Homelessness

HOMELESSNESS:
rograms and the eople

hey erve
SUMMA RY REPORT
Findings of the
National Survey of Homeless Assistance
Providers and Clients
D E C E M B E R 1 9 9 9
HOMELESSNESS:
rograms and the eople
hey erve
SUMMA RY REPORT
Findings of the
National Survey of Homeless Assistance
Providers and Clients
A U G U ST 1 9 9 9
MarthaR.Burt
LaudanY.Aron
TobyDouglas
JesseValente
EdgarLee
BrittaIwen
ThenonpartisanUrbanInstitutepublishesstudies,reports,andbooksontimelytopicsworthyofpublicconsideration.Theviewsexpressed
arethoseoftheauthorsandshouldnotbeattributedtothestudysfederalfundersortotheUrbanInstitute,itstrustees,oritsfunders.
ontents
PREFACE .................................................. xiii
ACKNOWLEDGMENTS..................................... xv
HIGHLIGHTS .............................................. xvii
1 Introduction and Design Overview.......................... 1
Introduction ............................................. 2
OverviewoftheStudyDesign................................ 2
DataCollectionApproaches............................. 3
BasicAnalyticCategories ................................... 5
DeningHomelessnessStatus ........................... 5
SpecifyingTimeFrames................................ 6
DeningFamilyandSingleStatus........................ 6
DeningAlcohol/Drug/MentalHealth(ADM)Status......... 6
DescribingUrban/RuralLocation ........................ 7
StatisticalSignicanceofFindings............................. 7
CondenceIntervals .................................. 7
StatisticalSignicanceofComparisons .................... 7
RiskofFalsePositives.................................. 7
LimitationsofNSHAPCFindings ............................ 7
TheStudyIsDescriptive ............................... 7
ThePeopleintheStudyComefrom
HomelessAssistancePrograms ...................... 8
NSHAPCWasDesignedtoCollectDataonClients
WhoUseHomelessAssistanceServices................ 8
AllClientInformationComesfromtheClientsThemselves .... 8
WhattheStudyDoesNotDo ........................... 8
TheStructureofThisReport ................................ 9
AdditionalInformationMayBeFoundintheTechnicalReport.. 9
2 An Overview of Homeless Clients........................... 11
Introduction ............................................. 13
DemographicCharacteristicsofHomelessClients ................ 13
Sex................................................ 14
Race/Ethnicity....................................... 15
Age ............................................... 15
MaritalStatus........................................ 16
Education .......................................... 17
VeteranStatus ....................................... 18
TheChildrenofHomelessClients ............................ 18
ServiceNeeds,Stresses,andVulnerabilities...................... 20
ServiceNeedsasSeenbyClients ......................... 20
FoodConsumptionandHunger ......................... 21
VictimizationWhileHomeless........................... 22
PhysicalHealthStatusandInsurance...................... 22
Alcohol,Drug,andMentalHealthProblems................ 23
HistoryofIncarceration................................ 25
AdverseChildhoodExperiences.......................... 25
WhereHomelessClientsWereLiving.......................... 26
CharacteristicsofClientsUsingDifferentHousingand
OtherServices................................... 27
Income,Employment,andOtherIncomeSources ................ 28
Income............................................. 28
PaidEmployment .................................... 29
ReceiptofGovernmentBenets.......................... 29
HistoryofHomelessness.................................... 30
ClientsWhoChangeLocationsafterBecomingHomeless...... 32
ComparisonsofClientsfromCentralCities,Suburbs,and
RuralAreas ......................................... 33
Comparisonswith1987UrbanInstituteFindings................. 35
3
Comparing Currently with Formerly Homeless Clients
and Other Service Users................................... 39
Introduction ............................................. 41
BasicDemographicCharacteristics............................ 41
Sex................................................ 41
Race/Ethnicity....................................... 41
Age ............................................... 43
Education .......................................... 43
MaritalandHouseholdStatus........................... 43
VeteranStatus ....................................... 44
ServiceNeeds,Stresses,andVulnerabilities...................... 44
ServiceNeedsasSeenbyClients ......................... 44
FoodConsumptionandHunger ......................... 44
vi Contents
PhysicalHealthStatusandInsurance...................... 45
Alcohol,Drug,andMentalHealthProblems................ 49
Incarceration ........................................ 50
AdverseChildhoodExperiences.......................... 50
IncomeLevels,Sources,andEmployment....................... 52
HistoryofHomelessness.................................... 55
UseofHomelessAssistancePrograms.......................... 56
LifetimeServiceUse................................... 56
Urban/RuralLocation...................................... 57
4 Homeless Assistance Programs............................. 59
Introduction ............................................. 60
ServiceLocationsandProgramTypes .......................... 60
ServiceLevelandProgramSize............................... 61
TotalNumberofExpectedServiceContacts ................ 62
VariabilityinProgramSize.............................. 63
OperatingAgencies........................................ 64
FundingSources.......................................... 66
PopulationFocus.......................................... 66
HouseholdType...................................... 66
SpecialPopulationorSpecialNeed ....................... 67
OccupancyLevelsofShelter/HousingPrograms.................. 69
LocationofHomelessAssistancePrograms...................... 69
AvailabilityofServiceswithinNSHAPCs76SamplingAreas........ 71
DistributionofProgramContactswithinSamplingAreas ...... 72
DistributionofServiceswithinSamplingAreasby
ProgramType................................... 73
DistributionwithinSamplingAreasofContactswith
DifferentTypesofShelter/HousingPrograms........... 76
5 Postscript............................................... 79
APPENDIX A: NSHAPCs PRIMARY SAMPLING AREAS..... 81
APPENDIX B: NSHAPC PROGRAM DEFINITIONS........... 85
REFERENCES .............................................. 87
Contents vii
igures and ables
Figure1.1 SamplingAreasforNSHAPC.......................... 3
Table2.1 DemographicCharacteristicsofHomelessClients,by
FamilyStatus.................................. 14
Figure2.1 SexofHomelessClientsandtheU.S.AdultPopulation...... 15
Figure2.2 HomelessClientsinFamilies .......................... 15
Figure2.3 Race/EthnicityofHomelessClientsandU.S.Adults ........ 16
Figure2.4 AgeDistributionofHomelessClientsinFamilies,Single
HomelessClients,andU.S.Adults ................. 16
Figure2.5 MaritalStatusofHomelessClientsinFamilies,Single
HomelessClients,andAllU.S.Adults .............. 17
Figure2.6 EducationalAttainmentofHomelessClientsinFamilies,
SingleHomelessClients,andU.S.Adults............ 17
Table2.2 CharacteristicsofChildrenunder18LivingwithHomeless
Parents,andtheU.S.PopulationofChildren ......... 19
Table2.3 DemographicCharacteristicsofHomelessAdultsPlusTheir
ChildrenLivingwithThem,Comparedwiththe
U.S. PopulationinPovertyandtheGeneral
U.S.Population................................ 20
Figure2.7 ResidenceofMinorChildrenWhoDoNotLivewitha
HomelessParent ............................... 21
Figure2.8 MostImportantThingRespondentThinksIsPreventingExit
fromHomelessness ............................. 21
Figure2.9 FrequencyofFoodProblemsinthePast30Daysamong
HomelessClients............................... 22
Figure2.10 VictimizationofClientswhileHomeless ................. 23
Table2.4 Alcohol,Drug,andMentalHealth(ADM)Problemsamong
HomelessClients............................... 24
Figure2.11 Alcohol,Drug,andMentalHealthProblemsofHomeless
ClientsinDifferentTimePeriods .................. 25
Figure2.12 AdverseExperiencesbeforeReachingAge18 .............. 26
Figure2.13 WhereHomelessClientsSleptonDayofInterviewand
PreviousSevenDays ............................ 27
Table2.5 DemographicandOtherCharacteristicsofHomelessClients,
by StreetLocationandProgramUseinPastWeek...... 28
Table2.6 EconomicandOtherCharacteristicsofHomelessClients,by
Family Status.................................. 29
Figure2.14 ReceiptofMeans-TestedBenetsduringPastMonth,by
Family Status.................................. 30
Table2.7 HistoryofHomelessnessandTransiency,byFamilyStatus.... 31
Figure2.15 PatternofHomelessness,byFamilyStatus ................ 32
Table2.8 Movers:OriginsandDestinations ...................... 33
Table2.9 CharacteristicsofHomelessClientsinCentralCities,Suburbs,
andRuralAreas................................ 34
Figure2.16 Urban/RuralLocationofHomelessClientsComparedwiththe
PoorU.S.Population............................ 35
Table2.10 WhatHasChanged?ComparingHomelessClientsFoundin
Central CitySheltersandSoupKitchensin1987and1996. 36
Figure3.1 Sex,byHomelessStatus.............................. 41
Table3.1 BasicDemographicCharacteristics,byHomelessStatus...... 42
Figure3.2 Age,byHomelessStatus.............................. 43
Table3.2 ServiceNeeds,byHomelessStatus...................... 44
Table3.3 FoodConsumptionandHunger,byHomelessStatus........ 45
Table3.4 PhysicalHealthStatus,byHomelessStatus ............... 46
Figure3.3 AbilitytoSeeaDoctororNurse,byHomelessStatus........ 47
Figure3.4 MedicalInsuranceCoverage,byHomelessStatus........... 47
Table3.5 MentalHealthandSubstanceUseProblems,by
HomelessStatus ............................... 48
Figure3.5 AnyMentalHealth,Alcohol,and/orDrugUseProblems,by
HomelessStatus ............................... 49
Table3.6 HistoryofIncarceration,byHomelessStatus.............. 50
Table3.7 AdverseChildhoodExperiences,byHomelessStatus........ 51
Figure3.6 AdverseExperiencesbeforeAge18,byHomelessStatus...... 51
Figure3.7 Out-of-HomeExperiencesbeforeAge18,by
HomelessStatus ............................... 52
Table3.8 IncomeLevels,IncomeSources,andEmployment,by
HomelessStatus................................ 53
Figure3.8 IncomeReceivedintheLast30Days,byHomelessStatus.... 54
Figure3.9 Money/BenetsReceivedfromGovernmentSourcesinthe
Last 30 Days,byHomelessStatus.................. 54
Table3.9 NumberandLengthofHomelessPeriods,by
HomelessStatus ............................... 55
Figure3.10 NumberofTimesHomeless,byHomelessStatus........... 56
x Figuresand Tables
Figuresand Tables xi
Table3.10 UseofHomelessnessAssistancePrograms,by
HomelessStatus ............................... 57
Table3.11 Urban/RuralLocation,byHomelessStatus ............... 58
Figure4.1 NumberofHomelessAssistanceProgramsinthe
UnitedStates,1996............................. 61
Figure4.2 NumberofProgramContactsExpectedatProgramsof
DifferentTypesonanAverageDayinFebruary1996 ... 62
Figure4.3 SizeofHomelessAssistancePrograms.................... 63
Figure4.4 ProportionofProgramContactsProvidedby
LargerPrograms ............................... 64
Figure4.5 TypesofAgenciesThatOperateHomeless
AssistancePrograms............................. 65
Figure4.6 TypesofAgenciesOperatingHousing,Food,Health,and
OtherPrograms................................ 65
Figure4.7 ProgramRelianceonGovernmentFunding ............... 67
Figure4.8 TypesofHouseholdsServedbyHomeless
AssistancePrograms............................. 68
Figure4.9 SpecialPopulationFocusofHomelessAssistancePrograms ... 69
Figure4.10 SpecialNeedsFocusofHomelessAssistancePrograms....... 70
Table4.1 Shelter/HousingUtilizationandInformationonTurnaways... 71
Figure4.11 DistributionofProgramsComparedwithProgramContacts
amongCommunitiesofDifferentTypes............. 71
Figure4.12 DistributionofProgramContactsacrossDifferentTypes
of Communities ............................... 72
Table4.2 StatisticsforProgramContactsonanAverageDay
inFebruary1996inPrimarySamplingAreas ......... 73
Figure4.13 ProgramContactsinaPrimarySamplingAreabyOverall
Population,per10,000Population,andper10,000
Livingin Poverty............................... 74
Figure4.14 ProgramContactsinaPrimarySamplingArea,by
ProgramType ................................. 75
Figure4.15 RateofHousing/ShelterProgramContactsper10,000
PoorPeople,byTypeofHousingProgram............ 77
reface
The1996NationalSurveyofHomelessAssistanceProvidersandClientsisaland-
markstudy.Itwasdesignedtoprovideupdatedinformationabouttheprovidersof
homelessassistanceandthecharacteristicsofhomelesspersonswhouseservices.The
surveyisbasedonastatisticalsampleof76metropolitanandnonmetropolitanareas,
includingsmallcitiesandruralareas.Dataforthesurveywerecollectedbetween
October1995andNovember1996.
ThesurveyisaresponsetothefactthathomelessnessremainsoneofAmericas
mostcomplicatedandimportantsocialissues.Chronicpoverty,coupledwithphysical
andotherdisabilities,havecombinedwithrapidchangesinsociety,theworkplace,
andlocalhousingmarketstomakemanypeoplevulnerabletoitseffects.Withthe
enactmentoftheStewartB.McKinneyHomelessAssistanceActof1987,Congressrec-
ognizedtheneedtosupplementmainstreamfederallyfundedhousingandhumanser-
vicesprogramswithfundingthatwasspecicallytargetedtoassisthomelesspeople.
Over$11billioninMcKinneyfundshavebeenappropriatedsincethen,andbillions
morehavebeenprovidedthroughotherfederal,state,andlocalprogramsandbenets.
Thosewhoprovideassistancethegovernmentagencies,thethousandsofnon-
profitorganizations,andcountlessprivateindividualshavelearnedagreatdeal
abouteffectivewaystomeettheneedsofhomelesspeoplethroughimprovedsup-
portiveservices,increasedhousingoptionsandcooperativeventuresamongagencies
providingassistance.Althoughsubstantialprogresshasbeenmadeinobtaining
fundingandlearningabouteffectiveapproaches,muchmoreremainstobedone.
Despitesignicantincreasesinfunding,programadministratorshadtomanage
theirprogramswithoutreliablenationaldataonthecharacteristicsofthepeoplethey
wereservingandthenewlyemergingnetworksofservicesandserviceproviders.
Indeed,thelastnationalstudywasconductedbytheUrbanInstitutein1987.In1991,
federalagenciesbeganinitialplanningforanewnationalsurveytollthisgap.
Thenewsurveywasdesignedandfundedby12federalagencies
1
inacollabora-
tiveventureundertheauspicesoftheInteragencyCouncilontheHomeless,awork-
inggroupoftheWhiteHouseDomesticPolicyCouncil.TheU.S.Bureauofthe
Censuscollectedthedata,andtheUrbanInstituteanalyzedit.Apanelcomprised
ofpublicinterestgroups,nationallyrecognizedresearchers,andotherexpertson
issuesrelatedtohomelessnessreviewedandcommentedontheanalysisplanand
1
The12federalagencysponsorsincludetheDepartmentsofHousingandUrbanDevelopment,Health
andHumanServices,VeteransAffairs,Agriculture,Commerce,Education,Energy,Justice,Labor,andTrans-
portationaswellastheSocialSecurityAdministrationandtheFederalEmergencyManagementAgency.
draftreports.Allofthedraftsurveyinstrumentswere
publishedintheFederalRegisterforpublicreviewand
comment.
It is important to note that the survey was not
designedtoproduceanationalcountofthenumberof
homelesspeople,nordoesitincludeinformationon
clientcharacteristicsattheregionalorlocallevels.The
surveywasdesignedtoprovideup-to-dateinformation
abouttheprovidersofassistancetohomelesspeople,the
characteristicsofthosewhouseservicesthatfocuson
homelesspeople,andhowthispopulationhaschangedin
metropolitan areas since 1987. The analyses of the
providerdataexaminefactorssuchasgeographiclevel
(e.g.,national,centralcity,communitiesoutsideofcen-
tralcitiesbutstillwithinmetropolitanstatisticalareas,
andruralareas),programtype,andthetypesandlevelsof
servicesdelivered.Thedatareceivedfromserviceusers
includes,butisnotlimitedto,suchcharacteristicsasage,
race/ ethnicity,sex,familystatus,historyofhomelessness,
employment,education,veteranstatus,anduseofservices
andbenets.
Theinformationinthisreportiscriticaltodiscussions
abouteffectivepublicpolicyresponsesneededtobreak
thecycleofhomelessness.Assuch,itprovidesanimpor-
tantbaselineandfoundationforfutureassessmentsofthe
natureandextentofhomelessness.Italsoprovidesavalu-
ableoverviewthatwillimproveourunderstandingof
thecharacteristicsofhomelesspeoplewhouseservices,
thenatureofhomelessness,andhowbesttoaddressit.
2
xiv Foreword
2
Twootheritemsrelatedtothesurveyarecurrentlyavailable.Listscon-
tainingthenames,addresses,andtelephonenumbersofthehomelessassis-
tanceprovidersineachofthe76surveyareasareavailablefromtheInter-
agencyCouncilontheHomeless,HUD,4517thStreet,S.W.,Washington,
DC20410,Room7274,orbyemailingsurvey_results@hud.gov.Publicuse
datalesonCDmaybepurchasedfromCensusBureauCustomerService;
call(301) 457-4100.Filesarealsoavailablefordownloading:gotowww.
census.govandthenclickonHunderthealphabeticallistingAZ.
cknowledgments
Manypeopleplayedaroleinbringingthisreporttofruition.JamesHobenofthe
DepartmentofHousingandUrbanDevelopment,MaryEllenOConnellofthe
DepartmentofHealthandHumanServices,andGeorgeFergusonoftheInter-
agencyCouncilontheHomelessspearheadedtheeffortsofaFederalWorking
GroupundertheauspicesoftheInteragencyCouncil.Theyhadtheresponsibility
forsupervisingallphasesofthestudy;theircounselhasgreatlyimprovedthereports
structure,focus,andreadability.
OthermembersoftheFederalWorkingGroupwhocontributedideas,com-
ments,comparisondata,andsupportincludeKatherineMeredithoftheOfceof
ManagementandBudget;NancyGordon,CynthiaTaeuber,AnnettaSmith,Denise
Smith,MarjorieCorlett,CharlesAlexander,DaveHubble,andSteveTourkinof
theBureauoftheCensus;FredKarnas,MargeMartin,MarkJohnston,andMichael
RoanhouseoftheDepartmentofHousingandUrbanDevelopment;MarshaMar-
tin,PeteDelany,andMichaelShoagoftheDepartmentofHealthandHumanSer-
vices;PeteDougherty,ScottSteins,GayKoerber,andJosephineHawkinsofthe
DepartmentofVeteransAffairs;JoanneWiggins,JamesParker,RobinBouckris,
MariMargil,andWei-minWangoftheDepartmentofEducation;KateHine,Gary
Bickel,JohnPentecost,andAmyDonoghueoftheDepartmentofAgriculture;John
HeinbergandRaymondHigginsoftheDepartmentofLabor;CarolColemanand
YolandaJonesoftheFederalEmergencyManagementAgency;PatriciaBetch,
CassandraWilkins,ChristineGarcia,andPaulDaviesoftheSocialSecurityAdmin-
istration;PatriciaRoseoftheDepartmentofEnergy;BettyJacksonoftheDepart-
mentofTransportation;andMollyBrostrom,JeremyBenAmi,andMarySmithof
theDomesticPolicyCouncil.Inaddition,SharonFondelier,DaveHornick,Tracy
Mattingly,andotherCensusBureaustaffhaveremainedpoliteandforthcoming
undertheprovocationofwhatmusthaveseemedlikenever-endingrequestsfor
additionaldata,additionalinterpretationofmethods,additionalreviewsofdraft
methodsections,andadditionalhand-holding.
Wewerealsoassistedgreatlybyadevotedpanelofexpertsonresearchandpol-
icyrelatedtohomelessness.TheseincludedDennisCulhaneoftheUniversityof
Pennsylvania,MichaelL.DennisofChestnutHealthSystems,LindaFosburgofAbt
Associates,HowardGoldmanoftheUniversityofMarylandBaltimore,KimHopper
oftheNathanKlineInstitute,GerryHotalingoftheUniversityofMassachusetts
Lowell,PaulKoegeloftheRANDCorporation,NorweetaMilburnofHofstra
University,NanRomanoftheNationalAlliancetoEndHomelessness,Robert
RosenheckoftheDepartmentofVeteransAffairsNortheastProgramEvaluation
Center,JamesStrongeoftheCollegeofWilliamand
Mary,BeverlyToomeyofOhioStateUniversity,Sue
Watlov-Phillips of Elim Transitional Housing, Inc.,
LaurelWeiroftheNationalLawCenteronHomelessness
andPoverty,andBethWeitzmanofNewYorkUniversity.
Finally,MartinFrankelandK.P. SrinathofAbtAsso-
ciatesandFritzScheuren,JohnMarcotte,andDouglas
WissokeroftheUrbanInstituteassistedwithweighting
andotherstatisticalissues.
xvi Acknowledgments
ighlights
Study Purpose and Design
What is the purpose of the National Survey of Homeless Assistance
Providers and Clients (NSHAPC)?
NSHAPCwasconductedin1996toprovideinformationonhomelessassis-
tanceprogramsandtheclientswhousethemtofederalagenciesresponsiblefor
administeringhomelessassistanceprogramsandtootherinterestedparties.The
dataarenationalinscope,andthesurveyisthersttogather,throughoneeffort,
awiderangeofinformationrelevanttothemissionsofthefederalsponsors.
NSHAPCwasnot designedorconductedtoproduceacountorestimateof
homelesspersons.
How was NSHAPC conducted?
TheBureauoftheCensusconductedthestudyfor12federalagencies.
NSHAPCselectedasampleof76geographicalareastorepresenttheentire
UnitedStates,including
the28largestmetropolitanstatisticalareas(MSAs);
24smallandmedium-sizedMSAsrandomlyselectedfromtheremaining
MSAs;and
24groupsofruralcountiesrandomlyselectedfromallruralcounties.
Throughtelephoneinterviewsandamailsurvey,thestudyidentiedandgath-
eredinformationabout16typesofhomelessassistanceprograms:
emergencyshelters
transitionalhousingprograms
permanenthousingprogramsforformerlyhomelesspeople
programsdistributingvouchersforemergencyaccommodation
programsacceptingvouchersinexchangeforgivingemergencyaccommoda-
tion
foodpantries
soupkitchens
mobilefoodprograms
physicalhealthcareprograms
mentalhealthcareprograms
alcohol/drugprograms
Thesehighlightspresent
informationfrom
Homelessness: Programsand
thePeopleTheyServe
SummaryReport intheform
offrequentlyasked
questionsandanswers.
Also notedaresome
importantquestionsthat
thisstudydoesnot address.
HIV/AIDSprograms
outreachprograms
drop-incenters
migrantlaborcampsusedtoprovideemergency
shelterforhomelesspeople
otherprograms
Aclientsurveywasconducted.Forthissurvey,home-
lessassistanceprograms*wererandomlyselectedto
representallsuchprogramsineachofthestudyspri-
marysamplingareas.Thenusersoftheseprograms
(clients)wererandomlyselectedandinterviewedto
learnabouttheircharacteristics,situation,andneeds.
Who and what does theNSHAPC samplerepre-
sent? How should theresults beinterpreted?
Thendingsrepresent
homelessassistanceprogramsnationwidein1996;
and
homelesspeopleandotherusersoftheseprograms
in1996.
Representativesof11,909programswereactually
interviewed.TheseprogramsintheNSHAPCsam-
ple represent an estimated 40,000 such programs
nationwide.
4,207clientswhousetheseprogramswereactually
interviewed.Theyrepresentalloftheclientswhouse
suchprogramsnationwide.Ofthese,
54percentwerehomelessatthetimeoftheirinter-
view;
22percenthadbeenhomelessinthepastbutwere
nothomelessatthetimeoftheinterview;and
theremaining24percentwereotherserviceusers
whohadneverbeenhomeless.
AllinformationbasedonNSHAPCdataareestimates.
Ingeneral,percentagesreportedhaveamarginoferror
nogreaterthan4percentagepoints.
Homeless Families
What proportion of homeless clients arein family
households?
Eachhomelessclientisanadultrepresentingahomeless
household.
15percentofthesearefamilyhouseholds(thatis,the
clientshaveoneormoreoftheirownchildrenunder
age18withthem).
Onaverage,eachhomelessfamilyhouseholdincludes
2.2minorchildrenoftheclient.
If we include the children as part of the total,
what proportion of all homeless serviceusers are
members of homeless families?
34percentofhomelessserviceusersaremembersof
homelessfamilies.
23percentareminorchildrenand11percentaretheir
parents.
What arethebasic characteristics of theparent-
clients in homeless families?
84percentarefemaleand16percentaremale.
38percentarewhitenon-Hispanic,43percentare
blacknon-Hispanic,15percentareHispanic,3percent
areNativeAmerican,and1percentareotherraces.
26percentareages17to24,74percentareages25to
54,andlessthan0.5percentareages55andolder.
41percenthavenevermarried,23percentaremar-
ried,23percentareseparated,13percentaredivorced,
andnonearewidowed.
53percenthavelessthanahighschooleducation,21
percenthavecompletedhighschool,and27percent
havesomeeducationbeyondhighschool.
Single Homeless Clients
What arethebasic characteristics of singlehome-
less clients?
Mosthomelessclients(85percent)aresingle(thatis,
theydonothaveanyoftheirchildrenwiththem).
77percentaremaleand23percentarefemale.
41percentarewhitenon-Hispanic,40percentare
blacknon-Hispanic,10percentareHispanic,8percent
areNativeAmerican,and1percentareotherraces.
10percentareages17to24,81percentareages25
to54,and9percentareages55andolder.
50percenthavenevermarried,7percentaremarried,
14percentareseparated,26percentaredivorced,and
4percentarewidowed.
37percenthavelessthanahighschooleducation,
36percenthavecompletedhighschool,and28per-
centhavesomeeducationbeyondhighschool.
xviii Highlights
*Programsincludedemergencyshelters,transitionalandpermanent
housingprograms,voucherdistributionprograms,foodpantries,soup
kitchens,mobilefoodprograms,outreachprograms,drop-incenters,and
otherprograms.Programtypesnotexpectedtoimprovethecoverageof
homelesspeoplesignicantlywerenotincludedintheclientphase.
Problems
Do homeless clients get enough to eat?
28percentsaytheysometimesoroftendonotget
enoughtoeat,comparedwith12percentofpoor
Americanadults.
20percenteatonemealadayorless.
39percentsaythatinthelast30daystheywerehun-
grybutcouldnotaffordfoodtoeat,comparedwith
5percentofpoorAmericans.
40percentwentoneormoredaysinthelast30days
withoutanythingtoeatbecausetheycouldnotafford
food,comparedwith3percentofpoorAmericans.
What proportion have problems with alcohol,
drugs, or mental health?
Withinthepastmonth:
38percentreportindicatorsofalcoholuseproblems.
26percentreportindicatorsofdruguseproblems.
39 percent report indicators of mental health

