24-hour Internet cafes are now used by over 5,000 Japanese "Net cafe refugees". An estimated 75% of Japan's 3,200 all-night internet cafes cater to regular overnight guests, who in some cases have become their maiThe inhabitants of such refuges are called in some places, like New York City, "Mole People". Natural caves beneath urban centers allow for places where people can congregate. Leaking water pipes, electric wires, and steam pipes allow for some of the essentials of living.
Other housing options
Transitional housing
Transitional housing provides temporary housing for the certain segments of the homeless population, including the working homeless, and is meant to transition residents into permanent, affordable housing. This is usually a room or apartment in a residence with support services. The transitional time can be relatively short, for example, one or two years, and in that time the person must file for and obtain permanent housing along with gainful employment or income, even if Social Security or assistance. Sometimes transitional housing programs charge a room and board fee, maybe 30% of an individual's income, which is sometimes partially or fully refunded after the person procures a permanent residence. In the U.S., federal funding for transitional housing programs was originally allocated in the McKinney–Vento Homeless Assistance Act of 1986.[138][139][140]
Foyers
Foyers are a specific type of Transitional Housing designed for homeless or at-risk teens. Foyers are generally institutions that provide affordable accommodation as well as support and training services for residents. They were pioneered in the 1990s in the United Kingdom, but have been adopted in areas in Australia and the United States as well.
Supportive housing
Supportive housing is a combination of housing and services intended as a cost-effective way to help people live more stable, productive lives. Supportive housing works well for those who face the most complex challenges – individuals and families confronted with homelessness who also have very low incomes or serious, persistent issues such as substance abuse, addictions, alcoholism, mental illness, HIV/AIDS, or other serious challenges.
Government initiatives
In South Australia, the state government of Premier Mike Rann (2002–2011) committed substantial funding to a series of initiatives designed to combat homelessness. Advised by Social Inclusion Commissioner David Cappo and the founder of New York's Common Ground program, Rosanne Haggerty, the Rann government established Common Ground Adelaide,[141] building high-quality inner city apartments (combined with intensive support) for "rough sleeping" homeless people. The government also funded the Street to Home program and a hospital liaison service designed to assist homeless people admitted to the emergency departments of Adelaide's major public hospitals. Rather than being released back into homelessness, patients identified as rough sleepers were found accommodation backed by professional support. Common Ground and Street to Home now operate across Australia in other States.[citation needed]
Savings from housing homeless in the US
In 2013, a Central Florida Commission on Homelessness study indicated that the region spends $31,000 a year per homeless person to cover "salaries of law enforcement officers to arrest and transport homeless individuals – largely for nonviolent offenses such as trespassing, public intoxication or sleeping in parks – as well as the cost of jail stays, emergency room visits and hospitalization for medical and psychiatric issues. This did not include "money spent by nonprofit agencies to feed, clothe and sometimes shelter these individuals". In contrast, the report estimated the cost of permanent supportive housing at "$10,051 per person per year" and concluded that "[h]ousing even half of the region's chronically homeless population would save taxpayers $149 million over the next decade – even allowing for 10 percent to end up back on the streets again." This particular study followed 107 long-term-homeless residents living in Orange, Osceola or Seminole Counties.[142] There are similar studies showing large financial savings in Charlotte and Southeastern Colorado from focusing on simply housing the homeless."[143]
Health care
Student nurse at Jacksonville University School of Nursing takes the blood pressure of a homeless veteran during the annual Stand Down for Homelessness activity in Savannah, Georgia.
