supporting the Security of Families Experiencing Homelessness in Salt Lake County, Utah. Garcia and Kim [ 9 ] describe their research into The Road Home (TRH) program, which provides services to homeless individuals and families. TRH is known for their emergency shelters and also administers the Rapid Rehousing Program (RRHP), designed to help homeless families transition back into stable housing. After collecting qualitative data from focus groups with participants and families, landlords, case managers, and service providers, they make recommendations for program improvements that can increase the residential security of families experiencing homelessness.
• “It’s Just a Band-Aid on Something No One Really Wants to See or Acknowledge”: A Photovoice Study with Transitional Aged Youth Experiencing Homelessness to Examine the Roots of San Diego’s 2016–2018 Hepatitis A Outbreak. In this study, Felner et al. [ 10 ] examined the experiences and needs of transitional aged youth (TAY) aged 18–24 experiencing homelessness who may have been uniquely affected by an unprecedented outbreak of hepatitis A virus (HAV). The findings documented a stigmatization of TAY, interventions that failed to address root causes of the outbreak, and interactions with housing- and social support-related resources that limited rather than supported economic and social mobility. The findings have implications for understanding how media and public discourse, public health interventions, and the availability and delivery of resources can contribute to and perpetuate stigma and health inequities faced by TAY experiencing homelessness.
• Predictors of Overnight and Emergency Treatment among Homeless Adults. Iwundu et al. [ 11 ] aimed to identify the sociodemographic predictors associated with overnight and emergency hospital treatment among a sample of homeless adults. Participants were recruited from a shelter in Dallas, Texas and were predominantly uninsured, low-income men and women from various social and ethnic groups. In logistic regression models, gender emerged as the only predictor of overnight treatment in a hospital and treatment in an emergency department. Women were more likely than men to be treated overnight and use emergency care. The authors concluded that interventions and policies targeted toward homeless women’s primary health care needs would reduce health care costs.
• Association of Problematic Alcohol Use and Food Insecurity among Homeless Men and Women. In a study on alcohol use and food insecurity among homeless men and women, Reitzel et al. [ 12 ] investigated the link between problematic alcohol use and food insecurity among homeless adults in Oklahoma. Problematic alcohol use was measured using the Alcohol Quantity and Frequency Questionnaire and the Patient Health Questionnaire. Food insecurity was measured with the USDA Food Security Scale-Short Form. The results indicated that heavy drinking and probable alcohol dependence/abuse were each associated with increased odds of food insecurity. The results question whether alcohol may take precedence over eating or food purchases among this population of homeless individuals.
• Exploring Tiny Homes as an Affordable Housing Strategy to Ameliorate Homelessness: A Case Study of the Dwellings in Tallahassee, FL. “Tiny Homes” is an emerging strategy to combat homelessness, and Jackson et al. [ 13 ] raise a number of questions about the intentions, efficacy, and policy feasibility of this strategy. The paper seeks to understand the strategies used by stakeholders to plan, design, and implement a “Tiny Homes” strategy, and to assess their effectiveness. Using a case study, they examined how the community was planned, the experiences of residents, and the constraints to success. Their findings highlighted how funding constraints and NIMBYism (Not in My Backyard-ism) stymied stakeholder efforts to achieve equity and affordability, resulting in the inability to achieve project aims to develop affordable housing that served homeless populations.
• Predictors of Emergency Department Use among Individuals with Current or Previous Experience of Homelessness. The study by Gabet et al. [ 14 ] assessed the contributions of predisposing, enabling, and needs factors in predicting emergency department (ED) use among 270 individuals with a current or previous experience of homelessness. Participants were recruited from types of housing in Montreal, Quebec (Canada) and were interviewed about their ED use at baseline and again 12 months later. The findings revealed two needs factors associated with ED use: having a substance use disorder and low perceived physical health. Two enabling factors—the use of ambulatory specialized services and stigma—were also related to ED use. ED use was not associated with the type of housing. The authors suggest that improvements are needed to manage substance use disorders and the physical health of homeless individuals in order to reduce ED use.
• Being at the Bottom Rung of the Ladder in an Unequal Society: A Qualitative Analysis of Stories of People without a Home. The Mabhala and Yohannes article [ 15 ] examines the stories of homeless people and their perceptions of their social status using interviews in three centers for homeless people in Cheshire, in the English Northwest. Education, employment, and health were three domains that provided a theoretical explanation for the reasons that led to their homelessness. Participants catalogued their adverse childhood experiences, which they believe limited their capacity to meaningfully engage with social institutions for social goods, such as education, social services, and institutions of employment. They conclude that, although not all people who are poorly educated, in poor health, and unemployed end up being homeless, a combination of these together with multiple adverse childhood experiences may weaken resilience and contribute to homelessness.
• Commentary: Investing in Public Health Infrastructure to Address the Complexities of Homelessness. In a final commentary, Allegrante and Sleet [ 16 ] introduce the notion that investments in public health infrastructure are needed to address the complexities of homelessness, including the continued threats posed by SARS-CoV-2 (COVID-19) and its variants. The lack of affordable housing, widespread unemployment, poverty, addiction and mental illness, which all contribute to the risk of homelessness, would be well-served by improving the fundamental public health infrastructure. They argue that homelessness is exacerbated by system-wide infrastructure failures at the municipal, state and federal governments and from the neglect to invest in public infrastructure, including a modern public health system.

In conclusion, shelter is a basic human need. Thus far, we have an inadequate understanding of all the medical and nonmedical, public health, and infrastructural influences that drive homelessness and why so many people are living without adequate shelter. Housing is one of the most critical factors in addressing homelessness and one of the best-researched social determinants of health. Several articles here focus on innovative approaches to providing temporary or permanent housing for those who need it, and it is well known that selected housing interventions can improve health and decrease health care costs. From that perspective, some professionals in the field contend that housing equates to health [ 17 ] and that improved housing options for homeless individuals and families would advance population-level health.

Many of the articles in this Special Issue [ 18 ] focus on specific aspects of life, quality of life, and co-morbidities related to behavioral and social variables influencing homelessness. Explored in detail are factors such as lack of housing, distress, wellness, emergency department use, mental health, drug and alcohol addiction, poverty, low educational attainment, inadequate health care and social services, adverse childhood experiences, ongoing infections, unemployment, and public health infrastructure. In addition to highlighting the impact these factors can have on the likelihood that someone would become homeless, many of the articles also provide recommendations for relevant policies, practices, and interventions that could help reduce homelessness and improve overall well-being.

The intersection of environmental, behavioral, and social factors, in addition to the lack of an adequate infrastructure, must also be considered when studying the determinants of homelessness and designing appropriate interventions. Our ultimate goal in producing this Special Issue of IJERPH is to encourage the development of better evidence to inform public health, social services, and medical care policies and practices that will result in better health for homeless populations.

Acknowledgments

We thank the authors and reviewers for their commitment to preparing and editing these manuscripts and for adding to the knowledge base of this important public health problem.

Conflicts of Interest

The authors declare no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Homelessness: Causes and Solutions

Introduction.