problems.
66percentreportindicatorsofoneormoreofthese
problems.
What proportion havephysical health problems?
What types of problems do they have?
Atthetimeoftheinterview:
3percentreporthavingHIV/AIDS.
3percentreporthavingtuberculosis.
26percentreporthavingacuteinfectiousconditions,
suchasacough,cold,bronchitis,pneumonia,tuber-
culosis,orsexuallytransmitteddiseasesotherthan
AIDS.
8percentreporthavingacutenoninfectiouscondi-
tions,suchasskinulcers,lice,orscabies.
46percentreporthavingchronichealthconditions,
suchasarthritis,highbloodpressure,diabetes,or
cancer.
55percenthavenomedicalinsurance.
What proportion experience victimization or
violencewhilehomeless?
Whiletheyhavebeenhomeless:
38percentsaysomeonestolemoneyorthingsdirectly
fromthem.
41percentsaysomeonestolemoneyorthingsfrom
theirpossessionswhiletheywerenotpresent.
22percenthavebeenphysicallyassaulted.
7percenthavebeensexuallyassaulted.
How poor arehomeless clients?
Singlehomelessclientsreportameanincomeof$348
duringthelast30days.Thisamountisonly51per-
centofthe1996federalpovertylevelof$680/month
foroneperson.
Clientsinfamilyhouseholdsreportameanincome
of$475duringthelast30days.Thisamountisonly
46 percent of the 1996 federal poverty level of
$1,023/monthforafamilyofthree.
Singlehomelessclientsreceivedonly12percentofthe
medianmonthlyincomeofallAmericanhouseholdsin
1995($2,840)inthemonthbeforebeinginterviewed,
andhomelessfamiliesreceivedonly17 percent.
Sources of Income and Benets
How many homeless clients did any paid work in
thepast month?
44percentdidpaidworkduringthepastmonth.Of
these:
20percentworkedinajoblastingorexpectedto
lastatleastthreemonths.
25percentworkedatatemporaryordaylaborjob.
2percentearnedmoneybypeddlingorsellingper-
sonalbelongings.
3 percent report more than one source of earned

income.
How many receiveincomefrom family or friends?
21percentreceiveincomefromfamilymembersor
friends,including:
9percentfromparents.
2percentfromaspouse.
5percentfromotherrelatives.
12percentfromfriends,includingboyfriendsand
girlfriends.
1percentfromchildsupport.
8percentreportincomefrommorethanonetypeof
familymemberorfriend.
How many homeless clients receive government
benets? What types of benets?
37percentreceivefoodstamps.
52 percent of homeless households with children

receiveAidtoFamilieswithDependentChildren
(AFDC).(In1996,whenthesurveywasconducted,
AFDCwasstilloperating.)
Highlights xix
11percentreceiveSupplementalSecurityIncome
(SSI).
9percentreceiveGeneralAssistanceoranotherstate
orlocalcashassistancebenet.
6percentofhomelessveteransreceiveveteran-related
disabilitypayments;2percentreceiveveteran-related
pensions.
30percentreceiveMedicaid,andanother7percent
receivemedicalcarefromtheDepartmentofVeter-
ansAffairs.
How many homeless clients receive money from
panhandling?
8percentreportincomefrompanhandlinginthelast
30days.
The Location of Homeless Clients
In what types of communities (big cities, suburbs,
and rural areas) arehomeless clients found?
Therearehomelessclientsineverytypeofcommu-
nity.Themajorityofhomelessclients,71percent,are
incentralcities,while21percentareinthesuburbs
andurbanfringeareas,and9percentareinrural
areas.Thesefigurescontrastwiththedistributionof
31,46,and23percent,respectively,forpoorpeoplein
theUnitedStates.
How much do homeless clients move from one
community to another?
29percentofhomelessfamiliesand46percentofsin-
glehomelessclientsarenotlivinginthesamecityor
townwheretheybecamehomeless.
Majorreasonsgivenforleavingthecityortownwhere
theyfirstbecamehomelessarethelackofjobs,the
lackofaffordablehousing,andbeingevictedfromor
askedtoleavetheplacewheretheywereliving.
Majorreasonsforcomingtothecityortownwhere
theywereinterviewedarethepresenceofrelativesor
friends,thepossibilityofwork,andtheavailabilityof
shelters,missions,andotherservices.
Within their communities, where can homeless
clients befound? What services do they use?
31percentsleptonthestreetsorinotherplacesnot
meantforhabitationwithinthelastweek.
66percentusedanemergencyshelter,transitional
housingprogram,orprogramofferingvouchersfor
emergencyaccommodationwithinthelastweek.
36percentusedsoupkitchenswithinthelastweek.
10percentusedotherhomelessassistanceprograms
(e.g.,drop-incenters,foodpantries,outreachpro-
grams,mobilefoodprograms)withinthelastweek.
Patterns of Homelessness
How many peoplearehomeless for therst time?
How long arepeoplehomeless?
49percentofhomelessclientsareintheirrstepisode
ofhomelessness,while34percenthavebeenhome-
lessthreeormoretimes.Clientsinfamiliesandsin-
glehomelessclientsareequallylikelytobeintheir
firsthomelessepisode,butsingleclientsaremore
likelythanclientsinfamiliestohavebeenhomeless
threetimesormore(37versus23percent).
For 28 percent of homeless clients, their current

episodehaslastedthreemonthsorless,butfor30per-
centithaslastedmorethantwoyears.Clientsinfam-
iliesaremorethantwiceaslikelyassingleclientsto
havebeenhomelessforthreemonthsorless(49versus
23percent),whilesingleclientsarealmostthreetimes
aslikelyasclientsinfamiliestobeinhomelessspells
that have lasted more than two years (34 versus
13percent).
Other Important Proles
How many homeless clients areparents? Aretheir
children with them?
60percentofhomelesswomenhavechildrenages0to
17;65percentofthesewomenlivewithatleastoneof
theirminorchildren.
41percentofhomelessmenhavechildrenages0to
17;7percentofthesemenlivewithatleastoneof
theirminorchildren.
What are the characteristics of the children of
homeless clients?
53percentofthechildrenaccompanyingahomeless
parent in this study are male and 47 percent are
female.
Mostofthesechildrenareyoung:20percentareages
0to2,22percentareages3to5,20percentareages
6to8,33percentarebetweentheagesof9and17,
andagewasnotgivenfor5percent.
xx Highlights
Parentsreportthat45percentofthe3-to5-year-olds
attendpreschool,andthat93percentofschool-age
children(ages6to17)attendschoolregularly.
51percentofchildrenareinhouseholdsreceiving
AFDC,70percentareinhouseholdsreceivingfood
stamps,12percentareinhouseholdsreceivingSSI,
and73percentreceiveMedicaid.
How many homeless clients areveterans? What is
theproportion for homeless men?
23percentofhomelessclientsareveterans,compared
withabout13percentofallAmericanadultsin1996.
98percentofhomelessclientswhoareveteransare
men.33percentofmalehomelessclientsareveter-
ans,aswere31percentofAmericanmenin1996.
21 percent served before theVietnam era (before

August1964);47percentservedduringtheVietnam
era (between August 1964 and April 1975); and
57 percentservedsincetheVietnamera(afterApril
1975). Many have served in more than one time
period.
33percentofthemaleveteransinthestudyweresta-
tionedinawarzone,and28percentwereexposedto
combat.
What adversechildhood experiences did homeless
clients report?
27percentofhomelessclientslivedinfostercare,a
grouphome,orotherinstitutionalsettingforpartof
theirchildhood.
25percentreportchildhoodphysicalorsexualabuse.
21percentreportchildhoodexperiencesofhome-
lessness.
33 percent report running away from home and

22percentreportbeingforcedtoleavehome.
Homeless Assistance Programs
How many homelessassistanceprogramsaretherein
theUnited States? What kindsof programsarethey?
This study estimates that there are about 40,000

homelessassistanceprogramsintheUnitedStates,
offeredatanestimated21,000servicelocations.
Foodpantriesarethemostnumeroustypeofpro-
gram,estimatedtonumber9,000programs.Emer-
gencysheltersarenextwithanestimated5,700pro-
grams, followed closely by transitional housing
programs(4,400),soupkitchensandotherdistributors
ofpreparedmeals(3,500),outreachprograms(3,300),
andvoucherdistributionprograms(3,100).
Emergencysheltersexpected240,000programcontacts,
transitionalhousingprogramsexpected160,000, perma-
nenthousingprogramsexpected110,00,andvoucher
distributionprogramsexpected70,000programcontacts
onanaveragedayinFebruary1996.Expectedcontacts
includethosemadebybothhomelessandotherpeople
whouseservices.
49percentofallhomelessassistanceprogramsare
locatedincentralcities,32percentinruralareas,and
19percentinsuburbanareas.However,becausecen-
tralcityprogramsservemoreclients,alargershareof
programcontactshappenincentralcities(57percent)
thaninsuburbanandruralareas(20and23percentof
allprogramcontacts,respectively).
Greatvariationwasfoundamongthe76sampling
areasintheirlevelofexpectedprogramcontactson
anaveragedayinFebruary1996.
Theaverageestimatedrateof programcontactsper
10,000 poor peopleinasamplingareais1,437,with
ahighof9,000andalowof0.Thebiggestcities
areprovidingaboutequallevelsofserviceinrelation
totheirpoorpopulation.Smallandmedium-sized
metropolitanareasandruralareasrevealmuch
morevariabilityinservicelevels.
Changes between 1987 and 1996
What comparisonsarepossiblebetween NSHAPC
data and the last national study, conducted in
1987 by the Urban Institute (Burt and Cohen
1989)?
The1987studyi ncludedonlysheltersandsoup
kitchensinlargeU.S.cities(thosewith100,000or
morepopulation),thereforethe1996statisticsused
forthi scompari sonuseonlyhomelessNSHAPC
cli entsfoundi ncentralci ti eswhoweresampled
fromemergencyshelters,transitionalhousingpro-
grams, voucher di stri buti on programs, and soup
kitchens.
How do homeless shelter and soup kitchen clients
located in central cities in 1996 compareto those
in 1987?
Theyarelesslikelytobewhite(39versus46percent)
andmorelikelytobeblack(46versus41percent).
Theyarebettereducated(morelikelytohavecompleted
highschool39versus32percent,andtohavesome
educationbeyondhighschool27versus20percent).
Highlights xxi
Morehavenevermarried(51versus45percent),but
havethesamelikelihoodoflivinginfamilyhouse-
holds(10percentineachyear).
Theyaremuchmorelikelytogetgovernmentbene-
ts:AFDCamonghomelessfamilieswithchildren
58percentin1996versus33percentin1987;food
stampsamongallhomeless38versus18percent;
SSIamongallhomeless13versus4percent.
Theyhavehigheraveragemonthlyincomespercapita
afteradjustingforination($267in1996versus$189
in1987),butarestillverypoor.
Theyarelesslikelytosaytheysometimesoroftendo
notgetenoughtoeat28percentversus38percent;
andmorelikelytosaytheygetenoughofwhatthey
wanttoeat31percentversus19percent.
Nodifferenceswerefoundintheproportionexperi-
encinginpatienttreatmentforalcoholordrugabuse,
orformentalhealthproblems.
Questions This Report Does Not Answer
Howmanyhomelesspeoplearethere?Howmany
homelesspeoplearethereinmycity/county/state?
Whatarethecharacteristicsofhomelesspeopleinmy
city/county/state?
Whatfactorscausehomelessness?
Whatprogramsworkbest?
What If You Want to Know More?
Homelessness: Programsand thePeopleThey ServeSum-
maryReport containsmoredetailedinformationrelevant
tothequestionsposedinthesehighlights,aswellasmany
otherissues.Readerswhowantanevenmoredetailed
lookatstudyresults,orthosewhowanttoknowmore
aboutitsmethodology,shouldconsultHomelessness: Pro-
gramsand thePeopleThey ServeTechnical Report. Two
otheritemsrelatedtothesurveyarecurrentlyavailable.
Listscontainingthenames,addresses,andtelephone
numbersofthehomelessassistanceprovidersineachof
the76surveyareasareavailablefromtheInteragency
CouncilontheHomeless,HUD,4517thStreet,SW,
Room7274,Washington,D.C.20410,orbyemailing
survey_results@hud.gov.PublicusedatalesonCDmay
bepurchasedfromCensusBureauCustomerService;call
(301) 457-4100.Filesarealsoavailablefordownloading:
gotowww.census.govandthenclickonHunderthe
alphabeticallistingsAZ.
xxii Highlights
Highlights xxiii
1
1ntroduction and
esign Overview
NSHAPC Methods Highlights
The National Survey of Homeless Assistance Providers and Clients

(NSHAPC) was conducted to provide information about the
providers of homeless assistance services and the characteristics of
homeless clients who use these services for use by federal agencies
responsible for administering homeless assistance programs and
other interested parties. The data are national in scope, and the sur-
vey is the rst to gather, through one effort, a wide range of infor-
mation relevant to the missions of the federal sponsors. NSHAPC
was not designed or conducted to produce a count or estimate of
the number of homeless persons.
NSHAPC is based on a statistical sample designed to represent the

entire United States. The sample includes 76 primary sampling areas:
the countrys 28 largest metropolitan statistical areas (MSAs),
another 24 randomly sampled small and medium-sized MSAs, and
24 randomly sampled groups of rural counties.
NSHAPC involved two major phases: surveying administrators of

homeless assistance programs through telephone interviews and
mail surveys, and conducting face-to-face interviews with the clients
of these programs.
Telephone interviews were conducted with representatives of about

6,400 service locations operating about 12,000 programs. This was
followed by a mail survey of about 6,500 programs identied
through the telephone interviews. Finally, to reach clients the study
randomly selected programs within the primary sampling areas, and
from these programs randomly selected about 4,200 program clients
who completed in-person interviews.
NSHAPC covers 16 types of homeless assistance programs: emer-

gency shelters, transitional housing, permanent housing for the for-
merly homeless, programs offering vouchers for temporary housing,
programs accepting vouchers for temporary housing, food pantries
(in rural areas), soup kitchens/meal distribution programs, mobile
food programs, physical health care programs, mental health care
programs, alcohol/drug programs, HIV/AIDS programs, outreach pro-
grams, drop-in centers, migrant housing used for homeless people,
and other programs.
H I G H L I G H T S
This study interviewed a random sample of clients who use homeless assistance programs.* Many were
not homeless at the time of the interview. Some had been homeless at some earlier point in their lives,
while others had never been homeless. In addition, although NSHAPC is nationally representative, it
does not represent homeless people who do not use services or those in communities that have few or
no homeless assistance services. These areas may have homeless people but because the NSHAPC
sample is service based, they would not be included in this survey.
All numbers and simple percentages presented in the text have a 90 percent condence interval
(margin of error) less than or equal to 4 percentage points unless otherwise noted. All comparisons
presented in the text are statistically signicant at a 90 percent level or better (p < .10).
This report does not answer several frequently asked questions, including: How many homeless people
are there? How many homeless people are there in my city/county/state? What are the characteristics
of homeless people in my city/county/state? What programs work best?
H I G H L I G H T S (Continued)
2 Homelessness: Programsand thePeopleTheyServe
Introduction
HomelessnesshasbeenaconstantpresenceinAmerican
cities,towns,andruralareasformanyyears,although
duringtherecessionof198182itwasidentifiedasa
nationalissueforthefirsttimesincetheGreatDepres-
sion.Sincetheearly1980s,homelessnesshasbeenareg-
ularfocusofmediainterestandatopicofpolicydebate.
Thearrayofprogramsandservicesforhomelesspersons
hasincreasedgreatlyduringthisperiod,ashasthefund-
ingneededtosupportthem.
Reliableandcomprehensiveinformationabouthome-
lessclientshasnotbeeneasytoobtainatthenational
level.In1987theUrbanInstituteconductedthefirst
nationalstudytointerviewhomelessclientsatsome
depthonavarietyoftopics.Thedatafromthatstudy
were collected before the passage of the Stewart B.
McKinneyHomelessAssistanceActof1987,andbefore
thesignificantincreaseinfederalinvolvementandpro-
gram development that followed. Further, although
nationalinscope,theUrbanInstitutestudyonlywent
tocentralcitiesandcollecteddataonlyfromshelterand
soupkitchenusers,soitcouldnotbeusedtocharacterize
homelessnessintheentireUnitedStates.
Nineyearslater,theNationalSurveyofHomeless
AssistanceProvidersandClients(NSHAPC)wascon-
ducted to remedy this serious gap in knowledge. It
becamethesecondprobability-basedinterviewstudyon
homelessnesstobenationalinscope.Thistime,homeless
clientsinsmallercities,suburbs,andruralareaswere
includedforafullpictureofhomelessserviceusersinlate
1996.NSHAPCthusprovidestherstopportunitysince
1987toupdatethenationalpictureofhomelessnessina
comprehensiveandreliableway.Occurringasitdid
beforeimplementationofmajorchangesinwelfarepro-
grams,italsoprovidesabaselinefortheeffectsofwel-
farereformonhomelessassistanceprograms.
NSHAPCwasconceived,developed,andfundedby12
federalagenciesundertheauspicesoftheInteragency
CouncilontheHomeless,aworkinggroupoftheWhite
HouseDomesticPolicyCouncil.
1
TheCensusBureaucar-
riedoutthedatacollectiononbehalfofthesponsoring
agencies.Thischapterpresentsndingsrelatedtothechar-
acteristicsandexperiencesofhomelessclients.Wherepos-
sible,dataonhomelessclientsarecomparedtostatisticsfor
thepopulationofallAmericanadultsorthoselivingin
poverty,toprovidereaderswithsomecontext.
Overview of the Study Design
2
TheNSHAPCstudywasdesignedtoprovideanation-
allyrepresentativesampleofhomelessandotherclients
whousehomelessassistanceprograms,andofthepro-
gramsthemselves(exhibit1.1).Therewere76primary
samplingareas
3
(gure1.1),including
the28largestmetropolitanstatisticalareasinthe
UnitedStates;
24smallandmedium-sizedmetropolitanstatistical
areas,selectedatrandomtoberepresentativeofgeo-
1
The 12 federal sponsoring agencies are the U.S. Departments of
HousingandUrbanDevelopment,HealthandHumanServices,Veterans
Affairs, Agriculture, Commerce, Education, Energy, Justice, Labor, and
Transportation; the Social Security Administration; and the Federal
EmergencyManagementAgency.
2
ReadersinterestedinmoredetailaboutthemethodsusedinNSHAPC
shouldreadchapters1and2inHomelessness: Programsand thePeopleThey
ServeTechnical Report, andthatreportsappendixesdealingwithsampling,
weighting,andthesurveyinstruments.
3
AppendixAprovidesthefulllistofthe76primarysamplingareas.
*Programs included emergency shelters, transitional and permanent housing programs, voucher distribution
programs, food pantries, soup kitchens, mobile food programs, outreach programs, drop-in centers, and other
programs.
Introduction and Design Overview 3
graphicalregions(northeast,south,midwest,west)
andsize;and
24ruralareas(groupsofcounties),selectedatrandom
fromasamplingframedenedasthecatchmentareas
ofCommunityActionagencies,andrepresentativeof
geographicalregions.InNewEngland,theactual
areassampledwerepartsofcounties.
The study began by i denti fyi ng and col l ecti ng
informationaboutall oftheprogramswithineachof
the76 primarysamplingareasthatmetitsdefinition
ofahomelessassistanceprogram.Suchprogramshad
tohavea focusonservinghomelesspeople(although
they di d not have to serve homel ess cl i ents excl u-
si vely).Theyalsohadtoofferdi rectservi ce,andbe
wi thi nthegeographi calboundari esofthesampli ng
area.Inruralareasthestudysdefinitionofaprogram
wasexpandedtoincludeprogramsthatservedhome-
lesspeoplebutmaynothavehadthispopulationasa
focus.Si xteentypesofhomelessassi stanceprograms
weredefined(exhibit1.1).
4
Data Collection Approaches
Thestudycollectedinformationinthreeways:
Homeless assistance programs basic description
Telephoneinterviewswith representativesof 6,307 service

locationsoffering11,983 homelessassistanceprograms
Aservice location isthephysicallocationatwhich

oneormoreprogramsoperate.Ahomeless assis-
tance programisasetofservicesofferedtothesame
groupofclientsatasinglelocationandfocusedon
servinghomelesspeopleasanintendedpopulation
(althoughnotalwaystheonlypopulation).
Programdirectorsorotherstaffknowledgeable
abouttheprogram(s)offeredataparticularloca-
tionwereinterviewedbytelephone.Basicdescrip-
tionsofallhomelessassistanceprogramsofferedat
thatlocationwereobtained.
Homeless assistance programs detailed information
about services
Mail surveysfrom5,694 programs
Surveyswerecompletedbyastaffpersonwho
4
AppendixBprovidesfullprogramdenitions.
FI GURE 1. 1
Sampling Areas for NSHAPC
Source: U.S. Department of Commerce, DSMD Bureau of the Census.
knewtheprogramanditsclientswell.Detailed
informationwascollectedaboutclientneeds,the
extent to whi ch these needs were met, and
whetherservicestomeettheseneedswereavail-
ableattheirownprogramorotherprogramsin
thecommunity.
Aservice isanygoodoractivityofferedtoclients
usingaprogram,butnotqualifyingonitsownas
aprogram.
Clients of homeless assistance programs
Interviewswith 4,207 clients
Aclient issomeonewhousesaprogram,whether
heorsheishomelessornot.Interviewswerecon-
ductedwithclientsofanyageaslongastheywere
notaccompaniedbyaparentorguardian.
Ineachsamplingarea,thestudyselectedasample
oftheprogramsidentifiedthroughthetelephone
E X HI B I T 1 . 1 Overview of NSHAPC Study Design
NATIONAL SAMPLE BASED ON:
28 largest metropolitan statistical areas (MSAs)
24 MSAs randomly sampled from the remaining small and medium-sized
MSAs
24 randomly sampled groups of rural counties
DEFINITIONS
Service location: a physical location at which one or more homeless assistance
programs operate
Program: any one of the 16 types of programs eligible for inclusion in
NSHAPC:
1. emergency shelters
2. transitional shelters/housing
3. permanent housing for formerly homeless people
4. programs offering vouchers for emergency accommodation
5. programs accepting vouchers for emergency accommodation
6. food pantries
7. soup kitchens/meal distribution programs
8. mobile food programs
9. physical health care programs
10. mental health care programs
11. alcohol/drug programs
12. HIV/AIDS programs
13. outreach programs
14. drop-in centers
15. migrant housing used for homeless people
16. other programs
Service: goods or activities offered to program clients
Client: anyone who uses a program and is not accompanied by a parent
DATA COLLECTION TECHNIQUES
Telephone interviewswith representatives of all service locations identied in
the sampled geographic areas (nal unweighted sample of 6,307 service loca-
tions and the 11,983 programs they report offering)
Mail survey of programs reported during the telephone interviews (nal
unweighted sample of 5,694 programs)
Client interviewsin a sample of programs in each of the sampled geographic
areas (nal unweighted sample of 4,207)
interviews,takingintoconsiderationprogramtype
andprogramsize.Sixtoeightclientswereinter-
viewedateachofapproximately700programvis-
its.CensusBureaustaffworkedwiththeprograms
selectedtoestablishthebesttimesandmethodsto
selectandinterviewclients,andmethodstopay
clientsonceinterviewswerecompleted.
Sixtoeightpeoplewereselectedrandomlyfrom
amongallclientsusingtheprogramatthetimeof
datacollection.Theywereinterviewedinpersonby
trainedinterviewersfromtheCensusBureau.Most
interviewstookplaceattheprogramlocation.Clients
selectedthroughoutreachprogramsorprograms
operatingintheeveningoratnightweresometimes
interviewedthenextdayatlocationsarrangedin
advance.Everyeffortwasmadetoassureprivacy
duringtheinterview.Clientscompletingtheinter-
viewreceived$10fortheirtime.
Basic Analytic Categories
Threeimportantclientsubgroupsareusedthroughout
thisreportandneedtobedefinedforthereader.These
are homelessness status, family status, and alcohol/
drug/mentalhealth(ADM)status.Alsodescribedisthe
geographicbasisforthetermscentralcity,suburbs/
urbanfringe,andrural,andthetimeframesusedin
thereport.
Dening Homelessness Status
Thestudyadoptedthesamedenitionofhomelessas
thatusedintheStewartB.McKinneyHomelessAssis-
tanceActof1987,namelyanindividualwholacksa
fixed,regular,andadequatenighttimeresidence,oran
individualwhohasaprimarynighttimeresidencethat
is:(a)asupervisedpubliclyorprivatelyoperatedshelter
designedtoprovidetemporarylivingaccommodations
(includingwelfarehotels,congregateshelters,andtran-
sitionalhousingforthementallyill);(b)apublicorpri-
vate place that provides a temporary residence for
individualsintendedtobeinstitutionalized;or(c)apub-
licorprivateplacenotdesignedfor,orordinarilyused
as,regularsleepingaccommodationsforhumanbeings.
Thefollowingspecificconditionswereusedtoclassify
NSHAPCclientsascurrently homeless:
Theclientsreportedstayinginanyofthefollowing
placesonthedayofthesurveyorduringtheseven-day
periodpriortobeinginterviewedforNSHAPC:
1. anemergencyshelterortransitionalhousingpro-
gram,or
2. ahotelormotelpaidforbyasheltervoucher,or
3. anabandonedbuilding,aplaceofbusiness,acaror
othervehicle,oranywhereoutside.
Ortheclients
4. reportedthatthelasttimetheyhadaplaceof
[their]ownfor30daysormoreinthesameplace
wasmorethansevendaysago,or
5. saidtheirlastperiodofhomelessnessendedwithin
thelastsevendays,or
6. wereselectedforinclusionintheNSHAPCclient
surveyatanemergencyshelterortransitionalhous-
ingprogram,or
7. reportedgettingfoodfromtheshelterwhereyou
livewithinthelastsevendays,or
8. onthedayoftheinterview,saidtheystayedintheir
ownorsomeoneelsesplacebutthattheycould
notsleepthereforthenextmonthwithoutbeing
askedtoleave.
Use of the first criterion (shelter use) classifies
34.9 percentofthesampleascurrentlyhomeless.Cri-
teriatwo(voucheruse)andthree(placesnotmeant
forhabitation)add1.7percentand9.8percent,respec-
tively,foratotalof46.4percent.Theveremainingcri-
teriatogetheraddanother7.1percent,forafinaltotal
of 53.5 percent of the sample classified as currently
homeless.AllbutthenalcriterionmeettheMcKinney
Actdefinitionofhomelessness;thelastcriterionadds
only0.3percentagepointstothenalproportionclassi-
edascurrentlyhomeless,andwasincludedbecausethe
surveyitselftreatsclientsinthissituationashomeless.
Manyclientswhowerenotliterallyhomelessreported
havingbeenhomelessatsomeearliertimeintheirlives
(22percentofthefullsample).Thecircumstancesused
toclassifyclientsasformerlyhomelessalsomeetthe
McKinneyActdefinitionofhomelessness.Clientswere
classiedasformerly homeless ifthey
didnotmeetanyoftheconditionsqualifyingthem
ascurrentlyhomelessbutatsomepointintheirlives
hadstayedinanyofthefollowing:
1. anemergencyortransitionalshelter,or
2. awelfare/voucherhotel,or
3. an abandoned building, a place of business, a
car/othervehicle,oranywhereoutside,or
4. apermanenthousingprogramfortheformerly
homeless;or
saidtheyhadpreviouslyhadaperiodwhentheywere
homeless.
Theremaining24percentofNSHAPCclientshad
neverbeenhomelessaccordingtothecriteriausedhere,
andalsosaidtheyhadneverbeenhomeless.Theyare
referredtothroughoutthisreportasother service users.
Specifying TimeFrames
Alltimeperiodsdiscussedinthisreportrelatetothedaya
clientwasinterviewedforthestudy(betweenOctober18
andNovember14,1996).Thus,pastweekorpastseven
daysreferstotheweekbeforetheinterview;pastmonth
orpast30daysreferstothemonthbeforetheinterview;
andpastyearreferstotheyearbeforetheinterview.
Lifetimereferstotheclientslifeuptothetimeofthe
interview.
Dening Family and SingleStatus
Inthisreport,aclientisconsideredtobeinafamilyhouse-
holdifsheorheliveswithoneormoreofhisorherown
childrenunderage18.Forthesakeofsimplicitythrough-
outthereport,theseclientswillbereferredtoasclientsin
families.Itisnotpossibletodeterminewhoelsemightbe
membersofthesefamilyhouseholds,norisitpossibletosay
withcertaintythatarespondentisalone.However,forsim-
plicityoflanguage,thefamilystatusvariablereported
throughoutthisstudyclassiesclientsintotwomutually
exclusivegroups:clients in families andsingle clients.
Dening Alcohol/Drug/Mental Health
(ADM) Status
Ingeneral,individualsareclassifiedashavinganADM
problemiftheyhavehadatleastonealcoholuse,drug
use,ormentalhealthproblemduringthepastmonth.
Presenceofeachproblemwasdenedasfollows.
Clientswereclassiedashavingapast month alcohol
use problemifanyofthefollowingconditionsweremet:
(1)theyscored0.17orhigheronamodifiedAddiction
SeverityIndex
5
(ASI)measure,(2)theyreporteddrinking
togetdrunkthreeormoretimesaweekwithinthepast
month,(3)theyreportedbeingtreatedforalcoholabuse
withinthepastmonth,or(4)theyreportedeverhaving
beentreatedforalcoholabuseanddrinkingthreeormore
timesaweekwithinthepastmonth.
Clientswereclassifiedashavingapast year alcohol
use problem iftheymetthesesamecriteriawithinthe
pastyear(includingthepastmonth),andashavingalife-
time alcohol use problem iftheymetthesesamecriteria
intheirlifetimeoriftheyreportedeverhavinghadthree
ormorealcohol-relatedproblems(suchasblackouts,
tremors,and/orconvulsions).
Clientswereclassifiedashavingapast month drug
use problem i fanyofthefollowi ngcondi ti onswere
met:(1)theyscored0.10orhigheronamodifiedASI
measure, (2) they reported bei ng treated for drug
abusewithinthepastmonth,(3)theyreportedusing
drugs i ntravenousl y (shooti ng up),
6
or (4) they
reportedusinganyofavarietyofspecificdrugsthree
ormoretimesaweekwithinthepastmonth.
7
Clients
wereclassi fi edashavi ngapast year drug use prob-
lem iftheymetthesesamecriteriawithinthepastyear
(includingthepastmonth),andashavingalifetime
drug use problem i ftheymetthesesamecri teri ai n
theirlifetimeoriftheyreportedeverhavinghadthree
ormoredrug-rel atedprobl ems(suchasbl ackouts,
convul si ons, wi thdrawal symptoms, and/ or i l l egal
activitiestogetmoneyfordrugs).
Cl i ents were cl assi fi ed as havi ng a past month
mental health problem i fanyofthefollowi ngcon-
ditionsweremet:(1)theyscored0.25orhigherona
modi fi edASI measure,(2)theyreportedrecei vi ng
treatment or counsel i ng or bei ng hospi tal i zed for
emotionalormentalproblemswithinthepastmonth,
(3)theyreportedtaki ngprescri bedmedi cati onsfor
psychologicaloremotionalproblemswithinthepast
month,(4)theyreportedthatamentalhealthcondi -
tionisthesinglemostimportantthingkeepingthem
fromgettingoutofhomelessness,or(5)theyreported
recei vi ngtreatmentorcounseli ngorbei nghospi tal-
izedforemotionalormentalproblemsatsomepoint
i nthei rl i vesandhavi ngoneormoreoftheASI s
sevenemoti onalorpsychologi calcondi ti onswi thi n
thepastmonth.
8
Cl i entswerecl assi fi edashavi nga
past year mental health problem ifthesesamecriteria
weremetwi thi nthepastyear(i ncl udi ngthepast
month), and as havi ng a lifetime mental health
6
This item is part of question 10.1 of the client survey, that asked
aboutcurrentmedicalconditions.
7
See Homelessness: Programs and the People They ServeTechnical
Report,chapter8and/orquestion13.14oftheclientsurvey(appendixE
oftheTechnical Report)foralistofthesedrugs.
8
SeeHomelessness: Programsand thePeopleTheyServeTechnical Report,
chapter 8and/orquestion12.1oftheclientsurvey(appendixEoftheTech-
nical Report)foralistoftheseemotionalandpsychologicalconditions.
5
The Addiction Severity Index is an instrument developed by the
National Institute on Drug Abuse (Fureman, Parikh, Bragg, and
McLellan1990).Itcontains subscales tomeasure arespondents levelof
problems with alcohol, with drugs, and with mental or emotional
problems.Cutofflevelsusedinthisreportareslightmodicationsofthe
meansreportedinZanis,McLellan,Cnaan,andRandall(1994).
problem ifthesesamecriteriaweremetintheirlife-
timeoriftheyreportedeverhavingstayedinanclient
grouphome,crisisresidence,orotherhousingforthe
mentallyill.
Describing Urban/Rural Location
Anumberofanalysesfocusonthegeographiclocation
whereclientswerefound,includingcentralcities,sub-
urbanandurbanfringeareas,andruralareas.Central
citiesarethemainorprimarycitiesofmetropolitansta-
tisticalareas(MSAs).Suburban and urban fringeareas
aredefinedaswhatisleftofMSAsaftertakingoutthe
centralcities,andmayincludesmallercities,suburbs,
towns,andevenopenlandifitisinthecountiesmak-
inguptheMSA.Rural areasaredenedasallareasout-
side of MSAs, and may include small cities (under
50,000people),towns,villages,andopenland.
Statistical Signicance of Findings
Thisreportcontainsmanystatistics.Somearenumbers,
suchasthenumberofhousing,food,andotherprograms
intheUnitedStates.Othersaresimplepercentages,such
asthepercentageofclientswhoaremale.Stillothersare
comparisonsbetweentwogroups.
CondenceIntervals
A 90 percent criterion has been used for confidence
intervals in this report.
For numbers: Ninetypercentconfidenceintervals