Health care for homeless people is a major public health challenge.[144] Homeless people are more likely to suffer injuries and medical problems from their lifestyle on the street, which includes poor nutrition,[145] exposure to the severe elements of weather, and a higher exposure to violence. Yet at the same time, they have reduced access to public medical services or clinics,[146] in part because they often lack identification or registration for public healthcare services. There are significant challenges in treating homeless people who have psychiatric disorders because clinical appointments may not be kept, their continuing whereabouts are unknown, their medicines may not be taken as prescribed, medical and psychiatric histories are not accurate, and other reasons. Because many homeless people have mental illnesses, this has presented a crisis in care.[73][147][148]
Homeless people may find it difficult to document their date of birth or their address. Because homeless people usually have no place to store possessions, they often lose their belongings, including identification and other documents, or find them destroyed by police or others. Without a photo ID, homeless persons cannot get a job or access many social services, including healthcare. They can be denied access to even the most basic assistance: clothing closets, food pantries, certain public benefits, and in some cases, emergency s
Transitional housing
Transitional housing provides temporary housing for the certain segments of the homeless population, including the working homeless, and is meant to transition residents into permanent, affordable housing. This is usually a room or apartment in a residence with support services. The transitional time can be relatively short, for example, one or two years, and in that time the person must file for and obtain permanent housing along with gainful employment or income, even if Social Security or assistance. Sometimes transitional housing programs charge a room and board fee, maybe 30% of an individual's income, which is sometimes partially or fully refunded after the person procures a permanent residence. In the U.S., federal funding for transitional housing programs was originally allocated in the McKinney–Vento Homeless Assistance Act of 1986.[138][139][140]
Foyers
Foyers are a specific type of Transitional Housing designed for homeless or at-risk teens. Foyers are generally institutions that provide affordable accommodation as well as support and training services for residents. They were pioneered in the
Foyers
Foyers are a specific type of Transitional Housing designed for homeless or at-risk teens. Foyers are generally institutions that provide affordable accommodation as well as support and training services for residents. They were pioneered in the 1990s in the United Kingdom, but have been adopted in areas in Australia and the United States as well.
Supportive housing
Supportive housing is a combination of housing and services intended as a cost-effective way to help people live more stable, productive lives. Supportive housing works well for those who face the most complex challenges – individuals and families confronted with homelessness who also have very low incomes or serious, persistent issues such as substance abuse, addictions, alcoholism, mental illness, HIV/AIDS, or other serious challenges.
Government initiatives
In South Australia, the state government of Premier Mike Rann (2002–2011) committed substantial funding to a series of initiatives designed to combat homelessness. Advised by Social Inclusion Commissioner David Cappo and the founder of New York's Common Ground program, Rosanne Haggerty, the Rann government established Common Ground Adelaide,[141] building high-quality inner city apartments (combined with intensive support) for "rough sleeping" homeless people. The government also funded the Street to Home program and a hospital liaison service designed to assist homeless people admitted to the emergency departments of Adelaide's major public hospitals. Rather than being released back into homelessness, patients identified as rough sleepers were found accommodation backed by professional support. Common Ground and Street to Home now operate across Australia in other States.[citation needed]
In 2013, a Central Florida Commission on Homelessness study indicated that the region spends $31,000 a year per homeless person to cover "salaries of law enforcement officers to arrest and transport homeless individuals – largely for nonviolent offenses such as trespassing, public intoxication or sleeping in parks – as well as the cost of jail stays, emergency room visits and hospitalization for medical and psychiatric issues. This did not include "money spent by nonprofit agencies to feed, clothe and sometimes shelter these individuals". In contrast, the report estimated the cost of permanent supportive housing at "$10,051 per person per year" and concluded that "[h]ousing even half of the region's chronically homeless population would save taxpayers $149 million over the next decade – even allowing for 10 percent to end up back on the streets again." This particular study followed 107 long-term-homeless residents living in Orange, Osceola or Seminole Counties.[142] There are similar studies showing large financial savings in Charlotte and Southeastern Colorado from focusing on simply housing the homeless."[143]
Health care
[144] Homeless people are more likely to suffer injuries and medical problems from their lifestyle on the street, which includes poor
nutrition,
[145] exposure to the severe elements of weather, and a higher exposure to violence. Yet at the same time, they have reduced access to public medical services or clinics,
[146] in part because they often lack identification or registration for public healthcare services. There are significant challenges in treating homeless people who have psychiatric disorders because clinical appointments may not be kept, their continuing whereabouts are unknown, their medicines may not be taken as prescribed, medical and psychiatric histories are not accurate, and other reasons. Because
many homeless people have mental illnesses, this has presented a crisis in care.
