On this page we will explore two broad areas of neighborhood and housing problems: 1) Residential segregation and the housing industry and 2) housing insecurity and houselessness. We provide a contemporary perspective on housing problems including on racial discrimination and gentrification. We then discuss research findings on housing instability and houselessness, as well as tie them to the housing affordability crisis. Finally, we discuss consequences of these problems, including the racial wealth gap, health and well-being outcomes, and educational inequalities.
Residential Segregation and the Housing Industry
Although federal law now prohibits segregated housing, neighborhoods across the country are nonetheless highly segregated by race, which we named in the Overview page as racial residential segregation. Black individuals and families in particular are highly segregated by residence in many cities, much more so than is true for other people of color. This residential segregation is so extensive that it has been termed hypersegregation.
In a widely cited book, sociologists Douglas S. Massey and Nancy A. Denton (1993) termed this situation “American apartheid.” They said that these segregated neighborhoods result from a combination of several factors, including (a) “white flight” into suburbs, (b) informal – and often illegal – racially discriminatory actions that make it difficult for African Americans to move into white neighborhoods (such as real estate agents falsely telling black couples that no houses are available in a particular neighborhood), and (c) a general lack of income and other resources that makes it very difficult for African Americans to move from segregated neighborhoods.
Recall our discussion on a historical perspective on residential segregation and housing discrimination in the US from the Overview page. We will now discuss how discriminatory housing practices continue even today.
Contemporary Perspective
When loan officers review mortgage applications, they consider many factors, including the person’s income, employment, and credit history. The law forbids them to consider race and ethnicity. Yet Black and Latinx applicants are more likely than whites to have their mortgage applications declined (Blank, Venkatachalam, McNeil, & Green, 2005). Because members of these groups tend to be poorer than whites and to have less desirable employment and credit histories, the higher rate of mortgage rejections may be appropriate, albeit unfortunate.
To control for this possibility, researchers take these factors into account and in effect compare applicants who are Black, Latinx, and white with similar incomes, employment, and credit histories. Some studies are purely statistical, and some involve individuals who independently visit the same mortgage-lending institutions. Both types of studies find that Black and Latinx applicants are still more likely than whites with similar qualifications to have their mortgage applications rejected (Turner et al. 2002). We will probably never know whether loan officers are consciously basing their decisions on racial prejudice, but their practices still amount to racial and ethnic discrimination whether the loan officers are consciously prejudiced or not.
There is also evidence of banks rejecting mortgage applications for people who wish to live in certain urban, supposedly high-risk neighborhoods, and of insurance companies denying homeowner’s insurance or else charging higher rates for homes in these same neighborhoods. Practices like these that discriminate against people buying houses in certain neighborhoods are considered redlining, and they violate the law (Ezeala-Harrison, Glover, & Shaw-Jackson, 2008).
Banks have rejected mortgage applications from people who wish to live in certain urban, high-risk neighborhoods. This practice, called redlining, violates the law. Because many of the loan applicants who experience redlining are people of color, redlining is an example of institutional discrimination.
Taber Andrew Bain, http://www.flickr.com/photos/88442983@N00/2943913721
In addition to mortgage rejections, a pattern of subtle discrimination today by realtors and homeowners makes it difficult for African Americans to find out about homes in white neighborhoods and to buy them (Pager, 2008). For example, realtors may tell Black clients that no homes are available in a particular white neighborhood, but then inform white clients of available homes. The now routine posting of housing listings on the Internet might be reducing this form of housing discrimination, but not all homes and apartments are posted, and some are simply sold by word of mouth to avoid certain people learning about them.
Today, despite repeated efforts by city officials to create more mixed-race and mixed-income neighborhoods, many neighborhoods remain demographically segregated. In cities across the US, the available inventory of affordable housing has been reduced by redevelopment and gentrification – the process by which investors, corporations, and affluent (often white) individuals move into neighborhoods that are historically low-income (and of color), displacing the people who live there as rents, taxes, and costs of local goods and services increase. City planning projects have continued to benefit white homeowners while communities of color have been burdened, displaced, excluded, and disproportionately vulnerable to housing insecurity.