Contemporary social problems are not only a consequence of individual factors that do not depend on people, for instance, political fluctuations in the international arena but also the outcome of unreasonable and ineffective government practices. One of these issues is homelessness a phenomenon that is acutely felt in the modern United States. People who do not have a permanent place of residence and are forced to live on the street fall into the spectrum of the authorities’ attention, but a comprehensive solution to this problem, nevertheless, has not yet been found. As a result, concomitant issues are manifested in the community of those who have to survive in the absence of housing, for example, drug addiction and alcoholism. Addressing homelessness in America today is an important and responsible step to take. This problem should be resolved by influencing its causes and removing those constraints that impede the improvement of the situation. Educational programs and coping with the country’s opioid crisis are seen as potentially effective objectives to overcome homelessness, but creating affordable housing is the best solution to help people in need return to normal life.

Homelessness and Its Causes

The problem of homelessness is acutely felt where, along with rich housing and developed infrastructure, some people have to live on the street. There are several reasons for this contrast across the country. According to Hobbes, housing that low-income families could afford has become unaffordable over the years due to the constant price rise. Rufo notes that, in Los Angeles, since 2011, the number of homeless citizens has increased by 15%, and in some regions, this figure reaches 25%. The real estate market, as dynamic and adaptive industry, responds to demand. As a consequence, with the emergence of widespread interest from high-income citizens, it becomes unprofitable to sell affordable housing, which, in turn, leads to the inability of many people to pay their rent. Individual districts and neighborhoods are becoming elite, properties are being bought out to accumulate profits in the long term, and not everyone can withstand this competition. As a result, under the influence of the trend of gentrification, when urban areas are ennobled and become elite, several citizens cannot afford housing, which forces them to lead a wandering lifestyle.

The issue of homelessness concerns not only those who live on the street but also those who have a permanent place of residence. According to the study conducted by Glynn and Fox, in such metros as Los Angeles, New York, Washington, and Seattle, “there exists a strong relationship between housing costs and homelessness” (575). No one is immune from the fact that, in conditions of a constant rise in the price of living standards, paying for utilities may become unavailable. Despite policymakers’ attempts to create conditions in which citizens can count on employment and stable earnings, the proceeds may not be enough to pay for housing, and the measures taken are ineffective. Therefore, although democratic values ​​and freedoms are promoted, class inequality can be a significant driver of homelessness that can affect almost everyone.

At the same time, despite the aforementioned statistics, one can note that the problem of homelessness is less widespread than it is perceived to be and can be overcome with effective measures. For instance, as Hobbes argues, “between 2012 and 2018, the number of people living on the streets declined by 11 percent nationwide,” which indicates positive shifts. Moreover, Khurshid and Gadnis provide an example of blockchain technology as a tool to track non-residents and provide them with timely assistance, including healthcare services (e10654). As a result, one of the positions is that homelessness can be overcome through constant supervision and increased social responsibility.

Nevertheless, even while taking into account the national statistics and potential decisions to implement digital control methods, the real facts about homelessness in large cities indicate a much more difficult situation. Homeless people often suffer from alcohol and drug addiction, which complicates their socialization. Another critical constraint is the predisposition to mental illnesses that progress in homeless people and maybe the cause of their poor living conditions. According to Rufo, about three-quarters of the homeless have mental health problems and at least one form of substance addiction. These statistics mean that this is crucial to address the issue in question not only through surveillance. The authorities should take urgent measures aimed to help the homeless to get an opportunity to pay for affordable housing and receive qualified help in dealing with mental health problems.

Potential Solutions

To solve the problem under consideration, the choice of the best working methods is an important task that can be implemented at different levels. As an alternative method for overcoming homelessness in the United States, discussing the issue within the current educational program can be potentially valuable. In addition, overcoming the existing opioid crisis caused by active pharmaceutical companies is an urgent step. The analysis of these solutions may help identify the specifics of the target work in these areas.

The popularization of the problem of homelessness in the educational environment can be an effective solution to create an understanding of the issue in the young audience. In addition, this step may contribute to promoting the importance of helping those who find themselves in difficult life situations. Hallett et al. consider cooperation with homeless liaisons as a mechanism for involving students in targeted social work and participation in projects and programs dedicated to public awareness (90). Moreover, the discussion of the issue with primary school students is also seen as an efficient solution contributing to the popularization of the problem and the formation of social responsibility among young citizens. According to Kim, “over 25% of families experiencing homelessness have children” (820). This means that understanding peer problems can raise awareness of the challenges of homelessness among young pupils. As Cronley et al. state, promoting this knowledge in education can help educate future social workers and practitioners who will understand the range of difficulties and gaps and make efforts to address them (S16). Therefore, such initiatives can be seen as potentially viable solutions to address.

However, to provide a worthy resistance to the trend of homelessness, many years need to pass before children can grow up and help in fighting against this issue. In addition, modern curricula are coordinated at different levels, and the inclusion of additional subjects and courses in the learning process may not be approved by the Ministry of Education. As a result, the popularization of the problem among students has relevance as a factor in the dissemination of knowledge about homelessness, but from the standpoint of efficiency, few real outcomes can be achieved.

Coping with the Opioid Crisis

From the standpoint of efficiency, the fight against the opioid crisis is a more valuable solution to implement than popularizing the problem of homelessness in the educational process. Moreover, not only in the United States but also in other countries, people feel the relevance of this issue that has more severe implications on human health. According to Mendez, substance overdose is the most common cause of death in homeless people. Controlling the release and distribution of opioid-based drugs may help reduce the influence of pharmaceutical companies. In pursuit of profit, they supply the market with a wide range of hazardous substances, and Daniulaityte et al. compare the current situation with the epidemic (1785). Moreover, Boyajyan argues that “about 20 to 25% of the homeless population in the United States suffers from a severe mental illness,” and one of the reasons for this is drug addiction (8). Pharmaceutical companies need to be held accountable and restrict the distribution of readily available opioid-based drugs to ensure that they do not enter the market freely. This can be done through class action lawsuits, attracting the authorities’ attention, and other measures involving massive interference.

At the same time, even with potential constraints, a decision to curb the activities of pharmaceutical companies may not have the intended effect on homelessness. Many corporations are accountable to the government and contribute greatly to the treasury through tax payments. The loss of a significant market share is fraught with losses, which is unacceptable in conditions of economic competition. In terms of the impact on mental health, not all homeless people are ready to accept their problem, and even if the sale of opioid drugs is limited, many of these citizens will be able to find access to them in the illegal market. Moreover, as Boyajyan remarks, few people without a permanent place of residence can afford comprehensive and effective drug addiction treatment due to financial challenges (10). These restraints are objective reasons for finding a more effective solution to the problem of homelessness.

Creating Affordable Housing: The Best Solution

Creating affordable housing is a key objective that the authorities need to strive for to overcome the problem of homelessness and provide people in need with an opportunity to count on permanent residence. This decision can have different forms of implementation and should not be associated with colossal spending from the federal budget. For instance, Jackson et al. suggest paying attention to tiny homes that, despite their size, can be an alternative to housing lost due to financial hardship and debts (661). In modern metros, this is possible to realize such an idea, and today, there are examples of special camps in which formerly homeless people have a chance to count on a roof over their heads and minimal amenities. Olson notes that in Los Angeles, in 2019, more than $538 million was spent on solving the issue of homelessness, which, however, did not bring the desired result due to mainly legislative rather than practical solutions. Therefore, the construction of special residential complexes is one of the forms of the program aimed to create affordable housing.

