at home on the streets.
causes.
What triggers homelessness? For families, the top three causes are lack of affordable housing, poverty and unemployment. The most common causes for single individuals are substance abuse, mental illness and lack of affordable housing.
Risk Factors Affordable Housing A rising shortage of affordable housing is largely responsible for the increase of homelessness over the past few decades. Federal support and assistance for low-income housing has fallen 49% from 1980 to 2003.
88 work hours per week at minimum wage to afford a one bedroom apartment in the U.S. at fair market rent
$
$
Domestic violence and childhood neglect heavily influence the likelihood of becoming homeless in the U.S.
Drugs & Alcohol Drug and alcohol abuse is the most pervasive health problem among homeless individuals. It’s hard for a person struggling with addiction to remain in housing because most of their funds are used for substances. This makes treatment a difficult option because they can barely meet their own basic survival needs.
Mental Health
Poverty $
Family Conflict
People living in poverty often have to make the difficult choice of deciding which necessity they will drop due to limited resources. Most of the time it is housing as it absorbs a large portion of an individual’s income.
Unemployment In the current economy, jobs are becoming more difficult to find and unemployment rates remain high. Even if people manage to find work, this does not mean an immediate escape from poverty as declining wages still keep housing out of reach for many people.
01 | At Home on the Streets
Mental illness interferes with the way people carry out daily functions. In many cases, the mentally ill will turn to street drugs to self medicate. Having a mental illness and an addiction problem keeps these individuals away from jobs and residential stability.
25%
of the homeless suffer from a severe mental illness
The Housing Crisis Lack of affordable housing is the leading cause of homelessness in America. In North Carolina’s Orange and Durham Counties, the Community Empowerment Fund (CEF) is helping low-income families access market-rate housing. CEF builds relationships with its members and helps them sustain the transition out of homelessness. CEF invests a lot of time in Section 8, the Housing Voucher Choice program in Orange County. It provides rental assistance to families and individuals who find themselves at or below 50% of the county median income. In early September 2016, the Durham Housing Authority opened the HVC waitlist for just a week.
“ Housing is a question of the will. It’s not rocket science. ” Connie Pascale
The crowds poured in to the CEF office, but for many, access to housing was denied because the landlords said no. To help bridge the gap between landlords, voucher holders, and the homeless community in Orange County, CEF has started the Unlocking Doors Initiative. The plan is to focus on four main things: listening to voucher holders, identifying barriers and solutions, building a supported network of landlords and property managers, and continuing to unite the Durham Housing Authority and the community.
North Carolina
70 work hours
per week at minimum wage to afford a one bedroom apartment in North Carolina at fair market rent ($658)
25% of renters in NC pay at least ½ of their income on rent
Breakdown of Causes Umemployment
12 Substance abuse
14 11
Other
Mental health
18
% of homeless affected by each cause
45
Housing & low-income
35 months
is the average wait time for Section 8 Vouchers
geography. In order to understand homelessness, we need to recognize social issues such as poverty, affordable housing, disabilities, and others. Where people live has a significant impact on the degree to which such issues affect the homeless population.
National U.S.A. Since 2014, 33 states reported decreases in overall homelessness and 16 states reported increases. States with decreases were concentrated in the south and midwest.
New York • 19,795,791 people • 80,590 homeless
Illinois • 12,859,995 people • 13,107 homeless
Florida • 27,469,114 people • 41,542 homeless California • 39,144,818 people • 113,952 homeless
Homeless Population
Texas • 12,859,995 people • 28,495 homeless
92
92
$5
FL
9,3
$6
TX
$5
-15
In 2015, families in states with higher rates of homelessness had yearly median incomes ranging between $40k and $70k. The top five states were California, Texas, Florida, New York, and Illinois respectively.
$4 4,2
-10
40-115k
Median Family Income
7,4
0 -5
12-26k
34
CA
30-40k
3,2
5
8-12k
46
IL
20-30k
59
10
4-8k
$4
15
NY
Examining rates of homelessness can provide a clearer picture of the prevalence of homelessness in individual states. Texas experienced the most fluctuation, while Florida consistently had the lowest rates.
