There have always been homeless people in the United States, but their plight has only recently stirred widespread public reaction and concern. Part of this new recognition stems from the problem's prevalence: the number of homeless individuals, while hard to pin down exactly, is rising. In light of this, Congress asked the Institute of Medicine to find out whether existing health care programs were ignoring the homeless or delivering care to them inefficiently. This book is the report prepared by a committee of experts who examined these problems through visits to city slums and impoverished rural areas, and through an analysis of papers written by leading scholars in the field.

Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised citizens. In recent decades, federal agencies, nonprofit organizations, and the philanthropic community have worked hard to develop and implement programs to solve the challenges of homelessness, and progress has been made. However, much more remains to be done. Importantly, the results of various efforts, and especially the efforts to reduce homelessness among veterans in recent years, have shown that the problem of homelessness can be successfully addressed. Although a number of programs have been developed to meet the needs of persons experiencing homelessness, this report focuses on one particular type of intervention: permanent supportive housing (PSH). Permanent Supportive Housing focuses on the impact of PSH on health care outcomes and its cost-effectiveness. The report also addresses policy and program barriers that affect the ability to bring the PSH and other housing models to scale to address housing and health care needs.

The homeless person is thought to be different. Whereas we get to determine our difference or sameness, the homeless person's difference is imposed upon them and assumed to be known because of their homelessness. Exclusion from housing - either a commodity that should be accessed from the market or social provision - signifies the homeless person's incapacities and failure to function in what are presented as unproblematic social systems. Drawing on a program of research spanning ten years, this book provides an empirically grounded account of the lives and identities of people who are homeless. It illustrates that people with chronic experiences of homelessness have relatively predictable biographies characterised by exclusion, poverty, and trauma from early in life. Early experiences of exclusion continue to pervade the lives of people who are homeless in adulthood, yet they identify with family and normative values as a means of imaging aspirational futures.

Homeless assistance has frequently adhered to the “three hots and a cot” model, which prioritizes immediate material needs but may fail to address the political and social exclusion of people experiencing homelessness. In this study, Loehwing reconsiders typical characterizations of homelessness, citizenship, and democratic community through unconventional approaches to homeless advocacy and assistance. While conventional homeless advocacy rhetoric establishes the urgency of homeless suffering, it also implicitly invites housed publics to understand homelessness as a state of abnormality that destines the individuals suffering it to life outside the civic body. In contrast, Loehwing focuses on atypical models of homeless advocacy: the meal-sharing initiatives of Food Not Bombs, the international competition of the Homeless World Cup, and the annual Homeless Persons’ Memorial Day campaign. She argues that these modes of unconventional homeless advocacy provide rhetorical exemplars of a type of inclusive and empowering civic discourse that is missing from conventional homeless advocacy and may be indispensable for overcoming homeless marginalization and exclusion in contemporary democratic culture. Loehwing’s interrogation of homeless advocacy rhetorics demonstrates how discursive practices shape democratic culture and how they may provide a potential civic remedy to the harms of disenfranchisement, discrimination, and displacement. This book will be welcomed by scholars whose work focuses on the intersections of democratic theory and rhetorical and civic studies, as well as by homelessness advocacy groups.