Homelessness is a multifaceted issue that affects over a half-million Americans on a single night in the US and is associated with adverse social, health, and economic outcomes.1,2 Homeless individuals or families lack a fixed, regular, and adequate nighttime residence, including those who live in a shelter designated for momentary housing (sheltered) or in places not designated as proper housing (unsheltered).3 Between 2014-2018, Missouri homelessness has decreased by 18%.4 However, social disparities in homelessness are much greater in certain geographical areas (i.e., St. Louis) and have not improved in recent years.
There are four categories of homelessness: family, youth, veteran, and chronic. An individual or family is considered homeless if:
Chronic homelessness is defined “as an individual who has experienced homelessness for at least a year while struggling with a disabling condition including mental illness and/or substance use disorder.”6 Research has demonstrated that a history of homelessness at any age is a consistent, strong predictor for adverse physical and mental health outcomes throughout the lifespan.2,7 In the United States, one homeless individual costs taxpayers anywhere from $5,000 to $35,000 per year.8,9
The Governor’s Committee to End Homelessness implemented 8 continuums of care (CoC) across the state to have a developed strategy to prevent homelessness whenever possible; if it cannot be prevented, then the experience should be rare, brief, and non-recurring.10 CoCs are meant to reduce, and ultimately end, homelessness by providing funding to non-profit groups. Additionally, CoCs encourage state and local governments to rehouse homeless individuals and families in a timely manner to lessen the trauma and dislocation associated with homelessness.3 There are seven CoCs in urban areas throughout the state; the eighth is the Balance of State CoC which includes 101 counties divided into 10 sub-regions (figure 1)..3,4 The main tactic to combat homelessness is to provide housing services and resources to those already homeless.8 While these programs provide housing as quickly as possible to those who need it, these resources are not equally available and accessible. Research suggests that a more effective way to combat homelessness is to prevent it by providing financial relief to help individuals and families stay in their homes.8 In Chicago, IL, a temporary financial program, part of the Homeless Prevention Call Center, provided financial relief to maintain their homes and individuals were 71% less likely to enter a shelter.8
The Missouri Housing Development Commission indicated that 5,883 individuals experienced homelessness in 2018 which is an 18% reduction in the number of individuals affected by homelessness in 2014.4 Six CoCs reported a reduction in homelessness while rates increased in St. Louis County and Andrew, Buchanan, and Dekalb Counties (St. Joseph).4 Statewide, homelessness affects more men (55.8%) and Caucasians (53%), however, this statistic is not upheld in certain geographical areas (i.e., St. Louis area).4 Relating to gender disparities, 10% more women are reported as experiencing homelessness compared to men in St. Louis County and in the neighboring St. Charles, Warren, and Lincoln counties.4 Nearly 75% of individuals experiencing homelessness in St. Louis City and County are African American /Black Missourians (Figure 2).4 In St. Louis City and County, the African American / Black population is 45.3% and 25.0%, respectively.11 This means the rate at which minoritized individuals may experience homelessness is much greater than that of White Missourians and makes up a large, disproportionate part of the homeless population. These racial trends in homelessness are very similar to national trends.
Family and veteran homelessness across the state has decreased between 2014 and 2018 by 29% and 22%, respectively.4 Fifty-two percent of homeless veterans reside in Kansas City and St. Louis City.4 In 2017, Kansas City had met the criteria benchmarks for achieving an end to veteran homelessness developed in collaboration by the United States Interagency Council on Homelessness, Department of Housing and Urban Development, and Veterans Affairs.12 This does not mean every veteran is housed or has permanent housing, but that they are prepared to house all who may become homeless.
While family and veteran homelessness have decreased, those experiencing youth and chronic homelessness have increased by 13% and 8%, respectively.4 The increase in youth homelessness may be a result of life circumstances such as familial poverty, teen pregnancy, substance abuse, and transitioning out of foster care.13 The increase in chronic homelessness may be a result of a change in definition (2016) and consequently, an increased number of individuals classified as chronically homeless.4 Targeted approaches to reduce youth and chronic homelessness may be warranted.
Domestic violence, as it can be casual for immediate homelessness, has increased 47% and within each CoC region between 2014 and 2018; specifically, reports of domestic violence experiences have increased by 193% in St. Louis City.4 Domestic violence and homelessness are associated because many survivors will seek housing service programs for safety. Cases of domestic violence are often underreported; therefore, the number of domestic violence and homelessness cases are likely higher than published in the 2019 Statewide Homelessness Study.4 The current report does not indicate the demographics of the population experiencing domestic violence.