Racism in the housing industry is systemic and institutional. Please take some time to examine the chart below. It shows how Racist Policies, Racist Inequalities, and Racist Ideas reinforce each other over time. Starting with the first box, we see that slavery was legal until 1863. Racist laws and policies created the institution of slavery. The impact and consequences of those laws, or racist inequalities, result in millions of people being enslaved. Racist ideas rationalize or normalize the practice of slavery by asserting the false idea that Black people are less than human – that they are immoral, lazy, and stupid.
This chart illustrates Ibram X Kendi’s definition of racism as “…a marriage of racist policies and racist ideas that produce and sustain racial inequities” (2016). Notice the connections between racist policies in housing, racial inequities, and racist ideas. We can say that the entire system is racist because each component reinforces the other and leads to even more racial inequity.
“Racist Policies, Racist Inequities, and Racist Ideas in Housing” by Nora Karena, Michelle Osborne, and Toni Belcher is licensed under CC BY 4.0
These false ideas about the character and capabilities of Black people caused both de-facto segregation in the North and legalized segregation in the South. Jim Crow laws in the South and segregated housing policies in the North kept neighborhoods separate. Consequently, Black people lived in poorer neighborhoods, and even when they owned homes, their property was worth less. This reinforced beliefs about inequality – that if Black people moved into your neighborhood, the neighborhood would decline.
Over time, these false beliefs solidified into policies such as redlining, restrictive housing covenants, and other laws that further restricted Black people’s access to home ownership, which has had serious consequences. For instance, the lack of homeownership reduced Black families’ possibilities of creating generational wealth. Additionally, because there were “right” and “wrong” places for Black people to be, police surveilled Black people who were out of place – walking or driving while Black. They, and other white people often assumed that Black people were criminals if they were outside their own neighborhoods, another racist idea.
These mistaken ideas drove policies and practices around racial profiling and increased policing. Black people are arrested more often, not because they commit more crimes but because they are surveilled more. This cycle creates disproportionate housing instability for Black people and exacerbates other social problems. We return to consequences of discriminatory housing practices below.
Applying Social Research
The Poor Neighborhoods of Middle-Class Black Children
In a society that values equal opportunity for all, scholars have discovered a troubling trend: Black children from middle-class families are much more likely than white children from middle-class families to move down the socioeconomic ladder by the time they become adults. In fact, almost half of all Black children born during the 1950s and 1960s to middle-class parents ended up with lower incomes than their parents by adulthood. Because these children had parents who had evidently succeeded despite all the obstacles facing them in a society filled with racial inequality, we have to assume they were raised with the values, skills, and aspirations necessary to stay in the middle class and even to rise beyond it. What, then, explains why some end up doing worse than their parents?
According to a study by sociologist Patrick Sharkey (2009) for the Pew Charitable Trusts, one important answer lies in the neighborhoods in which these children are raised. Because of continuing racial segregation, many middle-class Black families find themselves having to live in poor urban neighborhoods. About half of Black children born between 1955 and 1970 to middle-class parents grew up in poor neighborhoods, but hardly any middle-class white children grew up in such neighborhoods. In Sharkey’s statistical analysis, neighborhood poverty was a much more important factor than variables such as parents’ education and marital status in explaining the huge racial difference in the eventual socioeconomic status of middle-class children. An additional finding of the study underscored the importance of neighborhood poverty for adult socioeconomic status: Black children raised in poor neighborhoods in which the poverty rate declined significantly ended up with higher incomes as adults than those raised in neighborhoods where the poverty rate did not change.
Why do poor neighborhoods have this effect? It is difficult to pinpoint the exact causes, but several probable reasons come to mind. In these neighborhoods, middle-class Black children often receive inadequate schooling at run-down schools, and they come under the influence of youths who care much less about schooling and who get into various kinds of trouble. The various problems associated with living in poor neighborhoods also likely cause a good deal of stress, which, as discussed elsewhere in this chapter, can cause health problems and impair learning ability.
Even if the exact reasons remain unclear, this study showed that poor neighborhoods make a huge difference. As a Pew official summarized the study, “We’ve known that neighborhood matters…but this does it in a new and powerful way. Neighborhoods become a significant drag not just on the poor, but on those who would otherwise be stable.” Sharkey added, “What surprises me is how dramatic the racial differences are in terms of the environments in which children are raised. There’s this perception that after the civil rights period, families have been more able to seek out any neighborhood they choose, and that…the racial gap in neighborhoods would whittle away over time, and that hasn’t happened.”