aregivenforallestimatesofnumbers.A90percent
confi dence i nterval of 400 means that i f the
reportednumberofsoupkitchensis4,000,4,000is
theestimateofthenumberofsoupkitchensandthe
probabi li ty i s 90 percent that the number falls
between3,600and4,400.
For percentages: Almost all simple percentages

reportedinthetexthavea90percentconfidence
intervalofnomorethan4percentagepoints.A90
percentconfidenceintervalof4percentagepoints
meansthatifthereportedpercentis60,60isthebest
pointestimateandtheprobabilityis90percentthat
thetruepercentfallsbetween56and64percent.In
thefewinstanceswhenthecondenceintervalexceeds
4percentagepoints,theactualcondenceintervalis
reportedinafootnotewiththefollowingnotation:
90%C.I.=Xpercentagepoints.
Statistical Signicanceof Comparisons
Comparisonsaretheotherimportantwaythatinforma-
tionispresentedinthisreport.Whenonereportsthat
currentlyhomelessclientsincludehigherproportionsof
menthandoformerlyhomelessclients,oneismaking
a comparison. A statistical test is used to determine
whetherthedifferencebetweentwopercentagesfromdif-
ferentgroupsissignificantinthestatisticalsense.As
withcondenceintervals,thesetestscanbecalculatedfor
differentlevelsofstatisticalsignicance.
A 90 percent criterion has been used for all compar-
isons in this report. Thus,allcomparisonsdiscussedin
thetextarestatisticallysignificantatp=.10orbetter,
meaningthatthereisonlya10percentchancethatthe
differenceisnot atruedifference.
Risk of FalsePositives
Thereadershouldnotethatwhenoneconductsavery
largenumberofstatisticalsignicancetests,someofthem
aregoingtoproducefalsepositives,meaningthatadiffer-
ence between two numbers really is not significant,
althoughthetestsaysitis.Thousandsoftestsforstatisti-
calsignicancewereperformedonthedatacontainedin
thisreport.Thereaderiscautionednottomaketoomuch
ofstatisticallysignificantbutrelativelysmalldifferences
betweenpopulations.Rather,attentionisbestdirectedto
seriousorsizabledifferencesbetweenpopulationsthatare
mostlikelytobestableandreliable,andalsomayhavea
chancetobeimportantforpolicypurposes.
Limitations of NSHAPC Findings
TherearesomeimportantaspectsoftheNSHAPCstudy
thatreadersneedtoknowifthestudysfindingsareto
beinterpretedcorrectly.
TheStudy Is Descriptive
Thisstudyisintendedtoprovideinformationdescribing
currentlyhomelessandotherclientsusinghomelessassis-
tanceprogramsintheUnitedStates.Thereisnointentto
infercausesofhomelessnessfromthisdescriptiveinfor-
mation.Statisticsarepresentedassimplyaspossible,for
easeofunderstanding.Whereinformationisavailable,
thereportcomparesstudyfindingsforhomelessclients
withstatisticsdescribingallAmericanadults,allpoor
adults,orotherrelevantnationalpopulations.Thisis
intendedtohelpthereaderunderstandsimilaritiesand
differencesbetweenpoorpeopleorthepopulationingen-
eralandclientsexperiencinghomelessnessinthefallof
1996.Whenastatisticlookssimplebutactuallyreflects
somehiddenthirdfactor,thereporttriestopointthisout.
Forexample,thereportshowsthatveteranscomprisea
higherproportionofstreetstayersthantheydoofshelter
stayers.Butthereportalsopointsoutthatthisisbecause
morestreetstayersaremenandalmostalloftheveteransin
thesamplearemen,notbecauseveteranshaveaspecial
propensityforsleepingonthestreets.
ThePeoplein theStudy Comefrom Homeless
AssistancePrograms
The people interviewed for NSHAPC are clients of
homelessassistanceprograms.Incitiesandothercom-
munitieswithmanyprograms,thisapproachisaneffi-
cientandeffectivewaytondandinterviewaveryhigh
proportionofhomelesspeople.However,incommuni-
tieswithoutmanyservices,thisapproachwillmissmany
homelesspeople,andthecompleteabsenceofservices
inacommunity,andthereforeofpeopleinterviewedfor
thisstudy(ashappenedintworuralsamplingareas),can-
notbetakentomeanthatsuchcommunitiesdonothave
anyhomelesspeople.
Inaddition,theremaybesomesystematicbiasesin
thehomelesspeoplewhoareinterviewedandthosewho
aremi ssedwhenacommuni tydoesnothaveafull
rangeofhomelessassistanceservices.Ifsoupkitchens
arerareinruralareas,typicalsoupkitchenuserswillbe
lesslikelytoappearinruralhomelesssamples.Ifsub-
urbswillaccepttransitionalhousingprogramsforfam-
iliesbutnotforrecoveringsubstanceusersorpeople
wi th mental health problems, then a servi ce-based
methodologywillmakesuburbanhomelesspopulations
lookasiftheyhavehigherproportionsoffamiliesand
lowerproportionsofclientswithmentalhealthorsub-
stanceuseproblems.
Aservi ce-basedapproachtodatacollecti oni sthe
mostreasonablewaythatanational studyofhomeless-
nesscouldbeundertakenandstillbestatisticallymean-
ingful.(SeethepaperbyTourkinandHubble,appendix
AoftheTechnical Report, foranexplanationofwhythis
studyusedaservi ce-baseddesi gn.)Localstudi escan
compensateforgapsinacommunitysservicesystem,
butthereisnorealisticwayforanationalstudytodo
so.Thereaderi sthereforeadvi sedtousecauti oni n
interpretingdifferencesinhomelessnessbetweencom-
munitiesofdifferenttypes,assomeofthedifferences
wi llprobablyreflectservi cesystemvari ati onsrather
thantruedifferencesinhomelesspopulations.
NSHAPC Was Designed to Collect Data
on Clients Who UseHomeless AssistanceServices
Manyhomelessassistanceprogramsserveclientswho
arenotcurrentlyhomeless.Asaresultofthestudysran-
domsamplingofallprogramclients,someclientsinthe
NSHAPCsamplewerenothomelessatthetimethey
wereinterviewed.Thisisparticularlytrueforprograms
thatarenotsheltersortransitionalhousingprograms.
Informationcollectedduringtheinterviewindicatedthat
somehavebeenhomelessatleastonceintheirlifetime;
thisreportreferstothisgroupasformerlyhomeless
clients.Theremainingpeople,whoreportedneverhav-
ingbeenhomeless,arereferredtoasotherserviceusers.
Thestudydesignerswantedtoknowthecharacteris-
ticsofpeopleusingtheprograms,includinginforma-
tion about their living situation.The reader should
rememberthatwhilethestudydesignproducesasclose
toanationallyrepresentativesampleofhomelessclients
aspossible,thesameisnottrueforformerlyhomeless
clientsandotherserviceusers.Asunrepresentativeof
theirlargercategoriesasthesetwosubgroupsofthesam-
plemaybe,informationaboutthemisimportantfor
serviceproviders.Thesetwogroupsmakeupalmosthalf
ofallclientswhousehomelessassistanceprograms,so
informationabouttheircharacteristicscanbeofconsid-
erablehelptoprogrammanagers.
All Client Information Comes from
theClients Themselves
Thestudyinterviewedclientsofhomelessassistancepro-
grams about their experiences, and recorded their
responses.Noattemptwasmadetoverifyorconrmthe
accuracyofwhatclientssaidaboutthemselves.Thisis
especiallyimportantforreaderstorememberwhenthey
reviewinformationabouttheclientshealthconditions,
useofalcoholanddrugs,mentalhealthproblems,incar-
ceration,victimization,joblessness,andotherpossiblysen-
sitivesubjects.Clientsmaynotactuallyknowsomethings,
suchasmedicalconditions(e.g.,hypertension,anemia),if
theydonotseedoctorsregularly.Theymayhaveforgotten,
orwishtodownplay,otherthingsthatcarrysomelevelof
socialstigma.Furthermore,manyquestionswereasked
andleftuptotheclienttointerpret,includingsuchcritical
issuesaswhetherornottheyhadeverbeenhomeless(no
ofcialdenitionwasgivenorimposedonclients).
What theStudy Does Not Do
Allstudieshavelimitations,andNSHAPCisnodiffer-
ent.Thisreportdoesnotincludeinformationonthefol-
lowingissues,becausethestudywasnotdesignedto
addressthem:
Howmanyhomelesspeoplearethere?(Neitherthe
programnortheclientcomponentofNSHAPCpro-
videsorwasintendedtoprovideacountorcensusof
homelesspersonsintheUnitedStates.Suchacount
wouldbelogi sti callyi mpossi bleandprohi bi ti vely
costly,astheexperi enceoftheStreetandShelter
Ni ghtcomponentofthe1990Decenni alCensus
clearlyshowed.Further,NSHAPCmissesallhomeless
peoplewhonevercontactahomelessassistanceprogram,
eitheroutofpersonalpreferenceorbecausenopro-
gramsareavai labletothem.Homelessassi stance
programestimatesoftheclientstheyexpecttoserve
willbeinaccuratebecausetheyincludemanyclients
whoarenothomeless,aswellasanunknowable
amountofduplicatecountingbecauseclientsoften
usemorethanoneprogram.)
Howmanyhomelesspeoplearetherei nmyci ty/

county/state?(Thestudywasnotdesignedtoanswer
thisquestion.)
Whatarethecharacteristicsofhomelesspeopleinmy
city/county/state?(Thestudycanreliablydescribe
homelesspeopleincentralcitiesasagroup,suburbs
andurbanfringeareasasagroup,andruralareasasa
group.However,itcannotdescribepopulationchar-
acteristicsforsmallergeographicareas.)
Whatprogramsworkbest?(NSHAPCisnotapro-
gramevaluation,anddoesnotcontainanyoutcome
orimpactinformation.)
Arethereenoughservices?(Thisquestioncanonly
beansweredatthelocallevel,usinginformationabout
theamountofeachservicethatisavailableandthe
numberofclientswhoneedit.)
Itisalsoimportantforthereadertorememberthatthis
studyobtainedinformationabouthomelessclientsandother
serviceusersduringOctoberNovember1996.Aswithall
informationthatfocusesonhomelesspeopleatasinglepoint
intime,itwilloveremphasizepeoplewithlongepisodesof
homelessnessandunderemphasizepeoplewithshortperi-
odsofhomelessnessandalsopeoplewhoarehomelessforthe
rsttime.Anycharacteristicsassociatedwithlengthofa
homelessepisodewilllikewisebeskewedtowardthecharac-
teristicsofpeoplewithlongerspellsofhomelessness.
The Structure of This Report
Theremainderofthisreportpresentsinformationabout
peoplewhousehomelessassistanceprogramsincludedin
NSHAPC,referredtothroughoutasclients,andprograms
andservicelocations.Chapter2presentsanoverviewof
homelessclientsforthemostgeneralndingswithineach
ofthestudystopicareas.Chapter3looksatthesamend-
ings,askingwhethercurrentlyhomelessclientsdifferin
importantwaysfromthosewhowereoncebutarenotnow
homeless,andotherusersofhomelessassistanceprograms
whodonotreportanyepisodeofhomelessness.Chapter
4describeshomelessassistanceprograms,includingpro-
gramtype,size,auspices(nonprot,government,private),
funding,populationgroupsforwhichtheprogramshavea
specialfocus,andservicesoffered.Italsoexaminesthe
availabilityofshelter/housingservicesandsoupkitchen
mealsinrelationtothetotalpopulationandpopulation
inpovertyin1990ofeachofthestudys76primarysam-
plingareas.AbriefconclusionisprovidedinthePostscript.
AppendixAprovidesalistofthe76samplingareasusedin
thestudy.AppendixBprovidestheNSHAPCdenitionof
ahomelessassistanceprogramandfulldescriptionsof
the16typesofhomelessassistanceprogramsincludedin
thestudy.
Additional Information May BeFound
in theTechnical Report
Readerswhowouldliketoexaminemoredetailedinfor-
mationaboutthetopicssummarizedinthisreportorwho
wouldliketoreviewstudymethods,surveyinstruments,
andothertechnicaldetailsshouldreviewthecompanion
technicalvolumetothisreport,Homelessness: Programsand
thePeopleThey ServeTechnical Report. Afteranintro-
ductorychapterandachaptersummarizingmethods,
chapters3through13presentinformationaboutclients
andchapters14through17covertopicsrelatedtohome-
lessassistanceprograms.Chaptertopicsare
Chapter3:demographiccharacteristics.
Chapter4:historyofhomelessnessamongcurrently
andformerlyhomelessclients.
Chapter5:income,incomesources,employmentand
unemployment, and participation in government
programs.
Chapter6:physicalhealthconditionsandaccessto
medicalanddentaltreatment.
Chapter7:foodsituationofclients,includingfood
problemsandfoodaccess.
Chapter8:specialneeds,includingpastmonth,past
year,andlifetimealcohol,drug,andmentalhealth
problems; treatment experiences related to these
problems;incarcerationhistory;andvictimization
whilehomeless.
Chapter9:serviceneedsfromtheclientsperspective.
Chapter10:adversechildhoodexperiences,includ-
ingout-of-homeplacement,victimization,runaway
andhomelessexperiences,andearlyinvolvementwith
drugsandalcohol.
Chapter11:veterans.
Chapter12:childreninhomelessfamilies.
Chapter13:characteristicsofhomelessclientsincen-
tralcity,suburban,andrurallocations.
Chapter14:basiccharacteristicsofhomelessassis-
tanceprograms.
Chapter15:populationfocusesofhomelessassistance
programs.
Chapter16:serviceofferingsofhomelessassistance
programs.
Chapter17:variationsinserviceavailabilityamong
NSHAPCs76 samplingareas.
FiveappendicesareattachedtotheTechnical Report:
AppendixA:NSHAPCs76 samplingareas.
AppendixB:NSHAPCprogramdenitions.
AppendixC:explanationoftheNSHAPCstudyand
samplingdesign.
AppendixD:explanationofweighting.
AppendixE:NSHAPCdatacollectioninstruments.
H I G H L I G H T S
2
n Overview
of 1omeless (lients
Homeless Clients
1
Among homeless households(that is, the one or more people repre-

sented by each NSHAPC client), 15 percent are family households
(that is, they include the client and one or more of the clients minor
children). If one includes all minor children living with homeless
clients, then 34 percent of homeless people found at homeless
assistance programs are members of homeless families and
66 percent are not.
Homeless clients are predominantly male (68 percent) and nonwhite

(53 percent). Large proportions are also never married (48 percent)
and poorly educated (38 percent have less than a high school
diploma). These characteristics contrast sharply with those of the
U.S. population as a whole (48 percent male, 14 percent nonwhite,
23 percent never married, and 18 percent with less than a high
school education).
Sixty percent of homeless women have minor children, as do

41 percent of homeless men. Among these minor children, only
28 percent live with their homeless parent and 72 percent do not.
Twenty percent of the children living with a homeless parent are
infants and toddlers (ages 0 to 2), 22 percent are preschoolers (ages
3 to 5), another 33 percent are of elementary school age (6 to 11),
and 20 percent are adolescents (ages 12 to 17). Age was not given
for 5 percent.
Finding a job is the top need reported by homeless clients (42 percent).
Thirty percent of homeless clients cited insufcient income and

