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Facts & Learning

Problems faced by homeless people

Homeless people face many problems beyond the lack of a safe and suitable home. They are often faced with many social disadvantages and reduced access to private and public services such as:

These are a few of the difficulties that someone who becomes homeless may face. They contribute to the acceleration and perpetuation of crisis. Once someone becomes homeless, it becomes extremely difficult to remedy the situation without stabilizing their lives through access to shelter and stable employment.

Violent crimes against the homeless

There have been many violent crimes committed against the homeless. A recent study in 2007 found that this number is increasing.

Assistance and resources available to the homeless

Most countries provide a variety of services to assist homeless people. They often provide food, shelter and clothing and may be organized and run by community organizations (often with the help of volunteers) or by government departments. These programs may be supported by government, charities, churches and individual donors.

Income sources

Many non-profit organizations such as Goodwill Industries maintain a mission to “provide skill development and work opportunities to people with barriers to employment”, though most of these organizations are not primarily geared toward homeless individuals. Many cities also have street newspapers or magazines: publications designed to provide employment opportunity to homeless people or others in need by street sale.
While some homeless have paying jobs, some must seek other methods to make money. Begging or panhandling is one option, but is becoming increasingly illegal in many cities. Despite the stereotype, not all homeless people panhandle, and not all panhandlers are homeless. Another option is busking: performing tricks, playing music, drawing on the sidewalk, or offering some other form of entertainment in exchange for donations. In cities where plasmapheresis centers still exist, homeless people may generate income through frequent visits to these centers.

Homeless people have been known to commit crimes just to be sent to jail or prison for food and shelter. In police slang, this is called “three hots and a cot” referring to the three hot daily meals and a cot to sleep on given to prisoners. Similarly a homeless person may approach a hospital’s emergency department and fake physical or mental illness in order to receive food and shelter.

Invented in 2005, in Seattle, Bumvertising, an informal system of hiring the homeless to advertise by a young entrepreneur, is providing food, money, and bottles of water to sign-holding homeless in the Northwest. Homeless advocates accuse the founder, Ben Rogovy, and the process, of exploiting the poor and take particular offense to the use of the word “bum” which is generally considered pejorative.

United States

Housing First is an initiative to help the homeless get re-integrated into society, and out of homeless shelters. It was initiated by the federal government’s Interagency Council on Homelessness. It asks cities to come up with a plan to end chronic homelessness. In this direction, there is the belief that if homeless people are given independent housing to start off with, with some proper social supports, then there would be no need for emergency homeless shelters, which it considers a good outcome. However this is a controversial position.

In Boston, Massachusetts, in September 2007, an outreach to the homeless was initiated in the Boston Common, after some arrests and shootings, and in anticipation of the cold winter ahead. This outreach targets homeless people who would normally spend their sleeping time on the Boston Common, and tries to get them into housing, trying to skip the step of an emergency shelter. Applications for Boston Housing Authority were being handed out and filled out and submitted. This is an attempt to enact by outreach the Housing First initiative, federally mandated. Boston’s Mayor, Thomas Menino, was quoted as saying “The solution to homelessness is permanent housing”. Still, this is a very controversial strategy, especially if the people are not able to sustain a house with proper community, health, substance counseling, and mental health supportive programs.

Refuges for the homeless

There are many places where a homeless person might seek refuge.

Outdoors: On the ground or in a sleeping bag, tent, or improvised shelter, such as a large cardoard box, in a park or vacant lot.

Shantytowns: Ad hoc campsites of improvised shelters and shacks, usually near rail yards, interstates and high transportation veins.

Derelict structures: abandoned or condemned buildings

Squatting in an unoccupied house where a homeless person may live without payment and without the owners knowledge or permission.

Vehicles: cars or trucks are used as a temporary or sometimes long-term living refuge, for example by those recently evicted from a home. Some people live in vans, sport utility vehicles, covered pick-up trucks, station wagons, sedans, or hatchbacks.