Data from the 2010 Census confirm that the racial gap in neighborhoods persists. A study by sociologist John R. Logan (2011) for the Russell Sage Foundation found that Black and Latino families with incomes above $75,000 are more likely to live in poor neighborhoods than non-Latino white families with incomes below $40,000. More generally, Logan concluded, “The average affluent Black or Hispanic household lives in a poorer neighborhood than the average lower-income white household.”
One implication of this neighborhood research is clear: It is important to do everything possible to improve the quality and economy of the poor neighborhoods in which many Black children, middle-class or poor, grow up.
Housing Insecurity and Houselessness
In cities throughout the United States, adults and children live in the streets, abandoned vehicles or houses, cheap motels, or in someone else’s home temporarily. All of these situations – not just living on the streets – are examples of houselessness, the condition of not having a place to live. In cities with extremely cold or hot climates, houselessness can be life-threatening during the winter or summer months. But regardless of climate, those experiencing houselessness face other concerns. For instance, research finds that one-third of the houseless are victims of violence or theft during the year, a rate of victimization four times higher than the general population (Wenzel, Leake, & Gelberg, 2001).
Homelessness is a major problem in many cities. The federal government estimates that 650,000 Americans are homeless on any given night.
© Thinkstock
As should be clear, the problem of houselessness cannot be understood solely from the problem of poverty; however, there are important social class differences. Wealthy families that lose their homes, such as after a fire, usually can expect to find suitable temporary lodging and have their homeowners’ insurance pay for a new home (Lee, Tyler, & Wright, 2010). In contrast, poor families who can no longer pay their rent or mortgage payments face eviction and houselessness from which they find it difficult to recover.
It is rather challenging to determine the actual number of houseless persons. For example, if a family is living in the streets, we would all agree they are houseless. But if they are sleeping on a friend's couch or in a cheap motel, should they be considered 'homeless?' Keeping these measurement problems in mind, on one single night, there were more than half million (653,104) people experiencing houselessness, and the number of people experiencing houselessness exceeds the number of available shelter beds – with over 200,000 fewer beds than needed (Soucy, Janes, & Hall 2024).
The chart below uses data from HUD's point-in-time survey, when they estimate the houseless population at one point in time. We see that levels were relatively stable for many years, then began to increase after the COVID-19 pandemic. (They were unable to collect data during pandemic years.) Houselessness reached a 'record-high' of 771,480 people at the time of the count, which was an 18% increase over one year and a 33% increase from four years prior (Joint Center for Housing Studies of Harvard University 2025: 40).
This chart illustrates that, with some variation, rates of homelessness were relatively stable from 2007 to 2020, but have been increasing since 2022.
Source: Joint Center for Housing Studies of Harvard University 2025
Because people move in and out of houselessness, the number of people who experience it at least part of the year is undoubtedly much higher. National survey evidence suggests that 14% of Americans have been houseless at least once in their lives, a figure much higher than that in most European nations (Lee et al. 2010).
The video below tells part of the story of houselessness in one specific area of the nation: Portland, Oregon. Please take the time to watch the first 6 minutes of this 11 minute video that tells this story. As you watch, consider who is speaking and whose voices are not heard. These stories are powerful but insufficient. Who else may be houseless?
On the night of January 26th, 2022, when the temperature dipped down into the 20s, at least 14,655 unhoused people were counted in Oregon. In Multnomah, Washington, and Clackamas Counties, 6,633 people were unhoused, an increase of more than 25 percent since the last count in 2019 in Multnomah County alone (Hasenstab 2022). Of those counted, 3,525 met the HUD definition of unsheltered, while 3,108 spent that cold winter night in temporary shelter or transitional housing. More than 60% of the unhoused people that night met the definition of chronically homeless, having a disabling condition, and having been unhoused for at least 12 months (Multnomah County 2022). The annual point-in-time count of unhoused people does not consider people who were temporarily doubled-up with friends and family unhoused, even though they also lack a permanent residence.