The provision of assistance to the target population in the form of subsidies and vouchers should be expanded at the legislative level. According to Elder and King, today, the bulk of the funds goes to people with disabilities, veterans, older adults, and large families (402). Nonetheless, to address the problem of homelessness, more funds need to be channeled, taking into account individual cases. As Olson highlights, “homelessness is not an illness that can be cured, rather a symptom of gentrification, different physical and mental ailments, inefficiencies of governance, or sheer bad luck.” People who have lost their permanent place of residence for reasons beyond their control, for instance, the unfortunate coincidence of circumstances or fraudsters’ actions, have the right to count on the support of the state. Caring for the population involves not only the provision of healthcare, legal, and other services but also the protection of life. Therefore, subsidizing and providing housing choice vouchers are crucial initiatives to maintain a sustainable system of helping special cases, which, in turn, can support people with limited incomes in difficult life situations.

Leveraging the maximum available resources to reduce the cost of creating affordable housing is one of the opportunities to realize to combat homelessness successfully. Katz notes that gentrification causing people to lose their homes in large cities reflects economic hardships that citizens cannot overcome (2293). In this regard, the author proposes to use those resources that do not require great financial investments, for instance, to promote “scattered-site programs” and use already available land instead of full-scale construction (Katz 2293). As a result, homeless people can count on housing at significantly lower prices than those in the market, which have risen significantly due to gentrification.

Affordable housing programs can be challenged based on both economic and social constraints. For instance, Olson notes that in the media, homeless people are often portrayed as morally devastated people with persistent addictions and criminal inclinations. However, the lifestyle they lead is rarely voluntary, and the aforementioned reasons are the drivers of both behavioral and mental problems. Another potential counterargument is the fact that measures to create affordable housing are being taken regularly, and both legislative and practical activities are underway. However, according to Olson, in Los Angeles Country, about 45,000 people remain homeless, while in 2019, the figure was approximately 59,000. This means that, despite the authorities’ activities, the issue cannot be eliminated shortly. Therefore, the more actively affordable housing is built and offered, the higher the chances of overcoming homelessness and helping people in need.

To overcome such an acute social problem as homelessness, relevant solutions can be implemented, but the most effective of them is creating affordable housing. This measure aims to help homeless people with buying or renting housing through subsidies, vouchers, and engagement programs. The issue of homelessness is dangerous because almost no one is immune from it, and the trend of gentrification exacerbates the situation by creating a tense situation in the real estate market and affecting prices. Moreover, such severe factors as mental illnesses and alcohol and drug addictions are concomitant challenges. As alternative solutions, the discussion of the problem at the educational level and the fight against the opioid crisis may be proposed. However, both of them can be ineffective and do not have the desired effect on the situation. Despite various social or economic constraints, creating affordable housing is seen as the most meaningful solution to implement to help homeless people and address one of the most pressing urban problems.

Boyajyan, Karapet. The Painkiller Crisis: An Evaluation of the Effects of the Opioid Epidemic on the Homeless Population in the United States . 2019. MPA thesis.

Cronley, Courtney, et al. “Homelessness from a Holistic Paradigm: Bridging Gaps in Curriculum Through Supplemental Education Opportunities.” Journal of Social Work Education , vol. 56, no. 1, 2020, pp. S16-S27.

Daniulaityte, Raminta, et al. “Methamphetamine Use and Its Correlates Among Individuals with Opioid Use Disorder in a Midwestern US City.” Substance Use & Misuse , vol. 55, no. 11, 2020, pp. 1781-1789.

Elder, Jen, and Ben King. “Housing and Homelessness as a Public Health Issue: Executive Summary of Policy Adopted by the American Public Health Association.” Medical Care , vol. 57, no. 6, 2019, pp. 401-405.

Glynn, Chris, and Emily B. Fox. “Dynamics of Homelessness in Urban America.” The Annals of Applied Statistics , vol. 13, no. 1, 2019, pp. 573-605.

Hallett, Ronald E., et al. Addressing Homelessness and Housing Insecurity in Higher Education: Strategies for Educational Leaders . Teachers College Press, 2019.

Hobbes, Michael. “Why America Can’t Solve Homelessness.” HuffPost , 2019. Web.

Jackson, April, et al. “Exploring Tiny Homes as an Affordable Housing Strategy to Ameliorate Homelessness: A Case Study of the Dwellings in Tallahassee, FL.” International Journal of Environmental Research and Public Health , vol. 17, no. 2, 2020, p. 661.

Katz, Mitchell H. “Homelessness – Challenges and Progress.” JAMA , vol. 318, no. 23, 2017, pp. 2293-2294.

Khurshid, Anjum, and Ashish Gadnis. “Using Blockchain to Create Transaction Identity for Persons Experiencing Homelessness in America: Policy Proposal.” JMIR Research Protocols , vol. 8, no. 3, 2019, p. e10654.

Kim, Jinhee. “Homelessness as Difficult Knowledge in Early Childhood Education.” Early Childhood Education Journal , vol. 48, no. 6, 2020, pp. 815-823.

Mendez, David. “Overdose Deaths Increase Among LA’s Unhoused as Opioid Use Spreads.” Spectrum News 1 , 2021. Web.

Olson, Olivia. “Crisis on the Streets: Homelessness in Los Angeles County.” University of Southern California , 2020. Web.

Rufo, Christopher. “Homelessness in America: An Overview.” The Heritage Foundation , 2021. Web.

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5 Essays About Homelessness

Around the world, people experience homelessness. According to a 2005 survey by the United Nations, 1.6 billion people lack adequate housing. The causes vary depending on the place and person. Common reasons include a lack of affordable housing, poverty, a lack of mental health services, and more. Homelessness is rooted in systemic failures that fail to protect those who are most vulnerable. Here are five essays that shine a light on the issue of homelessness:

What Would ‘Housing as a Human Right’ Look Like in California? (2020) – Molly Solomon

For some time, activists and organizations have proclaimed that housing is a human right. This essay explores what that means and that it isn’t a new idea. Housing as a human right was part of federal policy following the Great Depression. In a 1944 speech introducing what he called the “Second Bill of Rights,” President Roosevelt attempted to address poverty and income equality. The right to have a “decent home” was included in his proposals. Article 25 of the Universal Declaration also recognizes housing as a human right. It describes the right to an “adequate standard of living.” Other countries such as France and Scotland include the right to housing in their constitutions. In the US, small local governments have adopted resolutions on housing. How would it work in California?

At KQED, Molly Solomon covers housing affordability. Her stories have aired on NPR’s All Things Considered, Morning Edition, and other places. She’s won three national Edward R. Murrow awards.

“What People Get Wrong When They Try To End Homelessness” – James Abro

In his essay, James Abro explains what led up to six weeks of homelessness and his experiences helping people through social services. Following the death of his mother and eviction, Abro found himself unhoused. He describes himself as “fortunate” and feeling motivated to teach people how social services worked. However, he learned that his experience was somewhat unique. The system is complicated and those involved don’t understand homelessness. Abro believes investing in affordable housing is critical to truly ending homelessness.

James Abro is the founder of Advocate for Economic Fairness and 32 Beach Productions. He works as an advocate for homeless rights locally and nationally. Besides TalkPoverty, he contributes to Rebelle Society and is an active member of the New Jersey Coalition to End Homelessness.

“No Shelter For Some: Street-Sleepers” (2019)

This piece (by an unknown author) introduces the reader to homelessness in urban China. In the past decades, a person wouldn’t see many homeless people. This was because of strict rules on internal migration and government-supplied housing. Now, the rules have changed. People from rural areas can travel more and most urban housing is privatized. People who are homeless – known as “street-sleepers” are more visible. This essay is a good summary of the system (which includes a shift from police management of homelessness to the Ministry of Civil Affairs) and how street-sleepers are treated.