another 24 percent cited lack of employment as the single most
important thing preventing them from leaving homelessness.
Homeless clients often have a hard time getting enough food. Fifty-
eight percent report at least one problem with getting enough food
to eat during the 30 days before being interviewed.
1
Unless noted specically, all comparisons are signicant at p .10 and all
percentages presented by themselves have a 90 percent condence interval no
larger than 4 percentage points. Condence intervals greater than
4 percentage points will be noted with a footnote as: 90% C.I. = X percentage
points.
Fifty-ve percent of homeless clients have no health insurance, and 24 percent say they needed med-
ical attention in the past year but were not able to get it.
Alcohol problems during the past month are reported by 38 percent of homeless clients, drug prob-
lems by 26 percent, and mental health problems by 39 percent. Sixty-six percent reported problems
with one or more of these issues during the month before they were interviewed.
Being homeless leaves ones person and possessions vulnerable to attack. Thirty-eight percent of
homeless clients report having money or things taken directly from them while homeless, and 41 per-
cent report thefts of their possessions while they were not present. In addition, 22 percent have been
physically assaulted and 7 percent sexually assaulted while homeless.
Over one-quarter (27 percent) of homeless clients lived in foster care, a group home, or other institu-
tional settings for part of their childhood. Twenty-ve percent report childhood physical or sexual
abuse. In addition, many had childhood experiences of homelessness (21 percent), running away from
home (33 percent), or being forced to leave home (22 percent).
The incomes of homeless clients are extremely low. Mean income during the 30 days before being
interviewed was $367. Mean income for clients living with their children was higher ($475), but was
still only 46 percent of the 1996 federal poverty level of $1,023/month for a family of three. Single
homeless clients report less income, averaging $348 during the past month, or just 51 percent of the
1996 federal poverty level of $680/month for one person. By comparison, the median monthly income
for all American households was $2,840 in 1995, indicating the extreme poverty of homeless clients
whether they be families or singles.
Forty-four percent of homeless clients worked for pay during the last 30 days, but less than half of
these workers had a regular job (one lasting or expected to last three months or more).
The means-tested government benets with the highest rates of participation among homeless clients
were food stamps (37 percent) and Medicaid (30 percent). Participation in cash assistance included Aid
to Families with Dependent Children (AFDC) (52 percent among homeless families), General Assistance
(GA) (9 percent), and Supplemental Security Income (SSI) (11 percent). Household status did not affect
receipt of the latter two benets, but homeless families were much more likely than other homeless
clients to receive food stamps and Medicaid. All 1996 rates of participation in government benet pro-
grams are signicant improvements over participation rates for homeless clients in 1987.
Almost half (49 percent) of homeless clients have been homeless only once, but 22 percent have been
homeless four or more times. Current spells of homelessness in this point-in-time study are about
equally likely to be short (28 percent were three months or less) and long (30 percent were two years
or more). Homeless families are more likely than single homeless clients to be in a rst episode that
has lasted less than six months (34 versus 15 percent).
About one-third (32 percent) of homeless clients spent time as street homeless during the week
before being interviewed.
Homeless clients changed their location frequently in the week before being interviewed, revealing a
great deal of overlap among clients sleeping in places not meant for habitation, shelters, and tempo-
rary accommodations. Seventy-three percent used shelters, of whom slightly more than half also had
slept in other arrangements and/or on the streets. Thirty-two percent slept on the streets, of whom 4
out of 5 also slept in shelters and/or other arrangements. Fifty-ve percent had slept in other arrange-
ments, of whom 9 out of 10 had also slept in shelters and/or on the streets.
The majority of homeless clients (71 percent) are in central cities, 21 percent in the suburbs and urban
fringe areas, and 9 percent in rural areas. This contrasts with the distribution of the U.S. population in
poverty of 43, 34, and 23 percent, respectively.
Comparing ndings from the Urban Institutes 1987 study of central city homeless shelter and soup
kitchen users with equivalent 1996 NSHAPC clients reveals both continuity and change during this
nine-year period. There is no change in the proportion of homeless clients in the two time periods
who are male, Hispanic, in families, or homeless for two years or more, or who have experienced inpa-
tient treatment for alcohol and/or drug and mental health problems. The biggest changes are evident
in increases from 1987 to 1996 in the proportion of clients whose current homelessness has lasted
three months or less, who receive AFDC
2
(family households only), SSI, and food stamps; an increase in
mean monthly income per person after adjusting for ination; and decreases in the proportion with
An Overview of HomelessClients 13
less than a high school education, who have never married, and who have problems getting enough
to eat.
Introduction
Homelessnesshasbeenrecognizedasasignicantsocial
problemintheUnitedStatesformanyyears.Intheearly
1980s,whenhomelessnessgainedprominenceasasocial
phenomenon,viewsoftheissuesitposedwererelatively
simple.Someobserversfeltthattheproblemwasatem-
poraryconsequenceoftherecessionof19811982,and
would go away when the economy recovered, while
othersarguedthattheproblemstemmedfromalackof
affordablehousingandthathomelessclientsweresim-
plyacrosssectionofpoorAmericans.
Knowledgegainedabouthomelessnessandhomeless
peoplesincetheearly1980sprovidesamorecomplicated
picture.Studiesleavenoquestionthatextremepovertyis
thevirtuallyuniversalconditionofclientswhoarehome-
less,andthatthispovertyisonereasontheycannotmain-
tainthemselvesinhousing.However,manypeoplewho
areverypoorneverbecomehomeless.Othervulnerabili-
tiescharacterizemanyhomelesspeople,suchaslowlevelsof
educationalachievement,fewjobskills,exhaustionofsocial
supportsorcompletelackoffamily,problemswithalcohol
ordruguse,severementalillness,childhoodandclient
experiencesofviolenceandvictimization,andincarceration
asachildorclient.Togetherwithextremepoverty,these
vulnerabilitiesincreaseapersonsriskofbecominghomeless
whenfacedwithanancialorpersonalcrisis.
3
Inaddition,
decreasesintheavailabilityofhousingatpricesaffordableto
clientsinlow-wageemploymentandincreasesintheskill
levelsneededtoobtainemploymentbeyondthelow-wage
levelhavechangedmanylocalenvironmentsintoonesthat
makeitmoredifcultforverypoorclientstomakeends
meeteveniftheyhavenoothervulnerabilities.
Thischapterincludesinformationaboutmanyissues
thatmayincreaseapersonsvulnerabilitytohomelessness.
Itdescribeshomelessserviceusersinverybasicways,such
astheirsex,age,race,andmaritalstatus.Otherpiecesof
thepictureofhomelessnessarethenexplored,including
clientreportsofserviceneeds,hunger,physicalhealthcon-
ditions,mentalhealthproblems,problemswithalcoholand
otherdrugs,andhistoryofincarceration,victimization,and
childhoodexperiencesofout-of-homeplacement.
Thereafter,thechapterdescribesclientsuseofvarious
homelessassistanceprogramsandexaminessimilaritiesand
differencesinthecharacteristicsofclientswhousedifferent
typesofprograms,andthosewhosleeponthestreets.
Itshowsclientsgeographicallocation,householdstatus,
historyofhomelessness,andlengthofcurrenthomelessspell
todescribevariationsintheconditionsoftheirhomelessness.
Itthenturnstooneoftheunderlyingrealitiesofvirtuallyall
homelessness,namely,incomelevels,incomesources,and
lowlevelsofsignicantlaborforceparticipation.
Thechapterendswithtwoimportantcomparisons.
Therstisanexaminationofsimilaritiesanddifferences
amonghomelessclientsincentralcities,suburbanand
urbanfringeareas,andruralareas.Thesecondisacom-
parisonof1987UrbanInstituteand1996NSHAPC
ndings,examiningwaysinwhichhomelesspopulations
havechangedorremainedthesame.
Demographic Characteristics
of Homeless Clients
4
Onmostbasicdemographiccharacteristics,homeless
clientsdifferconsiderablyfromthepopulationofthe
UnitedStates.Inaddition,theparentsinhomelessfam-
ilies using services, who comprise 15 percent of the
2
Data were collected in late 1996, when Temporary Assistance for Needy Families (TANF) had not yet taken effect
and AFDC was still the relevant cash benet program.
4
Forsimplicity,thetermhomelessisusedthroughoutthisreportto
meancurrentlyhomeless.
3
Bassuketal.1997;Catonetal.1994;Hermanetal.1997;Interagency
Council on the Homeless 1994; Koegel and Burnam 1991; Koegel,
Burnam,andMorton1996;Koegel,Melamid,andBurnam1995;Mangine,
Royse, andWiehe 1990; Piliavin, Sosin, andWesterfelt 1993; Robertson,
Zlotnick,andWesterfelt1997;Susser,Struening,andConover1987;
Susser et al. 1991; Weitzman, Knickman, and Shinn 1992; Wood et
al.1990.
homelessclientstoNSHAPCsurvey,alsodifferfromsin-
gle homeless clients on many of these same factors.
Table 2.1presentstherelevantinformation.TheNs
shown at the top of this and all other tables are
unweighted.Percentagesarebasedonweighteddata.
DemographiccharacteristicsofallU.S.adultsappear
intherstcolumnoftable2.1asapointofcomparison
tothehomelessclientswhoparticipatedintheNSHAPC
survey.Thesecondcolumndescribesthesehomeless
clients. The third and fourth columns break out
NSHAPChomelessclientsintothosewhoarewiththeir
ownchildren(homelessfamilies),andthosewhoarenot
(singlehomelessclients).
Sex
Asinotherstudies,mendominateamonghomelessclients,
comprising68percentofthisgroupcomparedto48per-
centofallU.S.clientsin1996(gure2.1).
5
However,these
statisticsmaskconsiderabledifferencesinthesexofhome-
lessclientsinhomelessfamiliesandsinglehomelessclients.
Amonghomelessclientsinfamilies,84percentarewomen
and16percentaremen(gure2.2).Amongsinglehome-
5
SexdistributionofU.S.adultpopulationcalculatedfromBureauof
theCensus(1997a),table14.
TA B L E 2 . 1
Demographic Characteristics of Homeless Clients, by Family Status
U.S. Adult All Homeless Clientsin Single
Population Clients HomelessFamilies HomelessClients
(1996) (N =2938) (N =465) (N =2473)
Sex
a
Male 48(%) 68(%) 16(%) 77(%)
Female 52 32 84 23
Race/Ethnicity
b
Whitenon-Hispanic 76 41 38 41
Blacknon-Hispanic 11 40 43 40
Hispanic 9 11 15 10
NativeAmerican 1 8 3 8
Other 3 1 1 1
Age
a
17to24years 13 12 26 10
25to54years 59 80 75 81
55ormoreyears 28 8 * 9
Marital Status
c
Nevermarried 23 48 41 50
Married 60 9 23 7
Separated
f
15 23 14
Divorced 10 24 13 26
Widowed 7 3 0 4
Educational Attainment
d
Lessthanhighschool 18 38 53 37
Highschoolgraduate/G.E.D. 34 34 21 36
Morethanhighschool 48 28 27 28
Veteran Status
e
13 23 5 26
Source: UrbanInstituteanalysisofweighted1996NSHAPCclientdata.
Note: Numbersdonotsumto100percentduetorounding.
*Denotespercentagelessthan0.5butgreaterthan0percent.
Sourcesfor U.S. adult population data:
a
BureauoftheCensus(1997a),datafor1996;table14,N =200million.Agerangeis18to 24.
b
Ibid.,table23,N =196.2million.
c
d
Ibid.,table245,N =168.3millionpersons25yearsandolder.
e
DepartmentofVeteransAffairs,datafor1995.
f
Includedinmarried.
lessclients,thesexratioisreversed;only23percentare
womenand77percentaremen(table2.1).
Race/Ethnicity
Homelessclientsareaboutequallydividedbetweennon-
Hispanicwhitesandblacks(41and40percent,respec-
tively),with11percentHispanics,8percentNative
Americans,and1percentother(gure2.3).Compared
withallU.S.adultsin1996,homelessclientsaredispro-
portionatelyblacknon-Hispanics(11versus40percent)
andNativeAmerican(1versus8percent).
6
Theracial/
ethnicmakeupofhomelessclientsdoesnotdifferby
familystatus.
Age
Theoverallstatisticsontheagesofhomelessclientsmask
verygreatdifferencesbetweenhomelessclientsinfamilies
F I G U R E 2 . 1
Sex of Homeless Clients and the U.S. Adult Population
Source: Urban Institute analysis of weighted 1996 NSHAPC client data. Sex distribution of U.S. adult
population calculated from the Bureau of the Census (1997a), table 14.
All Homeless Clients U.S. Adult Population (1996)
68%
32%
48%
52%
Male Female
Male
Female
Homeless Clients in Families
Single Homeless Clients
All Homeless Clients
Sex of Homeless Clients
in Families
85%
15%
84%
16%
F I G U R E 2 . 2
Homeless Clients in Families
Source: Urban Institute analysis of weighted 1996 NSHAPC client data.
6
AgedistributionofU.S.adultpopulationcalculatedfromtheBureau
oftheCensus(1997a),table14.
7
AgedistributionofU.S.adultpopulationin1996calculatedfrom
theBureauoftheCensus(1997a),table14.
andsinglehomelessclients.Clientsinfamiliesaremuch
younger,asshownintheirhigherprobabilityofbeingages
24andyounger(26versus10percent)andlowerprobabil-
ityofbeingages55andolder(lessthan0.5percentversus
9percent)(gure2.4).Thisagedistributionisquitediffer-
entfromthatofallU.S.adults,inwhichonly14percentare
under25yearsofageand28percentareages55andolder.
7
Marital Status
Forty-eightpercentofhomelessclientshavenevermarried.
Amongthe52percentwhohavebeenmarriedatonetime
or another, most have seen those marriages dissolve
throughdivorce(24percent)orseparation(15percent)
withoutsubsequentlyenteringintoanothermarriage.
Thesepatternsarerepeatedamongsinglehomelessclients,
andmodiedsomewhatamonghomelessclientsinfami-
lies(gure2.5).Thelattergroupismorelikelytoreport
beingmarried(23versus7percent)andlesslikelytoreport
beingdivorced(13versus26percent).Inaddition,theyare
lesslikelynevertohavemarried(41versus50percent),but
theproportionwhohavenevermarriedisstillhighcom-
paredtoallU.S.adultsat23percent.
8
Homeless Clients U.S. Adult Population (1996)
8%
1%
1%
11%
40%
41%
9%
3%
76%
11%
White non-Hispanic Black non-Hispanic Hispanic
Native American Other
F I G U R E 2 . 3
Race/Ethnicity of Homeless Clients and U.S. Adults
Source: Urban Institute analysis of weighted 1996 NSHAPC client data. Race/ethnicity information
for the U.S. adult population calculated from Bureau of the Census (1997a), table 23.
Note: Numbers do not sum to 100 percent due to rounding.
Homeless Clients in Families Single Homeless Clients U.S. Adult Population (1996)
26%
75%
81%
59%
13%
28%
10% 9%
17 to 24 years 25 to 54 years 55 years and older
Source: Urban Institute analysis of weighted 1996 NSHAPC client data. Age distribution of U.S. adult population calculated from the Bureau of
the Census (1977a), table 14.
F I G U R E 2 . 4
Age Distribution of Homeless Clients in Families, Single Homeless Clients, and U.S. Adults
8
MaritalstatusofU.S.adultpopulationin1996obtainedfromthe
BureauoftheCensus(1997a),table58.
Education
Thirty-eightpercentofhomelessclientshavedropped
outofhighschool,whilefor34percent,ahighschool
diplomaistheirhighestlevelofcompletededucation.
Fewer, but still more than one-quarter, have some
educationbeyondhighschool.Theseguresdiffercon-
siderablybetweenclientsinfamiliesandsinglehomeless
clients(gure2.6).Clientsinfamiliesaremorelikelyto
have ended their education before completing high
school(53versus37percent),andlesslikelytohave
exactly a high school diploma or G.E.D. (21 versus
Homeless Clients in Families Single Homeless Clients U.S. Adult Population (1996)
Never Married Married (including separated) Widowed Divorced
F I G U R E 2 . 5
Marital Status of Homeless Clients in Families, Single Homeless Clients, and All U.S. Adults
Source: Urban Institute analysis of weighted 1996 NSHAPCclient data. Marital status information from the Bureau of the Census (1997a), table 58.
46%
41%
13%
21%
50%
26%
4%
60% 23%
10%
7%
37
53
25
21
36
30
27
28
45
Homeless Clients in Families Single Homeless Clients
U.S. Adults Ages 25 and Older, 1996
F I G U R E 2 . 6
Educational Attainment of Homeless Clients in Families, Single
Homeless Clients, and U.S. Adults
Source: Urban Institute analysis of weighted 1996 NSHAPC client data. Educational attainment of
U.S. adult population calculated from the Bureau of the Census (1997a), table 245.
60
50
40
30
20
10
0
Less Than a High School More Than
High School Diploma Diploma/G.E.D. High School
P
e
r
c
e
n
t
a
g
e
36percent).However,thetwogroupsareequallylikely
tohavereceivedsomeeducationbeyondhighschool.
HomelessclientsarelesseducatedthantheadultU.S.
population:only25percentofAmericanadults(those
ages25andolder)havelessthanahighschooleducation,
34percenthaveahighschooldiploma,and45percent
havesomeeducationbeyondhighschool.
9
Veteran Status
Twenty-threepercentofhomelessclientsareveterans.
Examined separately by sex, 1 percent of homeless
womenareveteranscomparedto33percentofhomeless
men.Formen,thisproportionisnotdifferentfromthe
31percentofthegeneralclientmalepopulationwhom
theDepartmentofVeteransAffairsestimateswereveter-
ansin1996,butsomewhatlowerthanthe40percentof
veteransamonghomelessmenfoundinasystematicsyn-
thesisofdatafromotherstudiesofhomelesspopulations
(Rosenhecketal.1996).
The Children of Homeless Clients
Manymorehomelessclientsareparentsthanisindicated
bytheproportionwhohaveatleastoneoftheirchildren
withthem.Amonghomelesswomen,60percenthave
childrenunderage18,butonly65percentofthemlive
withatleastoneofthesechildren.Amonghomelessmen,
41percenthavechildrenunderage18,butonly7per-
centofthesefatherslivewithatleastoneoftheirown
children.
10
Lookedatfromthechildrensperspective,28
percentofminorchildrenofhomelessparentslivewith
thatparent,while72percentdonot.
Homelessfamilieshave,onaverage,twochildren.
Membersofthesefamiliescomprise34percentofall
homelesspeopleusingservices.Asthisgure(34percent)
isquitedifferentfromthefigurenotedearlier15per-
centofhomelessclientsareheadsofhomelessfamilies
someclaricationisinorder.Thetwoguresilluminate
acommonconfusionaboutthetermhomelessfamily.
Only15percentofhomelesshouseholdscontainanclient
andatleastoneminorchild,whichisacommondeni-
tionoffamilyusedinthecontextofhomelessness
research.However,whenonecountsclientsandchildren
together,34percentareinfamilies.Two-thirdsofthese
arechildren.
Childreninhomelessfamiliesusingservicesarefairly
evenlydividedbetweenmales(53percent)andfemales
(47percent),whichdoesnotdifferfromAmericanchil-
drengenerally(table2.2).Theyaredisproportionately
youngerthanschoolage(ages0to5)comparedtoall
U.S.children(42versus34percent).
11
Parentsreportthat
almosthalf(45percent)ofthesechildrenages3to5
attend preschool. In addition, almost all (93 per-
cent)ofschool-agechildren(ages6to17)arereportedto
attendschoolregularly.
12
Homelessclientsinfamilies(table2.1)andthechil-
dren themselves (table 2.2) are similarly distributed
amongracial/ethnicgroups.Thesesimilaritiesareduein
largeparttothefactthatchildrensrace/ethnicitywas
attributedfromthatoftheirparents,butalsoimpliesthat
thenumberofchildrenhomelesswiththeirparent(s)
doesnotdiffersystematicallyinrelationtotheparents
raceorethnicity.
NSHAPCparentsreportsoftheirchildrensschool
attendancecanbecomparedwithdataaboutschool
enrollmentofU.S.children(table2.2).Forty-fivepercent
ofthe3-to5-year-oldchildrenaccompanyinghomeless
NSHAPCclientsarereportedtobeattendingpreschool.
Parentsalsosaythat93percentoftheirchildrenages6to
17attendschoolregularly.Theclosestcomparablegures
forallU.S.childrenareforenrollmentratherthanfor
attendance.Theyindicatethat49percentof3- to4-year-
oldsand98percentof5- to17-year-oldsareenrolledin
school.
13
These figures are comparable to NSHAPC
informationabouthomelesschildren.
Homelesschildrenliveinhouseholdswhosereceipt
ofgovernmentbenefitsisquitesimilartothatofnon-
homelesschildreninpoorU.S.households.Seventyper-
centofchildreninhomelessfamiliesreceivefoodstamps,
whichdoesnotdifferfromthe66percentofpoorU.S.
childrenwhodoso.Nordoestheproportionofboth
groupscoveredbyMedicaiddiffer(73percentofhome-
lessand69percentofpoorU.S.children).Itisharder
totellwhetherdifferencesexistbetweenhomelessand
9
Educationalattainmentin1990ofU.S.adultpopulation(25and
older)obtainedfromtheBureauoftheCensus(1997a),table245.
10
The90percentconfidenceintervalforthepercentofwomenwho
havechildrenunder18is6percentagepoints.
11
Agedistributionin1996ofallchildrenobtainedfromtheBureauof
theCensus(1997a),table16.
12
Thislevelofregularschoolattendancemayseemhighinlightofa
studydonefortheU.S.DepartmentofEducationthatfoundinaseriesof
fieldvisitsthataboutone-fourthofschool-agehomelesschildrenexperi-
encesomeinterruptionsinschooling(Anderson,Janger,andPanton
1995).Bothsourcesofinformationarelikelytohavetheirbiases(parental
self-reportforNSHAPCclients,includingpersonaldefinitionsofwhat
constitutesregularschoolattendance,andsmallandpossiblyunrepre-
sentativefieldsitesfortheAndersonetal.study).Inaddition,itispossi-
blethathomelesschildrenhavetroubleattendingschoolwhentheyfirst
becomehomeless,butthatthesedifcultieshavebeenovercomeformany
inasamplethatincludesfamilieswithrelativelylonghomelessspells.
13
BureauoftheCensus(1997b),table1.
Combininghomelesschildrenwiththeirhomelesspar-
entandwithsinglehomelessclients,table2.3showshow
allhomelessserviceuserscomparetotheU.S.population
inpovertyonsomebasicdemographiccharacteristics.
14
All
homelessserviceusersincludeconsiderablymoremales
TA B L E 2 . 2
Characteristics of Children under 18 Living with Homeless Parents and
the U.S. Population of Children
Children under 18 U.S. Population,
(N=1007) 1996: Children
Childs Sex
a
Male 53(%) 51(%)
Female 47 49
Childs Age
a
02years 20 17
35years 22 17
68years 20 17
911years 13 17
1214years 11 16
1517years 9 16
Notanswered 5
Childs School Attendance/Enrollment Attendance Enrollment
c
Ages35,percentattending/enrolled
inpreschool 45 49
Ages617,percentattending/enrolled
inschoolregularly 93 98
Parents Race/Ethnicity
b
Whitenon-Hispanic 38 66
Blacknon-Hispanic 47 15
Hispanic 13 14
NativeAmerican 2 1
Other 1 4
In Household Receiving Childrenin
Government Benets PoorHouseholds
d
FoodStamps 70 66
AFDC 51 55
e
SSI 12
e
Medicaid 73 69
Source: UrbanInstituteanalysisofweighted1996NSHAPCclientdata.Informationwascollectedon
eachchildssex,age,schoolattendance,andenrollmentinMedicaid.Otherinformationisassignedtoeach
childbasedontheclient/parentscharacteristics.
Note: Numbersdonotsumto100 percentduetorounding.
Sourcesfor U.S. child population data:
a
BureauoftheCensus(1997a),datafor1996,table16,N =69.5million.
b
Ibid.,table22.
c
BureauoftheCensus(1997b),datafor1995,table1,N =59.0million3-to17-year-olds,datareect
enrollment,notattendance,the49percentpertainsto3-to4-year-oldsandthe98percentpertainsto6-to
17-year-olds.
d
BureauoftheCensus(1992);P60181,datafor1991,tableE,N =13.7millionchildrenages0to17.
e
This55percentisforchildreninhouseholdsreceivinganycashassistance,whichcouldincludeAFDC,
SSI,GeneralAssistance,orothermeans-testedcashbenets.
14
StatisticsforthewholeU.S.populationandallpoorpersonsinthe
UnitedStateswerecalculatedfromtheBureauoftheCensus(1997a),
table22,and(1997b),table1.
nonhomelesspoorchildrenintheirfamilysreceiptof
cashassistancebecausethedataarenotreportedinthe
samecategories.Fifty-onepercentofhomelesschildren
liveinfamiliesreceivingAFDC,and12percentlivein
familiesreceivingSSI.TheBureauoftheCensus(1992,
tableE)reportsthat55percentofnonhomelesspoor
childrenliveinhouseholdsreceivingcashassistance,
whichcouldbeAFDC,SSI,GeneralAssistance,orother
means-testedcashbenets.
thantheoverallAmericanpovertypopulation(65 versus
43 percent).Theyarelesslikelytobewhite(47 versus
67 percent)orHispanic(11 versus24 percent),andmore
likelytobeblack(42versus27percent).Theyarealsoless
likelytobechildren(24versus40percent),lesslikelytobe
ages55 andolder(7 versus15 percent),andmorelikely
tobeintheirmiddleyears(42 versus19percentare
betweentheagesof35and54).
Thelastissueofimportancewithrespecttochildren
ofhomelessclientsisthequestionofwherechildrenare
whentheyarenotwiththeirhomelessparent.Theanswer
isheavilydependentonthehomelessclientssex(fig-
ure2.7).Whenthehomelessclientismale,hischildren
whodonotlivewithhimaremostlikelytobewiththeir
(nonhomeless)mother(81percentofmalehomeless
clientsminorchildren).Butonly23percentoffemale
homelessclientsminorchildrenwhodonotlivewith
theirmotherlivewiththeirfather.Thewomansownpar-
entsorotherrelativesaremostlikelytobecaringforher
childreniftheyarenotwithher(46percentofchildrenof
femalehomelessparents),andaboutone-fth(19percent
ofhomelesswomensminorchildren)areinfostercare
orgrouphomes.
Service Needs, Stresses, and Vulnerabilities
ServiceNeeds as Seen by Clients
Clientswereaskedtonamethethreethingstheyneeded
mostrightnow,andalsotoidentifythesinglemost
importantthingkeepingtheminahomelesscondition.
Helpfindingajobwasthemostfrequentlycitedneed
(42 percent),followedbyhelpfindingaffordablehous-
ing(38 percent),andassistancewithpayingrent,mort-
gage, or utilities in relation to securing permanent
housing(30 percent).Otherneedscitedbymorethan
10 percentofclientswereassistancewithtransportation
(19percent),clothing(18percent),food(17percent),job
trainingandmedicalcare(13 percenteach),andaGED
anddentalcare(11 percenteach).
Insufcientincomewascitedmostfrequentlyasthe
singlemostimportantthingkeepingtheclienthome-
TA B L E 2 . 3
Demographic Characteristics of Homeless Adults Plus Their Children
Living with Them, Compared with the U.S. Population in Poverty and
the General U.S. Population
Homeless Poor Persons, 1996
c
U.S. Population, 1996
b
AdultsplusChildren
a
(All Ages) (All Ages)
(N =3945) (N =36.5 Million) (N =266.2 Million)
Sex
Male 65(%) 43(%) 49(%)
Female 35 57 51
Race
White 47 67 83
Black 42 27 13
Other 11 6 5
Hispanic Origin 11 24 11
Age
Under18years 24 40 26
1824 4 12 14
2534 19 14 15
3544 29 12 16
4554 13 7 12
5564 5 6 8
65andolder 2 9 13
a
Clientsplusanyoftheirownchildrenages0to17wholivewiththem.Childrensrace/ethnicityis
assignedbasedonparents.
b
SourcesforU.S.populationdata:BureauoftheCensus(1997a),sexandrace,table21;Hispanicorigin,
table23;age,table16.
c
Sourcesforpovertypopulationdata: Lamison-White(1997);P60198,sex,table2;race,Hispanic
origin,andage,tableA.
less,at30percentofallhomelessclients(gure2.8).An
additional24percentcitedlackofajoboremployment.
Lackofsuitablehousingwasmentionedby11percent
ofhomelessclients,andaddictiontoalcoholand/or
drugsby9 percent.Noothercategoriesexceptother
(14 percent)werereportedbymanyclients.
Food Consumption and Hunger
NSHAPCclientswereaskedabasicquestionaboutthesuf-
ciencyofthefoodtheyeat.Twenty-eightpercentofhome-
lessclientsreportthattheysometimesoroftendonotget
enoughtoeat.Only39percentgetenoughofthekindsof
Minor Children of Homeless
Male Clients
Minor Children of Homeless
Female Clients
81%
7%
10%
1%
46%
19%
10%
23%
Other Parent Other Relative FosterCare/Group Home Other
F I G U R E 2 . 7
Residence of Minor Children Who Do Not Live with a Homeless Parent
F I G U R E 2 . 8
Most Important Thing Respondent Thinks Is Preventing Exit
f rom Homelessness
30
24
11
9
35
30
25
20
15
10
5
0
Insufcient Lack of a No Suitable Addiction to
Income Job Housing Alcohol or Drugs
P
e
r
c
e
n
t
a
g
e
foodtheywanttoeat.Thiscontrastswith60percentofpoor
U.S.householdsand80percentofallU.S.householdswho
saytheygetenoughofwhattheywanttoeat.
15
Otherfood
problemsexperiencedbyhomelessclientsincludeusually
eatingonemealadayorless(20percent);beinghungry
inthepast30daysbutnoteatingbecauseonecouldnot
affordenoughfood(39percent);andgoingawholeday
withouteatinganythingatallinthelast30days(40per-
cent)(gure2.9).
DataforsomeoftheseproblemsfrompoorU.S.house-
holdsindicatethathomelessclientshavemuchhigherlev-
els of food problems than poor people generally.
Thirty-ninepercentofhomelessclientsversus5percentof
poorhouseholdsreportedthatinthelast30daystheywere
hungrybutdidnteatbecausetheycouldntaffordtobuy
food,and40versus3percentsaidtheydidnteatforone
wholedayormorebecausetheycouldntaffordtobuyfood.
Anindexoffoodproblemsbasedonclientsreported
hungeranddifcultiesobtainingadequatefoodwasalso
calculated.Thisfive-levelindexreportsthepercentage
ofhomelessclientsreportingnone,one,two,three,or
fourfoodproblems.Onthisindex,42percentofhome-
lessclientsreportnofoodproblems.Bycontrast,37per-
centhavetwoormorefoodproblems.
Victimization WhileHomeless
Inadditiontothestressesofndingenoughfoodtoeat,
beinghomelessremovesthesafetyofapermanentresi-
denceandleavesonespersonandpossessionsvulnerableto
attack.Robberyandtheftarecommonthreatsexperienced
bytwoinvehomelessclients(gure2.10).Thirty-eight
percentofhomelessclientsreporthavingmoneyorthings
stolendirectlyfromthemwhiletheywerepresent(rob-
bery),andasimilarproportion(41percent)reporthaving
moneyorthingsstolenfromtheirbags,locker,orother
locationwhiletheyweregone(theft).Inaddition,22per-
centreportbeingphysicallyassaultedorbeatenupatleast
oncewhilehomeless,and7 percentreportbeingsexually
assaultedorraped.
Physical Health Status and Insurance
Surveyclientsweregivenalistof17medicalconditions
andaskediftheyhadanyofthem.Theseincludecondi-
tionsclassiedas
acute infectious conditions (chest infection/cold/