16-20k
5,2
Rates of Change
1-4k
TX
FL
NY
IL
-20 -25
2012
2013
03 | At Home on the Streets
2014
2015
CA
Local
North Carolina Composed of an even 100 counties, N.C. had a total of 11,491 people homeless according to a 2015 research study done by the National Alliance to End Homelessness. While the ratio of homelessness seemed highest in the northwest, the highest rate of homelessness was in the counties with the largest cities such as Charlotte and Raleigh. Yancey, Mitchell, Avery, Watauga, Ashe, Alleghany, Wilkes counties • 210,092 people • 854 homeless
From 2014-2015 there was a
-7.0%
Orange County • 140,352 people • 108 homeless
drop in overall homelessness in N.C.
Homeless Population
14th
Mecklenburg County • 990,977 people • 2,014 homeless
0.21-0.30%
0.06-0.10%
0.31-0.40%
0.11-0.20%
0.41-0.50%
Average Yearly Income
for largest number of homeless people in the United States
$ $
$
Census data shows the average yearly income per capita for citizens in the more northwestern N.C. counties, which have the highest rates of homelessness.
3,4 $2
04 8,8
19 8,9 $1
$1 y
High: 50° F Low: 29° F
er
High: 63° F Low: 38° F
Av
High: 71° F Low: 46° F
gh an y Mi tch ell
High: 89° F Low: 68° F
All e
The climate of an area has great impact on the life of a homeless person. North Carolina has a large range of temperatures throughout the seasons that can add an extra challenge to the life of a homeless person.
65
Climate
50
N.C. ranked
0.01-0.05%
0,3
Incomplete data
$2
751-1000
e
101-250
Homeless Pop. / County Pop.
76
1.5 k-3k
As h
501-750
ey
51-100
$1 8,5
1 k-1.5k
nc
251-500
Ya
1-50
At Home on the Streets | 04
health.
Being Homeless is Bad for Your Health
A bad health condition can cause someone to lose their job, lose their health insurance and lead to becoming homeless. At the same time, homelessness can create new health problems or exacerbate existing ones.
Hunger Missing a meal or going without proper nutrition is one of the most common health risks among homeless people, and one of the first problems that can be experienced even in a short bout of unemployment or period of poverty.
Access to Healthcare
Many homeless people do not have health insurance, making it difficult to access even routine care such as getting prescriptions. Not having identification or reliable transportation can also be barriers to health care. Many homeless may only see a doctor in an emergency room when their life is on the line.
Violence
Assault and rape are serious dangers for people experiencing homelessness. Many advocates now categorize antagonistic violence against homeless people as a hate crime. Non-sheltered homeless are at a higher risk for assault, muggings and homicide.
Homelessness Hurts the Whole Body Homeless people have many of the same health problems as everyone else — but many lack health care. That can mean missing out on even simple care, like a trip to the eye doctor or dentist. The homeless are also more likely to develop specific issues like joint pain, skin problems, respiratory illnesses and infectious diseases due to their poor living conditions.
Exposure to Elements
Extreme weather hits hard on people who spend their days and nights outdoors. Cold can lead to frostbite or hypothermia while extreme heat can cause heat stroke and dehydration. Exposure also increases the likelihood of dying from other causes.
Infectious Diseases
Sheltered and non-sheltered homeless have higher rates of infectious diseases. Poor ventilation from close living quarters intensifies the spread of common illnesses. The homeless population also shows higher rates of deadly infections like HIV, bronchitis and tuberculosis.
Substance Abuse
Sometimes substance abuse leads to homelessness, and sometimes people turn to drugs or alcohol in response to the stress of being homeless. Drug related conditions and overdoses are a leading cause of death among the nation’s homeless.
lack of dental and optical care upper respiratory illnesses
hunger
accidental injuries
foot and skin prob-
“
The average age of death of homeless people is about 50 years —
05 | At Home on the Streets
Mental Health Much like health problems in general, poor mental health can be both a cause and result of homelessness. Individuals with a severe, untreated mental illness make up approximately one-third of the homeless population, according to a 2014 report from The Treatment Advocacy Center. Dealing with a mental illness can make it difficult for individuals to maintain relationships with family members who can offer support or to perform well at work and hold a job — both of which are factors in preventing homelessness. Those with severe longterm illnesses are especially vulnerable to becoming homeless, but even relatively healthy individuals can develop major depression and anxiety from the chronic stress of being homeless and living in extreme poverty.