“A Window Onto An American Nightmare” (2020) – Nathan Heller

This essay from the New Yorker focuses on San Francisco’s history with homelessness, the issue’s complexities, and various efforts to address it. It also touches on how the pandemic has affected homelessness. One of the most intriguing parts of this essay is Heller’s description of becoming homeless. He says people “slide” into it, as opposed to plunging. As an example, someone could be staying with friends while looking for a job, but then the friends decide to stop helping. Maybe someone is jumping in and out of Airbnbs, looking for an apartment. Heller’s point is that the line between only needing a place to stay for a night or two and true “homelessness” is very thin.

Nathan Heller joined the New Yorker’s writing staff in 2013. He writes about technology, higher education, the Bay Area, socioeconomics, and more. He’s also a contributing editor at Vogue, a former columnist for Slate, and contributor to other publications.

“Homelessness in Ireland is at crisis point, and the vitriol shown towards homeless people is just as shocking” (2020)#- Megan Nolan

In Ireland, the housing crisis has been a big issue for years. Recently, it’s come to a head in part due to a few high-profile incidents, such as the death of a young woman in emergency accommodation. The number of children experiencing homelessness (around 4,000) has also shone a light on the severity of the issue. In this essay, Megan Nolan explores homelessness in Ireland as well as the contempt that society has for those who are unhoused.

Megan Nolan writes a column for the New Statesman. She also writes essays, criticism, and fiction. She’s from Ireland but based in London.

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How to solve homelessness – lessons from around the world

There are an estimated 150 million homeless people worldwide. Some organizations are offering innovative solutions to the problem. Image:  Unsplash/Jon Tyson

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Stay up to date:, cities and urbanization.

• There are many causes of homelessness.
• Homelessness is on the rise in many parts of the developed world.
• New approaches might offer a solution to solving the problem.

It's estimated around 150 million people worldwide are homeless – around 2% of the global population.

But the actual number could be much higher, because there are many states of homelessness – and many causes, too.

Have you read?

This scottish café chain has built a village for the homeless, this is the critical number that shows when housing breaks down, making affordable housing a reality in cities.

Too often, people without a permanent home fall off the edge of the recorded world. They don’t appear on official registers, in census declarations or in social security records. This compounds the homelessness problem in two distinct but connected ways: it makes it impossible to say how many people are homeless and it creates further difficulties in trying to come up with solutions.

But a number of innovative approaches to homelessness are creating both short-term and long-term solutions.

The UK capital is one of the world’s most-visited cities – and the red double-decker bus is an iconic, must-see sight. But strict emissions regulations have pushed many of the older buses off the road and into retirement.

Now, a social enterprise called Buses4Homeless is converting some of those decommissioned vehicles into accommodation , classrooms, diners and health centres.

One bus can provide shelter for 16 people, who are also given vocational and life-skills training. Their health and wellbeing are also looked after while they’re under the care of the charity.

Finding work and being able to earn enough money to afford somewhere to live are obviously important for people trying to break out of the cycle of homelessness. Elsewhere in London, coffee is helping do just that.

An organization called Change Please is training homeless people to become baristas and work in its fleet of mobile coffee stores. Founder Cemal Ezel says, “If we can just get a small proportion of coffee drinkers to simply change where they buy their coffee, we could really change the world."

In Delhi, the charity Aashray Adhikar Abhiyan trained 20 homeless people to repair mobile phones . Almost half of those who completed the course went on to either find work or start their own businesses. The organization plans to run the course again next year.

UK charity Crisis lists the following as some of the common causes of homelessness :

• A lack of affordable housing
• Poverty and unemployment
• Leaving prison, care or the armed forces with no stable home to go to
• Escape from a violent relationship or abusive childhood home
• Relationship breakdown
• Mental or physical health problems
• Substance misuse and other addictive behaviours

This means there is no one-size-fits-all solution, and the solution one person’s problems might only offer temporary respite for another.

Addressing the symptomatic problems of homelessness can be beneficial, but it won’t automatically fix the root cause of an individual’s circumstances.

For someone struggling with poor mental health or substance abuse, for example, it can be practically impossible to meet the commitments of training and employment.

These people can find themselves outside of possible routes to help, too, with some shelters and hostels not accepting people who have not dealt with their addictions.

The US-based non-profit Community Solutions believes it may have an answer, though.

Across the United States, more than half a million people are homeless. Most of them are sleeping in shelters and transient accommodation.

As Community Solutions says, “No single actor is fully accountable for ending homelessness in a community. Each local agency or programme holds its own small piece of the solution, but no one has their eye on how the pieces fit together.”

Therein lies the explanation for the intractability of homelessness. Operating in isolation from one another, even the most effective and well-intentioned of support services can fail to see the bigger picture.

By connecting all the different agencies and organizations that interact with homeless people, Community Solutions’ president Rosanne Haggerty believes homelessness can be eliminated altogether.

"Imagine a world where homelessness is rare, brief when it happens, and really gets fixed for those people to whom it happens – the first time,” she says.

In Abilene, Texas, they can do more than just imagine. They can see the results. Following the Built for Zero programme championed by Community Solutions, the Abilene authorities set the goal of zero homelessness.

Their first target was the homeless veterans’ community, which has now been completely eradicated by moving everyone into a home of their own.

A similar philosophy has been adopted in the Finnish capital, Helsinki. Rather than offer housing only to people who have taken steps to fix some of their everyday problems, such as substance abuse, the authorities now follow a homes-first approach.

Finland is the only EU country where homelessness is in decline . And it started by scrapping hostels and shelters that had been providing short-term respite for homeless people.

“It was clear to everyone the old system wasn’t working; we needed radical change,” says Juha Kaakinen, who runs an organization called Y-Foundation, which helps deliver supported and affordable housing .

The Data for the City of Tomorrow report highlighted that in 2023, around 56% of the world is urbanized. Almost 65% of people use the internet. Soon, 75% of the world’s jobs will require digital skills.

The World Economic Forum’s Centre for Urban Transformation is at the forefront of advancing public-private collaboration in cities. It enables more resilient and future-ready communities and local economies through green initiatives and the ethical use of data.

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Want to know more about our centre’s impact or get involved? Contact us .

“We decided to make the housing unconditional,” he says. “To say, look, you don’t need to solve your problems before you get a home. Instead, a home should be the secure foundation that makes it easier to solve your problems.”

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Why mental health and social services are as crucial as physical shelter to address the homelessness crisis

• Paul Constant is a writer at Civic Ventures and cohost of the " Pitchfork Economics " podcast.
• He spoke with Josephine Ensign, a professor and former policy worker, about the homelessness crisis.
• Ensign says social services are critical to address the mental health needs of unhoused people.

It's difficult to even begin to have a conversation about homelessness in America anymore.

Even in progressive cities like Seattle and San Francisco, coverage of our historically high levels of homelessness has become so hyperpartisanized that it's impossible for people to agree on the causes of the housing crisis, let alone work together to find solutions. Where some people see homelessness as strictly an economic failure, others position each case of homelessness as an individual failure, blaming it on untreated mental illness or a drug addiction problem. 