[73][147][148]
Homeless people may find it difficult to document their date of birth or their address. Because homeless people usually have no place to store possessions, they often lose their belongings, including identification and other documents, or find them destroyed by police or others. Without a photo ID, homeless persons cannot get a job or access many social services, including healthcare. They can be denied access to even the most basic assistance: clothing closets, food pantries, certain public benefits, and in some cases, emergency shelters. Obtaining replacement identification is difficult. Without an address, birth certificates cannot be mailed. Fees may be cost-prohibitive for impoverished persons. And some states will not issue birth certificates unless the person has photo identification, creating a Catch-22.[149] This problem is far less acute in countries which provide free-at-use health care, such as the UK, where hospitals are open-access day and night and make no charges for treatment. In the U.S., free-care clinics for homeless and other people, do exist in major cities, but often attract more demand than they can meet.[150]
The conditions affecting homeless people are somewhat specialized and have opened a
Homeless people may find it difficult to document their date of birth or their address. Because homeless people usually have no place to store possessions, they often lose their belongings, including identification and other documents, or find them destroyed by police or others. Without a photo ID, homeless persons cannot get a job or access many social services, including healthcare. They can be denied access to even the most basic assistance: clothing closets, food pantries, certain public benefits, and in some cases, emergency shelters. Obtaining replacement identification is difficult. Without an address, birth certificates cannot be mailed. Fees may be cost-prohibitive for impoverished persons. And some states will not issue birth certificates unless the person has photo identification, creating a Catch-22.[149] This problem is far less acute in countries which provide free-at-use health care, such as the UK, where hospitals are open-access day and night and make no charges for treatment. In the U.S., free-care clinics for homeless and other people, do exist in major cities, but often attract more demand than they can meet.[150]
The conditions affecting homeless people are somewhat specialized and have opened a new area of medicine tailored to this population. Skin conditions, including scabies, are common because homeless people are exposed to extreme cold in the winter and have little access to bathing facilities. They have problems caring for their feet[151] and have more severe dental problems than the general population.[152] Diabetes, especially untreated, is widespread in the homeless population.[153] Specialized medical textbooks have been written to address this for providers.[154]
There are many organizations providing free care to homeless people in countries which do not offer free state-run medical treatment, but the services are in great demand given the limited number of medical practitioners. For example, it might take months to get a minimal dental appointment in a free-care clinic. Communicable diseases are of great concern, especially tuberculosis, which spreads more easily in crowded homeless shelters in high-density urban settings.[155] There has been ongoing concern and studies about the health and wellness of the older homeless population, typically ages 50 to 64, and older, as to whether they are significantly more sickly than their younger counterparts and if they are under-served.[156][157]
In 1985, the Boston Health Care for the Homeless Program was founded to assist the growing numbers of homeless living on the streets and in shelters in Boston and who were suffering from lack of effective medical services.[158][159] In 2004, Boston Health Care for the Homeless in conjunction with the National Health Care for the Homeless Council published a medical manual called "The Health Care of Homeless Persons", edited by James J. O'Connell, M.D., specifically for the treatment of the homeless population.[160] In June 2008 in Boston, the Jean Yawkey Place, a four-story, 7,214.2-square-metre (77,653 sq ft) building, was opened by the Boston Health Care for the Homeless Program. It is an entire full-service building on the Boston Medical Center campus dedicated to providing healthcare for homeless people. It also contains a long-term care facility, the Barbara McInnis House, which expanded to 104 beds, and is the first and largest medical respite program for homeless people in the United States.[161][162][163]
A 2011 study led by Dr. Rebecca T. Brown in Boston, conducted by the Institute for Aging Research (an affiliate of Harvard Medical School), Beth Israel Deaconess Medical Center, and the Boston Health Care for the Homeless Program found the elderly homeless population had "higher rates of geriatric syndromes, including functional decline, falls, frailty and depression than seniors in the general population and that many of these conditions may be easily treated if detected". The report was published in the Journal of Geriatric Internal Medicine.[164] There are government avenues which provide resources for the development of healthcare for the homeless. In the United States, the Bureau of Primary Health Care has a program which provides grants to fund the delivery of healthcare to the homeless.[165] According to 2011 UDS data community health centers were able to provide service to 1,087,431 homeless individuals.[166] There are also many nonprofit and religious organizations which provide healthcare services to the homeless. These organizations help meet the large need which exists for expanding healthcare for the homeless.
