Homelessness

Background

On any given night in 2015, nearly 565,000 people experienced homelessness in the US. That is down about 11 percent from 2007 as a result of increased federal funding for beds and services available to the homeless population.

Despite this decline, as the baby boomer population ages, the number of homeless older adults is expected to rise. The average age of a homeless older adult is 53, with a life expectancy of only 64. In fact, homeless older adults have a mortality rate that is three to four times that of the general population.

Older adults, especially those who are homeless, have a higher frequency of health problems and frailty. They are less likely than younger people to survive exposure to the severe weather conditions people who are homeless must endure. They are also exposed more frequently to unsafe and unsanitary conditions, which can exacerbate health problems that accompany aging.

Often, older adults with unaddressed housing needs have few options for shelter and are sometimes forced to choose between homelessness and placement in a nursing home because the only funding that may be available is for that kind of care. Policy interventions can reduce the numbers of older adults who are in these circumstances (see Chapter 8, Long-Term Services and Supports).

Homelessness, especially chronic homelessness, can contribute to declines in physical and mental health. This is due both to exposure to harsh environmental conditions and the lack of adequate medical monitoring and access to treatment common among people with inadequate shelter.

Many factors contribute to homelessness, including unemployment, poverty, chronic mental or physical health problems, and lack of affordable housing. Although the economy has improved since the Great Recession, households with low incomes and those with high housing-cost burden are still at risk of becoming homeless should their financial conditions worsen. Therefore, maintaining a supply of affordable and adequate housing along with supportive services can help families mitigate the risk of homelessness.

Permanent supportive housing can address homelessness by providing affordable and adequate units combined with services specifically targeted to the physical, mental, and social needs of the individual. For older adults, services are provided that meet age-specific needs, such as help with activities of daily livingActivities of daily living (ADLs) include: bathing or showering, dressing, getting in and out of bed or a chair, walking, using the toilet, and eating. or placement in an accessible home that complies with the Americans with Disabilities Act and includes universal design features to aid mobility (see this chapter’s section on Housing Accessibility and Universal Design).

Homelessness: Policy

Funding and assistance

In this policy: State

States should provide additional housing funds and support services for people who are homeless or mentally ill. Greater emphasis should be placed on early intervention, such as emergency assistance to prevent evictions, and on the development of a continuum of transitional and supportive housing arrangements.

Program coordination

In this policy: FederalLocalState

Policymakers should coordinate activities that prevent or reduce homelessness.

McKinney-Vento Homeless Assistance Act of 1987

In this policy: Federal

Congress should fund assistance to the homeless, as authorized by the McKinney-Vento Homeless Assistance Act, at least at current levels.

The Department of Housing and Urban Development should encourage the use of the Act and other funds to support early-intervention and outreach programs and to develop a continuum of transitional and supportive housing arrangements for homeless people.