Does Race Matter in Addressing Homelessness? A Review of the Literature

Date01 June 2016
Published date01 June 2016
Does Race Matter in Addressing Homelessness?
A Review of the Literature
Marian Moser Jones
Since the 1980s, black persons have been overrepresented in the United States homeless population.
Given that morbidity and mortality is elevated among both the black population and the homeless
population in comparison to the general U.S. population, this overrepresentation has important
implications for health policy. However, the racial demographics of homelessness have received little
attention from policymakers. This article reviews published social and behavioral science literature
that addresses the relationship between race and contemporary homelessness in the United States.
This literature points to substantial differences between racial subgroups of the U.S. homeless
population in vulnerabilities, health risks, behaviors, and service outcomes. Such observed differences
suggest that policies and programs to prevent and end homelessness must explicitly consider race
as a factor in order to be of maximum effectiveness. The limited scope of these f‌indings also suggests
that more research is needed to better understand these differences and their implications.
KEY WORDS: race, homelessness, poverty
In 1985, a groundbreaking study of homelessness in Ohio revealed that black
were signif‌icantly overrepresented in this group (Roth, 1985). This study,
the f‌irst ever systematic survey of homelessness to be conducted across an entire
state since the Great Depression, provided empirical support for ethnographers’
earlier observations that profound demographic shifts were occurring in the
United States’ homeless population (Baxter & Hopper, 1981). A dwindling cluster
consisting primarily of “older white men, who were uneducated and ensnared in
alcoholism” (Bachrach, 1984; Hodnicki, 1990, p. 59) was giving way to a new,
younger, more racially diverse population of homeless men and women (Baxter
& Hopper, 1981). Other research also supported the f‌inding that black persons
were overrepresented in the entire U.S. homeless population, over and above the
disproportionate percentage of these persons living in poverty (Burt & Cohen,
1989; Farr, Koegel, & Burnham, 1986).
Thirty years later, black persons remain substantially overrepresented in
the U.S. homeless population, comprising roughly 40.4 percent of the total U.S.
World Medical & Health Policy, Vol. 8, No. 2, 2016
1948-4682 #2016 Policy Studies Organization
Published by Wiley Periodicals, Inc., 350 Main Street, Malden, MA 02148, USA, and 9600 Garsington Road, Oxford, OX4 2DQ.
homeless population, but only 12.5 percent of the overall population (United
States Department of Housing and Urban Development, 2015; hereafter HUD).
Black persons also made up 48.7 percent of homeless persons in families,
according to HUD’s 2015 Point-in-Time (PIT) estimates of homelessness (HUD,
2015). An analysis of 2010 data indicated that members of black families were
seven times as likely as members of white families to spend time in a homeless
shelter (Institute for Children, Poverty, and Homelessness, 2012). Hispanic
persons, in contrast, are underrepresented in the homeless population, despite
having poverty rates comparable to black persons (Krogstad, 2014).
The enduring overrepresentation of black persons in the U.S. homeless
population has serious implications for population health and health disparities.
Homeless populations have age-adjusted mortality rates double to triple that of
the general population (Barrow, Herman, Cordova, & Streuning, 1999; Hibbs
et al., 1994), are at elevated risk of premature death even in comparison to other
low-income populations, and suffer disproportionately from a variety of chronic
health conditions (O’Connell, 2005). Additionally, the U.S. black population still
has an average life expectancy of 3.8 years less than the white population, with
higher death rates than the white population for leading causes of death
including heart disease, cancer, diabetes, and homicide (Kochanek, Arias, &
Anderson, 2013; Williams & Mohammed, 2009). The black homeless population
thus likely faces a double dose of vulnerability.
The racial demography of homelessness and its potential implications have
received little attention from policymakers. In 2010, the U.S. Interagency Council
on Homelessness (USICH) released Opening Doors, the federal government’s f‌irst
comprehensive strategic plan to prevent and end homelessness (USICH, 2010).
While the plan acknowledged that people face “vulnerabilities associated with
race and gender” as well as other factors (USICH, 2010, p. 44), none of its
objectives, strategies, or updates explicitly addressed how racial dynamics in
homelessness might affect its efforts (USICH, 2010, 2015). Similarly, the National
Alliance to End Homelessness (NAEH), a leading nongovernmental organization,
has not once mentioned race or racial discrimination in recent editions of its
widely distributed yearly report, The State of Homelessness in America (NAEH,
2011, 2012, 2013, 2014). While the 2015 Annual Homelessness Assessment Report
to Congress (AHAR), released in November 2015 by HUD, does include data on
the proportions of the homeless population belonging to black, Hispanic, and
white racial/ethnic groups, it remains to be seen whether policy organizations
will analyze this data.
A colorblind approach to addressing homelessness would be justif‌ied if the
risk and protective factors related to homelessness, the pathways into homeless-
ness, and outcomes of services and programs to address homelessness did not
differ from one racial group to another. “Race” is only a socio- historical category
and is not a means for explaining biological differences between groups (Smedley
& Smedley, 2005), and racial discrimination in housing, employment, education,
voting, and public accommodations has been illegal in the United States for
over 50 years (The Leadership Conference, 2009). Some policymakers might,
140 World Medical & Health Policy, 8:2

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