Higher Rates of Conditions
Overlapping Problems
100%
Lack of Health Care
No Insurance
Homeless Non-homeless
Chronic Illness or Pain Poor Mental Health
Poverty
in a 2013 study of low-income patients in federally supported health centers
0 n
o er iti liv nd co
Exposure to disease or physical danger Addiction
21% overdose
h
t
t oo
ss
lo
s
es
n re ill ve al se ent m
e ol enc oh nd c al pe de
Leading Causes of Death Among NYC Homeless 2015*
18% heart disease
c ni tis ro hi ch onc br
11% accidents
6% alcohol
6%
homicide or suicide
abuse
* in the Tenth Annual Report on Homeless Deaths, New York City Department of Health and Mental Hygiene
Mortality People who are homeless are three to four times more likely to die in any given year than the general population. As an average, this statistic is true across age groups, although young women and middle-aged men are particularly at risk. Many homeless people experience early deaths from treatable conditions — like heart disease and cancer — or from problems related to their homelessness, such as addiction, assault or exposure to the elements.
the age at which Americans commonly died in 1900. - National Healthcare for the Homeless Council
”
At Home on the Streets | 06
women. Experiences
Domestic Violence
"It's not easy to be a woman on the streets, OK?" Susan says. "We tend to hide our features. In other words, we will wear more than one sweatshirt to look more like a man than a woman." When darkness falls, Susan pulls out her dark and bulky clothes. A slight Boston accent betrays her childhood origins, and it's particularly strong when she speaks of her children and grandchildren. But Susan says those relationships are complicated. Susan is what experts call a rough sleeper; it's a small and hard-core subset of the homeless population. Research suggests this group often struggles with mental health issues and substance abuse, but their defining feature is that they choose not to go into shelters. Susan sometimes stays in shelters but she doesn't like them. There is no place for her bags and she finds them rigid, with strict curfews and rules. She says she prefers the freedom of the outdoors, where "I can go and I can come." Story Courtesy of NPR
1.3 million women are victims of domestic abuse every year. Women who leave their abusive homes often have few resources and end up having to choose between a home or personal safety. Between 22-57% of homeless women consider domestic abuse a a direct cause of their homelessness.
By the Numbers 51 Days
the average stay of single women in emergency shelters
70 Days
the average stay of families in emergency shelters
Struggles
In order to avoid unneccessary attention, many women dress unobtrusively like men.
Many women lack access to important hygiene products such as tampons, pads, or bras, and find bathing a dangerous and vulnerable time.
Finding a place to sleep can be an arduous task that takes all day. Women have to find a place that is safe from the elements as well as human threats, both physical and sexual.
Approximately 1/4 of women experience domestic abuse in their lifetime.
Approximately 63% of homeless women experience domestic abuse in their lifetime.
not easy to be a woman “ It's on the streets, OK? ” Susan, domestic abuse survivor
Interact Raleigh interactofwake.org N.C. Coalition Against Domestic Violence Durham nccadv.org
Causes
Experiences
costs. Homeless individuals often have higher rates of hospitalizations, incarcerations and utilization of many other public agencies. This leads to immense costs for public agencies and taxpayers. However, there are solutions like supportive housing that could potentially reduce these costs and significantly reduce homelessness.
Homeless in Hospitals Homeless individuals are more likely to use the most costly health care services. They spend an average of 4 days longer per hospital visit. That’s $2,414 per hospitilization. After 18 months of housing and case management services, a group of chronically homeless individuals in Chicago experienced:
Common Costs Mental Health and Addiction Treatment Services
29%
Jail and Court Costs
fewer hospitalizations
12
25
Average monthly costs
fewer days in hospitals
29%
63
24%
Hospital Costs *Exact percentages have been rounded
fewer ER visits
We learned that you could either sustain people “ in homelessness for $35,000 to $150,000 a year, or
you could literally end their homelessness for $13,000 to $25,000 a year. -Philip Mangano
”
09 | At Home on the Streets
Supportive Housing Average Monthly Costs by Public Agencies for Persons in Supportive Housing vs. Homeless in LA County $2897
$3000
Where does the money go? Cost Studies and other evaluations of permanent supportive housing have demonstrated many improvements for homeless people in housing stability, reductions in days of homelessness, and reductions in the utilization and costs of public services such as emergency shelter, hospital emergency room and inpatient care, sobering centers, and jails.
