The morning commute in downtown Seattle brought Janet face-to-face with the same man she’d seen for months. He sat huddled under a tattered blue tarp, his belongings packed into a weathered shopping cart. She had watched his health visibly deteriorate through the changing seasons.
Understanding the Crisis
Homelessness in the United States is an urgent public health issue and humanitarian crisis. It impacts cities, suburbs, and rural towns in every state. Housing is a social determinant of health, meaning lack of it has a negative impact on overall health and life expectancy.
Tens of thousands of people die every year due to the dangerous conditions of living without housing—conditions that have worsened due to climate change’s rise in extreme weather. People who experience homelessness die nearly 30 years earlier than the average American—and often from easily treatable illnesses.
Before we can address homelessness, we need to understand it. Approximately 580,000 Americans experience homelessness on any given night. This includes families with children, veterans who served our country, young people, seniors, and individuals struggling with disabilities, addiction, or mental health challenges.
Contrary to common assumptions, homelessness rarely results from a single personal failing. Instead, it emerges from a complex interplay of structural problems and individual circumstances: skyrocketing housing costs, stagnant wages, inadequate mental health services, and disappearing safety nets. Small personal setbacks—a medical bill, a job loss, or a family breakdown—can push someone into homelessness.
The typical homeless American might surprise you. Many work full or part-time jobs but still can’t afford housing. Others have disabilities that prevent employment but receive benefits too meager to cover rent. Some struggle with addiction or mental illness without access to appropriate care. Many are children and teens, either with families or on their own after escaping abuse or rejection.
As housing costs continue rising faster than wages, millions more Americans live precariously close to homelessness, often just one missed paycheck or unexpected expense away from losing their homes. In a typical year, U.S. landlords pursue eviction on 3.6 million occasions. Evictions occur for many reasons, but the inability to afford rising rent costs is one of the biggest.
Homelessness: Fact vs. Fiction
Fact: While employment helps people stay housed, it does not guarantee housing. As many as 40%–60% of people experiencing homelessness have a job, but housing is unaffordable because wages have not kept up with rising rents.
Myth: People experiencing homelessness choose to live outside in tents or cars.
Fact: Homelessness usually happens because of economic reasons, and many people have nowhere else to go but outside. Many shelters are full or limited by restrictive rules that exclude parents, couples, pet owners, LGBTQI+ members, and people with criminal records or active addictions.
Myth: People experiencing homelessness are dangerous and violent.
Fact: Not having a home does not make someone a criminal; people experiencing homelessness are far more likely to be victims of violent crime than to commit it.
Myth: Most people experiencing homelessness have a substance use or mental health disorder.
Fact: While rates are high for some subgroups, the majority of people without homes do not have these disorders. Most Americans with mental health or substance use disorders are not homeless.
Myth: Homelessness is not preventable.
Fact: Homelessness is a policy choice. The COVID-19 pandemic demonstrated the power of prevention: eviction moratoriums, emergency rental assistance, expanded unemployment aid, and direct cash payments prevented millions of evictions and stabilized housing for many families.
Two Paths Forward: Treatment First vs. Housing First
For decades, America primarily approached homelessness through the Treatment First model, which requires individuals to resolve personal issues—addiction, mental health, or unemployment—before qualifying for permanent housing. While it appeals to ideas of personal responsibility, the model has produced disappointing results.
Beginning in the 1990s, a fundamentally different approach emerged: Housing First. This model provides permanent housing immediately, without preconditions, followed by supportive services. Housing First operates on a simple premise: housing is a basic need, not a reward for good behavior. Once someone has stability, they can more effectively address other challenges.
The Evidence of Success
- Utah — A statewide Housing First initiative reduced chronic homelessness dramatically between 2005 and 2015.
- Finland — National Housing First policy reduced homelessness and long-term homelessness significantly between 2008 and 2018.
- Canada — The At Home/Chez Soi project followed 2,000 participants and found strong housing stability for people with varying needs.
- Houston & Denver — Cities that reduced homelessness substantially through coordinated Housing First approaches and innovative funding models.
The Unexpected Economic Case
While providing housing might seem expensive, it often costs less than managing homelessness through emergency services, law enforcement, and shelters. Homeless individuals frequently cycle through emergency rooms, jails, detox centers, and psychiatric hospitals—at taxpayer expense. Housing stability reduces these costly interactions.
Examples from multiple communities show large per-person savings when people move from chronic homelessness into stable housing, along with improved health and reduced incarceration.
Beyond the Numbers: Changing Lives
Housing First also produces life-changing human outcomes. Examples include veterans who regain health and family connections after getting housing and families who stabilize, enabling parents to work and children to improve in school.
Challenges and Limitations
Housing First requires upfront investment in affordable housing units, ongoing funding for subsidies and services, and coordination across systems. Critics worry about enabling unhealthy behavior by not requiring treatment; however, most people voluntarily engage with services once housed. Housing First is particularly effective for chronically homeless individuals with complex needs, while short-term economic homelessness may require other tailored approaches.
Building a Comprehensive Approach
A complete strategy prevents homelessness before it starts: zoning reform and public investment to expand affordable housing, strengthened safety nets to help households weather crises, improved mental health and addiction services, and coordinated rapid-response systems to identify and assist people at risk.
The Path Forward
America has the knowledge and resources to dramatically reduce homelessness. The barriers are often political rather than technical. Solving homelessness requires investing in long-term, evidence-based solutions and seeing beyond stereotypes to the diverse realities of people without homes.
The man Janet passes each morning doesn’t need to remain on the street. Families doubled up in overcrowded apartments shouldn’t become the next wave of shelter residents. Veterans sleeping in cars shouldn’t have to choose between medication and housing.
By adopting Housing First and prevention measures, communities can make homelessness rare, brief, and non-recurring. Housing is more than a roof—it is the foundation for participation, recovery, and contribution.