Encampments of unhoused people, sometimes called tent cities, have become a common, often unwelcome fixture in Portland. You can read about Dignity Village in Portland, Oregon, an encampment community that is self-organized and offers some security. Because many encampments are not officially legal, people living in them lack stability and live under the threat of being “swept” or evicted. In 2017, 255 encampments were reported across the US, ranging in size from 10 to over 100 people living in them, but that number does not include many more illegal encampments. Encampments are a response to the fact that shelters constantly operate at maximum capacity, and communities do not have enough affordable housing (Tent Cities in America 2022).
Sidewalk tent camps in Northeast Portland, Oregon, United States. Do all people who are houseless live like this?
“Northeast Portland homeless camp tents” by Graywalls is licensed under CC BY-SA 4.0
Shelters provide needed temporary immediate service to over 1.5 million Americans each year. Shelters provide some relief against crime, hunger, and the many other problems arising from houselessness, but too few shelters exist to meet the demand, and those that do exist are underfunded. Many nonprofit organizations also provide additional supportive services and housing assistance for families and individuals. Day shelters, such as Rose Haven in Portland, Oregon, also offer support and food to unhoused people. Some churches allow people to car-camp and/or erect tents on the church property and have provided hygiene centers that include showers, hand-washing, laundry, and food services.
Tensions exist between tent dwellers, staff, and users of shelters, and the business and home-owning communities since being unhoused is messy, and people who are unhoused are vulnerable to crime and abuse. In Corvallis, Oregon, the community has struggled for years to find a permanent location for the men’s overnight cold-weather shelter. Advocates for people who are unhoused argue for a location close to needed city services; accessibility is important when walking, bicycling, and public transportation are the primary modes of getting around.
A larger share of Americans are housing insecure, meaning that they face an array of challenges related to housing. To measure this, one study used a residual-income approach, which estimates whether households have enough money left after paying rent and utilities to afford a decent standard of living, and found that 19.2 million (62.1%) were cost burdened. However we measure it, the cost burden puts people at risk for being homeless (National Low Income Housing Coalition 2022).
College students are another group of people who are often housing insecure. You watched a video of their stories earlier in this chapter. In addition to qualitative stories, we have quantitative data about how many college students experience housing instability, as shown in the figure below.
Food Insecurity and Housing insecurity at Two-year and Four-year Colleges
Students in community colleges often experience more food and housing insecurity than students in four-year colleges. Do you think that this is causation or correlation?
“Food Insecurity and Housing Insecurity at Two-year and Four-year Colleges” by the Hope Center is included under fair use
A recent national survey, the 2019 #RealCollege Survey, found that students at two-year institutions had higher levels of food insecurity and housing insecurity or houselessness than students at four-year colleges. This report indicates that more than half of community college students are struggling with stress related to having a safe, stable place to care for themselves and their families.
The College and University Basic Needs Insecurity Report found that being a woman, transgender, Native American, Black, Latinx, and 21 or older increased your chances of being housing insecure or homeless. Although men, people who are white, young (18–20), and athletes were less likely to experience houselessness or housing insecurity, they still did so in double-digit percentages (Goldrick-Rab et al. 2019).
Using our Oregon example, the median individual and household income in 2020 was $35,393 and $65,677, respectively. Average rents also increased significantly (US Census 2020). More than 35 percent of Portland renters surveyed reported being behind on rent, and more than 56,000 households in the Portland region are considered housing insecure (Bates 2020).
Rural communities have unique housing pressures, especially in resort areas where housing stock tends to be inadequate. One rural area is Lincoln County, Oregon, where wages are generally lower than most of the rest of the state. The average income of a Lincoln County resident is $25,130 a year (BestPlaces 2020). If we calculated that a person could only use 30 percent of their income for housing to remain stable, their rent could be $7,539 per year or $628.25 per month.
The fair market rent for a one-bedroom apartment in Lincoln County is $877 (RentData.org 2022). At fair market value, the renter would be paying about 42 percent of their income. When you add that less than one percent of all homes in Lincoln City, Oregon, are vacant and available to rent (Bestplaces 2020), you begin to see the fragility of our housing system. Even when work is plentiful, houselessness is only a step away. One job loss, one major illness, or commonly, one landlord who chooses to sell their property rather than continue to rent, and houselessness occurs.