Let's be clear that simply building large amounts of housing will not solve our housing crisis, as some urbanists claim. But neither is homelessness a personal failing free from systemic economic pressures. A Zillow study from 2017 found that homelessness increases in cities where rents exceed a third of the average income, and each rent increase of $100 is associated with a corresponding jump in homelessness of anywhere from 6% to 32%. Given that median rents in some cities have skyrocketed by up to 91% over the past decade, that's a minimum of tens of thousands of Americans who are being pushed out into the street for the first time every year. 

Related stories

University of Washington Professor Josephine Ensign joined the "Pitchfork Economics" podcast to discuss her 40-year career working with homeless populations around the world as a researcher, nurse, and policy worker. Her latest book, " Skid Road: On the Frontier of Health and Homelessness in an American City ," specifically explores the history of homelessness in Seattle.

How did we get to a point when nearly every American city is dotted with tent encampments? Ensign cites the "steady defunding of [Department of Housing and Urban Development] services, in terms of support for low-income housing redevelopments" that has taken place through the latter half of the 20th century, as well as "the gentrification of inner city areas that have displaced, especially, persons of color and people living intergenerationally in poverty," and the "deinstitutionalization of people with pretty severe mental health issues and developmental issues" that took place in the late '70s and throughout the '80s.

In short, there's no one smoking gun to point to as the root cause of America's homelessness crisis. Instead, a wide array of policy failures, worsened by American leaders' 40-year love affair with trickle-down austerity, have led to this moment. (For proof, consider the fact that European nations with robust social safety nets don't have the same growing number of unhoused people as we do.)

A universal healthcare system alone would resolve many of the issues that push Americans onto the streets, and which exacerbate their problems once they're on the street.

With rents and housing prices rising astronomically, we obviously need much more affordable housing in American cities right now. It's cheaper to house homeless people than it is to put them through the endless piecemeal cycle of homeless shelters and triage services that cost taxpayers somewhere between $30,000 and $80,000 per homeless person per year . But the fact is that physical shelter needs are only part of the problem. 

"It's not just a problem with inadequate low income and supportive housing," Ensign said. "It is also the sense of belonging, the sense of community, the community supports in terms of health and social services, that are needed for people to be safe and healthy and happy in low-income and long-term permanent housing." 

People experience trauma before they're forced into homelessness, and they experience trauma while they're homeless. If we don't have systems in place to address that emotional damage, homeless populations will continue to rise.

So what would Ensign do if she could establish policies to ameliorate homelessness in a major American city? "The biggest thing that I would fund is ongoing supportive services in shelters and day shelters and outreach programs," she said, including high-quality mental health and substance abuse programs for homeless families and individuals, "because if they're not quality, if they're not sustainable, it actually does more harm than good for people trying to become more stable in housing and health."

"With quick interventions and appropriate counseling and treatment for the child and for the family," Ensign said, those traumas "can be overcome and can actually become sources of strength." 

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• Homelessness Essays

Homelessness as a Social Problem Essay

Homelessness is a social problem which is associated with numerous social problems. The challenges that the homeless people face in the society are mostly caused by illnesses due to poor housing facilities or coldness and overcrowding. Reports indicate that contagious and respiratory diseases have been rampant among the homeless people. Moreover, due to poor living conditions, homeless people suffer from other types of diseases caused by poor hygiene. Homelessness as a problem is however not a naturally occurring phenomenon. Although poverty has been cited as the major cause of homelessness among the people, the reality is that poverty as a problem is not caused by nature. Apart from poverty, various other factors have been associated with the problem of homelessness. Sociologists have used three theoretical perspectives to explain the causes of homelessness in the society. According to sociologists, symbolic interaction, functionalism, and conflict theory are the major causal factors to the homelessness problem. This essay will analyse how sociologists articulate these theories to the problem of homelessness. It will also try to verify whether there are any efforts by the society in trying to address the problem and whether these efforts have been successful.

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Homelessness has been defined as the lack of regular and decent housing among individuals in a society or in some parts of the society. These factors that have been associated with mental illness, drug abuse, physical or sexual abuse as well as lack of money due to poverty. In giving solutions to these problems, sociologists have pointed out on the three sociological theories. Functionalist sociologists associate the complexity of the society with the problem of poverty and lack of finances to acquire proper housing. The functionalist approach compares the evolution of the society with that of an organism, combining all parts of that organism together to make it whole. They consider the society to have evolved through such processes, making the structures function together to achieve a common goal, which is developing together (Isajiw 38). The complex nature of the society has been associated with complexity of the institutions. Building blocks of the society in the view of these sociologists are the family as well as the clan. The clan is part of the larger society, and through relationships developed by the individual people in the society, the result is strong solidarity among these people. According to the theory, the significance of an individual is not is not vested in his or her individuality, but in the status that he has accorded to his own status, his opinion in social relation patterns and the kind of behaviours associated with that particular status. Relationships developed by these structures are supposed to be the pillars in which the society is built upon. As social institutions keep on developing, people are expected to be careful about one another. As the individual cares about other people in the family, the family cares about the clan. This is the essence of the society in which all people ought to be mindful of one another. However, this is not the case altogether. Isajiw (102) observes that people are increasingly being more independent from each other, breaking the structures already set by the rules of functionalism. With the increase in individualism, more people are becoming poor. There is little assistance accorded to the poor by the rich and the able people in the society.

This has been as a result of the broken structures. The only attachment that is currently in existence in the society is the family, which is also breaking apart with time. This has increasingly alleviated the problems that people face in the society. Even the people who are supposed to be caring about their partners have grown apart, making the people poorer. The needs of the needy people increases, yet there are few available opportunities to solve them. Problems that lead to homelessness increases and consequently, people remain homeless for a long time. The emphasis of conflict theory is on the role played by coercion in bringing social order. Sociologists such as Karl Max saw the society to be fragmented into different small groups of people that try to compete with each other to acquire both social and economic resources. Social order according to Bartos and Paul (13) is brought about by the domination of one group of people to other groups. Power is in the hands of the people who have the greatest authority in the society is those who control the political, economic and social resources.

The competition that results from individuals struggling for power and control of the resources victimizes the poor people in the society. This results into conflicts and exploitation. Individuals who control the resources and means of production victimize the others. As a result of control of these resources, most of the people lack the opportunity to improve their lives. The poor thus remains poor, while the rich remains rich and gets richer.

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The disparities created by this problem lead to lack of the very basic needs by the poor people. Shelter is a basic need which every person is entitled to. However, in the event of poor distribution of resources, the poor do not have the access to these resources and means of production. However, this does not occur over night. Control of the means of production by a few individuals by a few people increases their greed. This deprives the rest of the people of these resources and creates a vicious circle of poverty. Those who have been denied the opportunities by the society are therefore regarded as poor. Due to their high levels of poverty, they cannot afford decent housing.

Symbolic interaction according to sociologists influences many areas and disciplines in the society. According to various sociologists, people act towards various things by the virtue of their meanings. These meanings are derived from socially developed interactions, which are later modified through interpretation. According to the father of the theory Max Weber, individual’s actions are determined by their interpretation of the meaning of the world. Through its analysis of the society, the theory addresses the different and yet subjective meanings that people impose on objects, events, and behaviours (Herman 88).