Public places: Parks, bus or trainstations, airports, public transportation vehicles (by continual riding where unlimited passes are available), hospital lobbies or waiting areas, college campuses, and 24-hour businesses such as coffee shops. Many public places use security guards or police to prevent people from loitering or sleeping at these locations for a variety of reasons, including image, safety, and comfort.

Homeless Shelters: such as emergency cold-weather shelters opened by churches or community agencies, which may consist of cots in a heated warehouse, or temporary Christmas Shelters.

Inexpensive Boarding houses: Also called flophouses, they offer cheap, low-quality temporary lodging.

Residential hotels: where a bed as opposed to an entire room can be rented cheaply in a dorm-like environment.

Inexpensive motels also offer cheap, low-quality temporary lodging. However, some who can afford housing live in a motel by choice. For example, David and Jean Davidson spent 22 years at a UK Travelodge.

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 main source of income.

Friends or family: Temporarily sleeping in dwellings of friends or family members (“couch surfing”). Couch surfers may be harder to recognize than street homeless people

Underground tunnels such as abandoned subway, maintenance, or train tunnels are popular among the permanent homeless. The inhabitants of such refuges are called in some places, like New York City, “Mole People”. Natural caves beneath urban centers allow for places where the homeless can congregate. Leaking water pipes, electric wires, and steam pipes allow for some of the essentials of living.

Health care for the homeless

Health care for the homeless is a major public health challenge. Homeless people are more likely to suffer injuries and medical problems from their lifestyle on the street, which includes poor nutrition, substance abuse, exposure to the severe elements of weather, and a higher exposure to violence (robberies, beatings, and so on). Yet at the same time, they have little access to public medical services or clinics. This is a particular problem in the US where many people lack health insurance: “Each year, millions of people in the United States experience homelessness and are in desperate need of health care services. Most do not have health insurance of any sort, and none have cash to pay for medical care.”

Homeless persons often find it difficult to document their date of birth or their address. Because homeless people usually have no place to store possessions, they often lose their belongings, including their identification and other documents, or find them destroyed by police or others. Without a photo ID, homeless persons cannot get a job or access many social services. They can be denied access to even the most basic assistance: clothing closets, food pantries, certain public benefits, and in some cases, emergency shelters.
Obtaining replacement identification is difficult. Without an address, birth certificates cannot be mailed. Fees may be cost-prohibitive for impoverished persons. And some states will not issue birth certificates unless the person has photo identification, creating a Catch-22.
This problem is far less acute in countries which provide free-at-use health care, such as the UK, where hospitals are open-access day and night, and make no charges for treatment. In the US, free-care clinics, especially for the homeless do exist in major cities, but they are usually over-burdened with patients.

The conditions affecting the homeless are somewhat specialized and have opened a new area of medicine tailored to this population. Skin conditions and diseases abound, because homeless people are exposed to extreme cold in the winter and they have little access to bathing facilities. Homeless people also have more severe dental problems than the general population. Specialized medical textbooks have been written to address this for providers.

There are many organizations providing free care to the homeless in countries which do not offer free medical treatment organised by the state, but the services are in great demand given the limited number of medical practitioners. For example, it might take months to get a minimal dental appointment in a free-care clinic. Communicable diseases are of great concern, especially tuberculosis, which spreads more easily in crowded homeless shelters in high density urban settings.

In 1999, Dr. Susan Barrow of the Columbia University Center for Homelessness Prevention Studies reported in a study that the “age-adjusted death rates of homeless men and women were 4 times those of the general US population and 2 to 3 times those of the general population of New York City”.


If you want to learn more about homelessness in America, visit these websites. They have an abundance of research on homelessness and current information on Congressional policy:

National Alliance to End Homelessness
Homebase: Center for Common Concerns
National Law Center on Homelessness and Poverty
Homelessness Resource Center

History and Current Activities Associated with Homelessness in Chinatown