cough/bronchitis,pneumonia,tuberculosis,STDs
otherthanAIDS);
acutenoninfectiousconditions(skindiseases,lice/
scabies);or
chronichealthconditions(diabetes,anemia,high
bloodpressure,heartdisease/stroke,liverproblems,
F I G U R E 2 . 9
Frequency of Food Problems in the Past 30 Days among Homeless Clients
28
20
39 40
50
40
30
20
10
0
Sometimes/Often Ate One Meal a Hungry but Didnt Eat Went Whole
Not Enough Day or Less because No Money Day without
to Eat for Food Eating
P
e
r
c
e
n
t
a
g
e
15
Informationinthisandthefollowingparagraphsaboutfoodprob-
lemsforallandpoorU.S.householdscomesfromtheCurrent Population
SurveyFood SecuritySupplement,April1995(FoodandConsumerSer-
vice,1999).
arthritis/rheumatism,cancer,problemswalking/lost
limb/otherhandicap,HIV/AIDS),aswellasother
conditions.
Reportedratesoftheseconditionsmaybeunderestimates
becausetheyrelyonclientself-reports.Theseself-reports
maybelowduetolackofknowledgeordiagnosisof
medicalconditions,orreluctancetoadmittohaving
someofthem.Itisalsopossiblethatiftheinterviewhad
inquiredaboutotherconditions,reportedrateswould
behigher.Twenty-sixpercentofclientsreportoneor
moreacuteinfectiousconditions,8percentreportoneor
moreacutenoninfectiousconditions,and45percent
reportoneormorechronichealthconditions.Threeof
thefourmostcommonlyreportedmedicalconditionsare
chronichealthconditions:arthritis,rheumatism,orjoint
problems(24percent);highbloodpressure(15percent);
andproblemswalking,alostlimb,orotherhandicap
(14percent).Chestinfection,cold,cough,orbronchitis
(acuteinfectiousconditions)arealsoamongthemost
highlyreported,at22percent.
Twenty-fourpercentofhomelessclientsreportthat
theyneededmedicalattentioninthepastyearbutwerenot
abletogetit.Forty-sixpercentcouldnotgetaccesstoa
dentistwhenonewasneeded.Thislackofaccessmaybe
dueinparttotheirgenerallackofinsurancecoverage.
Fifty-vepercentreportthattheyhavenomedicalinsur-
anceofanykind;thecomparablegureforallAmerican
adultsis16percent.Bycontrast,30percentsaytheyare
coveredbyMedicaid,7percentbymedicalcarethrough
theDepartmentofVeteransAffairs,4percentbyprivate
insurance,and10percentbyinsuranceofothertypes.A
fewclientsmentionedmorethanonetypeofinsurance.
Amonghomelessclientsinfamilyhouseholds,10per-
centreportthattheirchildrenneededtoseeadoctoror
nurseinthepastyearbutwerenotabletodoso.Home-
lesschildrenaremuchlesslikelythanhomelessclients
tobewithoutinsurancecoverage.Only20percentof
homelessfamilyhouseholdshavenoinsurancefortheir
children.Seventy-threepercent
16
reportMedicaidcover-
agefortheirchildren,while6percenthaveprivateinsur-
ancecoverageand6percenthavesomeothertypeof
medical insurance coverage for their children (some
clientsinfamilyhouseholdsmentionedmorethanone
typeofinsurance).
Alcohol, Drug, and Mental Health Problems
Clientswereaskedaboutexperiencesconsideredtobe
indicatorsofalcohol,drug,andmentalhealth(ADM)
problems,andabouttreatmentexperiencesrelatedto
theseproblems.Responsestoquestionswerecombined
tocategorizeclientsashavingornothavingparticular
problemsduringthepastmonth,pastyear,and/ortheir
F I G U R E 2 . 1 0
Victimization of Clients while Homeless
38
41
22
7
50
40
30
20
10
0
Money or Things Money or Things Physically Assaulted, Sexually Assaulted,
Stolen Directly Stolen While Beaten Up Raped
from You You Were Gone
16
90%C.I.=12percentagepoints.
P
e
r
c
e
n
t
a
g
e
lifetime(seechapter1fordetailsonhowalcohol,drug,
andmentalhealthproblemsweredefined).Whenlook-
ing at the results, it is important to remember that
NSHAPCinformationisnotbasedonclinicaldiagnoses.
Past Month. Homelessclientsreportavarietyofprob-
lemswithmentaloremotionalconditions,alcoholuse,
oruseofillegaldrugswithinthepast30days(table2.4).
Duringthisperiod38percentreportproblemswithalco-
holuse;26percentreportproblemswithdruguse,and
39percentreportmentalhealthproblems.
Sixty-sixpercentofhomelessclientsreportoneor
moreoftheseproblemsduringthepastmonth(figure
2.11).Thirteenpercentreportonly alcohol problems,
7 percentreportonly drugproblems,17percentreport
onlymental healthproblems,22percentreportcombina-
tionsoftwoproblems,and8percentreportallthree
problemsduringthepastmonth.
Past Year. Thelongertimeperiodofthepastyear
(includingthepastmonth)capturesalargerproportion
ofhomelessclientswhoreportoneormoreproblems
withmentaloremotionalconditions,alcoholuse,oruse
ofillegaldrugs.Duringthisperiod,46percentreport
problemswithalcoholuse;38percentreportproblems
withdruguse,and45percentreportmentalhealthprob-
lems.Seventy-fourpercentofhomelessclientsreportone
ormoreoftheseproblemsduringthepastyear(figure
2.11).Twelvepercentreportonlyalcohol problems,7per-
centreportonly drugproblems,15percentreportonly
mental healthproblems,27percentreportcombinations
oftwoproblems,and14percentreportallthreeprob-
lemsduringthepastyear.
Lifetime. Asthelongesttimeperiodbeingconsidered,
itisnotsurprisingthatlifetimehistoriesrevealthehigh-
estlevelofproblems.Duringtheirlifetime,62percent
ofhomelessclientsreportproblemswithalcoholuse;58
percentreportproblemswithdruguse,and57percent
reportmentalhealthproblems.Eighty-sixpercentof
homelessclientsreportoneormoreoftheseproblems
duringtheirlifetime(figure2.11).Ninepercentreport
only alcohol problems,6percentreportonly drugprob-
lems,10percentreportonlymental healthproblems,32
percentreportcombinationsoftwoproblems,and30
percentreportallthreeproblemsduringtheirlifetime.
Overall Patterns. Lookingoverthethreetimeperi-
odsexamined,itisclearthatasthetimeperiodlength-
ensmoreclientsreportproblemsineacharea.Second,
asthetimeperiodlengthenstheproportionofclients
whoreportasingleproblemdecreasesandtheproportion
who report combinations of two or three problems
increases.Third,ineachsucceedingtimeperiodthedif-
ferencedecreasesintheproportionreportingproblems
withalcoholcomparedtotheproportionreportingdrug
problems,untilforlifetimeproblemsthedifferenceis
nolongerstatisticallysignicant.Fourth,theproportion
TA B L E 2 . 4
Alcohol, Drug, and Mental Health (ADM) Problems among
Homeless Clients
ADM Combinations Past Month Past Year Lifetime
Any ADM Problem
a
66(%)
b
74(%) 86(%)
Alcohol Problem 38 46 62
Drug Problem 26 38 58
Mental Health Problem 39 45 57
Specic Problems and Problem Combinations
Alcoholproblemonly 13 12 9
Drugproblemonly 7 7 6
Mentalhealthproblemonly 17 15 10
Alcoholanddrugproblems 7 10 15
Alcoholandmentalhealthproblems 10 10 9
Drugandmentalhealthproblems 5 7 8
Alcohol,drug,andmentalhealthproblems 8 14 30
NoADMproblems 34 26 14
Note: Percentagesdonotsumto100percentduetorounding.
a
TheseADMmeasuresincludeasmallnumberofcases(21forthepastmonth,3forthepastyear,and5
forlifetime)whoansweredquestionssuggestingtheyhadasubstanceuseproblem(questions2.11a(13b),
3.15a(13b),and14c(5))butdidnotsatisfyanyotherspeciccriteriaforalcoholordrugproblems.Because
theprecisenatureoftheproblemcannotbedeterminedfromthesemeasures,theyarenotincludedinthe
problem-specicmeasures.
b
ThisisthemeasureusedthroughoutthisreportastheADMstandardbreak.
reportingcombinationsinvolvingmentalhealthprob-
lemsplusalcoholand/ordrugproblemsincreasesfrom
23percentduringthepastmonthto31percentduring
thepastyearupto47percentoverclientslifetimes,
17
withthemostdramaticincreaseoccurringinthepro-
portionreportingallthree.
History of Incarceration
Abouthalf(49percent)ofhomelessclientshavespent
veormoredaysinacityorcountyjailintheirlifetime.
Someofthesejailexperiencesmayhavebeenadirect
resultoftheirhomelessness(i.e.,thechargesmightbe
forbehaviorsthataredifficulttoavoidifoneishomeless,
suchasloitering).Eighteenpercentofclientshavebeen
inastateorfederalprison,and16 percentwereheldin
juveniledetentionatleastoncebeforereachingtheir18th
birthday.Altogether,54percenthavesomeexperience
ofincarceration.
AdverseChildhood Experiences
EversinceaMinneapolisstudy(Piliavin,Sosin,andWest-
erfelt1993)identiedchildhoodout-of-homeplacement
infostercareasacommonexperienceofhomelesspeople,
interesthasbeenfocusedontheseearlyseparationsfrom
familyandthewaysthatlackoffamilysupportafterage18
(whenonehastoleavefostercare)mightincreaseayoung
personsriskofhomelessness.Homelessclientsinthepre-
sentstudyrevealthat27percentwereplacedinfostercare,
agrouphome,orotherinstitutionalsettingbeforetheir
18thbirthday(gure2.12).Manyexperiencedmultiple
placements,as12 percentwereinfostercare,10percent
hadbeeninagrouphome,and16percenthadbeeninres-
identialinstitutions.
Twenty-ninepercentofhomelessclientsalsoreport
abuseorneglectinchildhoodfromsomeoneintheir
household(12percentneglect,22percentphysicalabuse,
and13percentsexualabuse).Thirty-threepercentran
awayfromhomeand22percentwereforcedtoleavehome
F I G U R E 2 . 1 1
Alcohol, Drug, and Mental Health Problems of Homeless Clients in
Diff erent Time Periods
100
80
60
40
20
0
Past Month Past Year Lifetime
ADMProblem
Alcohol problem Drug Problem Mental Health Problem Any ADM
38
26
39
66
46
38
45
74
62
58
57
86
P
e
r
c
e
n
t
a
g
e
17
Peoplewhoreportregularuseofmarijuana(threeormoretimesa
week)butdo not reportanyother druguseareincludedinestimatesof
peoplereportingproblemswithdruguse.Weretheytobeexcluded,the
proportionwithanydrugproblemwoulddropforthepastmonthby
about6percentagepoints,forthepastyearbyabout8percentagepoints,
andforlifetimebyabout10percentagepoints.However,theproportion
withanyADMwoulddroponlybyabout2percentagepointseachforpast
month,pastyear,andlifetimeADMproblem.
18
Mostofthis6percentreportingtemporaryhousingwithnooverlap
tosheltersorstreetsactuallyindicatedinotherwaysthattheyarecur-
rentlyhomeless,includinghavingbeenfoundinanemergencyortransi-
tionalshelter;sayingtheygotfoodattheshelterwheretheylived;orsaying
inanswertothebasicscreenerquestionthatthelasttimetheyhadaper-
manentplacetolivewasmorethansevendaysago.
foratleast24hoursbeforetheyreachedage18.Inaddi-
tion,21percentreportthattheirrstperiodofhomeless-
nesspredatedtheir18thbirthday(thishomelessnessmight
havebeenwiththeirfamilyorontheirown).
Where Homeless Clients Were Living
Evenwithintheweekdocumentedbythisstudy,home-
lessclientsdidnotstayinoneplace.Onthedayoftheir
interviewandthesevendaysprecedingit,manyclients
sleptorrestedinanumberofdifferentplaces.These
couldincludeplacesnotmeantforhumanhabitation;
emergencyortransitionalshelters;ortemporaryarrange-
mentssuchasahouse,apartment,orroominwhich
someoneisallowedtostayonatemporarybasis.
Thirty-twopercentofhomelessclientssleptorrested
inplacesnotmeantforhumanhabitation(designated
streetsingure2.13),includingtransportationdepots,
commercialspaces,carsorothervehicles,abandoned
buildings,outdoorlocations,andothervenuesofsimi-
lartype.Thusjustunderone-thirdofhomelessclients
wouldhavebeenfoundduringatypicalweekstimeusing
suchplacesforsleep.
Homelesssheltersarethemostcommontypeofloca-
tionwherehomelessclientsmaybefound.Morethan
twiceasmanyhomelessclients(73percent)sleptinone
ormoreofavarietyofsheltersduringtheeight-day
periodbeingexaminedassleptinplacesnotmeantfor
humanhabitationduringthesameperiod.Some,of
course,sleptinbothtypesofvenue.Shelterstakemany
forms,includingemergencyshelters,transitionalhousing
programs,andvouchersforemergencyhousing(desig-
natedsheltersingure2.13).
Inaddition,figure2.13showsthat54 percentof
homelessclientssleptorrestedinoneormoretempo-
raryaccommodations,
18
includingafriendsorrelatives
place,theirownplace,ahotelormotelroomtheypaid
forthemselves,orapermanenthousingprogramforfor-
merlyhomelesspeople(designatedtemporaryaccom-
modationsingure2.13).
Tounderstandhowextremelytransienthomelessclients
are,itisimportanttoexaminetheoverlapinthesecate-
gories.Sixpercentofhomelessclientshadsleptorrestedin
allthreevenuesduringtheeight-dayperiod.Attheother
extreme,7percenthadstayedonlyonthestreets,34percent
hadstayedonlyinshelters,6percenthadstayedonlyintem-
poraryhousing.Theoverlapisgreatestforsheltersandtem-
porary accommodations, with 34 percent of homeless
clientsusingbothduringtheeight-dayperiod.Bycontrast,
theoverlapbetweenstreetsandsheltersisquitelow,with
only11percentofhomelessclientsstayinginboth.
F I G U R E 2 . 1 2
Adverse Experiences bef ore Reaching Age 18
27
29
33
22
21
40
35
30
25
20
15
10
5
0
Out-of-Home Abuse and/or Ran Away Kicked Out First Time
Placement Neglect by Someone from Home of Home Homeless
in Household <Age 18
P
e
r
c
e
n
t
a
g
e
Characteristics of Clients Using Different
Housing and Other Services
Peoplestayinginthedifferentvenuesdisplayedingure
2.13arequitedifferentfromeachotheronanumberof
dimensionsofimportancetoplanners,serviceproviders,
andothersofferingassistancetohomelessclients.To
understandthesedifferences,table2.5presentssomebasic
descriptiveinformationforclientswhosleptonthestreets
onthedayoftheinterviewand/orthepreviousseven
days,andclientswhoduringthesametimeperiodstayed
inashelter,usedasoupkitchen,orusedothertypesof
homelessassistanceprograms.Thesegroupsarenotmutu-
allyexclusive;manyclientsfallintomorethanoneof
them,andsomeclientscouldbeincludedinallfour.
Menareasimilarproportionofclientswhosleptin
thestreetsandthosewhousedasoupkitchenduringthe
lasteightdays(86and85percent,respectively)andare
morelikelytobefoundinthosevenuesthaninshelters
orotherprograms(wheretheycomprise65and67per-
centofusers).Fewsignificantracial/ethnicdifferences
existbetweenthefourvenues.Shelterstayersaremore
likelytobeinarsthomelessepisodelastingsixmonths
orless(22percent)thanistrueforanyothergroup.
Table2.5alsoreportstheprevalenceofseveralsub-
groupswithinthefourserviceusepatterns.Relativelyfew
surveyclientsinanyvenueareyouthages24andyounger.
Clientsinhomelessfamiliesarealargerproportionofshel-
terusers(16percent)andusersofotherprograms(14per-
cent)thantheyareofstreetstayers(3 percent)orusersof
soupkitchens(6percent).PersonsreportingHIV/AIDS
areaverysmallproportion(2to5percent)ineveryvenue.
Morethanhalfofclientsineachvenuehavenotdone
anyworkforpayinthelast30days.Streetstayersand
usersofotherprogramsarelesslikelythanshelterstayers
tohavedoneanypaidwork,andusersofotherprograms
arealsolesslikelythansoupkitchenuserstohaveworked
forpayduringthepastmonth.
Thepresenceofanyalcohol,drug,and/ormental
healthproblemsishighestamongstreetstayersandthose
whousedotherprograms(75and74percent,respec-
tively).Ratesarelowerbutstillconsiderableamong
homelessclientsusingsheltersandsoupkitchens(63and
66percent,respectively).Problemswithdruguseare
lowestamongshelterstayers(23percent),anddonotdif-
feramongclientsusingtheothervenues(31to35per-
cent).Bothstreetstayers(45percent)andotherprogram
users(43percent)aremorelikelytoreportalcoholuse
Shelters73%
Temporary
Housing54%
Streets32%
34%
7%
5%
6%
14%
6%
28%
F I G U R E 2 . 1 3
Where Homeless Clients Slept on Day of Interview and Previous
Seven Days*
*Client used option at least once during the eight days including the day of the interview and the
seven previous days, including being sampled at the site.
Shelters = emergency and transitional shelters and voucher programs; Streets = any place not
meant for habitation; Temporary Housing = own or other persons house, apartment, or room,
including hotel/motel room that client paid for, but without the possibility of sleeping there for the
next month without being asked to leave.
problemsthanareshelterstayers(35percent).Theonly
significantdifferencebyvenueformentalhealthprob-
lemsisthatahigherproportionofusersofotherpro-
grams(46percent)reportsuchproblemscomparedto
thosewhostayedinashelter(38percent)orthosewho
usedasoupkitchen(37percent).
Thesefindingswithrespecttoshelterandotherpro-
gramvenuesprobablyreflectthedifferinginfluencesof
programgoalsandrules.Manytransitionalhousingpro-
gramsaredesignedexplicitlyforclientswiththeseprob-
lems, but many emergency shelters have rules that
explicitlyoreffectivelyexcludeclientswiththeseprob-
lems,leavingthestreetsastheironlyalternative.Users
ofbothtypesofprogramsarecombinedintheshelter
usercategory.Further,someotherprograms,especially
outreach programs, drop-in centers, and permanent
housingprogramsareexplicitlydesignedtoreachand
serveclientswithalcohol,drug,and/ormentalhealth
problems.
19
Income, Employment,
and Other Income Sources
Income
The average income of homeless clients during the
monthbeforebeinginterviewedwas$367(table2.6).
20
Further,13percentreceivednocashincomeatalldur-
TA B L E 2 . 5
Demographic and Other Characteristics of Homeless Clients, by Street Location and Program Use in
Past Week
ProgramUse
All Homeless Slept on Stayed in a Used a Soup Used Other
Clients Streets Shelter Kitchen Program
(N =2938) (N =768) (N =2352) (N =1727) (N =909)
Sex
Male 68(%) 86(%) 65(%) 85(%) 67(%)
Female 32 14 35 15 33
Race/Ethnicity
Whitenon-Hispanic 41 40 41 38 35
Blacknon-Hispanic 40 38 39 39 45
Hispanic 11 13 11 13 11
NativeAmerican 8 7 8 10 8
Pattern of Homelessness
Firsttimehomeless
6monthsorless 18 10 22 14 11
Morethan6months 31 35 30 31 38
Notrsttimehomeless
Currentspell6monthsorless 21 23 21 25 18
Currentspellmorethan6months 30 32 28 31 33
Other Characteristics
Youth(ages1724) 12 9 14 8 11
Livingwithownchild<age18 15 3 16 6 14
Nopaidworklast30days 56 61 53 56 65
AnyADMproblem,past30days 66 75 63 66 74
Alcoholuseproblem 38 45 35 40 43
Druguseproblem 26 35 23 31 32
Mentalhealthproblem 39 44 38 37 46
HIV/AIDS 3 2 3 2 5
Veteran 23 27 20 22 23
Note: Numbersdonotsumto100 percentduetorounding.Streetlocationsincludeanyplacenotmeantforhabitation(e.g.,transportationsites,places
ofbusiness,vehicles,abandonedbuildings,anywhereoutside,etc.).Sheltersincludeemergencyshelters,transitionalhousingprograms,andvouchersfor
temporaryshelter.Otherprogramsincludepermanenthousingprogramsforformerlyhomelessclients,foodpantries,outreachprograms,drop-incenters,
andotherprograms.
19
Clientswerenotaskedabouttheiruseofhealth,mentalhealth,alco-
hol/drug,orHIV/AIDSprograms.
20
Thestandarddeviationforthe$367averagepastmonthincomefor
allhomelessclientswas$354;forfamiliesthestandarddeviationontheir
averageincomeof$475was$342;forsinglesthestandarddeviationon
theiraverageincomeof$348was$353.
ingthepastmonth.Clientsinfamiliesaveraged$475,
butthisamounthadtosupporttheparentandtwochil-
dren(onaverage).Homelessfamiliesthuswerelivingon
46percentofthefederalpovertylevelof$1,023fora
familyofthree.Singlehomelessclientsaveraged$348
duringthemonthbeforetheinterview,whichwas51
percentofthefederalpovertylevelof$680amonthfor
asingleperson.Acomparisonofthesefigureswiththe
1995medianmonthlyhouseholdincomeof$2,840for
allAmericanhouseholdsshowsjusthowimpoverished
homelessclientsreallyare.
Paid Employment
Almosthalf(44percent)ofhomelessclientsdidsome
paidworkduringthe30daysbeforebeinginterviewed,
and21percentreceivedmoneyfromfamilyorfriends.
Ofthosewhoreportworkinginthelast30days,20per-
centdidsoinajoblastingorexpectedtolastatleast
threemonths,25percentworkedatatemporaryorday
laborjob,and2percentearnedmoneybypeddlingor
sellingpersonalbelongings.Threepercentnamemore
thanonesourceofearnedincome.Ofthosereceiving
moneyfromfamilymembersorfriends,9percentreceive
itfromparents,2percentfromaspouse,5percentfrom
other relatives, 12 percent from friends, including
boyfriendsandgirlfriends,and1percentfromchildsup-
port.Eightpercentreceiveincomefrommorethanone
typeoffriendorfamilymember.Eightpercentreport
obtainingmoneythroughpanhandling.Considerably
fewer(29percent)homelessclientsinfamiliesdidany
paidwork.Ontheotherhand,homelessclientsinfami-
lies were more likely than other homeless clients to
receivemoneyfromfamilymembersorfriends(32versus
19percent),includingspouses,otherrelatives,friends
includingboyfriendsandgirlfriends,andchildsupport.
However,thishelpwasclearlynotenoughtosupplyan
adequateincome.
Receipt of Government Benets
Homelessclientsreceiveincomefromavarietyofsources
inadditiontoearningincomethroughajob.Means-
testedgovernmentsourcesofincomeincludeAFDC
(52percentofhomelessfamilies),GA(9percent),and
SSI(11percent).Foodstampswasthegovernmentben-
ethelpingthelargestproportionofhomelessclients(37
percent),followedbyMedicaid(30percent).
Receiptofmeans-testedbenefitsdiffersconsiderably
byfamilystatus(gure2.14).Aswouldbeexpected,52
percentofhomelessfamiliesreceiveAFDC.Inaddition,
TA B L E 2 . 6
Economic and Other Characteristics of Homeless Clients, by Family Status
All Homeless Clientsin Single
Clients HomelessFamilies HomelessClients
(N =2938) (N =465) (N =2473)
Economic Characteristics
Meanmonthlyincome($)
a
$367 $475 $348
Anypaidworkinpastmonth 44(%) 29(%) 46(%)
Anymoneyfromfamily/friends
b
21 32 19
Haveproblemsgettingenoughfood 58 54 59
Government Benets
Anymeans-testedbenets 40 79 39
AFDC 10 52 3
GeneralAssistance 9 10 9
SSI 11 11 11
Foodstamps 37 71 31
Medicaid 30 61 25
Alcohol/Drug/Mental Health Problems
AnyADMproblempast30days 66 49 69
Alcoholuseproblem 38 18 41
Druguseproblem 26 20 27
Mentalhealthproblem 39 36 40
a
Thestandarddeviationsforthethreemeanincomesare$354,$342,and$353,respectively.
b
Includesspouse,parents,otherrelatives,friends(includingboyfriendsandgirlfriends),andchildsupport.
homelessclientslivinginfamiliesaremuchmorelikely
than single homeless clients to receive food stamps
(61 versus25percent),andMedicaid(71 versus31 per-
cent).Althoughthetwogroupsdonotdifferintheir
receiptofGeneralAssistanceorSSI,thedifferenceattrib-
utable to the three programs linked through AFDC
(AFDC,foodstamps,andMedicaid)isenoughtoraise
thelevelofhomelessfamiliesreceivinganymeans-tested
benetto79percent,comparedwithhalfofthat(39per-
cent)amongsinglehomelessclients.
History of Homelessness
Foralmosthalf(49percent)ofhomelessclients,their
currentspellofhomelessnessistheirrst(table2.7).Of
theremaininghomelessclients,17percentareintheir
secondspelland34percenthavehadatleastthreehome-
lessspellsincludingthecurrentone.Twenty-eightper-
centofcurrentepisodeshavelastedthreemonthsorless,
another11 percenthavelastedbetweenfourandsix
months,15 percentbetweensevenandtwelvemonths,
16 percentbetweenthirteenandtwenty-fourmonths,
and30percenthavelastedtwoyearsormore.
Patterns of homelessness differ between homeless
clientsinfamiliesandsingleclients,primarilyamong
thosewhoareintheirrsthomelessepisode(gure2.15).
Bothgroupsareequallylikelytobeinafirstepisode
(50 and49percent).However,homelessfamiliesare
morelikelythansinglehomelessclientstobeinashort
rstepisode(34versus15percent),andlesslikelytobe
inalongrstepisode(16versus34percent).
Homelessclientsgivemanydifferentreasonswhythey
hadtoleavetheirlastresidence,butonlyafewreasonsare
identifiedbyatleast5percentofclients.Theseinclude
notbei ngabletopaytherent(15percent),losi nga
j oborhavi ngaj obend(14percent),doi ngdrugs
(7percent),thelandlordmakingoneleave(6percent),
andnotgettingalongwiththepeoplethere(5percent).
Reasonsforleavingoneslastresidencediffergreatlyby
familystatus.Morehomelessclientsinfamiliesthansin-
glehomelessclientsleftbecausetheycouldnotpaythe
rent(22versus14percent),becausetherewasviolence
inthehousehold(13versus2percent),orbecausethe
landlordmadethemleave(12versus5percent).Con-
versely,fewerhomelessclientsinfamiliesthansingle
homelessclientssaytheyleftbecausetheylosttheirjob
(2 versus16percent).
F I G U R E 2 . 1 4
Receipt of Means-Tested Benets during Past Month, by Family Status
3
52
10
9
11 11
71
31
61
79
39
25
Homeless Clients in Families Single Homeless Clients
100
80
60
40
20
0
AFDC General SSI Food Stamps Medicaid Any
Assistance Means-Tested
Benet
P
e
r
c
e
n
t
a
g
e
TA B L E 2 . 7
History of Homelessness and Transiency, by Family Status
All Homeless Clientsin Single
Clients HomelessFamilies HomelessClients
(N =2938) (N =465) (N =2473)
Number of Times Homeless
One 49(%) 50(%) 49(%)
Two 17 27 15
Threeormore 34 23 37
Length of Current Homeless Period
3months 28 49 23
46months 11 11 11
712months 15 16 15
1324months 16 11 17
25+months 30 13 34
Pattern of Homelessness
Firsttimehomeless
6monthsorless 18 34 15
Morethan6months 31 16 34
Notrsttimehomeless
Currentspell6monthsorless 21 26 20
Currentspellmorethan6months 30 25 31
Things Mentioned Most Frequently as
Primary Reasons for Leaving Last Residence
Couldntpaytherent 15 22 14
Lostjoborjobended 14 2 16
Wasdoingdrugs 7 4 7
Landlordmademeleave 6 12 5
Didntgetalongwiththepeoplethere 5 3 5
Clientorchildabused/violenceinhousehold 4 13 2
When Homeless, Number of Towns/Cities
Where Stayed Two or More Days
1(thelocationwheretheywereinterviewed) 56 71 54
2 22 16 23
3 8 10 8
4 3 2 3
5to10 6 1 6
11ormore 5 * 6
Clients Reporting a Move from One
Community to Another While Homeless 44 29 46
Amongmovers, wherelivingnow
versuswhen rst becamehomeless
Insamestate 61 74 59
Indifferentstate 37 26 39
Indifferentcountry 1 0 2
Amongmovers, reasonsleft city/town
wherebecamehomeless
Nojobsavailable 18 10 19
Evicted/askedtoleavehousing 14 20 13
Noaffordablehousingavailable 13 18 12
Noservicesavailable 5 13 4
Amongmovers, reasonscametothiscity/town
Hadfriends/relativeshere 25 29 24
Availabilityshelters/missions 21 41 18
Availabilitygoodservices/programs 19 27 17
Tolookforwork,heardjobswereavailable 16 16 16
PeopleWho ChangeLocations
after Becoming Homeless
Fifty-sixpercentofhomelessclientswereinterviewedin
thesamecity,town,orruralcommunitywherethey
becamehomelessthistime;thatis,theyhavenotchanged
communitiessincebecominghomeless(table2.7).An
additional22percentsaytheyhavestayedforatleasttwo
daysintwodifferentcommunitiessincebecominghome-
less(includingtheonewheretheywereinterviewed),
8percenthavestayedinthreedifferentcommunities,and
14percenthavestayedinfourormoredifferentcom-
munities since becoming homeless. Among movers,
61 percent moved from one community to another
withinthesamestate,with74percentofhomelessfami-
liesand59 percentofsinglehomelessclientswhomoved
stayingwithinthesamestate.
Familystatusmakesabigdifferenceinthelikelihood
ofmovingfromonecommunitytoanotherwhilehome-
less.Homelessclientsinfamiliesweremuchmorelikely
tohaveremainedinthesamecommunitythanweresin-
glehomelessclients(71versus54percent).Inaddition,
theyweremuchlesslikelytohavestayedinveormore
communitieswhilehomeless(1versus12 percent).
Why They Move. Respondentswhoreporthavingleft
thecommunitywherethisepisodeofhomelessnessbegan
explainedwhytheyleftthatplace,andwhytheycameto
the city or town where they were interviewed for
NSHAPC.Manyreasonsweregivenforleavingtheirorig-
inaltown.Thefourmostcommonwerethattherewere
nojobsinthatplace(18percent),therewasnoaffordable
housinginthatplace(13percent),theywereevictedor
askedtoleavetheirhousing(14percent),andtherewereno
servicesinthatplace(5percent).Clientsinfamilieswere
lesslikelythansinglehomelessclientstogivelackofjobs
asareasonforleaving(10versus19percent),andmore
likelytogiveasreasonsthelackofaffordablehousing
(18 versus 12 percent), eviction/being asked to leave
(20 versus 13 percent), and perceived lack of services
(13versus4percent).
Homelesscli entswhomovedalsogavemanyrea-
sonsforcomi ngtotheci tyortownwheretheypar-
ticipatedinNSHAPC.Onlyfourreasonsweregiven
by10 percentormoreofmovers:theyhadfri ends
and/ orrelati veshere(25percent),shelters/ mi ssi ons
werehere(21percent),theywerelookingforworkor
heardtherewerejobshere(16percent),andtherewere
goodservi cesandprogramshere(19percent).Only
F I G U R E 2 . 1 5
Pattern of Homelessness, by Family Status
34
34
16
15
25
26
31
20
More than 6 months Less than or equal to 6 months
60
50
40
30
20
10
0
Clients in Families Single Clients Clients in Families Single Clients
First Homeless Episode Homeless at Least Once Before
P
e
r
c
e
n
t
a
g
e
thetwoservi ce-relatedreasonsdi fferenti atefami li es
fromsi ngl ehomel esscl i ents.Forty-onepercentof
familieswhomovedmentionedtheavailabilityofshel-
tersormissionsintheirnewlocation,comparedwith
18 percent of si ngl e homel ess who moved, whi l e
27 percentoffami l i eswhomovedmenti onedgood
servicesorprogramsasareasontocometotheircur-
rent l ocati on, compared wi th 17 percent of si ngl e
homelessclientswhomoved.
Where They Move from and Where They Move to.
Thebasicpatternofmovesbetweencommunitytypesis
forpeopletomovetoaplacethatislargerthantheone
theycamefrom.
21
Amongpeoplewhochangedthetype
ofcommunityinwhichtheywerelivingafterbecoming
homelessfortheircurrentepisode,28percentstartedin
alargecentralcity,14percentinamedium-sizedcentral
city,31and10percent,respectively,intheurbanfringes
oflargeandmedium-sizedcentralcities,10percentin
largeorsmalltowns,5percentinruralareas,and1per-
centinanothercountry(table2.8).
Comparisons of Clients from Central
Cities, Suburbs, and Rural Areas
Amongallhomelessclients,71percentwereinterviewedin
centralcities,21percentinsuburbanareas,and9percent
inruralareas(table2.9).Thisdistributiondoesnotvaryby
whetherornottheclientisinafamilyhousehold,norwould
itchangeifoneincludedthechildrenaswellastheirpar-
entsintheanalysis.Homelessclientsarethusmuchmore
likelytoliveincentralcitiesthantheU.S.poorpopulation,
41 percentofwhomliveincentralcities,35percentinthe
suburbsandurbanfringeareas,and23percentinruralareas
outsideofmetropolitanstatisticalareas(gure2.16).
Centralcityandruralclientsdonotdifferintheirsex
distribution(71and77percentmale),butsuburban
clientsaresignicantlylesslikelytobemale(55percent).
Suburbanclientsarealsomorelikelytobewhitenon-
Hispanics(54percent)thanclientsfromeithercentral
cities(37percent)orruralareas(42percent).
Ingeneral,ruralhomelessclientshaveexperienced
fewerandshorterepisodesofhomelessnessduringtheir
lifetimes.Fifty-fivepercentofruralclientshavebeen
homelessforthreemonthsorless,comparedwith22to
27 percentofcentralcityandsuburbanhomelessclients.
Inaddition,only27percenthavebeenhomelessfor
morethanayear,comparedwith48percentofcentral
cityand49percentofsuburbanclients.
TA B L E 2 . 8
Movers: Origins and Destinations
LocationsWhereClientsBecameHomeless, ThisEpisode
Urban Urban
Fringeof Fringeof
Large Medium Large Medium Large Small Another
Central City Central City Central City Central City Town Town Rural Country
Of Those Who Moved, Where They
Came From 28(%) 14(%) 31(%) 10(%) 3(%) 7(%) 5(%) 1(%)
Moved within Same Type of Place 66 49 50 27 0 0 1 0
Moved to Different Type of Place 34 51 50 73 100 100 99 100
Whattypeofplacedidtheymoveto?
Largecentralcity NA 40 34 25 44 22 27 InsufcientN
Medium-sizedcentralcity 20 NA 14 47 55 38 60
Urbanfringeoflargecentralcity 14 8 NA 1 * 41 3
Urbanfringeofmedium-sizedcentralcity * 4 1 NA 1 0 10
Largetown,smalltown,orrurallocation 0 0 1 0 0 0 0
*Denotesvaluesthatarelessthan0.5butgreaterthan0percent.UnweightedN ofmoverswithusableanswers=1,337.
NA=Notapplicable.
21
Theexceptiontothisgeneralizationispeoplewhobecamehomeless
inalargecentralcity.Thereisnocategorytorepresentanymovesofthese
peopletolargerplaces,althoughthe66percentofthisgroupwhomoved
toanotherlargecentralcitymaywellhavebeenmovingtoalargerplace.
Alargerproportionofcentralcityclients(21percent)
reportstayinginplacesnotmeantforhabitationthanis
trueforsuburban(12percent)orruralclients(4per-
cent).Clientsfromcentralcitiesaremorelikelythan
thosefromsuburban/urbanfringeandruralareastohave
usedasoupkitchen(68percent,50percent,and45per-
cent,respectively)andadrop-incenterintheirlifetime
(30percent,18percent,and14percent,respectively).
Thelackofavailabilityoftheseprogramsoutsideofcen-
tralcitiesmostlikelyaffectstheseresults.
Centralcityhomelessclientsareconsiderablypoorer
thanotherhomelessclients.Clientsmedianincomeis
$250incentralcities,$395insuburbanareas,and$475
inruralareas.Fifteenpercentofcentralcityclientsreport
noincomeoverthelast30dayscomparedwithonly6
to7 percentofotherclients.
Ruralhomelessclientsreportlessaccesstomedical
care.Forty-sevenpercentofruralclientssaytheyneeded
toseeadoctorornurseinthelastyearbutwerenotable
todoso,comparedwith22percentofhomelessclients
inbothcentralcitiesandsuburban/urbanfringeareas.
Similarproportions(64to68percent)ofcentralcity,
suburban,andruralclientshaveacurrentmentalhealth
and/oralcoholand/ordrugproblem.However,clientsfrom
centralcitiesaremorelikely(25percent)thanthoseinsub-
urbanareas(17percent)tohavecurrentproblemswith
TA B L E 2 . 9
Characteristics of Homeless Clients in Central Cities, Suburbs,
and Rural Areas
HomelessClients
Clientsin
Clientsin Suburban/Urban Clientsin
Central Cities FringeAreas Rural Areas
(N =2295) (N =410) (N =269)
Proportion of Currently Homeless 71(%) 21(%) 9(%)
Sex
Male 71 55 77
Female 29 45 23
Race/Ethnicity
Whitenon-Hispanic 37 54 42
Blacknon-Hispanic 46 33 9
Hispanic 11 11 7
NativeAmerican 5 1 41
Other 1 1 *
Age
Under25years 13 12 7
2554years 79 77 88
55yearsandolder 8 11 5
Family Status with Own Child 14 16 17
Economic Characteristics
Meanmonthlyincome $341 $422 $449
Medianmonthlyincome $250 $395 $475
Length of Current Homeless Episode
3monthsorless 27(%) 22(%) 55(%)
Morethan12months 48 49 27
Alcohol/Drug/Mental Health Problems
AnyADMproblempast30days 67 64 67
Alcoholuseproblem 39 30 48
Druguseproblem 28 24 15
Mentalhealthproblem 41 37 26
bothmentalhealthandalcoholand/ordruguse.And
clientsinbothcentralcitiesandsuburbanareasaremore
likelythanruralclients(11percent)tohavesuchproblems.
Thirty-threepercentofsuburbanhomelessclients,
24percentofthosefromcentralcities,and12percent
ofthosefromruralareasreportbeingphysicallyorsexu-
allyabusedbeforetheageof18.Incarcerationfollowsthe
oppositepattern,withthesuburbslowestandruralareas
highest.Sixty-fourpercentofclientsfromruralareashave
spenttimeinjuveniledetention,jail,orstateorfederal
prison,comparedwith55percentofthosefromcentral
citiesand44percentfromsuburbanareas.
Comparisons with 1987
Urban Institute Findings
In1987theUrbanInstituteconductedanationalsurvey
ofhomelessclientsusingsheltersandsoupkitchensin
largeU.S.cities(thosewith100,000ormorepopulation
in1994).Asthereisconsiderableinterestinexamining
whether,andinwhatways,clientswhoarehomelessmay
havechangedduringthenineyearsbetweentheUrban
InstituteandNSHAPCsurveys,relevantcomparisonsare
presentedhere.ForthisanalysisNSHAPCdatahavebeen
restrictedtobecomparabletothe1987data.Thismeans
thatthe1996statisticsinthiscomparisonarebasedonly
onhomelessNSHAPCclientsfoundincentralcitieswho
weresampledfromshelters,voucherdistributionprograms,
andsoupkitchens.Table2.10presentscomparablegures
for1987and1996usingtheseparameterstoanalyzethe
1996NSHAPCdata.
Ascanbeseenfromthedataintable2.10,in1996
homelessshelterandsoupkitchenuserslocatedincentral
citiesarelesslikelytobewhite(39versus46percent)and
morelikelytobeblack(46versus41percent)thanthose
from1987.Theyaremorelikelytohavecompletedhigh
school39versus32percent,andtohavesomeeducation
beyondhighschool27versus20percent.Theyaremore
likelytohavemarriedatsometimeintheirlives(51versus
45percent),buthavethesamelikelihoodofbeingina
homelessfamily(10percentineachyear).
Althoughthemeanlengthofclientscurrenthomeless
episodeisshorterin1996thanitwasin1987(39versus
32months),thereisnosignicantdifferenceinthemedian
length(12versus10months).
22
Thereissomeincreasein
theproportionwithshortspells(30versus21percentwith
spellsofthreemonthsorless).However,thereisnochange
intheproportionwithlongspells(31percentofboth1987
UrbanInstituteandcomparable1996NSHAPC clients
reportedspellsoftwoormoreyearsduration).
In1996,alargerproportionofhomelesshouseholds
receivedmeans-testedbenefits(AFDC,SSI,andfood
stamps)thanwastruein1987.In1987,33percentof
homelessclientsinfamiliesreportedreceivingAFDC,
whichincreasedto58 percentofcomparableNSHAPC
clientsin1996.Twiceaslargeaproportionofallhomeless
centralcityusersofsheltersandsoupkitchensreceived
All Homeless Clients Poor U.S. Population (1996)
71%
9%
43% 23%
Central City Suburban/Urban Fringe Rural
F I G U R E 2 . 1 6
Urban/Rural Location of Homeless Clients Compared with the Poor
U.S. Population
Source: Urban Institute analysis of weighted 1996 NSHAPC client data. Geographic distribution of
the poor U.S. population taken from Lamison-White (1997), P60-198, table A.
21%
34%
22
Themeanspelllengthinbothstudiesissomuchhigherthanthe
medianspelllengthbecauseaboutone-fifthofeachsamplehavespell
lengthsinexcessof60 months,andverylongspellsaffectthemeanmuch
morethantheydothemedian.
foodstampsin1996comparedwith1987(37percent
versus18percent).ForSSIthegurestripled(13 versus
4 percent).Thesedifferencesareprobablyattributableto
signicantlygreatereffortsbyhomelessserviceproviders
tohelpclientsobtainbenefits,andtogreateroutreach
effortsonthepartofthegovernmentbenefitprograms
themselves. Major SSI rule changes that effectively
reducedtheeligibilityofmanyclientsathighriskfor
homelessness(byeliminatingeligibilityforclientswitha
primarydiagnosisofalcoholand/ordrugabuse)didnot
takeeffectuntilafterNSHAPCdatawerecollected.
Probablyasaconsequenceofincreasedaccesstopub-
licbenets,meanmonthlyperpersonincomeishigherin
1996($267)thanitwasin1987($189)
23
amongcom-
parableclients.Theseestimatesassumethatthe10per-
centofclientswhohavechildrenwiththemhaveon
averagetwochildreneach,andthattheremaining90
percentofclientsarebythemselves.
Thefoodsituationhasimprovedsomewhatforhome-
lessclients.In1987,38percentofclientsintheUrbanInsti-
tutestudy(homelessusersofcentralcitysheltersandsoup
kitchens)saidtheysometimesoroftendidnotgetenoughto
eat.AmongcomparableNSHAPCclients,28 percentsay
TA B L E 2 . 1 0
What Has Changed? Comparing Homeless Clients Found in
Central City Shelters and Soup Kitchens in 1987 and 1996
1987 1996
(N =1704) (N =1472)
Sex Percent Male 81(%) 79(%)
Race/Ethnicity
Whitenon-Hispanic 46
a
39
Blacknon-Hispanic 41 46
Hispanic 10 11
Other 3 4
Education
Lessthan12thgrade 48 34
Completed12thgrade 32 39
Morethan12thgrade 20 27
Relationship/Household Status
Nevermarried 55 49
Homelessfamily 10 10
Length of Current Homeless Spell
Mean(inmonths) 39 months 32 months
Median(inmonths) 10months 12months
3monthsorless 21(% ) 30(% )
2yearsormore 31 31
Receipt of Public Benets
AFDC(householdswithchildrenonly) 33 58
SSI 4 13
FoodStamps 18 37
Mean Monthly Income per Person $189
b
$267
Sometimes or Often Dont Get Enough to Eat 38(% ) 28(% )
Get Enough of Desired Foods 19 31
ADM Inpatient Treatment
c
Inpatientalcoholand/ordrugtreatmentonly 24 22
Mentalhospitalizationonly 10 10
Both 9 12
Neither 57 56
Source: 1987statisticsfromBurtandCohen,1989;1996statisticsbasedonspecialruns,withmodied
weights,ofNSHAPCclientswhomatchthecriteriausedin1987(centralcity,currentlyhomeless,foundin
sheltersandsoupkitchens).
a
Withinrows,statisticsinbold aresignicantlydifferentfromeachotheratp=.10.
b
This1987gurehasbeenadjustedforinationto1996dollarsusingCPI-U;guresforbothyears
assumethreepeopleperfamilyhouseholdandonepersonforallotherhouseholds.
c
Basedonallclients,becausenovariablesexistinthe1987databasefromwhichtodeterminetheexis-
tenceofaqualifyingcondition/problem.
23
Adjustedforinationto1996dollarsusingCPI-U.
thesamein1996.Thegreaterlikelihoodofreceivingfood
stampsmayberelatedtothisimprovedfoodsituation.In
addition,31percentsaytheygetenoughofthekindsof
foodtheywanttoeat,comparedwith19percentin1987.
Theproportionofcentralcityhomelessclientswho
haveexperi encedi npati enttreatmentforalcoholor
drug abuse or for mental health problems has not
changedatallbetween1987and1996.Thestatistics
i nthi sanalysi sarebasedonallcentralci tyhomeless
clients,ratherthanbeingrestrictedtothosewhohave
anyalcohol,drug,ormentalhealthproblem,because
the1987UrbanInstitutedatadonotincludetheinfor-
mationneededtoassessserviceuseonlyamongthose
withaproblem.
3
(omparing (urrently with
ormerly 1omeless (lients and
Other ervice 1sers
H I G H L I G H T S
Comparing Currently with Formerly Homeless Clients
and Other Service Users
1
Fifty-four percent of NSHAPC clients are homeless, 22 percent are