One driver of housing insecurity is the housing affordability crisis. Adequate housing is not affordable for many individuals and families across the nation, as housing prices can be very high, plus residents’ incomes can be quite low. For every 100 extremely low-income renters, there are just 31 affordable units (National Coalition for the Homeless 2020). Cities in particular have a great need for adequate, affordable housing. Recall that housing is considered affordable when a household pays no more than 30% of its annual income on housing. In the US, 21 million renter households are cost-burdened (Census 2024c).
Housing and Social Location
Housing problems vary by social location such as social class, race, and gender. Additionally, correlations between social location and housing stability reveal some ways that social class mobility can be limited by race, gender, and age. Here we will provide some examples of this variation.
Social class. As you might expect, communities with high poverty rates tend to have high rates of unhoused people. Housing stability is a prerequisite for class mobility (Ramakrishnan et al. 2021). Homeownership is a milestone for upward social mobility, so long as the homeowner is not cost burdened. Housing is generally a household’s largest expense whether we rent or own. For people who own, though, their house payments become an investment, possibly generating more wealth over time. Those who rent do not see any investment return on their monthly payments.
Race/Ethnicity. In 2022, the nationwide Point-in-Time Homeless Count identified 421,392 people who were unhoused. Of these people, 230,839 were white. White people make up the majority of houseless people by raw numbers. However, Black people represent 13% of the total US population, representing over 30% of the unhoused population. This comparison indicates disproportionality, which is the overrepresentation or underrepresentation of a racial/ethnic group compared with its percentage in the total population (Child Welfare Information Gateway 2021). Black people are disproportionately houseless. Native American and Native Alaskan, and certain groups of people who are Native Hawaiian or Pacific Islanders also experience disproportionate rates of houselessness and housing insecurity.
National Point In Time Homeless Count By Race and Ethnicity, 2022
| Race/Ethnicity |
Total Number |
Percent |
| Race |
|
|
| American Indian, Alaska Native, or Indigenous |
15,491 |
3.7% |
| Asian or Asian American |
6,559 |
1.6% |
| Black, African American, or African |
137,638 |
32.7% |
| Native Hawaiian or Pacific Islander |
6,429 |
1.5% |
| White |
230,839 |
54.8% |
| Multiple Races |
24,458 |
5.8% |
| Ethnicity |
|
|
| Non-Hispanic/Non-Latin(a/o/x) |
328,799 |
78.0% |
| Hispanic/Latin(a/o/x) |
92,581 |
22.0% |
Most homeless people are white, but people of color are often disproportionately represented. What does this mean?
“National Point In Time Homeless Count By Race and Ethnicity” from “The 2022 Annual Homelessness Assessment Report (AHAR) to Congress” by the US Department of Housing and Human Development is in the Public Domain
The story for Latinx people is a bit different. Black and Hispanic people in the United States share similar risk factors for houselessness. However, Hispanic people experience lower rates of houselessness (Conroy and Heer 2003). Some researchers argue that Hispanic people have strong social networks – ie, they can live with family. However, when Conroy and Heer tested this theory in Los Angeles, they found that houselessness for Latinx people was undercounted because they were more likely to live in abandoned buildings rather than using shelters or churches where they might be counted. In more recent research in LA County, Chinchilla finds this to be true. She also adds that Latinos were less likely to engage in housing services. They were also more likely to live in overcrowded households (Chinchilla 2019).
This picture is changing over time. Nationwide, the 2022 Point-In-Time count shows that rates of houselessness for Hispanic/Latino people have increased by 7.6 percent. The causes of this increase are complex. However, part of this increase may be due to the impacts of COVID-19. Because Hispanic/Latino people are more likely to be seasonal or temporary workers, they have less access to COVID-19 relief funds. Therefore, they were more likely to be evicted (Chinchilla, Moses, and Visotzky 2023).
Whenever a social problem impacts members of a specific race at a higher rate than the general population, we can say that racial inequity exists. Ibram X. Kendi asserts that any policies that result in racial inequity and ideas that justify or excuse racial inequity are racist.
Gender, Sexuality, and Age. Seventy percent of people who are unhoused identify as men (National Alliance to End Homelessness 2021). Most of these men are in their 50’s and 60’s. They meet the definition of chronically homeless. In 2021, in Los Angeles County, California, 83% of the 1800 unhoused people who died were men. Most of those deaths were classified as preventable (Dolak 2022).