The 2010 passage of the Patient Protection and Affordable Care Act could provide new healthcare options for the homeless in the United States, particularly through the optional expansion of Medicaid. A 2013 Yale study indicated that a substantial proportion of the chronically homeless population in America would be able to obtain Medicaid coverage if states expanded Medicaid under the Affordable Care Act.[167]
There have been significant numbers of unsheltered persons dying of hypothermia, adding impetus to the trend of establishing warming centers as well as extending enumeration surveys with vulnerability indexes.[168][169]
In 1999, Dr. Susan Barrow of the Columbia University Center for Homelessness Prevention Studies reported in a study that the "age-adjusted death rates of homeless men and women were four times those of the general U.S. population and two to three times those of the general population of New York City".[170] A report commissioned by homeless charity Crisis in 2011 found that on average, homeless people in the UK have a life expectancy of 47 years, 30 years younger than the rest of the population.[171]
Health impacts of extreme weather events
western countries such as the United States, the typical homeless person is male and single,[178] with the Netherlands reporting 80% of homeless people aged 18–65 to be men. Some cities have particularly high percentages of males in homeless populations, with men comprising eighty-five percent of the homeless in Dublin.[179] Non-white people are also overrepresented in homeless populations, with such groups two and one-half times more likely to be homeless in the U.S. The median age of homeless people is approximately 35.[180]
Statistics for developed countries
In 2005, an estimated 100 million people worldwide were homeless.[181] The following statistics indicate the approximate average number of homeless people at any one time. Each country has a different approach to counting homeless people, and estimates of homelessness made by different organizations vary wildly, so comparisons should be made with caution.
- European Union: 3,000,000 (UN-HABITAT 2004)
- United Kingdom: 0 rough sleepers, 0 households in temporary accommodation (Department for Communities and Local Government 2005)
- Canada: 150,000[182]
- Austral
In 2005, an estimated 100 million people worldwide were homeless.[181] The following statistics indicate the approximate average number of homeless people at any one time. Each country has a different approach to counting homeless people, and estimates of homelessness made by different organizations vary wildly, so comparisons should be made with caution.
- European Union: 3,000,000 (UN-HABITAT 2004)
- United Kingdom: 0 rough sleepers, 0 households in temporary accommodation ([204][205] In some developing countries such as Nigeria and South Africa, homelessness is rampant, with millions of children living and working on the streets.[206][207] Homelessness has become a problem in the countries of China, India, Thailand, Indonesia, and the Philippines despite their growing prosperity, mainly due to migrant workers who have trouble finding permanent homes.[208]
Determining the true number of homeless people worldwide varies between 100 million and 1 billion people based on the exact definition used.[209] Refugees, asylum-seekers, and internally displaced persons (ITDs) can also be considered homeless in that they too experience "marginalization, minority status, socio-economic disadvantage, poor physical health, collapse of social supports, psychological distress, and difficulty adapting to host cultures" like the domestic homeless.[210]
In the past twenty years, scholars like Tipple and Speak have begun to refer to homelessness as the "antithesis or absence of home" rather than rooflessness or the "lack of physical shelter." This complication in the homelessness debate further delineates the idea that home actually consists of an adequate shelter, an experienced and dynamic place that serves as a "base" for nurturing human relationships and the "free development of individuals" and their identity.[211] Thus, the home is perceived to be an extension of one's self and identity. In contrast, the homeless experience, according to Moore, constitutes more as a "lack of belonging" and a loss of identity that leads to individuals or communities feeling "out of place" once they can no longer call a place of their own home[212]
This new perspective on homelessness sheds light on the plight of refugees, a population of stateless people who are not normally included in the mainstream definition of homelessness. It has also created problems for researchers because the nature of "counting" homeless people across the globe relies heavily on who is considered a homeless person. Homeless individuals, and by extension refugees, can be seen as lacking lack the "crucible of our modern society" and lacking a way of actively belonging to and engaging with their respective communities or cultures[213] As Casavant demonstrates, a spectrum of definitions for homelessness, called the "continuum of homelessness," should refer to refugees as homeless individuals because they not only lose their home, but they are also afflicted with a myriad of problems that parallel those affecting the domestic homeless, such as "[a lack of] stable, safe and healthy housing, an extremely low income, adverse discrimination in access to services, with problems of mental health, alcohol, and drug abuse or social disorganization"[214] Refugees, like the domestic homeless, lose their source of identity and way of connecting with their culture for an indefinite period of time.