formerly homeless, and 24 percent are other service users who have
never been homeless.
Men and women gure very differently in the three subpopulations

of clients. Men comprise 68 percent of currently homeless clients
compared with 54 percent of formerly homeless clients. Among
other service users, 39 percent are men.
There are no signicant racial differences between currently and

formerly homeless clients. Equivalent proportions are white non-
Hispanic (41 and 46 percent), black non-Hispanic (40 and 41 per-
cent), Hispanic (11 and 9 percent), Native American (8 and 2 per-
cent) and other races (1 and 2 percent). Among other service users,
54 percent are white non-Hispanic, 41 percent are black non-
Hispanic, 11 percent are Hispanic, and 1 percent each are Native
American and other races.
Young clients (ages 17 to 24) make up a greater share of currently

than formerly homeless clients (12 versus 6 percent). The age group
of 25- to 34-year-olds is also more common among currently than
formerly homeless clients (25 versus 16 percent). The opposite is true
as age increases; 45- to 54-year-olds as well as those ages 55 and
older are more numerous among formerly than currently homeless
clients.
Currently homeless clients are more likely than formerly homeless

clients to report needing help nding a job (42 versus 30 percent),
help nding affordable housing (38 versus 21 percent), and assis-
tance with rent, mortgage, or utilities for securing permanent
housing. Formerly homeless clients are more likely than currently
homeless clients to report needing help to obtain food (32 versus
1
Unless noted specically in the text, all comparisons are signicant at p = .10
or better, and all percentages presented by themselves have a 90 percent
condence interval no larger than 4 percentage points. Condence intervals
greater than 4 percentage points will be noted in the text as: 90% C.I. = X
percentage points.
17 percent). Among other service users, help obtaining food and help with other issues are their most
important needs.
Currently and formerly homeless clients are more than twice as likely as poor U.S. households who are
not homeless to say they sometimes or often do not get enough to eat (28 and 25 percent versus
12 percent). Other service users do not differ on this dimension from nonhomeless poor clients
(16 versus 12 percent).
Currently and formerly homeless clients are alike in their reported level of acute infectious conditions
(26 and 28 percent) and acute noninfectious conditions (8 and 6 percent). However, formerly homeless
clients have more chronic health conditions than do currently homeless clients (62 versus 46 percent).
Other service users are quite likely to report chronic health conditions (67 percent).
Over half (55 percent) of currently homeless clients have no health insurance, compared with 32 percent
of formerly homeless clients. More formerly homeless clients than currently homeless clients receive
Medicaid (53 versus 30 percent). Forty-three percent of other service users receive Medicaid, 28 percent
have other insurance, and 31 percent have no insurance.
In general, currently homeless clients have higher rates than formerly homeless clients of alcohol and
drug problems in the past month, past year, and lifetime. Currently and formerly homeless clients
report similar rates of mental health problems regardless of time period. As the time period increases,
the proportion of clients reporting problems in these areas increases. Other service users have the low-
est rates of any group, for every time period.
More currently than formerly homeless clients report having spent time in a state or federal prison (18
versus 9 percent) or in juvenile detention before they reached the age of 18 (16 versus 9 percent). Four
percent of other service users had spent time in either venue.
Twenty-ve percent of currently homeless clients began drinking before age 15, and 18 percent rst
started using drugs at this young age. Both of these rates are higher than those for formerly homeless
clients (19 percent for drinking and 13 percent for using drugs). Six percent of other service users
started drinking before age 15, and 4 percent started using drugs before that age.
Twenty-ve percent of currently homeless clients report being physically and/or sexually abused by a
household member before reaching their 18th birthday. Their rate of childhood abuse is similar to that
of formerly homeless clients (at 22 percent). Other service users report an abuse rate of 6 percent
before reaching the age of 18.
More currently than formerly homeless clients (27 and 19 percent, respectively) were placed in foster
care, a group home, or other out-of-home placement. Similar proportions of both groups had been
forced to leave home for more than 24 hours (22 and 19 percent, respectively). The two groups differ
in the proportion who had run away from home for more than 24 hours (33 versus 27 percent) and
had a homeless experience before the age of 18 (21 versus 12 percent).
Currently homeless clients are the poorest. Their mean income during the last 30 days is $367, com-
pared with a mean income of $469 among formerly homeless clients during the past 30 days. These
gures are signicantly lower than the 1996 federal poverty level of $680 a month for a single person.
Other service users also have a mean income, at $575 during the last 30 days, that indicates that even
other service users are very poor.
Food stamps are the most common type of government benet for currently and formerly homeless
clients, but formerly homeless clients are more likely than currently homeless clients to receive them
(48 versus 37 percent). Currently homeless clients are less likely than formerly homeless clients to
receive SSI (11 versus 29 percent) and General Assistance (9 versus 16 percent). Food stamps (at 37 per-
cent), Social Security (at 33 percent), and General Assistance (at 26 percent) are the most common
income sources for other service users.
Currently homeless clients are more likely than formerly homeless clients to have had only one home-
less episode (49 versus 40 percent). No difference exists in the proportion of currently and formerly
homeless clients who have been homeless four or more times (21 to 22 percent).
Currently homeless clients are more likely than formerly homeless clients to have been interviewed in
central cities (71 versus 64 percent), and less likely to have been interviewed in rural areas (9 versus 19
percent). Other service users are equally likely to have been interviewed in rural areas (40 percent) and
central cities (39 percent).
ComparingCurrentlywith FormerlyHomelessClientsand Other ServiceUsers 41
Introduction
NSHAPCwasdesignedtoincludeinterviewswithall
usersofhomelessassistanceprograms,includingthose
whoarenothomeless.Informationaboutnonhomeless
clientshelpsinunderstandingwhoelseisusingthesepro-
grams,andwhatexperiencestheymayhavewithhome-
lessness.Inlookingatresultspresentedinthischapter
thatcomparethesegroups,readersshouldbeawareof
someimportantlimitationsofNSHAPCdatathatlimit
simpleinferencesofcausality.Formerlyhomelessclients
andotherserviceusersintheNSHAPCsamplearearan-
domandrepresentativesampleofformerlyandnever
homelessusersof NSHAPC homelessassistanceprograms,
butarenot arepresentativesampleofallformerlyand
neverhomelessclientsintheUnitedStates.
2
Aswillbeseen,manysimilaritiesexistbetweencur-
rentlyandformerlyhomelessclientsofNSHAPChome-
less assistance programs (see chapter 1 for how these
groupsaredened).Thesesimilaritiessuggesttwothings,
atleast.First,someproportionofclientsclassiedasfor-
merlyhomelessbyNSHAPCareessentiallythesameas
currentlyhomelessclientswithahistoryofepisodichome-
lessness,andthesurveycaughtsomeinahomelessphase
andothersinahousedphase.Second,however,itisclear
thatsomeproportionofformerlyhomelessclientshave
beenhelpedtoleavehomelessnessthroughtheauspicesof
public benefits and/or permanent housing programs.
Becauseeligibilityfortheseprogramsusuallyrequiressome
levelofdisability(especiallyforprogramsthatarefeder-
allyfunded),theinclusionofpermanenthousingprogram
residentsraisesthelevelofreportedhealthandotherprob-
lemsofNSHAPCsformerlyhomelessgroup.
Otherusersofhomelessassistanceprogramsarealsoof
interesttoserviceprovidersandpolicymakers.Although
housed,theirpovertyissufcienttobringthemtohome-
less assistance programs for help, usually with food
(75percentwerefoundinfoodprograms,includingsoup
kitchens,foodpantries,andmobilefoodprograms).
Basic Demographic Characteristics
Basic demographic characteristics for currently and
formerlyhomelessclientsandotherserviceusersarepre-
sentedintable3.1.
Sex
Menandwomengureverydifferentlyinthethreesubpop-
ulationsofclients(gure3.1).Mencomprise68percentof
currentlyhomelessclientscomparedwith54percentoffor-
merlyhomelessclients.Amongotherserviceusers39percent
aremenand61percentarewomen.Onlythesexdistribu-
tionofformerlyhomelessclientsresemblesthatoftheU.S.
adultpopulation,whichwas48percentmaleand52per-
centfemalein1996(BureauoftheCensus1997,table14).
Race/Ethnicity
Therearenosignificantracialdifferencesbetweencur-
rentlyandformerlyhomelessclients.Equivalentpropor-
Currently Homeless Formerly Homeless Other Service Users
32%
68% 54%
46% 61%
39%
F I G U R E 3 . 1
Sex, by Homeless Status
Male Female
2
Obtainingarepresentativesampleofallformerlyandneverhomeless
individualsintheUnitedStateswouldrequireacompletelydifferentdata
collectionstrategy.Specically,onewouldneedtotakearandomsampleof
thehousedpopulationoftheUnitedStatessuchasthoseconductedbyLink
andhiscolleagues(Linketal.1994,1995).
TA B L E 3 . 1
Basic Demographic Characteristics, by Homeless Status
Currently Formerly
Homeless Homeless Other Service U.S. Adult
Clients Clients Users Population
(N =2938) (N =677) (N =518) (1996)
Sex
Male 68(%) 54(%) 39(%) 48(%)
a
Female 32 46 61 52
Race/Ethnicity
Whitenon-Hispanic 41 46 54 76
b
Blacknon-Hispanic 40 41 32 11
Hispanic 11 9 11 9
NativeAmerican 8 2 1 1
Other 1 2 1 3
Age
17 1 0 1 NA
1821 6 2 4 7
c
2224 5 2 5 5
2534 25 17 12 21
3544 38 36 18 22
4554 17 26 16 17
5564 6 11 16 11
65andolder 2 6 29 17
Education/Highest Level of
Completed Schooling
Lessthanhighschool 38 42 49 18
d
Highschoolgraduate/G.E.D. 34 34 32 34
Morethanhighschool 28 24 19 48
Marital Status
Nevermarried 48 45 28 23
e
Married 9 9 22 60
Separated 15 14 10
f
Divorced 24 25 15 10
Widowed 3 6 25 7
Living Situation
Clientages17to24
Clientsinfamilies
Men * * * NA
Women 3 1 4
Singleclients
Men 5 2 2
Women 4 1 2
Clientages25andolder
Clientsinfamilies
Men 2 3 2
Women 9 13 14
Singleclients
Men 62 50 34
Women 16 30 42
Veteran Status 23 22 14 13
g
*Denotesvaluesthatarelessthan0.5butgreaterthan0percent.
Sourcesfor adult population data:
a
BureauoftheCensus(1997a),datafor1996;table14,N =196.2million.Agerangeis18to 24.
b
c
d
Ibid.,table245,N =168.3millionpersonsages25andolder.
e
f
Includedinmarried.
g
DepartmentofVeteransAffairs,datafor1995.
tionsarewhitenon-Hispanic(41 and46 percent),black
non-Hispanic(40 and41 percent),Hispanic(11 and
9 percent),NativeAmerican(8 and2 percent)andother
races (1 and 2 percent). Among other service users,
54 percentarewhitenon-Hispanic,32 percentareblack
non-Hispanic,11 percentareHispanic,and1percent
eachareNativeAmericanandotherraces.However,all
groups are significantly less likely to be white non-
HispanicsthantheU.S.populationasawhole(76per-
cent),andmorelikelytobeblacknon-Hispanics(40,41,
and32percentversus11percent)(BureauoftheCensus
1997a,table23).
Age
Youngclients(ages17to24)makeupagreatershareof
currentlythanformerlyhomelessclients(12versus4per-
cent)(figure3.2).Theagegroupof25-to34-year-oldsis
also more common among currently than formerly
homelessclients(25versus17percent).Theoppositeis
trueasageincreases;45-to54-year-oldsaswellasthose
ages55andolderaremorenumerousamongformerly
thancurrentlyhomelessclients.Sixty-onepercentof
otherserviceusersareages45andolder,with29percent
beingages65andolder.
Education
Nodifferencesexistintheeducationalattainmentofcur-
rentlyandformerlyhomelessclients.Thirty-fourper-
centofeachgrouparehighschoolgraduatesorhavea
G.E.D.,with28and24percent,respectively,having
someeducationbeyondhighschool.Abouthalfofother
service users (49 percent) have not completed high
school, 32 percent have high school diplomas, and
19 percenthavesomeeducationbeyondhighschool.All
threegroupsaresimilarintheirproportionofhighschool
graduatescomparedwiththeU.S.adultpopulationasa
whole(at34percent).ButallU.S.adultsaresignicantly
morelikelythananygroupofNSHAPCclientstohave
someeducationbeyondhighschool(48percent)(Bureau
oftheCensus1997a,table245).
Marital and Household Status
Similarproportionsofcurrentlyandformerlyhomeless
clientshavenevermarried(48and45percent),divorced
(24and25percent),andseparated(15and14 percent).
Inaddition,equalproportionsaremarried(9percentin
eachgroup)andwidowed(3and6percent).Among
other service users, 28 percent have never married,
22percentarecurrentlymarried,25percentarewidowed
(reflecting their high proportion of older women),
10 percentareseparated,and15percentaredivorced.
Informationaboutwhetherornotaclientlivesina
familywascombinedwithinformationabouttheclients
ageandsextodescribeasbestaspossibletheclients
householdstatus.Theresultsarereportedintable3.1.
Amongclientsages17to24,aboutone-fourthofcur-
rentlyhomelessclients(3of12percent)andone-sixth
offormerlyhomelessclients(1of6percent)arewomen
livinginfamilies.Currentlyhomelessclientsaremore
likelythanformerlyhomelessclientstobesinglemen
ages25andolder(61versus49percent).Tenpercentof
otherserviceusersareages17to24,amongwhom4in
10arewomenlivinginfamilies.Sixteenpercentofother
serviceusersareclientsages25andolderlivinginfami-
lies.Singleclientsages25andoldercomprise74percentof
17%
12%
6%
38%
2%
25%
36%
17%
4%
6%
11%
26%
16%
10%
12%
16%
18%
29%
F I G U R E 3 . 2
Age, by Homeless Status
17 to 24 years 25 to 34 years 35 to 44 years 45 to 54 years 55 to 64 years 65 years and older
otherserviceusers;33 percentaremenand41percent
arewomen.
Veteran Status
The proportion of currently and formerly homeless
clientswhoareveteransissimilar(23and22percent,
respectively).Amongotherserviceuserstheproportionis
14percent.TheDepartmentofVeteransAffairsestimates
thatin1995,13percentofallAmericanadultswere
veterans.
Service Needs, Stresses,
and Vulnerabilities
ServiceNeeds as Seen by Clients
Eachclientwasaskedtoselectfromanextensivelistof
variousneedsthethreethingsyouneedthemosthelp
withnow.Responsesarereportedintable3.2.
Currentlycomparedwithformerlyhomelessclients
aremorelikelytoreportneedinghelpfindingajob
(42versus30percent),helpfindingaffordablehousing
(38versus21percent),andassistancewithrent,mort-
gage,orutilitypaymentsforsecuringpermanenthousing
(30versus15percent).Formerlyhomelessclientsare
morelikelytosaytheyneedhelpobtainingfood(32per-
cent,comparedwith17percentforcurrentlyhomeless
clients).Amongotherserviceusers,thehighestservice
needsareforhelpobtainingfood(33percent),andother
needs(31percent).
Otherneedswerementionedbyalmostone-thirdof
otherserviceusers,andbyone-fourthofcurrentlyand
formerlyhomelessclients.Smallproportionsmentioned
needinghelpwithgettingclothing,transportation,legal
aid,medicalordentalcareforthemselvesortheirchil-
dren,drug/alcohol/mentalhealthtreatment,enrolling
childreninschool,anddomesticviolence,inadditionto
assistancewithjobtrainingandmanagingmoney.Also
manyclientsmentionedanotherneedthatwasper-
sonal,suchasagoodman/woman,spiritualgrowth,
andpeaceofmind.Alloftheseresponsesareincluded
intheotherresponsecategory.
Food Consumption and Hunger
Clientsreportedwhetherthey(1)getenoughofthe
kindsoffoodstheywant;(2)getenoughbutnotalways
thekindsoffoodstheywant;(3)sometimesdonotget
enoughfoodtoeat;and(4)oftendonotgetenoughfood
toeat.Currentlyandformerlyhomelessclientsreporta
similarlikelihood(28and25percent)ofsometimesor
oftennotgettingenoughtoeat(table3.3).Thislike-
lihoodismuchhigherthanthelikelihoodofhaving
similardifficultiesamongallU.S.households(4percent)
andevenamongallpoorhouseholdsinthecountry
(12percent).
3
Currentlyandformerlyhomelessclientsareequally
likelytoreporttwoormoreproblemsgettingenough
TA B L E 3 . 2
Service Needs, by Homeless Status
Currently Formerly
Homeless Homeless Other Service
Clients Clients Users
(N =2938) (N =677) (N =518)
Five Top Responses Clients Provided to
What Are the (Three) Things
You Need the Most Now?
Findingajob 42(%) 30(%) 22(%)
Findingaffordablehousing 38 21 14
Assistancewithrent,mortgage,orutilities
forsecuringpermanenthousing 30 15 5
Other
a
24 25 31
Transportationassistance 19 17 14
Note: Numbersmaynotsumto100percentduetorounding.
a
Otherwasanactualanswercategorychosenbymanyclients,anddoesnot includeassistancegetting
clothing,food,legalaid,medical/dentalcare(forselforchildren),drug/alcohol/mentalhealthtreatment,
assistancewithparenting,childcareservicesandcosts,enrollingchildreninschool,domesticviolence,edu-
cationalissues,moneymanagement,jobtraining,orconictresolution.
3
Current Population SurveyFood SecuritySupplement,April1995,
table1(FoodandConsumerService1999).
food(38and31percent).Thirteenpercentofotherser-
viceusersreportthislevelofproblemsgettingenough
food.Individualproblemsoverthepast30daysincluded
inthisindexareeatingonceadayorless,beinghungry
butnothavingmoneyforfood,andgoingawholeday
withouteatingbecauseofnothavingmoneyforfood.
Similarproportionsofcurrentlyandformerlyhomeless
clientsreporteatingonceadayorless(20and17per-
cent).Currentlyhomelessclientsaremorelikelythanfor-
merlyhomelessclientstoreporttheothertwomeasures
(39versus26percentforhungrybutnotenoughmoney
forfood,and40versus33percentforwholedaywith-
outeating).Botharemuchhigherthanparallelfigures
forallU.S.households(2and1percent,respectively)
andpoorU.S.households(5and3percent,respectively).
Otherserviceusersreportsomelevelofdifcultyget-
tingenoughfood.Sixteenpercentreportsometimesor
oftennotgettingenoughtoeat,and13percentreport
twoormorefood-relatedproblems.Specificproblems
reportedforthepast30daysinclude10percentwho
reporteatingonceadayorless,11percentwhowere
hungrybutdidnothaveenoughmoneyforfood(com-
paredto5percentofpoorU.S.households),and17per-
centwhowentawholedaywithouteatingbecausethey
couldnotaffordfood(comparedto3percentofallU.S.
households).Thusotherserviceusersalsohavemore
problems getting adequate food than do poor U.S.
households.
Physical Health Status and Insurance
Surveyclientswereaskedabout17medicalconditions,
classifiedsubsequentlyasacuteinfectiousconditions
(chest infection/cold/cough/bronchitis, pneumonia,
tuberculosis,STDsotherthanAIDS);acutenoninfec-
tiousconditions(skindiseases,lice/scabies);chronic
healthconditions(diabetes,anemia,highbloodpressure,
heartdisease/stroke,liverproblems,arthritis/rheuma-
tism,cancer,problemswalking/otherhandicap,HIV/
AIDS);whethertheyuseddrugsintravenously;andother
medicalproblems.
Currentlyandformerlyhomelessclientsreportthe
samelevelsofacuteinfectiousoracutenoninfectious
conditions.However,formerlyhomelessclientsreport
higherratesofchronichealthconditionsthandocur-
rentlyhomelessclients(62versus46percent).Two-thirds
TA B L E 3 . 3
Food Consumption and Hunger, by Homeless Status
Currently Formerly All U.S.
Homeless Homeless Other Service Householdsbelow All U.S.
Clients Clients Users thePovertyLevel Households
(N =2938) (N =677) (N =518) (1995)
a
(1995)
a
Best Description of Food Situation
Getenoughofkindsoffoodwanted 39(%) 37(%) 50(%) 60(%)
d
80(%)
b
Getenough,butnotalways
whatiswanted 33 38 34 29 16
Sometimesnotenoughtoeat 18 15 14 9 3
Oftennotenoughtoeat 10 10 2 3 1
Current Food Problems
None 42 48 66 NA NA
One 20 22 21
Two 17 18 8
Three 13 8 4
Four 8 5 1
Eats Once a Day or Less 20 17 10 NA NA
In Last 30 Days, Hungry but
Not Enough Money for Food 39 26 11 5
e
2
c
In Last 30 Days, Went at Least
One Whole Day without Eating 40 33 17 3
e
1
b
a
DataforU.S.householdsandU.S.householdsbelowthepovertyleveltakenfromtheCurrent Population SurveyFood SecuritySupplement, April1995,
table1(FoodandConsumerService1999).
b
N associatedwiththesedatais5,480.
c
d
N associatedwiththesedatais877.
e
ofotherserviceusersreportchronicconditions,29per-
centreportacuteinfectiousconditions,and3percent
reporttheacutenoninfectiousconditionsaboutwhich
thesurveyasked(table3.4).
Themostcommonconditionsamongallgroupsare
arthritis,rheumatism,andjointproblems,althoughat
quitedifferentlevels.Currentlyhomelessclientsareless
likelytoreportthesechronicconditionsthanarefor-
merlyhomelessclients(24versus37percent).Currently
homelessclientsarealsolesslikelythanformerlyhome-
less clients to report high blood pressure (15 versus
22percent),andproblemswalkingorotherphysical
handicap(14versus22percent).Amongotherservice
userstherateforarthritisandsimilarproblemsis42per-
cent,highbloodpresssureis33percent,problemswalk-
ing/otherhandicapis30percent,andupperrespiratory
problemsis27percent.
Similarproportionsofcurrentlyandformerlyhome-
lessclients(24and26percent)neededbutwereunable
toseeadoctorintheyearpriortothesurvey(gure3.3).
Thisfigureismuchloweramongotherserviceusers
(12percent).Farfewerofthechildrenlivingwithclients
wereaffectedbythislackofaccesstocare,withsim-
ilarproportions(8and9percent)ofparentsineach
subgroupreportinganyproblemswithaccessfortheir
children.
Coveragebyhealthinsurancevariesconsiderablyby
homelessstatus(figure3.4).Clientscouldreportmore
thanonetypeofinsurance,soguresdonotsumto100
percent.Overhalf(55percent)ofcurrentlyhomeless
TA B L E 3 . 4
Physical Health Status, by Homeless Status
Currently Formerly
(N =2938) (N =677) (N =518)
Reported Health Problems
a
Acuteinfectiousconditions(oneormore) 26(%) 28(%) 29(%)
Acutenoninfectiousconditions(oneormore) 8 6 3
Chronicconditions(oneormore) 46 62 67
Four Most Common Medical Conditions
Arthritis,rheumatism,jointproblems 24 37 42
Chestinfection,cold,cough,bronchitis 22 24 27
Problemwalking,lostlimb,otherhandicap 14 22 30
Highbloodpressure 15 22 33
Needed but Not Able to See Doctor or Nurse
in Last Year 24 26 12