$605
$0
Supportive Housing
Reduction in Utilization of Major Resources Before/After Supportive Housing in North Carolina Homeless
Before Supportive Housing
$41,542
$12,472
Per year, leaving a person chronically homeless costs taxpayers
$30,000 - $50,000
After Supportive Housing
resources. What do you do if you’re homeless? The homeless population has many needs that are not easily met. From food and housing to job placement and regression prevention, accessing all the pieces in the puzzle of reintegration is neither simple nor easy. For each step in the process, there are a number of resources available across the country and here in North Carolina. Here, we explore some of the different options available throughout the state. We also take a closer look at the available resources in the Chapel Hill area and describe some of the ways that anyone can give to these organizations.
What resources exist in NC? Food - The North Carolina Association of Feeding America Food Banks provides healthy food to populations in need - Salvation Army Hunger Relief serves more than 56 million meals to anyone in need through its many soup kitchens, sit-down meal programs, food pantries, mobile meals and community gardens
Short-term housing - Shelterlistings.org lists emergency and day shelters in over 80 cities in NC - Dialing 211 anywhere in NC contacts United Way NC, which helps find housing, food, healthcare, and more - The White Flag Initiative provides emergency overflow shelter to homeless people in the event of severe weather
Long-term housing - The North Carolina Housing Coalition advocates for low-income housing at local, state and federal levels - The Helen Wright Center for Women serves homeless women without families. The initial stay is two months but can be extended
life is hard and trying to find housing with “ Shelter an eviction and limited income is nearly impossible. When I found myself in this situation I didn’t know where life would go, but it did get better. People need to know it can be done.
”
- Donna Carrington, Durham County Community Empowerment Fund 11 | At Home on the Streets
Chapel Hill - The Community Empowerment Fund provides assistance for individuals transitioning out of homelessness through financial counseling, goal setting and other free services - Inter-Faith Council for Social Service provides shelter, food, direct services, advocacy and information to people in need - Freedom House Chapel Hill provides transitional housing and offers a continuum of services, which are tailored to meet the needs of individual clients. Our twelve-step based program draws on the best recovery models from all disciplines.
Regression prevention - Goodwill Community Foundation provides facilities for employment, education and life enrichment opportunities - Dress for Success Triangle NC empowers women to achieve economic independence by providing a network of support, professional attire and development tools - Triangle Literacy Council teaches adults better reading and writing skills with ESL programs, tutor training, and juvenile literacy programs
Education and employment - Triangle Family Resources offers counseling services in debt management and teaches a range of financial literacy seminars - Child Care Referral Central helps families find care for children 0-12 by providing customized referral to programs that meet the family’s needs - LawHelpNC provides assistance with legal issues such as child custody, bankruptcy and benefits
Substance abuse and rehabilitation - The Caldwell House facilitates the recovery of alcoholics and addicts and helps them re-enter society - North Carolina Halfway Houses provide listings of halfway houses and sober living facilites throughout NC, many of which are low income and sliding scale
At Home on the Streets | 12
THE TEAM ART DIRECTOR
ASSISTANT ART DIRECTOR
Michael McGowan
Nikki Murdoch
DESIGNERS
MOTION GRAPHICS
MaryRachel Bulkeley Rachel Garzarelli Tanner Brice Jessica Zhang Madison Stevens Hans Harlacher Hanna Davison Paige Ehlers Maddy Sweitzer Lindsay Thompson Elizabeth Schlemmer
Lauren Song Justin Wynn
SPECIAL THANKS Terence Oliver Stephanie Brown Erin Black Michelle Lotker Donna Carrington
SOURCES Colorado Coalition National Institute of Justice Family and Youth Services Bureau GreenDoors National Law Center on Homelessness and Poverty National Coalition for the Homeless National Network to End Domestic Violence The American Congress of Obstetricians and Gynecologists NPR NYT Huffingtonpost Aljazeera America StandUp for Kids National Child Traumatic Stress Network Covenant House Joint Center for Housing Studies of Harvard University The U.S. Department of Housing and Urban Development Orange County Community Empowerment Fund National Health Care for the Homeless Council Premature Mortality in Homeless Populations
Treatment Advocacy Center National Alliance to End Homelessness United States Interagency Council on Homelessness University of Pennsylvania Scholarly Commons Politifact.com The New England Journal of Medicine Thinkprogress.org Economic Roundtable: Where We Sleep United Way Homelessness Resource Guide NC Housing Coalition NC Association of Feeding America Food Banks The Salvation Army Inter-Faith Council for Social Service ShelterListings.org The Caldwell House HalfwayHouses.us GFC Global Dress For Success Triangle NC UNC Carolina Population Center