Women have lower rates of houselessness overall but are more likely to face housing insecurity. They are more likely than men to be unemployed and renters. This increases their risk of becoming severely cost burdened by housing (Zillow 2020). Additionally, most unhoused single parents are women.
A 2022 survey found that 30% of transgender people experienced houselessness during their lifetime (James et al. 2024), and a 2021 survey found that 28% of LGBTQ+ youth experienced homelessness or housing instability during their lifetime (The Trevor Project 2022). Socially constructed ideas of 'normal' or 'acceptable' identities hinder many people from accessing shelter, housing, and many other services. Specifically, in the case of shelters, transgender women may be refused admittance by the women’s shelter and are at risk of violence at the men’s shelter (National Center for Transgender Equality 2019).
People in families with children make up 30% of the homeless population, and unaccompanied youth (under age 25) account for another 30% of unhoused people. Youth experiencing houselessness are at a higher risk of an array of adverse health and educational outcomes than those who are housed, as described below.
Consequences of Neighborhood and Housing Problems
Massey and Denton (1993) argue that residential segregation worsens the general circumstances in which many urban African Americans live. Several reasons account for this effect. As whites flee to the suburbs, the people left behind are much poorer. The tax base of cities suffers accordingly, and along with it the quality of city schools, human services, and other social functions. All these problems help keep the crime rate high and perhaps even raise it further. Because segregated neighborhoods may be poor and crime ridden, businesses do not want to invest in them, and employment opportunities are meager. This fact worsens conditions in segregated neighborhoods even further. Consequently, concluded Massey and Denton, racial segregation helps to keep very poor people living in deep poverty and decaying neighborhoods.
Other research supports this conclusion. As a review of the research evidence summarized this situation, “Whether voluntary or involuntary, living in racially segregated neighborhoods has serious implications for the present and future mobility opportunities of those who are excluded from desirable areas. Where we live affects our proximity to good job opportunities, educational quality, and safety from crime (both as victim and as perpetrator), as well as the quality of our social networks” (Charles, 2003, pp. 167–168).
The hypersegregation experienced by Black residents cuts them off from the larger society, as many rarely leave their immediate neighborhoods, and results in concentrated poverty, where joblessness, crime, and other problems reign. For several reasons, then, residential segregation is thought to play a major role in the seriousness and persistence of Black poverty (Rothstein, 2012; Stoll, 2008).
We will now examine a few other consequences of residential segregation, housing discrimination, housing insecurity, and houselessness.
The Racial Wealth Gap
Homeownership is responsible for most wealth growth among the middle-class. Due to redlining, GI Bill exclusions, and decades of racial discrimination in the housing industry, many Black families and other families of color have experienced blocked opportunities to grow wealth in order to pass it down through the generations of their families. This is one cause of the current racial wealth gap, the discrepancy in wealth between white and Black families or Latinx families. White families have recently had up to 10 times more in wealth than these families of color (Sullivan, Hays, & Bennett 2024).
In the fourth quarter of 2024, white families had about 1.5 million in wealth on average whereas Black families had just over $350,000 and Latinx families had less than $300,000 (Kent 2025). The chart below illustrates this large gap.
This chart displays the racial wealth gap. How is this a consequence of neighborhood and housing problems?
Source: Kent 2025
Wealth growth has been faster in recent years for white families than others, though is has been growing for all groups. For instance, with an end point of late 2024, "white household average wealth grew 68%, from $918,000 to about $1.5 million, since the end of the Great Recession; Black household average wealth grew 53%, from $231,000 to $352,000; and Hispanic household average wealth grew 63%, from $175,000 to $285,000" (Kent 2025).
A large racial gap also exists in regard to having no net worth or having negative net worth, that is, having your debt exceed your assets. The Census reports that in 2021, just under 1 in 4 households with a Black householder had zero or negative wealth, compared to 1 in 12 households with a white householder (Sullivan, Hays, & Bennett 2024). The chart below displays the distribution of household worth among Black and white households, with the top bar representing having zero or negative net worth.
This chart helps visualize the racial wealth gap, showing that white households are far more likely to have over 1 million in net worth while Black households are far more likely to have zero or negative net worth. What do you think that we can do to help close the racial wealth gap?