Type of Current Medical Insurance
b
Medicaid 30 53 43
VAmedicalcare 7 6 3
Privateinsurance 4 5 13
Noinsurance 55 32 31
Other 10 11 28
AmongClientsin Families (N =465) (N =117) (N =126)
Children Needed but Not Able to See Doctor
or Nurse in Last Year 8 9 9
Childrens Medical Insurance
b
Medicaid 73 74 61
Privateinsurance 6 7 11
Noinsurance 20 14 20
Other 6 5 10
Note: Numbersdonotsumto100percentduetoroundingorbecauseclientscouldchoosemorethan
oneanswer.
a
Surveyclientswereaskedabout17medicalconditions,classiedsubsequentlyasacuteinfectiouscondi-
tions(chestinfection/cold/cough/bronchitis,pneumonia,tuberculosis,STDsotherthanAIDS);acutenon-
infectiousconditions(skindiseases,lice/scabies);chronichealthconditions(diabetes,anemia,highblood
pressure,heartdisease/stroke,liverproblems,arthritis/rheumatism,cancer,problemswalking/otherproblem,
HIV/AIDS);other;andwhethertheyuseddrugsintravenously.
b
Clientscouldnamemorethanonetypeofinsurance.
F I G U R E 3 . 3
Ability to See a Doctor or Nurse, by Homeless Status
8
24
26
9
12
9
Adults who needed but were not able to see a doctor or nurse in the past year
Families whose children needed but were not able to see a doctor or nurse in the past year
30
25
20
15
10
5
0
P
e
r
c
e
n
t
a
g
e
F I G U R E 3 . 4
Medical Insurance Coverage, by Homeless Status
30
7
4
55
10
53
6
5
32
11
43
3
13
31
28
Medicaid VA Medical Care Private Insurance No Insurance Other
80
60
40
20
0
P
e
r
c
e
n
t
a
g
e
clientshavenohealthinsurance,comparedwith32per-
centofformerlyhomelessclients.Moreformerlyhome-
less clients than currently homeless clients receive
Medicaid(53 versus30 percent).Otherserviceusers
reporthealthinsurancecoveragebyMedicaid(43 per-
cent),privateinsurance(13percent),otherinsurance(28
percent),andnoinsurance(31percent).Theother
insurancereportedbyotherserviceusersisprobably
Medicare,giventheageofmanyinthisgroup(28 per-
centareages65 andolder).
Similarproportions(73and74percent)ofcurrently
andformerlyhomelessclientslivinginfamiliesreport
thattheirchildrenarecoveredbyMedicaid.(Clients
couldreportmorethanonetypeofinsurancecoverage.)
Only6to7percentofthechildrenlivingwithcurrently
andformerlyhomelessclientsarecoveredbyprivate
insurance.Twentypercentofcurrentlyhomelesshouse-
holdswithchildrenhavenohealthinsurancefortheir
children,comparedwith14percentofformerlyhomeless
householdswithchildren.Thesehighlevelsofhealth
TA B L E 3 . 5
Mental Health and Substance Use Problems, by Homeless Status
Currently Formerly
(N =2938) (N =677) (N =518)
Past Month
Alcoholproblems 38(%) 29(%) 16(%)
Drugproblems 26 17 4
Mentalhealthproblems 39 41 16
Speciccombinations
Alcohol,drug,andmentalhealthproblems 8 5 *
Past Year
Alcoholproblems 46 33 17
Speciccombinations
Lifetime
Alcoholproblems 62 56 36
Speciccombinations
Note: Percentagesdonotsumto100percentduetorounding.
tively).However,whentheprobabilityofhavingatleast
oneoftheseproblemsoverclientslifetimesisexamined,
currentlyandformerlyhomelessclientsareequallylikely
(86and87percent)tohavehadatleastoneoftheprob-
lems(gure3.5).
Lookingatcombinationsofdifferentproblemsexperi-
encedbythesameperson,asthetimeperiodlengthens
frompastmonthtolifetime,morecurrentlyandformerly
homelessclientsreportatleastoneADMproblem(table
3.5).Also,forthelongertimeperiods(pastyearandlife-
time),formerlyhomelessclientsaremorelikelythancur-
rently homeless clients to report only mental health
problems(21versus15percentforpastyear;17versus10
percentforlifetime).Alcoholuseproblemsaremorepreva-
lentthandruguseproblemsineachtimeperiodforboth
currentlyandformerlyhomelessclients.Alcoholuseand
mentalhealthproblemsshowthesamelevelsinalltime
periodsforcurrentlyhomelessclients,butformerlyhome-
lessclientsreportmoreproblemswithmentalhealththan
withalcoholuseforpastmonth(41versus29percent)and
pastyear(46versus33percent).Currently,comparedwith
formerly,homelessclientsreporthigherratesofalcoholuse
problemsduringthepastmonth(38versus29percent)
insurancecoverageforchildrenlivingwithNSHAPC
parentshelptoexplainwhyparentsreportthatrelatively
fewoftheirchildrenexperiencedanyproblemsgetting
neededhealthcare.
Alcohol, Drug, and Mental Health Problems
Measuresofalcohol,drug,andmentalhealth(ADM)
problemsarereportedforpastmonth,pastyear(includ-
ingpastmonth),andlifetime(includingpastyear).These
measuresarecompositesofclientreportsofbehaviors,
experiences,andtreatment,asdenedinchapter1.
Ingeneral,foralcoholanddrugproblemsinallthree
timeframes,currentlyhomelessclientsreporthigher
ratesthanformerlyhomelessclients.Currentlyandfor-
merlyhomelessclientsreportsimilarratesofmental
healthproblemsinalltimeperiods(table3.5).Looking
atcombinationsofalcohol,drug,andmentalhealth
problemsindicatesthatforrelativelyrecenttimeperi-
ods,currentlyhomelessclientshavehigherratesofoneor
moreproblemsduringthepastmonth(66percent)and
pastyear(74percent)thanformerlyhomelessclients
(59and66percentforpastmonthandpastyear,respec-
F I G U R E 3 . 5
Any Mental Health, Alcohol, and/or Drug Use Problems,
by Homeless Status
66
74
86
59
66
87
31
36
56
Past Month Past Year Lifetime
100
80
60
40
20
0
P
e
r
c
e
n
t
a
g
e
andpastyear(46versus33percent),butaresimilarover
theirlifetimes(62versus56percent).
Thirty-onepercentofotherserviceusersreportatleast
oneADMproblemduringthepastmonth,36percent
dosoforthepastyear,and56percentdosoforlifetime
problems. Mental health and alcohol use problems
appearinthisgroupatthesamelevelsforpastmonth
(16percenteach)andpastyear(17and21percent),but
lifetimealcoholuseproblemsarehigher(36versus28per-
cent).Druguseproblemsarelesscommonlyreported
(4 percentforpastmonth,7percentforpastyear,and
18 percentforlifetime).
Incarceration
Currentlyandformerlyhomelessclientsareequallylikely
(49and43percent)tohavespentveormoredaysinacity
orcountyjail,whichmayberelatedtotheirconditionof
homelessnessaswellastootherbehavior(table3.6).More
currentlythanformerlyhomelessclientsreporthaving
spenttimeinastateorfederalprison(18versus9percent)
orinjuveniledetentionbeforetheyreachedtheageof18
(16versus9percent).Takingalloftheirincarcerationexpe-
riencestogether,54percentofcurrentlyhomelessclients
havespentsometimeincarcerated,comparedwith45per-
centofformerlyhomelessclients.Only14percentofother
serviceusershaveeverbeenincarcerated.
AdverseChildhood Experiences
NSHAPCresultsindicatethatmentalhealthandalcohol
and/ordrugproblemsmayhaverootsinthechildhood
ofmanyclients,asdoeshomelessnessitself.Between
one-fthandone-fourthofbothcurrentlyandformerly
homelessclientsreportthatbeforetheageof18they
(1) starteddrinkingandusingdrugs;(2)experienced
physicalabuse,sexualabuse,orbothfromsomeonein
theirhousehold;(3)spenttimeinjuveniledetention;
(4) livedinfostercareorotherout-of-homeplacement;
(5) ran away from or were forced to leave home; or
(6) becamehomelessforthersttime(table3.7).
Ingeneral,currentlyhomelessclientsaremorelikely
thanformerlyhomelessclientstoreportinitiationof
drinkingandusingdrugsatyoungerages.Analysisof
data from the National Household Survey on Drug
Abuseindicatesthatpeoplewhostartdrinkingandusing
drugsbeforetheageof15areatsignicantlyhigherrisk
forproblemswithsubstanceuseasadults(Dennisand
McGeary1998).NSHAPCdataindicatethat25per-
centofcurrentlyhomelessclientsbegandrinkingbefore
age15,andthat19percentfirststartedusingdrugsat
thisyoungage.Bothoftheseratesarehigherthanthose
forformerlyhomelessclients(19percentfordrinking
and13percentforusingdrugs)(gure3.6).
Twenty-vepercentofcurrentlyhomelessclientsand
asimilarproportionofformerlyhomelessclients(22per-
cent)reportbeingphysicallyand/orsexuallyabusedbya
householdmemberbeforereachingtheir18thbirthday
(gure3.6).Ratesthatcombineneglectwithabuseexpe-
riencesshowroughlythesamepattern,butforthiscom-
binationcurrentlyhomelessclientsdoreportsignicantly
higherratesthanformerlyhomelessclients(29versus
23percent).Only8percentofotherserviceusersreport
anyabuseorneglectexperiencebeforeage18(table3.7).
Finally,16percentofcurrentlyhomelessclientshad
spent some time in juvenile detention before they
reachedtheageof18.Thisproportionishigherthanthat
forformerlyhomelessclients(at9percent).Otherservice
usersreportarateof4percentfortimespentinjuvenile
correctionsinstitutions.
TA B L E 3 . 6
History of Incarceration, by Homeless Status
Currently Formerly
(N =2938) (N =677) (N =518)
History of Time Served
Fiveormoredaysinacityorcountyjail 49(%) 43(%) 13(%)
Fiveormoredaysinamilitaryjail/lock-up 4 3 2
Stateorfederalprison 18 9 4
Juveniledetentionbeforeage18 16 9 4
Oneormoretypesofincarceration 54 45 14
Neverincarcerated 46 55 86
TA B L E 3 . 7
Adverse Childhood Experiences, by Homeless Status
Currently Formerly
(N =2938) (N =677) (N =518)
Substance Use/Justice System Experiences
Whenrststarteddrinking
Beforeage15 25(%) 19(%) 6(%)
Betweenages15and17 21 19 15
Whenrststartedusingdrugs
Beforeage15 19 13 4
Betweenages15and17 19 10 3
Juveniledetentionbeforeage18 16 9 4
Abuse/Neglect Experiences before Age 18:
Someoneyoulivedwith:
Leftyouwithoutadequatefoodorshelter 12 10 4
Physicallyabusedyou,tocausephysicalharm 22 18 5
Forcedyouorpressuredyoutodosexualacts
thatyoudidnotwanttodo 13 13 2
Abuse/neglectcombinations
Physicaland/orsexualabusebutnotneglect 25 22 6
Oneormoreabuse/neglectexperiences 29 23 8
Out-of-Home Experiences before Age 18:
Placedinfostercare,grouphome,orinstitution 27 19 NotAsked
Ranawayfromhomeformorethan24hours 33 27 NotAsked
Forcedtoleavehomeformorethan24hours 22 19 NotAsked
Homelessforthersttime 21 12 NotAsked
F I G U R E 3 . 6
Adverse Experiences bef ore Age 18, by Homeless Status
25
6
19 19
13
4
25
22
16
6
9
4
30
25
20
15
10
5
0
Started Drinking Started Using Drugs Physical and/or Juvenile Detention
Alcohol before Age 15 before Age 15 Sexual Abuse by
Household Member
P
e
r
c
e
n
t
a
g
e
Ratesofexperiencesawayfromoneschildhoodfamily
reportedbycurrentlyandformerlyhomelessclientsare
highenoughandoftensimilarenoughtosuggest,asother
researchhasdone,thatthesemaybesignicantriskfactors
foradulthomelessness(e.g.,Piliavin,Sosin,andWesterfelt).
Thesequestionswerenotaskedofotherserviceusers.
Morecurrentlythanformerlyhomelessclients(27and
19percent,respectively)wereplacedinfostercare,agroup
home,orotherout-of-homeplacement(gure3.7).Sim-
ilarproportionsofbothgroupshadbeenforcedtoleave
homeformorethan24hours(22and19percent,respec-
tively).Thetwogroupsdiffer,however,intheproportion
whohadrunawayfromhomeformorethan24hours
(33percentofcurrentlyand27percentofformerlyhome-
lessclients)andhadahomelessexperiencebeforetheage
of18(21and12percent).Theiranswersindicatethat
manydonotconsidertheirrunawayexperiencetobe
homelessness,sincemanymoreinbothgroupsreportthe
formerthanthelatterexperience.
Income Levels, Sources, and Employment
Currentlyhomelessclientsreportalowerlevelofincome
duringthepast30days,onaverage,thanformerlyhome-
lessclients($367versus$470,table3.8).
4
Further,13per-
centofcurrentlyhomelessclientsreportnocashincome
atallduringthepastmonth,comparedwith5percentof
formerlyhomelessclients.Botharesignicantlybelowthe
federalpovertylevelof$680amonthforasingleperson.
Medianincomesareverylow,at$300forcurrentlyhome-
lessand$462forformerlyhomelessclients.Otherser-
viceusersreportameanincomeoverthepast30daysof
$575,andamedianof$514.
Currentlyhomelessclientsaremorethantwiceas
likelyasformerlyhomelessclientstohaveincomesbelow
$100duringthepast30days(30versus14percent).The
proportionofclientswithincomesbelow$300is49per-
centforcurrentlyhomelessclients,30percentforfor-
merlyhomelessclients,and21percentforotherservice
users(gure3.8).
Currently,comparedwithformerly,homelessclients
aremorelikelytohaveworkedforpayduringthelast
30days(44versus34percent)(table3.8).However,
F I G U R E 3 . 7
Out-of -Home Experiences bef ore Age 18, by Homeless Status
27
33
19
27
22
19
21
12
Currently Homeless Formerly Homeless
Source: Urban Institute analysis of weighted 1996 NSHAPC client data. Questions were not asked of
other service users.
40
35
30
25
20
15
10
5
0
Foster Care or Ran Away from Forced to Leave Home Homeless for
Other Out-of-Home Home >24 Hours >24 Hours First Time
Placement
P
e
r
c
e
n
t
a
g
e
4
Thestandarddeviationforthe$367averagepastmonthincomefor
currentlyhomelessclientswas$354;forformerlyhomelessclientsthestan-
darddeviationontheiraverageincomeof$470was$317;forotherservice
usersthestandarddeviationontheiraverageincomeof$575was$380.
althoughtheyarelesslikelytoworkatall,ahigherpro-
portionoftheworkactivityofformerlyhomelessclients
isinjobslastingorexpectedtolastthreemonthsormore,
whereasmorethanhalfoftheworkdonebycurrently
homelessclientsisintemporaryordaylaborjobs.Forty-
vepercent(20/44=45%)ofcurrentlyhomelessclients
whoworkreportjobslastingorexpectedtolastthree
monthsormore,comparedwith62percent(21/34=
62%)offormerlyhomelessclientswithearnedincome.
Foodstampsarethemostcommonsourceofmeans-
testedgovernmentbenefitsforcurrentlyandformerly
homelessclients(37and48percent,respectively)(fig-
ure3.9).Currentlyhomelessclientsarelesslikelythan
formerlyhomelessclientstoreceiveSSI(11versus29
TA B L E 3 . 8
Income Levels, Income Sources, and Employment, by Homeless Status
Currently Formerly
(N =2938) (N =677) (N =518)
Mean Income from All Sources (Last 30 Days)
a
$367 $470 $575
Median Income from All Sources (Last 30 Days)
a
300 462 514
Income from All Sources over Last 30 Days
None 13(%) 5(%) 5(%)
Lessthan$100 17 9 6
$100to$299 19 16 10
$300to$499 18 30 25
$500to$699 14 20 21
$700to$799 4 6 7
$800to$999 5 6 7
$1,000to$1,199 3 2 3
$1,200ormore 4 5 12
Noanswer 3 1 2
Did Any Paid Work at All in Last 30 Days 44 34 28
Sources of Earned Income in Last 30 Days
Joblasting3ormoremonths 13 14 16
Jobexpectedtolast3ormoremonths 7 7 4
Temporaryjob,nonfarmwork 8 6 3
Temporaryjob,farmwork 3 * 1
Dayjoborpick-upjob 14 5 5
Peddlingorsellingpersonalbelongings 2 2 *
Received Money/Benets from Government Sources in Last 30 Days
AidtoFamilieswithDependentChildren(AFDC) 10 8 10
AidtoFamilieswithDependentChildren(AFDC)
onlyfamilieswithchildren 52 45 45
GeneralAssistance 9 16 7
SupplementalSecurityIncome 11 29 26
SocialSecurityDisabilityInsurance(SSDI) 8 16 10
SocialSecurity 3 6 33
Veteransdisabilitypayments(veteransonly) 6 14 23
Veteranspension(notdisabilityrelatedveteransonly) 2 1 16
Foodstamps 37 48 37
Received Means-Tested Government Benets
b
Anyincludingfoodstamps 45 70 56
Anyotherthanfoodstamps 28 57 47
Other Sources of Income over the Last 30 Days
Parents 9 4 6
Friends(includesboyfriendsorgirlfriends) 12 9 5
Askingformoneyonthestreets 8 3 *
a
Ifanincomerangewasreportedbyclient,mid-pointofrangewasusedincalculatingmean.
b
AFDC,GA,SSI,foodstamps,housingassistance.
F I G U R E 3 . 8
Income Received in the Last 30 Days, by Homeless Status
30
14
11
19
16
10
18
30
25
14
20
16
21
19
29
35
30
25
20
15
10
5
0
Less than $100 $100 to $299 $300 to $499 $500 to $699 Above $700
P
e
r
c
e
n
t
a
g
e
F I G U R E 3 . 9
Money/Benets Received f rom Government Sources in the Last 30
Days, by Homeless Status
52
9
8
11
3
37
45
16
29
16
48
6
45
26
7
10
33
37
AFDC for Families with Children General Assistance Supplemental Security
Social Security Disability Insurance Social Security Food Stamps
60
50
40
30
20
10
0
P
e
r
c
e
n
t
a
g
e
percent).Formerlyhomelessclientsaremorelikelythan
currentlyhomelessclientstoreceiveGeneralAssistance
(16versus9 percent).Formerlyhomelessclientsarealso
morelikelythancurrentlyhomelessclientstoreceive
SSDI(16 versus8percent).Otherserviceusersaremost
likelytogetfoodstamps(37percent),SocialSecurity
(33 percent),andSSI(26percent).
History of Homelessness
Currently and formerly homeless clients were asked
abouttheirexperienceswithhomelessness,including
howmanytimestheyhadbeenhomeless,thelengthof
theircurrenthomelessepisode(ifhomelessnow),andthe
lengthofthemostrecentcompletedepisodeofhomeless-
ness(forformerlyhomelessclientsandcurrentlyhome-
lessclientswhohavebeenhomelessmorethanonce).
Resultsareshownintable3.9.
Currentlyhomelessclientsaremorelikelythanthose
whoareformerlyhomelesstohavehadonlyonehomeless
episode(49versus40percent).Similarproportionsofcur-
rentlyandformerlyhomelessclients(22and21percent)
havebeenhomelessfourormoretimes(gure3.10).
Twenty-eightpercentofcurrentlyhomelessclients
havebeenhomelessduringtheirpresentspellforthree
monthsorless,while30percenthavebeenhomeless
TA B L E 3 . 9
Number and Length of Homeless Periods, by Homeless Status
Currently Formerly
Homeless Homeless
Clients Clients
(N =2938) (N =677)
Number of Times Homeless for 30 Days or More
1 49(%) 40(%)
2 17 26
3 12 12
410 18 15
11ormore 4 6
Length of Current Period of Homelessness
<1week 5 Not
1weekand<1month 8 Applicable
13months 15
46months 11
712months 15
1324months 16
2560months 10
5ormoreyears 20
Spell History and Current Spell Length
Firsttimehomeless
6monthsorless 18 Not
Morethan6months 31 Applicable
Notrsttimehomeless
Currentspell6monthsorless 21
Currentspellmorethan6months 30
AmongCurrentlyor FormerlyHomelesswith at Least
OneCompleted HomelessSpell
Length of Most Recent Completed
Period of Homelessness
<1week 5 2
1weekand<1month 9 9
13months 30 33
46months 15 13
712months 20 21
1324months 9 7
2560months 5 7
5ormoreyears 7 8
F I G U R E 3 . 1 0
Number of Times Homeless, by Homeless Status
49
17
18
12
4
40
26
15
12
6
1 2 3 410 11 or more
60
50
40
30
20
10
0
Currently Homeless Formerly Homeless
P
e
r
c
e
n
t
a
g
e
for two years or more. There are no di fferences
betweenformerlyhomelesscli entsandthoseamong
thecurrentlyhomelesswhohavehadmorethanone
spellregardi ngthelengthofthei rmostrecentcom-
pleted spel l . The most frequentl y menti oned spel l
l engthwasbetweenoneandthreemonths(33 and
30 percent,respecti vel y).Thenextmostfrequentl y
mentionedcategorywasepisodesof7to12months,
indicatedby21and20percent.Relativelyfewclients
reportedcompl eti ngepi sodesoftwoyearsormore
(15 and12percent).
Use of Homeless Assistance Programs
Clientsuseofvarioushomelessassistanceprograms,
includingfoodandotherprogramsinadditiontoshel-
ters,isreportedintable3.10.Programusewithinthe
weekbeforebeinginterviewedforNSHAPCshowssig-
nificantvariationbyhomelessstatus.Soupkitchensare
themostcommonlyusedprogramamongcurrentlyand
formerlyhomelessclients(31and35percent,respec-
tively,reportusingthematleastonceduringtheweek
beforetheinterview),althoughthedifferencebetween
soupkitchen,emergencyshelter,andtransitionalhousing
programuseisnotsignificantforcurrentlyhomeless
clients.Emergencyandtransitionalshelterswereeach
usedbyaboutaquarterofcurrentlyhomelessclients
(26and28percent)but,bydenition,werenotusedby
formerlyhomelessclientsandotherserviceusers.Other
serviceusersalsoreportthemostuseofsoupkitchens
(19 percent).
LifetimeServiceUse
Theproportionofclientsreportinghavingever usedvar-
iousprogramsorservicesatsometimeintheirlivesis
obviouslymuchhigherthanusageintheweekbefore
being interviewed (table 3.10). Equal proportions
(65percent)ofcurrentlyandformerlyhomelessclients
haveusedanemergencyshelteratsometimeintheir
lives.Moreformerlythancurrentlyhomelessclients
(19versus10percent)haveusedpermanenthousingpro-
grams(thisstatisticprobablyowesalottothefactthat
usingtheprogramispartofwhatgetsapersonclassied
asformerlyhomeless),whilethesituationisreversedfor
transitionalhousingprograms(40versus23percent).
Thetwogroupsreportsimilaraccesstoprogramsoffer-
ingvouchersforemergencyaccommodation(15and
18percent).
Formerlycomparedwithcurrentlyhomelessclients
aremorelikelytohaveusedasoupkitchenintheirlife-
time(74versus62percent).Formerlyhomelessclients
aremorelikelythancurrentlyhomelessclientstohave
TA B L E 3 . 1 0
Use of Homelessness Assistance Programs, by Homeless Status
Currently Formerly
(N =2938) (N =677) (N =518)
Clients Reporting Program Use in
Week before Interview
Emergencyshelter 28(%) 0(%) 0(%)
Transitionalhousing 26 0 0
Shelter
a
3 0 0
Permanenthousing 3 11 0
Sheltervouchers 1 0 0
Soupkitchen 31 35 19
Foodpantry 5 10 6
Mobilefoodprogram 5 6 8
Outreach 7 3 1
Drop-incenter 9 10 5
Clients Reporting Having Ever
Used Program
Emergencyshelter 65 65 0
Transitionalhousing 40 23 0
Permanenthousing 10 19 0
Sheltervouchers 15 18 0
Soupkitchen 62 74 32
Foodpantry 40 59 50
Mobilefoodprogram 21 18 17
Outreach 17 14 9
Drop-incenter 26 27 11
a
Thisincludesclientswhodidnotreportstayinginanemergencyshelter,transitionalshelter,permanent
housing,orvoucherprogramoverthethelastsevendaysbutsaidthattheyreceivedfoodoverthelastseven
daysintheshelterwheretheylive.
usedfoodpantries(59versus40percent).Mobilefood
programshaveservedequalproportions(21and18per-
cent)ofcurrentlyandformerlyhomelessclients.Similar
proportionsofcurrentlyandformerlyhomelessclients
haveuseddrop-incenters(26and27percent)andout-
reachprograms(17and14percent).Otherserviceusers
frequentfoodpantries(50percent)andsoupkitchens
(32 percent), with lower percentages using mobile
foodprograms(17percent),drop-incenters(11per-
cent),andoutreachprograms(9percent).Useoffood
programsofallvarietiesclearlyreectsgreatneedrelated
tofoodamongeverysubgroupofclientsincludedin
NSHAPC.
Urban/Rural Location
Theurban/rurallocationofcurrentlyandformerlyhomeless
clientsandotherserviceusersisdramaticallydifferent(table
3.11).Currentlyhomelessclientsaremorelikelythanfor-
merlyhomelessclientstobefoundincentralcities(71versus
64percent),buttheproportionforbothishigherthan
theproportionoftheU.S.populationinpovertyfound
intheselocations.Currentlycomparedwithformerly
homelessclientsarelesslikelytobefoundinruralareas
(9versus19percent).Otherserviceusersareequallylikely
tobefoundincentralcitiesandinruralareas(39 and
40 percent).
TA B L E 3 . 1 1
Urban/Rural Location, by Homeless Status
Currently Formerly Poor
Homeless Homeless Other Service U.S.
Clients Clients Users Population
(N =2938) (N =677) (N =518) (1996)
Urban/Rural Location
Centralcities 71(%) 64(%) 39(%) 43(%)
Suburban/urbanfringe 21 17 21 34
Rural 9 19 40 23
Source: UrbanInstituteanalysisofweighted1996NSHAPCclientdata.Geographicdistributionofthe
poorU.S.populationtakenfromLamison-White(1997),P60198,tableA.
1omeless ssistance rograms
4
H I G H L I G H T S
Homeless Assistance Programs
1
This study estimates that about 40,000 homeless assistance pro-