According to this theory, people are in a position to decide what they want and why they want that thing through their individual and personalized interpretation of the world. People thus define the term “home” differently according to this theory. While to some people a home is a symbol of unity and mutual coexistence of different individuals in a group of people, to others it is a sense of belonging. These groups do not see the meaning of having a constant place where they live in. they possess little wealth and attach little value to the things that define wealth and achievements. A house according to them has no use. The mental condition of these people is the biggest contributing factor to their definition of a home. Some of them are mad, while others are drug users. This results to their condition of homelessness. The various causes of homelessness in the society have adequately been discussed. There are efforts to reduce the number of people who are homeless in the society. These efforts have been shown by different groups in the society. Some have vested interests while others are simply concerned parties to the problem of homelessness. The government for example has developed many projects that are geared at developing housing projects for the poor at affordable prices. Due to the increased prices of mortgages, owning a home by the poor people has remained a dream due to affordability issues. To house these people, the government has implemented various housing projects for the poor.

The non-governmental organizations and the well-wishers have also chipped in their efforts in trying to address the problem of homelessness among the people. Various groups have tried to provide homes to the street people who do not have a place to stay. Even the children’s homes have tried to solve this issue. However, these problems have not been adequately addressed as more needs to be done to solve this problem.

Homelessness as discussed in this paper is a social problem. Having been caused by social structures, the problem is not regarded as individual. According to the three sociological theoretical perspectives of symbolic interaction, functionalism, and conflict theory, this problem can only be solved by addressing the contributing factors to the problem. Failure to address these factors, social structures will create more homeless conditions than those solved by the efforts extended towards solving the problem.

Works Cited

• Bartos, Otomar J, and Paul E. Wehr. Using Conflict Theory. New York: Cambridge University Press, 2002. Print.
• Herman, Nancy J. Symbolic Interaction: An Introduction to Social Psychology. Walnut Creek, CA [u.a.: AltaMira [u.a., 2003. Print.
• Isajiw, Wsevolod W. Causation and Functionalism in Sociology. New York: Schocken Books, 1968. Print.

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American Homelessness, Its Causes and Solutions Essay

There should not be homeless people anywhere in the twenty-first century. However, the scenario is different across the world. Countries suffer different magnitudes of homelessness depending on their economic development levels. The worst-hit is the so-called third world. This may be more complicated by political upheavals. The problem still persists in the developed world.

The United States of America has a fair share of the homeless. Surveys that have been conducted government agencies such as the U.S. Department of Housing and Urban Development, over a period of 30 years indicate that a good number of Americans are homeless. Although there is an improvement in percentages compared to the entire population, the statistics remain high (Quigley, Raphael, and Smolensky 1). Taking a comparison between Sweden and America based on the homeless numbers, the latter leads. Sweden has come up with strategies for tackling homelessness. There is strong welfare that caters to the needy and the less privileged. These are the people that are affected by homelessness and helping them could only mean fewer problems. Sweden has made the cost of owning homes affordable. The government has also been subsidizing housing for the poor who would otherwise remain on the streets. If Sweden being a small country could do it, then America ought to do better.

In America, homelessness is caused by many factors but the main ones are unavailability of affordable housing, poverty, and unemployment. The cost of owning a home in America is quite high (Quigley, Raphael, and Smolensky 1). This also has far reaching implications on the cost of renting houses. The poor cannot own homes or afford to rent hence they remain on the streets. Housing and poverty are inseparable. In the absence of poverty, the population would afford decent housing and avoid residing on the streets. The levels of unemployment have been sky rocketing for some time now. This was worsened by the slackened economic growth which was witnessed across America recently. The depression did not spare even the employed and many people were retrenched. This further compounded the problem of the homeless population.

The homeless in America could be categorized into three groups. The first one comprises of the veterans. The veterans are the people who for generations have not known any decent shelter. The majority of the veterans have become used to this kind of life and very few make efforts to change their situation (Rollinson and Pardeck 2). Of the total number of homeless, this group comprises a small percentage.

The second group is made up of youth who are normally unaccompanied. The majority of those in this group come from conventional homes. They are sent to the streets by a wide range of factors. The crucial one is rebellion to their parents which is partly attributed to adolescence crisis. They are therefore seen as the group which has come up due to effects of hardships in their homes and families. Drugs may also be blamed for making this group homeless (Garner and Ratschen 7). Drug abuse that is rampant in America causes the youth to leave their homes under influence or to seek the drugs altogether.

Children have always been the undisputable victims of circumstances and homelessness has not spared them either. They form a majority of the people living in the streets and other informal settlements. They are children of the street families where they were born and bred. Projections from the surveys indicate that the number of children becoming homeless increases every year. As a result, they form a majority of the imminent homeless. These are the people predicted to be homeless in the near future. Some of the children come from troubled homes that they opt to stay away from. Others are forced out by poverty and in pursuit of basic needs, they find themselves homeless. This makes them to miss important opportunities in life such as education. This can only mean that the future is dark for them.

The homeless people also affect the rest of the society. The government through the police force finds itself on the receiving end due to the prevalence of crime. Not all the homeless commit crime but a majority finds it to be the only means of making a living. Since these people cannot be ignored by policy makers, plans have to be made outside the national budget to accommodate them. The hopelessness associated with this population makes it vulnerable to committing crime.

To eradicate the above mentioned problems, I would recommend measures to be carried out in the form of an action plan. The most important step is for the government to tackle the issue of housing seriously. This could come in the form of subsidies to the poor to encourage them to buy houses. It is a high time that the government considered introducing mortgage for the poor. Low cost houses should be established across the country (Quigley, Raphael and Smolensky 4). The government should also come up with cheap convertible houses which could be assembled within a short time. These would come in handy when the homeless are identified across the country. By reducing or eliminating taxes on building materials, the construction industry would get a huge boost.

The second measure should target reduction of unemployment. As earlier noted, the unemployed cannot afford any form of housing. They are not capable of purchasing homes or renting decent houses. The responsibility of the government should be to create employment. This could be done through partnership with the private sector where investors are given incentives while starting businesses that are labor oriented. The government should also reduce the allocation of funds to foreign programs and create a reserve to cater for the unemployed. For those people who cannot work, the government should take the responsibility of housing them. Settlement schemes should be established in areas where the homeless are many. Through such schemes, this category of people would get housing unconditionally.

To deal with poverty, I recommend that the government creates programs aimed at raising the standards of living for the homeless (Rollinson and Pardeck 1). This could come in the form of free medical care and education. It should also create a fund for paying monthly assistance to the street parents. They could also be made to access soft loans for starting small businesses. Organizing these people into economic groups where they could pull resources together and further be boosted by the government to do business should be a priority.

Educating the street children should be done earnestly. Follow up mechanisms should be put in place to ensure that dropout rates for these children are lowered completely. Ensuring education for these people would be one way of ensuring that their future is secured.

Implementing the above detailed recommendations will be beneficial for the American government and people. The first reason for taking the action plan would be to reduce the gap between the rich and the poor. As has already been observed, poverty takes a centre stage in rendering people homeless. By improving the economic conditions of the poor, they are elevated upwards. In the final analysis, the country will gear towards a classless society.

America being a super power should be at the front line in taking care of its citizens. It is a disturbing scenario whereby people are homeless and yet they are citizens of a country seen by other people as the heaven on earth. If Sweden has succeeded, then there is a lot that could be borrowed from there. Implementing the recommendations would make the country to regain its international recognition.

Security is very crucial for the smooth running of any country and it is greatly undermined by homelessness. As observed before in this paper, crime has some connection to lack of shelter. The streets become unsafe at night due to mugging and other criminal activities. Terrorism networks could also take advantage of these people by offering them rewards once they agree to aid in terror attacks. Violence that is rampant in America is accelerated by hopelessness among the homeless. This further affects issues pertaining to security.