Thus, the current definition of homelessness unfortunately allows people to simplistically assume that homeless people, including refugees, are merely "without a place to live" when that is not the case. As numerous studies show, forced migration and displacement brings with it another host of problems including socioeconomic instability, "increased stress, isolation, and new responsibilities" in a completely new environment[215]
For people in Russia, especially the youth, alcoholism and substance abuse is a major cause and reason for becoming and continuing to be homeless.[216] The United Nations, United Nations Centre for Human Settlements (UN-Habitat) wrote in its Global Report on Human Settlements in 1995: "Homelessness is a problem in developed as well as in developing countries. In London, for example, life expectancy among homeless people is more than 25 years lower than the national average."
Poor urban housing conditions are a global problem, but conditions are worst in developing countries. Habitat says that today 600 million people live in life- and health-threatening homes in Africa, Asia, and Latin America. For example, more than three in four young people had insufficient means of shelter and sanitation in some African countries like Malawi.[217] "The threat of mass homelessness is greatest in those regions because that is where population is growing fastest. By 2015, the 10 largest cities in the world will be in Asia, Latin America, and Africa. Nine of them will be in developing countries: Mumbai, India – 27.4 million; Lagos, Nigeria – 24.4; Shanghai, China – 23.4; Jakarta, Indonesia – 21.2; São Paulo, Brazil – 20.8; Karachi, Pakistan – 20.6; Beijing, China – 19.4; Dhaka, Bangladesh – 19; Mexico City, Mexico – 18.8. The only city in a developed country that will be in the top ten is Tokyo, Japan – 28.7 million."[218]
In 2008, Dr. Anna Tibaijuka, Executive Director of UN-HABITAT, referring to the recent report "State of the World's Cities Report 2008/2009",[219] said that the world economic crisis we are in should be viewed as a "housing finance crisis" in which the poorest of poor were left to fend for themselves.[220]
By country
Australia
Homelessness in Canada has grown in size and complexity since 1997.[223] While historically known as a crisis only of urban centres such as Montreal, Laval, Vancouver, Edmonton, Calgary, and Toronto, increasing homelessness in suburban communities requires new services and resources.[224]
In recent years homelessness has become a major
social issue in
Canada. In Action Plan 2011, the Federal Government of Canada proposed $120 million annually from April 2014 until April 2019—with $70 million in new funding—to renew its Homelessness Partnering Strategy (HPS). In dealing with homelessness in Canada, the government focus is on the
Housing First model. Thus, private or public organizations across Canada are eligible to receive HPS subsidies to implement Housing First programs. Canada spends more than 30 billion annually on social service programs yearly for the homeless.
