A Place to Call Home – The Health Care Blog


Congratulations, America. We have another new record, albeit a dismal one. According to the Department of Housing and Urban Development (HUD), there are now 653,000 homeless people, up 12% from the prior year. As one can imagine, compiling such a number is problematic at best, and no doubt misses a non-trivial number of such unfortunate people.

“Homelessness is solvable and should not exist in the United States,” said HUD Secretary Marcia L. Fudge. Well, yeah, like kids without enough food, pregnant women without access to adequate prenatal care, or people without health insurance, yet here we are.

HUD says that the increase was driven by people who became for the first time, up some 25%. It attributes this to “a combination of factors, including but not limited to, the recent changes in the rental housing market and the winding down of pandemic protections and programs focused on preventing evictions and housing loss.” As with the recent increase in child poverty, the lessons that we should have learn from our COVID response didn’t survive our willingness to put the pandemic behind us.

Jeff Olivet, executive director of the U.S. Interagency Council on Homelessness, told AP: “The most significant causes are the shortage of affordable homes and the high cost of housing that have left many Americans living paycheck to paycheck and one crisis away from homelessness.” The National Low Income Housing Coalition estimates we’re missing some 7 million affordable housing units, so I suppose we should be relived there are “only” 653,000 homeless people.

“For those on the frontlines of this crisis, it’s not surprising,” Ann Oliva, CEO of the National Alliance to End Homelessness, also told AP. Indeed, we’ve all seen news accounts of homeless encampments spreading seemingly out of control, many of us have spotted homeless people as we go about our daily lives, and yet most of us don’t want either homeless people or low income housing units in our neighborhoods.

We often tell ourselves that homeless people are mentally ill or drug users, but data suggests that most are homeless due to economic reasons.  As many as 60% of them are still working, but just can’t afford housing. Too many of us are one missing paycheck away from being on the street.

They’re more likely to be victims of crimes than criminals; in fact, BBC reports that violence against homeless people – including homicide – seems to be on the rise, although there is no systemic tracking of such violence.

In a searing piece in The Atlantic,  Annie Lowrey blasts our lack of anything resembling a national housing policy. She notes: “…today’s HUD is not much of a housing agency. And it is definitely not much of an urban-development agency.” Secretary Fudge told her: “HUD is doing all in our power to invest in those who have often been left out and left behind.” And that’s a big part of the problem.

As Ms. Lowry laments, despite the obvious housing crisis and record number of homeless,

Yet legislators have not passed a significant bill to get people off the streets and out of shelters. Joe Biden has not signed a law to increase the supply of rental apartments in high-cost regions or to protect families from predatory landlords. Congress has not made more families eligible for housing vouchers, or passed a statute protecting kids from the trauma of eviction, or set a goal for the production of new housing.

“The country’s lack of a national housing policy is part of the reason we are in a housing crisis,” she says, “and Washington needs to take a real role in ending it.”

What really got my attention was that a number of states and cities – most of them run by Democrats – want the Supreme court to overturn Martin vs. Boise, which ruled that evicting homeless people who had no choice of indoor housing was “cruel and unusual punishment” and thus unconstitutional. If you want to evict them from their outdoor housing, the court said, you better have places to put them.

Seems reasonable to me. I mean, they’re already homeless; where else do you expect them to go? It doesn’t help that many places are criminalizing homelessness, as though it was a choice those people were making.

I don’t usually look to Texas for solutions to social issues, but when it comes to the homeless, it may be a leader. Over the last decade, Texas has decreased its homeless population by nearly a third, in part because it builds more housing, and less expensive housing.

Cities such as Austin, Houston, and San Antonio have been particular innovators. Houston has cut its homeless population by two-thirds. There was a concerted city-county effort to coordinate the work of public agencies and over 100 non-profits. (Outgoing) Houston Mayor Sylvester Turner brags. “Instead of a hundred NGOs competing with each other, we’ve kind of pulled them all together. They’re now operating under a single umbrella, The Way Home.”

The focus is to get homeless people into housing first, then address their other issues. As The Way Home says, “first, we give them a key.” Then they work on providing them supportive services to help stabilize their lives. Even law enforcement is on board; Harris County Sheriff Ed Gonzalez says:

“…I think it’s important for us to recognize that it really is a public health issue: How can we better develop those systems of care, to better route people where they may need to be, rather than just looking at it through the lens of policing.”

That sure beats just breaking up encampments.

Meanwhile, Austin has focused on providing “tiny homes,” while San Antonio has built a huge homeless shelter. It’s important to note that these are local initiatives; Texas itself provides very little state funding for the homeless.  None of these cities has “solved” homelessness, but they’ve shown ways to lessen it.


Like poverty, homelessness isn’t inevitable; it is a policy choice. Sociologist Matthew Desmond, author of the must-reads Poverty and Evicted, told Ms. Lowrey: “Think of lining up families who qualify for food stamps and only one in four families gets to eat. That’s exactly how we treat housing policy today. It doesn’t make a lot of sense, because, without stable shelter, everything else falls apart.” Accordingly, Ms. Lowrey asserts: “affordable housing for everyone, everywhere, and the end of homelessness should be the policy priority now.”

We may not be able to end homelessness, but we can and should stop treating them as undesirables and start treating them as people – people who first and foremost need a place to live.

Kim is a former emarketing exec at a major Blues plan, editor of the late & lamented Tincture.io, and now regular THCB contributor

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