If the action plan is fully implemented, the American society will experience a real change. Decent housing will replace the ghettos or informal settlements. Such areas will change from being security threats to become conventional residential estates. The dangers posed by the homeless will be eliminated totally. The streets will be secure and the police will be left free to tackle other issues. The society will be educated and the wastage in education due to dropping out will be reduced to minimum levels. An educated population will steer the country to greater heights of prosperity. The gap between the rich and the poor will reduce drastically while violence related to inequalities will be a thing of the past. All in all, the American society will assume its rightful position as an advocate of human rights.

Works Cited

Garner, Laura, and Elena Ratschen. “Tobacco Smoking, Associated Risk Behaviours, and Experience with Quitting: A Qualitative Study with Homeless Smokers Addicted to Drugs and Alcohol.” BMC Public Health 13.1 (2013): 31-46. Academic Search Premier . Web.

Quigley, John M., Steven Raphael, and Eugene Smolensky. “Homeless in America, Homeless In California.” Review of Economics & Statistics 83.1 (2001): 37-51. Business Source Complete . 2014. Web.

Rollinson, Paul A., and John T. Pardeck. Homelessness in Rural America: Policy and Practice / Paul A. Rollinson, John T. Pardeck. n.p.: New York : Haworth Press, c2006., 2006. Harvard Library Bibliographic Dataset . Web.

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What to know about the crisis of violence, politics and hunger engulfing Haiti

A long-simmering crisis over Haiti’s ability to govern itself, particularly after a series of natural disasters and an increasingly dire humanitarian emergency, has come to a head in the Caribbean nation, as its de facto president remains stranded in Puerto Rico and its people starve and live in fear of rampant violence. 

The chaos engulfing the country has been bubbling for more than a year, only for it to spill over on the global stage on Monday night, as Haiti’s unpopular prime minister, Ariel Henry, agreed to resign once a transitional government is brokered by other Caribbean nations and parties, including the U.S.

But the very idea of a transitional government brokered not by Haitians but by outsiders is one of the main reasons Haiti, a nation of 11 million, is on the brink, according to humanitarian workers and residents who have called for Haitian-led solutions. 

“What we’re seeing in Haiti has been building since the 2010 earthquake,” said Greg Beckett, an associate professor of anthropology at Western University in Canada. 

What is happening in Haiti and why?

In the power vacuum that followed the assassination of democratically elected President Jovenel Moïse in 2021, Henry, who was prime minister under Moïse, assumed power, with the support of several nations, including the U.S. 

When Haiti failed to hold elections multiple times — Henry said it was due to logistical problems or violence — protests rang out against him. By the time Henry announced last year that elections would be postponed again, to 2025, armed groups that were already active in Port-au-Prince, the capital, dialed up the violence.

Even before Moïse’s assassination, these militias and armed groups existed alongside politicians who used them to do their bidding, including everything from intimidating the opposition to collecting votes . With the dwindling of the country’s elected officials, though, many of these rebel forces have engaged in excessively violent acts, and have taken control of at least 80% of the capital, according to a United Nations estimate. 

Those groups, which include paramilitary and former police officers who pose as community leaders, have been responsible for the increase in killings, kidnappings and rapes since Moïse’s death, according to the Uppsala Conflict Data Program at Uppsala University in Sweden. According to a report from the U.N . released in January, more than 8,400 people were killed, injured or kidnapped in 2023, an increase of 122% increase from 2022.

“January and February have been the most violent months in the recent crisis, with thousands of people killed, or injured, or raped,” Beckett said.

Armed groups who had been calling for Henry’s resignation have already attacked airports, police stations, sea ports, the Central Bank and the country’s national soccer stadium. The situation reached critical mass earlier this month when the country’s two main prisons were raided , leading to the escape of about 4,000 prisoners. The beleaguered government called a 72-hour state of emergency, including a night-time curfew — but its authority had evaporated by then.

Aside from human-made catastrophes, Haiti still has not fully recovered from the devastating earthquake in 2010 that killed about 220,000 people and left 1.5 million homeless, many of them living in poorly built and exposed housing. More earthquakes, hurricanes and floods have followed, exacerbating efforts to rebuild infrastructure and a sense of national unity.

Since the earthquake, “there have been groups in Haiti trying to control that reconstruction process and the funding, the billions of dollars coming into the country to rebuild it,” said Beckett, who specializes in the Caribbean, particularly Haiti. 

Beckett said that control initially came from politicians and subsequently from armed groups supported by those politicians. Political “parties that controlled the government used the government for corruption to steal that money. We’re seeing the fallout from that.”

Many armed groups have formed in recent years claiming to be community groups carrying out essential work in underprivileged neighborhoods, but they have instead been accused of violence, even murder . One of the two main groups, G-9, is led by a former elite police officer, Jimmy Chérizier — also known as “Barbecue” — who has become the public face of the unrest and claimed credit for various attacks on public institutions. He has openly called for Henry to step down and called his campaign an “armed revolution.”

But caught in the crossfire are the residents of Haiti. In just one week, 15,000 people have been displaced from Port-au-Prince, according to a U.N. estimate. But people have been trying to flee the capital for well over a year, with one woman telling NBC News that she is currently hiding in a church with her three children and another family with eight children. The U.N. said about 160,000 people have left Port-au-Prince because of the swell of violence in the last several months. 

Deep poverty and famine are also a serious danger. Gangs have cut off access to the country’s largest port, Autorité Portuaire Nationale, and food could soon become scarce.

Haiti's uncertain future

A new transitional government may dismay the Haitians and their supporters who call for Haitian-led solutions to the crisis. 

But the creation of such a government would come after years of democratic disruption and the crumbling of Haiti’s political leadership. The country hasn’t held an election in eight years. 

Haitian advocates and scholars like Jemima Pierre, a professor at the University of British Columbia, Vancouver, say foreign intervention, including from the U.S., is partially to blame for Haiti’s turmoil. The U.S. has routinely sent thousands of troops to Haiti , intervened in its government and supported unpopular leaders like Henry.

“What you have over the last 20 years is the consistent dismantling of the Haitian state,” Pierre said. “What intervention means for Haiti, what it has always meant, is death and destruction.”

In fact, the country’s situation was so dire that Henry was forced to travel abroad in the hope of securing a U.N. peacekeeping deal. He went to Kenya, which agreed to send 1,000 troops to coordinate an East African and U.N.-backed alliance to help restore order in Haiti, but the plan is now on hold . Kenya agreed last October to send a U.N.-sanctioned security force to Haiti, but Kenya’s courts decided it was unconstitutional. The result has been Haiti fending for itself. 

“A force like Kenya, they don’t speak Kreyòl, they don’t speak French,” Pierre said. “The Kenyan police are known for human rights abuses . So what does it tell us as Haitians that the only thing that you see that we deserve are not schools, not reparations for the cholera the U.N. brought , but more military with the mandate to use all kinds of force on our population? That is unacceptable.”  

Henry was forced to announce his planned resignation from Puerto Rico, as threats of violence — and armed groups taking over the airports — have prevented him from returning to his country.  

Now that Henry is to stand down, it is far from clear what the armed groups will do or demand next, aside from the right to govern. 

“It’s the Haitian people who know what they’re going through. It’s the Haitian people who are going to take destiny into their own hands. Haitian people will choose who will govern them,” Chérizier said recently, according to The Associated Press .