Source: Sullivan, Hays, & Bennett 2024
Health and Well-being
As discussed in the prior chapter, poverty is associated with a variety of adverse health and well-being outcomes. The experience of housing insecurity or being unhoused has similar outcomes. For instance, research has found that experiencing houselessness is associated with a higher risk of physical and mental health problems and other difficulties. In particular, the unhoused are much more likely than the housed to experience hunger and food insecurity, and they are up to twenty times more likely to suffer from chronic illnesses such as hepatitis, high blood pressure, tuberculosis, and vascular disease. On average, houseless adults die by their midfifties, about twenty years shorter than the average life span of housed adults (Lee et al. 2010).
The long-term impacts for youth who are unhoused include significantly higher rates of emotional, behavioral, and immediate and long-term health problems, along with increased risks for substance use and suicide. Four out of five children experiencing houselessness have been exposed to at least one serious violent event by age 12 (Substance Abuse and Mental Health Administration 2022).
Children and adults experiencing houselessness may face other consequences related to well-being, such as a higher risk of contracting diseases or experiencing violence. The US Conference of Mayors (2011) compiled information on houselessness in twenty-nine cities across the country, and found that over a quarter (26%) had a severe mental illness, 13% were survivors of domestic violence, and 4% were HIV positive.
LGBTQ+ unhoused individuals may be a greater risk as they have higher rates of mental health problems overall due to social factors such as stigma and family rejection, which can be exacerbated by the experience houselessness or housing insecurity. One study found that LGBTQ+ youth who experienced houselessness or housing instability have higher rates of mental health challenges then stably-housed LGBTQ+ youth. Housing insecure LGBTQ+ youth also had higher rates of victimization, being in foster care, and food insecurity (The Trevor Project 2022).
In addition to housing insecurity, residential segregation also impacts health outcomes. Neighborhoods of color are more likely than white neighborhoods to be resource deserts, areas lacking critical amenities. There are several types of resource deserts including for health care, transportation, or green spaces; however, one that strongly impacts health is food deserts, areas that lack access to nutritious affordable food. If there is no large grocery store nearby, which offers access to healthy and low-cost produce, neighborhood residents sometimes must resort to purchasing food at the 'corner store' or fast food shops, which offer foods high in fat, sodium, and sugar. Eating those foods then worsens health outcomes. Living in a food desert can even shorten one's life span (Massey et al. 2023).
Applying Social Research
Residential Segregation and Health Outcomes
Social scientists have long thought that poor urban neighborhoods pose, in and of themselves, significant health risks for their residents. These neighborhoods may lack supermarkets with fresh fruits and vegetables, and they lack safe parks and other settings for exercise. They are also neighborhoods with high crime rates and thus much stress. For all these reasons, they should impair the physical health of their residents. Reflecting this argument, the residents of poor urban neighborhoods do, in fact, exhibit significant health problems compared to the residents of wealthier neighborhoods.
Although this argument might sound compelling, the residents of poor and wealthier neighborhoods might differ in other ways that affects their respective health. For example, people living in wealthier neighborhoods are generally more educated and more conscious of taking care of their health. If their health then is better than that of their counterparts in poor neighborhoods, it is difficult to know how much the neighborhood setting itself plays a role in the health of residents.
For this reason, a real-life experiment provided compelling evidence of the importance of the quality of a neighborhood for one’s health. In the 1990s, the federal government conducted an experiment in which 1,800 poor urban women were randomly selected and, with their permission, assigned to move from their neighborhoods to wealthier neighborhoods. The women were studied a decade after they moved. In particular, they were weighed and had their blood checked for evidence of diabetes. Their results were then compared to women in their original neighborhoods who were not selected to move away. The women who did move away ended up with somewhat lower rates of diabetes and obesity than those who stayed behind.
The experimental design of this study allowed the researchers to conclude that the change in neighborhoods was the reason for their improvement in these two health measures. Reflecting this conclusion, the secretary of the US Department of Housing and Urban Development said, “This study proves that concentrated poverty is not only bad policy, it’s bad for your health.” A news report observed that the results of this study “offered some of the strongest support yet for the idea that where you live can significantly affect your overall health, especially if your home is in a low-income area.”
The results of this experimental study underscore the need to improve the living conditions of poor urban neighborhoods, as these conditions affect many life outcomes of the adults and children who live in them.
