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Homelessness in Portland

Homelessness is a significant issue that affects the general population as well as the healthcare system. In the United States, homelessness affects the major cities in all the states, and a solution has to found. Portland is one of the cities affected by homelessness, and this has an impact in the health of the individuals affected.

According to the National Alliance to End, Homeless homelessness in the United States is caused by a lack of housing, lack of income, health issues, domestic violence, and racial inequality. Housing relates to the affordability of houses and the most impoverished in the United States cannot afford to house. Affordable housing existed in the 1970s, but this was affected in 1980s when the supply of low-cost housing decrease. Rent continued to rise, and the lower income individuals have either stagnant or low wage growth. Currently, eight million low-income families pay at least half of their income to the house, which puts them at risk of homelessness and housing instability. Homelessness solutions include the provision of housing that is affordable and dealing with other issues like employment, health and substance abuse. Permanent supportive housing is a long-term solution to families or individuals with chronic diseases, mental health, and disabilities. Rapid re-housing provides short-term solutions by assisting individuals to get housing quickly, become self-sufficient and remain housed. Federal housing assistance includes the “Voucher Program” that provides vouchers to low-income families to assist pay housing in the private market. Public housing is another solution from the Federal Government in providing subsidized rates to low-income families, disabled and the elderly.

Income is vital in the acquiring of houses. Low-income individuals are at the highest risk of being homeless. Low-income individuals are usually underemployed or unemployed. Underemployment is caused by challenges such as limited education, challenging labor market, work history gaps, criminal record, disability, poor health, unstable housing or unreliable transportation. Employed with low-income is caused by stagnant wages that are not increasing with the costs of housing. The low income and the decrease in low-cost housing put many people at risk of being unemployed. Solutions exist in placement and job training programs that are provided by the Federal Government can provide more skills to individuals who are searching for stable and long-term employment. Increasing access to supportive services such as transportation assistance and child care subsidies can play a major role in assisting individuals to be employed and remain housed through housing stability. Disability is another factor that affects the ability of an individual to earn a living, and they can be assisted through cash assistance from programs that provide such assistance depending aon eligibility.

Youth, families and single adults who are homeless usually experience domestic violence. Survivors of domestic violence search for a haven in homeless services. Some may use homeless services because they cannot afford their places after leaving an abusive relationship. Solutions to survivors of domestic violence involve the provision of safety. Some survivors can be able to stay in their homes with additional financial support while others can be provided with emergency shelter before getting an independent house. Long- or Short-term rental assistance is used to assist survivors in exit shelters and regain housing. Victims of domestic violence not only need housing needs, but they also need supportive services the help them from the trauma that is experienced and improves their well-being as well as economic security.

According to the homeless population is heterogeneous. Minority groups are more likely to experience homelessness at higher rates than whites which makes up an unequal share of the homeless individuals. Minority groups include African Americans, Alaska/Indian Natives and Native Hawaiians and Pacific Islanders. The African American are overrepresented in the homeless system because of slavery which systematically denied equal opportunities and rights. This brought discrimination and disparities in criminal justice, poverty, healthcare, and housing. African American homes are more likely to experience poverty that white individuals. Incarceration is higher in blacks due to the high rates of incarceration in the community. The relationship between the criminal justice system and securing housing and employment leads to ex-convicts having challenges in acquiring affordable housing, which can result in homelessness.

According to 2017 Point-in-Time Estimates of Homelessness in Oregon Data includes a homeless population that does not has shelter and live in transitional or emergency shelters. The data can have fewer figures because of three factors which are that many people are unable to fill the survey questions, the data is collected in the winter time when many people are looking for shelter and could miss in the counting, and finally the transient nature of homeless people makes it difficult to count them. Populations that are included in this data are from the Multnomah that includes the Portland Metro surroundings.

A total number of individuals who are homeless was 4,177 in any given night in 2017. Sixteen % of people who are considered homeless are part of households that have children of whom 88% are living in a shelter while the rest are not. The male population of the homeless constitute 62%, 37% are female, and 1%is identified as transgender. When the data is classified according to race, the white make up most of the homeless population at 69%. African Americans are second at 14 percent then Native Indian at 5 percent and finally the rest of the other races at 9 percent. Unaccompanied adults or youth under the age of eighteen years make up 0.4 percent of the homeless. Out of the total population, 57 percent are unsheltered, and the rest are sheltered. Veterans make up 11 percent of the homeless with 12 percent being female and 86 percent are male.