Haitians and their supporters have put forth their own solutions over the years, holding that foreign intervention routinely ignores the voices and desires of Haitians. 

In 2021, both Haitian and non-Haitian church leaders, women’s rights groups, lawyers, humanitarian workers, the Voodoo Sector and more created the Commission to Search for a Haitian Solution to the Crisis . The commission has proposed the “ Montana Accord ,” outlining a two-year interim government with oversight committees tasked with restoring order, eradicating corruption and establishing fair elections. 

For more from NBC BLK, sign up for our weekly newsletter .

CORRECTION (March 15, 2024, 9:58 a.m. ET): An earlier version of this article misstated which university Jemima Pierre is affiliated with. She is a professor at the University of British Columbia, Vancouver, not the University of California, Los Angeles, (or Columbia University, as an earlier correction misstated).

Patrick Smith is a London-based editor and reporter for NBC News Digital.

Char Adams is a reporter for NBC BLK who writes about race.

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Guest Essay

A Solution on North Korea Is There, if Biden Will Only Grasp It

By John Delury

Dr. Delury is a professor of Chinese studies and an expert on North Korea.

How do you solve a problem like North Korea?

Since the end of the Cold War, it seems that every formula, from threatening war to promising peace, has been tried. And yet, despite being under more sanctions than just about any other country, North Korea developed a nuclear arsenal estimated at 50 warheads and sophisticated missiles that can, in theory, deliver those weapons to targets in the continental United States.

President Biden’s administration has taken a notably more ambivalent approach toward North Korea than his predecessor Donald Trump, who alternately railed at and courted its leader, Kim Jong-un. But we shouldn’t stop trying to come up with bold ways to denuclearize North Korea, improve the lives of its people or lessen the risks of conflict, even if that means making unpalatable choices. On the contrary, there is more urgency now than there has been for years.

As the analyst Robert Carlin and the nuclear scientist Siegfried Hecker, two experienced North Korea watchers, warned in January, Mr. Kim has shifted away from pursuing better relations with the United States and South Korea and closer to President Vladimir Putin of Russia and may be preparing for war. Just days after the two experts issued their warning, Mr. Kim disavowed the long-cherished goal of peaceful reconciliation between the two Koreas, and he called for “completely occupying, subjugating and reclaiming” the South if war breaks out.

It might seem preposterous, even suicidal, for Mr. Kim to seek war. But many people in Ukraine doubted that Mr. Putin would launch a full invasion, right up until the rockets began landing in February 2022, and Hamas caught Israel completely by surprise in October. Both conflicts have had devastating human tolls and are severely taxing America’s ability to manage concurrent crises. The people of both Koreas certainly don’t need war, and neither does the United States.

Mr. Kim’s grandfather started the Korean War, and his father was a master of brinkmanship. Mr. Kim is cut from the same cloth and could instigate a limited conflict by, for example, launching an amphibious assault on South Korean-controlled islands in disputed waters of the Yellow Sea, less than 15 miles off North Korea’s coast. North Korea shelled one of the islands in 2010, killing two South Korean military personnel and two civilians and triggering an exchange of artillery with the South. Just two months ago, Pyongyang fired more than 200 shells into waters near the islands.

Mr. Kim may believe he can manage escalation of such a crisis — threatening missile or even nuclear attack to deter retaliation, perhaps taking the islands, then spinning it as a great propaganda victory and demanding a redrawing of maritime boundaries and other security concessions.

If anything like that scenario came to pass, Mr. Biden would have to explain another outbreak of war on his watch to weary American voters. And it would provide Mr. Trump an opportunity to trumpet his willingness to engage with Mr. Kim.

The mutual distrust between Washington and Pyongyang has only deepened under Mr. Biden, making a breakthrough seem unlikely. Yet there are two underappreciated dynamics at play in North Korea where the United States might find leverage.

The first is China. Despite the veneer of Communist kinship, Mr. Kim and President Xi Jinping of China are nationalists at heart, and they watch each other warily. I have made numerous visits to both nations’ capitals and met with officials and policy shapers. The sense of deep mutual distrust is palpable. Many Chinese look down on neighboring North Korea as backward and are annoyed by its destabilizing behavior. Many North Koreans resent China’s success and resist its influence; Pyongyang could allow much more Chinese investment but doesn’t want to be indebted to Chinese capital. And Mr. Kim seems to delight in timing provocations for maximum embarrassment in Beijing, including testing weapons — prohibited by U.N. sanctions — in the lead-up to sensitive Chinese political events .

Mr. Kim waited six years after becoming the paramount leader in 2011 before making a trip to Beijing to meet Mr. Xi. When Covid emerged, North Korea was among the first countries to shut its borders with China, and ties atrophied during those nearly three years of closure . Last year Mr. Kim chose Mr. Putin, not Mr. Xi, for his first postpandemic summit, skipping China to travel to Russia’s far east. Mr. Kim’s distrust of China is an opening for the United States.

The second point is Mr. Kim’s economic ambitions. For every speech mentioning nukes, he talks at much greater length about the poor state of his nation’s economy while promising to improve it. It was the prospect of American-led economic sanctions being lifted that persuaded him to make the 60-hour train ride from Pyongyang to Hanoi to meet then-President Trump for their second summit in 2019. Mr. Kim explicitly offered to dismantle his main nuclear weapons complex, but Mr. Trump demanded the North also turn over all of its nuclear weapons, material and facilities. The talks collapsed, and Mr. Trump seemed to lose interest in dealing with Mr. Kim. A rare opportunity was wasted, leaving Mr. Kim embittered.

The key to any new overture to North Korea is how it is framed. The White House won’t like to hear this, but success will probably depend on Mr. Biden putting his fingerprints all over the effort, by, for example, nominating a new White House envoy with the stature of someone like John Kerry and announcing a sweeping policy on North Korea and an intelligence review. Only the president can get through to Mr. Kim, and only Mr. Kim can change North Korean policy.

Mr. Biden also would need to use radically different language in framing a new overture as an effort to improve relations and aid North Korea’s economy — not to denuclearize a country that in 2022 passed a law declaring itself a nuclear weapons state. Yes, that would be a bitter pill for America to swallow: Denuclearization has been a guiding principle of U.S. policy toward North Korea for decades. But it is unrealistic to pretend that Pyongyang will surrender its nuclear weapons anytime soon. Disarmament can remain a long-term goal but is impossible if the two sides aren’t even talking.

Mr. Biden’s Republican opponents might accuse him of appeasement by engaging with Mr. Kim, but that is precisely what Mr. Trump tried. Mr. Kim, likewise, might mistake boldness for weakness. But it would be easy enough for the United States to pull back from diplomacy if it goes nowhere.

The United States must be realistic. The world is very different from when the United States, China, Russia, Japan and the two Koreas came together in the 2000s for negotiations to denuclearize North Korea. The country is now a formidable nuclear power, and its leader sounds increasingly belligerent. The president needs to get the wheels of diplomacy turning before it’s too late.

John Delury (@JohnDelury) is a professor of Chinese studies at Yonsei University in Seoul, the Tsao fellow at the American Academy in Rome and the author of “Agents of Subversion: The Fate of John T. Downey and the CIA’s Covert War in China.”

The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips . And here’s our email: [email protected] .

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Challenges of Homelessness

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Published: Mar 16, 2024

Words: 523 | Page: 1 | 3 min read

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Barriers in accessing basic necessities, impact on physical and mental health, systemic issues.

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