Public Health Homelessness
Holly A. Holtzen
  • LAST REVIEWED: 21 November 2012
  • LAST MODIFIED: 21 November 2012
  • DOI: 10.1093/obo/9780199756797-0021


Homelessness has existed throughout human history, and as far back as the 17th century in the United States. The causes of homelessness are complex and include both environmental and individual factors. External environmental factors include economic conditions, social policy changes, and demographic shifts. Individual vulnerabilities and circumstances also contribute to the risk of homelessness. Descriptions of homelessness as a social issue have shifted from the early “tramps,” to Skid Row with its extreme poverty and addiction, to the present-day view of invisible homelessness consisting of men and women, children, and veterans. Defining homelessness as a practical matter has proven difficult for policy makers and researchers. A decision about how to classify homeless people living in shelters, those receiving services, and those on the streets dramatically alters the count. Recent estimates suggest that 656,129 people were homeless at a single point in time (i.e., measured on one night in January annually) in the United States in 2009. Efforts to demonstrate the extent of homelessness guide social and housing policies. The varied counting methodologies influence the public policy response to homelessness differently, guiding housing policy and health and social services based on their inherent assumptions. Attempts to quantify homelessness as a social problem began with efforts by Peter H. Rossi in the Chicago studies and have continued with studies by the US Census Bureau, and most recently with biannual point-in-time counts conducted by the Continuum of Care. Providing homeless services and housing dramatically changed in the late 1980s with the passage of the Stewart B. McKinney Homeless Assistance Act (P.L. 100-77), which eventually created the Continuum of Care (CoC) system in the 1990s to provide coordinated outreach and assessment, prevention, permanent housing, and services. This legislation shifted the response to homelessness from a primarily grassroots effort to a national campaign to end homelessness. Under this act, funding and homeless services were consolidated to have a more regional approach to homeless services and housing. This coordinated approach was developed to address the diverse needs of the homeless, extending beyond providing shelter to addressing the causes of homelessness and the health-related risks. Homeless populations have a higher prevalence of infections and chronic diseases. Moreover, their mortality rate is four times higher than that of comparable housed populations. The homelessness literature is cross-disciplinary and reflects the diversity of homelessness, especially in the United States.

Introductory Works

Homelessness as a social issue has been described broadly in a variety of books. The introductory works Baumohl 1996, Blau 1992, Hopper 2003, and Robertson and Greenblatt 1992 provide a thorough collection of articles by leading experts covering public policy, research, and social issues related to homelessness in the United States. Levinson 2004 provides descriptions and suggestions for further reading on salient topics associated with homelessness. Since most of the introductory literature is somewhat dated, more recent publications (McNamara 2008; Barrett, et al. 2010) are useful because they describe current social policies and research on homelessness.

  • Baumohl, Jim, ed. 1996. Homelessness in America. Phoenix, AZ: Oryx.

    This book provides a broad overview of homelessness from a variety of perspectives. It is organized into three sections covering a range of topics from the causes of homelessness to prevention.

  • Blau, Joel. 1992. The visible poor: Homelessness in the United States. New York: Oxford Univ. Press.

    This is another book reviewing the basic issues of homelessness. It provides a synopsis of the key topics that describe homelessness, including causes, policy responses, needs, and misconceptions about the homeless.

  • Hopper, Kim. 2003. Reckoning with homelessness. 3d ed. Ithaca, NY: Cornell Univ. Press.

    This book is organized into three sections examining the history of homelessness and the evolution of homeless shelters, and it reviews early field work to examine homelessness and summarizes an ethnography of homeless men in New York. Finally, the author reviews the role of advocacy to legitimize the homeless and address their needs.

  • Lee, A. Barrett, Kimberly A. Tyler, and James D. Wright. 2010. The new homelessness revisited. Annual Review of Sociology 36:501–521.

    DOI: 10.1146/annurev-soc-070308-115940

    This is a review of research and public policies about homelessness from 1980 to present day. The purpose of this article was to highlight the most recent sociological literature that advanced knowledge of this social issue.

  • Levinson, David, ed. 2004. Encyclopedia of homelessness. Thousand Oaks, CA: SAGE.

    This is an introductory reference covering multiple topics associated with homelessness. This book provides the reader with basic information and suggestions for further reading on each subject.

  • McNamara, Robert, ed. 2008. Homelessness in America. 3 vols. Westport, CT: Praeger.

    Volume 1 focuses on demographics of the homeless population and covers topics such as homeless policies, homeless veterans, homeless women, and homeless families. Volume 2 discusses the causes of homelessness. The third volume focuses on solutions, discussing both old and new strategies, covering such topics as past attempts to solve homelessness, new shelter communities, criminalization of homelessness, and Homeless Management Information Systems.

  • Robertson, Marjorie J., and Milton Greenblatt, eds. 1992. Homelessness: A national perspective. New York: Plenum.

    This book is an overview of homelessness from a cross-disciplinary perspective. It provides a description of mental illness, health care for the homeless, substance abuse, veterans and elderly homeless, and homeless families and children.

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