[225] Finland
There are estimated to be 15,000 homeless persons in Hungary of which about 6,500 live in Budapest (2016).[228] There have been repeated attempts at criminalizing homelessness in Hungary by the Fidesz government and homeless people face severe restrictions in many cities.[229] 131 homeless people died of cold exposure in Budapest between 2006 and 2010.[230]
Russia and the USSR
In Sweden, municipalities are required to provide a home to any citizen who does not have one. However, landlords and lessors have the right to select guests among applicants. Owners, including municipalities themselves, avoid homeless people, unemployed people or people with a bad credit score. People who cannot pay their rent will be evicted, including families with small children. In 2009, 618 children were evicted.[235]
According to the National Board of Health and Welfare the number of homeless people in Sweden was approximately 33,000 in 2019.[236]
In Sweden, municipalities are required to provide a home to any citizen who does not have one. However, landlords and lessors have the right to select guests among applicants. Owners, including municipalities themselves, avoid homeless people, unemployed people or people with a bad credit score. People who cannot pay their rent will be evicted, including families with small children. In 2009, 618 children were evicted.[235]
According to the National Board of Health and Welfare the number of homeless people in Sweden was approximately 33,000 in 2019.According to the National Board of Health and Welfare the number of homeless people in Sweden was approximately 33,000 in 2019.[236]
Since the late 1990s, housing policy has been a devolved matter, and state support for the homeless, together with legal rights in housing, have therefore diverged to a certain degree. A national service, called Streetlink, was established in 2012 to help members of the public obtain near-immediate assistance for specific rough sleepers, with the support of the Government (as housing is a devolved matter, the service currently only extends to England). Currently, the service does not operate on a statutory basis, and the involvement of local authorities is merely due to political pressure from the government and charities, with funding being provided by the government (and others) on an ad hoc basis.[citation needed]
A member of the public who is concerned that someone is sleeping on the streets can report the individual's details via the Street Link website[237] or by calling the referral line number on 0300 500 0914. Someone who finds themselves sleeping on the streets can also report their situation using the same methods. It is important to note that the Streetlink service is for those who are genuinely sleeping on the streets, and not those who may merely be begging, or ostensibly living their life on the streets despite a place to sleep elsewhere (such as a hostel or supported accommodation).
The annual number of homeless households in England peaked in 2003–04 at 135,420 before falling to a low of 40,020 in 2009–10. In 2014–15, there were 54,430 homeless households, which was 60 per cent below the 2003–04 peak.[238] The UK has more than 80,000 children in temporary accommodation, a number which increases every year.[239][240] In 2007 the official figures for England[241] were that an average of 498 people slept rough each night, with 248 of those in London. It is important to note that many individuals may spend only a few days or weeks sleeping rough, and so any number for rough sleepers on a given night
A member of the public who is concerned that someone is sleeping on the streets can report the individual's details via the Street Link website[237] or by calling the referral line number on 0300 500 0914. Someone who finds themselves sleeping on the streets can also report their situation using the same methods. It is important to note that the Streetlink service is for those who are genuinely sleeping on the streets, and not those who may merely be begging, or ostensibly living their life on the streets despite a place to sleep elsewhere (such as a hostel or supported accommodation).
The annual number of homeless households in England peaked in 2003–04 at 135,420 before falling to a low of 40,020 in 2009–10. In 2014–15, there were 54,430 homeless households, which was 60 per cent below the 2003–04 peak.[238] The UK has more than 80,000 children in temporary accommodation, a number which increases every year.[239][240] In 2007 the official figures for England[241] were that an average of 498 people slept rough each night, with 248 of those in London. It is important to note that many individuals may spend only a few days or weeks sleeping rough, and so any number for rough sleepers on a given night hides the total number of people actually affected in any one year.
Homelessness in England since 2010 has been rising. By 2016 it is estimated the numbers sleeping rough had more than doubled since 2010.[242] The National Audit Office say in relation to homelessness in England 2010–17 there has been a 60% rise in households living in temporary accommodation and a rise of 134% in rough sleepers.[243][244] It is estimated 4,751 people bedded down outside overnight in England in 2017, up 15% on previous year.[245] The housing charity Shelter used data from four sets of official 2016 statistics and calculated 254,514 people in England were homeless.[246]
The Homelessness Reduction Act 2017 places a new duty on local authorities in England to assist people threatened with homelessness within 56 days and to assess, prevent and relieve homelessness for all eligible applicants including single homeless people from April 2018.[247]
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United Nations Economic Commission for Europe
affordable shared housing
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