Growth of the homeless is been experienced from 3,801 to 4,177 individuals from 2015 to 2017. Despite the increase in two years, the data highlights that most of the population are staying in shelters and not in the streets. In 2015 the number of homeless people that were sheltered and unsheltered was almost equal at 1,914 and 1,887. However, in the year 2017, the number of individuals in shelters stands at 31 percent at 2,509 people and the number of people who are unsheltered decreased to 1,668. The report states that a community’s commitment to prevention of homelessness, housing placement and emergency shelters are the major reasons behind the decrease in the unsheltered individuals. There is a contrast in the data compared to other cities with social service disparities and similar housing trends. Although there is a positive change in the homeless situation in Portland, many efforts need to be done to assist the hardships the homeless undergo.

Health can cause homelessness through behavioral or physical health predicament or long-term disabling conditions. A homeless individual can also aggravate a chronic medical illness. A person can become homeless if a chronic illness or health condition leaves him or her disabled and a stable house is difficult to maintain without help. According to the United States Department of Housing and Urban Development individuals living in shelters are twice at risk of developing disability compared to the general population. In 2017, in a given night, more than ten thousand individuals had HIV/AIDS, and 20 percent reported having a chronic mental illness, and 16 percent had conditions associated with heavy substance abuse. Homeless people have conditions such as heart disease, HIV/AIDS and diabetes at higher rates than individuals in the general population do. Individuals who have drug use and mental health conditions and are homeless are at higher risk of having an immediate fatal physical illness and live in dangerous conditions. More than 10 percent of individuals who seek mental health or substance abuse treatment in public health hospitals are homeless. Substance abuse is known as a common habit by the homeless people making them a risk factor to the vice. Opioid abuse has increased in the United States becoming a crisis as the abuse of prescription drugs has risen together with heroin. Opioid overdose deaths have also tripled since the year 2000. People who are considered homeless have challenges accessing healthcare because they do not have insurance or are having difficulty in engaging with healthcare providers in the community. The establishment of the Affordable Care Act has given low-income homes an option through the expansion of Medicaid programs.

According to Stafford and Wood (2017), housing is a basic human requirement and a major determinant of health. In the same report, social policy and medical care decision making in homeless individuals is burdening the healthcare system and leads to dealing with the immediate health needs due to constraints in resources. Interventions that are evidence-based such as House First, social care for homeless patients and integrated medical will not only improve the health of the people but also help in reduction of cost on the public service. Putting an end to homelessness requires an aggressive response to the issue and intervention on the social factors leading to it. Tackling the fundamental issues such as violence, trauma, poverty education limitations, and discrimination is vital.


Stafford, A., & Wood, L. (2017). Tackling Health Disparities for People Who Are Homeless? Start with Social Determinants. International journal of environmental research and public health, 14(12), 1535. doi:10.3390/ijerph14121535

National Alliance to End Homelessness. (2019). What causes homelessness? https://endhomelessness.org/homelessness-in-america/what-causes-homelessness/

2017 Point-in-Time Estimates of Homelessness in Oregon. Oregon Housing and Community Services. Retrieved from https://www.oregon.gov/ohcs/ISD/RA/2017-Point-in-Time-Estimates-Homelessness-Oregon.pdf

Michael Rowe Feed Michael Rowe, Charles Barber Feed Charles Barber, Yale University, & Wesleyan University. (2018, June 13). Homeless People Need More Than a House. They Need a Community. Retrieved from https://www.citylab.com/solutions/2018/06/the-power-of-giving-the-homeless-a-place-to-belong/562595/

Portland Homeless Family Solutions. (n.d.). Retrieved from http://www.pdxhfs.org/

Homelessness in America. (n.d.). Retrieved from https://endhomelessness.org/homelessness-in-america/

Institute of Medicine (US) Committee on Health Care for Homeless People. (1988, January 01). Health Problems of Homeless People. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK218236/

Why Are People Homeless? (n.d.). Retrieved from https://www.nationalhomeless.org/factsheets/why.html

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