Sources: Ludwig et al. 2011; Stobbe 2011
Educational Inequality
Children who are unhoused or have unstable housing may experience numerous academic difficulties, including below-grade level reading, high rate of learning disabilities, poor school attendance, and failure to advance to the next grade or graduate. The Housing Matters initiative via the Urban Institute reports that housing instability affects educational outcomes such as decreased school attendance, lower testing scores, a higher likelihood of completing high school late, and a lower likelihood of completing schooling at all (Chen 2024).
For instance, experiencing housing insecurity and houselessness can lead to to higher rates of absenteeism and switching schools more often ('mobility'), which may harm students' educational success. Galvez and Luna (2014) of the Urban Institute gathered the following research findings:
- "Among a sample of children living in a Los Angeles homeless shelter, approximately 16 percent missed more than three weeks of school in the previous 3 months.
- Chronically homeless children in a New York City supportive housing demonstration project missed on average 30 percent (54 of 180) school days each year. After families received supportive and stable housing, attendance improved by an average of 25 days per school year.
- Among a cohort of 10,000 third-grade students in Philadelphia, students with one or more homeless episodes were 30 percent more likely to meet the school district’s definition of 'truant' compared to students with only one homeless episode. ...
- An early study of a large sample of Denver K-12 students found that as mobility increased, academic achievement suffered. More mobile students had lower test scores and were more likely to perform below grade level compared with students who did not move. ...
- A sample of homeless adolescents in New York City changed schools more frequently than their low-income but stably housed peers (an average of 4.2 school moves since kindergarten, compared to 3.1). The higher mobility was associated with higher rates of being held back in school. ...
- Half of the sample of homeless New York City adolescents repeated a grade and 22 percent repeated two or more grades; in comparison, 40 percent of low-income youth who had never experienced homelessness repeated one grade and only 8 percent repeated two or more.
- Among Chicago homeless children, one third were held back at least once. Among homeless students who entered shelter in 10th grade, nearly half dropped out of high school."
You may explore more educational outcomes discussed in the report Homelessness and Housing Instability: The Impact on Education Outcomes.
Children and Our Future
The Plight of Houseless Children
The faltering economy and wave of home foreclosures of the past few years resulted in what has been called a “national surge” of houseless children. The number of children who are houseless at least part of the year now reaches more than 1.6 million annually, equal to more than 2 percent of all American children. Because of their circumstances, they are at greater risk than their housed peers for hunger, asthma and other chronic health conditions, and stress and emotional problems.
They are at also greater risk for poor school performance. Amid the surge in children’s houselessness, the nation’s schools marshaled their resources to help their houseless children. An official with a private charity that helps poor families pointed out the obvious problem: “It’s hard enough going to school and growing up, but these kids also have to worry where they’ll be staying that night and whether they’ll eat. We see 8-year-olds telling Mom not to worry, don’t cry.”
School districts began sending special buses to shelters, motels, and other settings for houseless children and their parents so that the children could continue attending their regular school. They also assigned social workers to help houseless families and other personnel to bring them school supplies, to drive them to look at shelters where they could live, and to perform other tasks. Federal legislation in fact requires schools to take extra measures to help houseless children, but school superintendents say that the federal government has not provided them the necessary funds to carry out the intent of the legislation. This lack of funding adds to their school districts’ already dire financial situation.
Charity Crowell, age 9, was just one of the hundreds of thousands of houseless children the schools were trying to help. During the semester her family became houseless, her grades fell to C’s from her usual high standard. One reason was that she had trouble staying awake in class. She explained why: “I couldn’t go to sleep, I was worried about all the stuff.”
Another houseless student, Destiny Corfee, age 11, became houseless after her parents lost both their jobs and then their house and had to move into their van. The family then parked the van at a Walmart so that their children could go into the store and clean themselves before they went to school. Recalling life in the van, Destiny said, “I was embarrassed that maybe one of my friends might see me. I don’t want anybody to know that I was actually in there.”
Sources: Bassuk, Murphy, Coupe, Kenney, & Beach 2011; Eckholm 2009; Pelley 2011
These are but a few examples of the consequences of neighborhood and housing problems. We will further discuss inequality in medicine/health and education in later chapters, as well as racial and other inequalities.
