Culture

The homeless population in the United States shares a common culture, meaning that there are shared beliefs, norms, behaviors, and social structures in response to a common economic and living situation; however, homelessness is complex and those who are homeless still have individual differences (Flaskerud & Strehlow, 2008; Philipps, 2012)

Historical Factors

Colonial Period

Homelessness is not a new problem in the United states as “poor wanderers and beggars” are mentioned from the colonial period (Jones, 2015).

Values in the United States

American culture often has little explicit value of this population, and many have accepted that the presence of homeless people is inevitable (Flaskerud & Strehlow, 2008).

There is not enough money spent on mental health care and treatment for substance abuse, and access to these services are limited for those who are homeless (Flaskerud & Strehlow, 2008).

The United States has an individualistic culture which promotes self-realization and independence; however, shelters force those who are homeless into dependence on others while the alternative of living on the streets allows autonomy (Schell & Gillen, 2019; Herring, 2015).

Living Situation

Those who are homeless lack adequate housing and are often living in shelters or on the streets (Flaskerud & Strehlow, 2008; National Health Care for the Homeless Council, n.d.).

Health and wellbeing are directly impacted by housing quality (Clifford et al., 2019).

1 in 2 people who are homeless are unsheltered, meaning they are sleeping outside and “in other locations not meant for human habitation (National Alliance to End Homelessness, 2020).

Social Factors

When homeless, previous social networks of support are broken and it is easy to feel socially isolated (Flaskerud & Strehlow, 2008; Philipps, 2012).

Detachment from communities and mainstream society is common (Flaskerud & Strehlow, 2008).

Among homeless populations, some support can be found as resources are shared and the presence of a similar understanding emerges; in fact, those who have spent the most time homeless and experienced the most trauma may even be respected by those in homeless communities (Philipps, 2012).

Research done by sociologists suggested homelessness is characterized by disassociation since bonds are not developed to family, school, work, religion, politics, recreation, etc. (Jones, 2015).

Gender

60% of the homeless population in the United States are men, but the number of women and families who are homeless is increasing (National Alliance to End Homelessness, 2020).

Women who are homeless are at higher risk for physical or sexual assault and do not have adequate access to reproductive health or family planning services (Philipps, 2012).

In 2016, the US Department of Housing and Urban Development’s Equal Access rule changed to state that transgender people using homeless shelters must be accommodated in accordance with their gender identity (National Alliance to End Homelessness, 2020).

Race and Ethnicity

Pacific Islanders and Native American ethnic groups are most likely to be homeless followed by black, multicultural, and hispanic (National Alliance to End Homelessness, 2020).

Implicit and explicit biases may impact access to housing, employment, and education, as well as how assistance is delivered including shelter rules, availability of services, locations of shelters, and investment in ending homelessness (Jones, 2015; Jones, 2016).

Women who are homeless and hispanic or black have higher rates of physical abuse, mental health hospitalization, serious medical symptoms, and lack of healthcare (Jones, 2016).

Family Life

Having a family in the United states increases expenses in food, childcare, basic necessities, healthcare, etc. making homelessness a real threat; of those who are homeless, 30% are families with children (Substance Abuse and Mental Health Services Administration, 2019; National Alliance to End Homelessness, 2020).

90% of families who are homeless are sheltered rather than unsheltered (Philipps, 2012).

When homeless, it is difficult for families to maintain routines and ensure consistency and stability for children. Time and energy used to seek employment and meet basic needs takes away from parenting. This often leads to feelings of failure for parents. (Mayberry et al., 2014)

Physical and Mental Health

Stress levels of those who are homeless is often high. There is an intense focus on survival to ensure basic needs such as safety, rest, and nourishment are met (Flaskerud & Strehlow, 2008; Philipps, 2012).

Preventable illnesses are common among those who are homeless at 3-6 times higher rates than the general population; however, there are many barriers to healthcare including lack of insurance (National Health Care for the Homeless Council, n.d.)

Approximately 25% of the United States’ homeless population has a mental illness compared to 6% of the general population. Depression is the most common mental illness due feelings of isolation and a lost sense of self (Philipps, 2012).