Homeless Are Impoverished and Ill, Survey Finds

Graeme Bacque (gbacque@idirect.com)
Wed, 08 Dec 1999 04:07:17 -0500


December 8, 1999

Homeless Are Impoverished and Ill,
Survey Finds

By NINA BERNSTEIN  The New York Times

A sweeping national study of homeless people served by shelters,
soup kitchens and other programs has found that almost half were
on their first episode of homelessness, 44 percent had worked at least
part time in the previous month and 42 percent said that what they
needed more than anything was help finding a job. 

But the study, being released today and based on Census Bureau surveys
in 1995 and 1996 and the most comprehensive study of homelessness
ever, also found that over all, the homeless were deeply impoverished
and most were ill. Two-thirds were suffering from chronic or infectious
diseases, not counting AIDS, 55 percent lacked health insurance, and 39
percent had signs of mental illness. Twenty-seven percent reported a
childhood history of foster care or institutional placement. 

"This is a definitive description of what we're dealing with when we
talk
about the quote, unquote, homeless," Andrew M. Cuomo, secretary of
Housing and Urban Development, said yesterday in discussing the study,
which was based on interviews with 12,000 service providers and 4,000
homeless clients. 

"There is no simple solution." 

Despite their handicaps, 60 percent of the homeless living alone and 76
percent of those living in families successfully left shelters for
permanent
housing when they received the services they needed, including housing
subsidies, health care, substance-abuse treatment, education and job
training, according to the study's surveys of representatives of about
40,000 programs that serve the homeless nationwide. 

While the study did not offer an estimate of the overall homeless
population, its 600 pages of statistics included figures showing that an
estimated 470,000 homeless people sheltered on an average night in
February 1996 were only a quarter of the people who were homeless at
any one time during the year. 

The previous national survey, done in 1987, estimated the number of
homeless people, including those in the streets, at 500,000 to 600,000
on any night. 

The study took three years to complete because it required the
collection
and analysis of an extraordinary amount of data and involved 12 federal
agencies, officials said. 

Experts on homelessness, including Martha Burt, the director of social
service research at the Urban Institute, which prepared the report to be
released by housing department today, cautioned that like any
point-in-time snapshot this survey over-represented the more chronically
homeless, who were more likely to be mentally ill or addicted to drugs,
and under-represented the people who became homeless sporadically
for economic reasons. 

"They are bookends," Cuomo agreed. "You have a pent-up need for
affordable housing and you have populations with underlying problems.
They are both driving the system." 

At a time when cities are using law enforcement to try to move homeless
people out of public places, Cuomo added, the study underlines that
punitive ordinances and police crackdowns will not work. 

"You need outreach to get people off the street -- not a police officer
with handcuffs," he said. "You need transitional services as a second
step, and then by definition you need the third step, which is permanent
housing." 

Among the surprises in the study was that while New York, Los Angeles
and other larger cities provided the most beds for the homeless, they
helped a smaller portion of their poor residents than some smaller
cities
like Minneapolis, San Francisco and St. Louis. 

Despite the booming economy, Ms. Burt said, there is no reason to
believe the picture drawn by the study has changed significantly. The
poverty rate remains almost the same, and other Housing Department
studies show that rising rents and a steep decline in housing subsidies
have left 5.3 million poor families in housing that was unaffordable or
severely substandard, a record number. 

"The economy is better but we are also cutting way back on the safety
net," Ms. Burt said. "This is poverty-related as well as
disability-related.
Lots of people have problems; we have alcoholic senators -- they're not
homeless." 

Homeless people are among the poorest in the nation, with incomes
averaging half the federal poverty level. Forty percent of those
surveyed
said they went without food one or more days in the previous month,
compared with 3 percent of other poor Americans. Almost a third of
homeless clients surveyed said they had slept on the streets or in other
places not meant for habitation within the week before the survey. Yet,
those in central cities were better off than their counterparts surveyed
in
1987, mainly because they were more likely to have government benefits
like public assistance and food stamps. 

"The fact that most of these folks don't have Medicaid is a pretty
damning statistic," said Dennis P. Culhane, a professor of social
welfare
policy at the University of Pennsylvania. 

The rates of mental illness were unchanged since the 1987 survey, a
fact,
Culhane added, that suggests known solutions to the homelessness of the
disabled -- treatment and supportive, permanent housing -- are not being
fully used. 

The survey shows the strengths of the expanded system of homeless
services, largely provided by nonprofit and religious-based charities
financed by the government, Culhane said, but also shows the limits of
that approach. 

Exploring the suspicion in many towns that the homeless come from
somewhere else, the study found that 29 percent of homeless families and
46 percent of single homeless clients said they were not living in the
same
place where they became homeless. In all cases, Ms. Burt said, they had
moved from a smaller to larger places. 

Major reasons included the lack of jobs and affordable housing in the
place they left, and the presence of relatives or friends and job
possibilities in the city where they were interviewed, as well as the
availability of shelters and other services. 

Serious childhood traumas were common among the homeless people
surveyed, the study found, with 25 percent reporting childhood abuse, 33
percent having run away from home and 21 percent having experienced
homelessness as children. 

"I think what you also see in this report is the failure of our primary,
early
intervention system," Cuomo said. "You are creating tomorrow's
homeless today."