grams operate in the United States, offered at an estimated
21,000 service locations.
Food pantries are the most numerous type of program, numbering

about 9,000 programs. Emergency shelters are next with about
5,700 programs, followed closely by 4,400 transitional housing pro-
grams, 3,500 soup kitchens and other distributors of prepared
meals, 3,300 outreach programs, and 3,100 voucher distribution
programs.
Food pantries expected to have over 1 million program contacts on

an average day in February 1996, followed by about 522,000 pro-
gram contacts expected at soup kitchens. Programs offering nan-
cial and/or housing assistance, outreach programs, and emergency
shelters all expected to have between 240,000 and 253,000 contacts
a day. Expected contacts at health programs were much lower.
These estimates of program contacts are probably high for average
daily service use, since February is a peak month for many homeless
assistance services.
Food programs are most likely to be large (37 percent expected

more than 100 program contacts daily). Shelter and housing pro-
grams are most likely to be small (59 percent expected to serve 25 or
fewer clients a day).
The biggest programs, though few in number, account for very

large proportions of program contacts on an average day. Among
food programs, 11 percent report more than 300 program contacts
daily, but they account for 55 percent of all contacts with food pro-
grams. The pattern is similar for shelter/housing programs. The
8 percent of shelter/housing programs reporting more than
100 program contacts daily provide 51 percent of all contacts in
shelter/housing programs.
1
Unless noted specically in the text, all comparisons are signicant at p = .10
or better, and all percentages presented by themselves have a 90 percent
condence interval no larger than 4.0 percentage points. Condence intervals
greater than 4 percentage points will be noted in the text as: 90% C.I. = X
percentage points.
Nonprot agencies operate 85 percent of all homeless assistance programs. Government agencies
operate only 14 percent.
Among nonprots, secular agencies operate 51 percent of homeless assistance programs and religious
nonprots operate 34 percent.
Secular nonprots operate more than half of the housing and other programs, religious nonprots operate
more than half of the food programs, and government operates more than half of the health programs.
Food programs are the least dependent on government funding (more than half do not receive any), while
health programs are the most dependent on government funding (more than half are funded completely
by government). Shelter and housing programs vary more in their reliance on government for funds.
Some programs have a special focus on one or more population groups. Victims of domestic violence
and veterans are commonly named groups (18 and 14 percent, respectively). Clients who have alcohol,
drug, or mental health problems, alone or in combination, are a special focus for 17 to 19 percent of
programs, with health programs being particularly likely to name one of these groups.
Central cities account for 49 percent of all homeless assistance programs, rural areas for the next
largest share at 32 percent, and suburban areas for the fewest at 19 percent. Because central city pro-
grams serve more clients, however, a larger share of program contactshappen in central cities (57 per-
cent) than in suburban and rural areas (20 and 23 percent of all program contacts, respectively), which
do not differ from each other.
Among the 76 primary sampling areas included in NSHAPC, the areas with the most population provide
the most homeless assistance services, as expected. However, a different picture emerges when service
levels are examined on a per capita basis as a rate per 10,000 population, and also in relation to need as
a rate per 10,000 poor people. Using rates makes clear that many medium-sized and even smaller sam-
pling areas actually offer more homeless assistance services in relation to their poor population than
larger sampling areas.
Introduction
Overthepastdecadethenumberandvarietyofprograms
servinghomelessclientshavegrowntremendously,but
nonationaldescriptionofthisservicenetworkhasbeen
available.NSHAPCprovidesthefirstnationaldescrip-
tionofthisservicenetwork,coveringcentralcities,sub-
urbsandurbanfringecommunities,andruralareas.This
chapteroffersanoverviewofprogramsandservicesavail-
ableintheUnitedStatesthathaveasignicantfocuson
serving homeless clients, spanning a wide variety of
programtypes(exhibit4.1).Readersinterestedinamore
detailedexaminationofprogramsandservicesarereferred
tochapters14through17ofHomelessness: Programsand
thePeopleTheyServeTechnical Report.
Service Locations and Program Types
EstimatesfromNSHAPCdataindicatethereareapprox-
imately21,000servicelocationsintheUnitedStates,
operatingabout40,000homelessassistanceprograms.A
littleoverhalfoftheservicelocations(about11,000)
offeronlyonehomelessassistanceprogram,andalittle
lessthanhalfoffertwoormoreprograms.Forpurposes
ofthisstudy,aservicelocationisthebuildingor physical
spaceat which oneor moreprogramsareoffered,anda
homelessassistanceprogramisa set of servicesoffered to the
samegroup of clientsat a singlelocation(seechapter1for
adetaileddiscussionofdenitions).
E X HI B I T 4 . 1 NSHAPC Program Types
Emergency shelters
Transitional housing
Permanent housing for formerly homeless clients
Voucher distribution for housing
Accept vouchers in exchange for housing
Food pantries
Soup kitchens/meal distribution programs
Mobile food programs
Physical health care programs
Mental health care programs
Alcohol and/or drug programs
HIV/AIDS programs
Outreach programs
Drop-in centers
Migrant housing used for homeless clients
Other
HomelessAssistancePrograms 61
ThreefeaturesofNSHAPCsdefinitionofaprogram
areimportanttokeepinmindthroughoutthischapter:
(1)nonhomelessclientsoftenusesomeofthesepro-
grams;(2)NSHAPCprogramsarenottheonlysources
ofassistancetohomelessclients;and(3) manyprograms
similartoNSHAPCprogramsmayexistinacommu-
nitybuthavenotbeenincludedbecausetheydonottar-
gettheirservicestowardhomelessclients(foodpantries
andhealthprogramsareexamples).
2
Figure4.1showstheestimatednumberofNSHAPC
programsbyfourgeneralprogramtypesofhousing,food,
health,andotherprograms.Notethatnancial/housing
programs(e.g.,EmergencyFoodandShelterProgram,
welfare,publichousingprograms)werenotanoriginal
NSHAPC category, but were mentioned frequently
enoughunderotherprogramstowarrantpresentation
asaseparatecategory.
Foodpantriesarethemostnumeroustypeofprogram
servinghomelessclients,withanestimated9,000pro-
gramsnationwide.Emergencysheltersarenext,with
almost5,700programs,followedcloselybytransitional
housingprograms(4,400),soupkitchensandotherdis-
tributorsofpreparedmeals(3,500),outreachprograms
(3,300),andvoucherdistributionprograms(3,100).Asa
group,homelessassistanceprogramswithahealthfocus
areleastnumerous.
Service Level and Program Size
Ofconsiderableinteresttomanypeopleareestimatesof
thenumberofclientsbeingservedbyhomelessassistance
programs.NSHAPCresultsofferanimportantoverview
ofserviceutilizationintheUnitedStates,buttheymust
beinterpretedcorrectly.Sincepeoplemayusemorethan
F I G U R E 4 . 1
Number of Homeless Assistance Programs in the United States
Source: Weighted NSHAPC data representing programs operating during an average week in February 1996.
Note: Financial (usually welfare) and housing assistance services were mentioned often enough under Other to warrant a category of their
own, and migrant housing was combined with Other because there were so few programs.
10
8
6
4
2
0
5.7
4.4
1.9
3.1
0.8
9
3.5
0.5
0.7
0.8
0.8
0.5
3.3
1.8
1.4
1.6
Housing Programs Food Programs Health Programs Other Programs
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Forexample,the9,000+foodpantriesestimatedfromtheNSHAPC
sample(whichincludefoodpantriesinmetropolitanaswellasruralareas)
areonly27percentofthe34,000+foodpantries,andNSHAPCsesti-
mateofapproximately3,500soupkitchensisonly45percentofthe7,700+
soupkitchens identifiedbySecondHarvestinits 1997survey(Second
Harvest1997).
ond,somehomelessclientsgetservicesfrommainstream
housing,health,andsocialserviceprogramsthatwere
notincludedinNSHAPCprogramuniversebecausethey
donotmeetthestudysdefinitionofahomelessassis-
tanceprogram.
Total Number of Expected ServiceContacts
ForeachtypeofNSHAPCprogram,figure4.2shows
howmanycontactstheprogramsexpectedtohaveon
anaveragedayinFebruary1996.Foodpantriesasa
groupclearlyexpectedtohavethemostprogramcontacts
(over1million)onanaverageday,followedbyabout
520,000contactsatsoupkitchens.Programsoffering
financialand/orhousingassistance,outreachprograms,
andemergencyshelterseachexpectedtohavebetween
240,000and250,000programcontactsaday.Incon-
trast,theestimateofprogramcontactsforallfourtypes
ofhealthprogramswithafocusonservinghomeless
F I G U R E 4 . 2
Number of Program Contacts Expected at Programs of Different Types on an Average Day in February 1996
Note: These are estimates from NSHAPC program representatives of how many contacts their program expected on an average day in February
1996. They contain duplication and cannot be added together to get the total number of people served on an average day.
1200
1000
800
600
400
200
0
240
160
110
70
30
1030
520
50
60
30
20 20
240
100
250
100
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onetypeofserviceduringanaverageday,theestimatesof
servicelevelsmadebyNSHAPCprogramsnecessarily
containanunknownandunknowableamountofdupli-
cation.Theiranswerscannotbeaddeduptodetermine
thetotalnumberofclientswhouseservicesonanaverage
day.Forthatreasontheyarereferredtoasprogramcon-
tacts,notasclientsserved.Further,manyoftheclients
usingtheprogramsincludedinNSHAPCarenothome-
less,socaremustbetakentointerpretthefollowingg-
uresappropriately,assimpleestimatesofprogramuseby
clientswhomayneedawidevarietyofdifferentservices
andmaygetthematavarietyofprograms.
Analcaveatisthattheseguresdonotrepresentall
ofeachtypeofserviceavailabletohomelessclients,for
tworeasons.First,sheltersservemealstotheirresidents,
andmayalsooffersometypesofhealthandotherser-
vices.Therefore,NSHAPCfoodandhealthprograms
donotrepresentallofthefoodand/orhealthservices
availabletohomelessclientswithinacommunity.Sec-
clients,takentogether,isonlyabout140,000,andthis
estimateisaccurateonlyifeachpersonusesoneandonly
onetypeofhealthserviceonanaverageday.Thesegures
probablyarehighestimatesforaveragedailyserviceuse,
sinceFebruaryisapeakmonthformanyhomelessassis-
tanceservices,andprogramrepresentativestendtorecall
theirpeakperiodsratherthantheiraveragedays.
Variability in Program Size
Homelessassistanceprogramsvarygreatlyinsize,where
sizeisdenedasthenumberofservicecontactsexpected
onanaveragedayinFebruary1996.Figure4.3shows
howprogramsofdifferenttypesaredistributedbysize.
Theguremakesclearthatfoodprogramsaremostlikely
tobequitelarge(26 percentexpected101to299 ser-
vicecontactsdailyand11 percentexpectedmorethan
300 service contacts daily), and only about 1 in 11
expectedasfewas1to10 servicecontactsinaday.Shel-
terandhousingprogramsarelikelytobesmall(28 per-
centexpected1to10 andanother31 percentexpected
11to25 servicecontactsaday),withonly2 percent
expectingmorethan300servicecontactsdaily.Health
andotherhomelessassistanceprogramsarethemost
evenlydistributedacrossarangeofsizes,withabout40
percent of each expecting 25 or fewer and between
44 and45percentofeachexpectingbetween26and
100 servicecontactsdaily.
F I G U R E 4 . 3
Size of Homeless Assistance Programs
Note: These are program staff estimates of how many program contacts their own program expected on an average day in February 1996. They
contain duplication and cannot be added together to get the total number of people served on an average day. Housing programs include emer-
gency, transitional, permanent housing, and voucher programs; food programs include pantries, soup kitchens, and mobile food programs; health
programs include general health, mental health, alcohol/drug, and HIV/AIDS programs; other programs include outreach, drop-in centers, nan-
cial/housing assistance, and other.
35
30
25
20
15
10
5
0
28
31
21
11
6
2
9
18
17
21
26
11
17
25
20
25
10
4
23
16
23
21
13
5
P
e
r
c
e
n
t
a
g
e
Estimated Number of Program Contacts Daily: 1 to 10 11 to 25 26 to 50 51 to 100 101 to 299 300+
Thebiggestprograms,thoughfewinnumber,account
forverylargeproportionsoftheclientsbeingservedonan
averageday(figure4.4).Thisistrueregardlessofwhich
typeofprogramoneexamines,butismosttrueforshel-
ter/housingprograms.The80percentofshelter/housing
programsserving50orfewerclientsdailyserveonly
32 percentofalltheclientswhousetheseprogramson
anaverageday(inFebruary1996).Ontheotherhand,
the8percentofshelter/housingprogramsservingmore
than100clientsdailyserve51percentoftheclientsusing
shelter/housingprograms.Indeed,the2percentofthese
programs serving more than 300 clients daily serve
28 percentofallshelter/housingusersonanaverageday.
Thestoryisthesamewithfoodandotherhomeless
assistanceprograms.Only11percentoffoodprograms
and 5 percent of other programs serve more than
300 clients daily, but these programs accommodate,
respectively,55percentofeveryonegettingfoodfrom
foodprogramsand55percentofeveryonegettinghelp
fromotherprogramsonanaverageday.Servicedelivery
inhealthprogramsforhomelessclientsislessskewed
towardtheverylargeprograms(over300daily)andaway
fromtheverysmallprograms(25orfewerdaily),but
evenherethe42percentofprogramsthatareverysmall
serveonly7percentofthosewhousehealthprogramson
an average day, while the very large programs serve
30percentofhealthprogramusers.
Operating Agencies
Nonprotagenciesofferthevastmajority(85percent)of
homelessassistanceprograms(figure4.5).Secularnon-
profitsoffer51percentofallprograms,whilereligious
nonprotsoffer34percent.Governmentagenciesoper-
ate 14 percent of all programs, and for-profit firms
accountforamere1percent.
F I G U R E 4 . 4
Proportion of Program Contacts Provided by Larger Programs
Source: Weighted NSHAPC data representing programs operating during an average week in
February 1996.
Note: These are program staff estimates of how many program contacts their own program
expected on an average day in February 1996. They contain duplication and cannot be added together
to get the total number of people served on an average day. Housing programs include emergency,
transitional, permanent housing, and voucher programs; food programs include pantries, soup
kitchens, and mobile food programs; health programs include general health, mental health,
alcohol/drug, and HIV/AIDS programs; other programs include outreach, drop-in centers,
nancial/housing assistance, and other.
60
50
40
30
20
10
0
23
28 28
30
55 55
23
20
P
e
r
c
e
n
t
a
g
e
Program Contacts Daily, for Programs Serving More than 100: 101299 300+
F I G U R E 4 . 5
Types of Agencies That Operate Homeless Assistance Programs
February 1996.
51%
14%
34%
1%
Secular nonprot Religious nonprot Government For-prot
F I G U R E 4 . 6
Types of Agencies Operating Housing, Food, Health, and Other Programs
Source: Weighted NSHAPC data representing programs operating during an average week in February 1996. Housing programs include emer-
60%
13%
26%
1%
39%
5%
55% For-prot
0%
43%
5%
51%
1%
55%
20%
34%
Secular nonprot Religious nonprot Government For-prot
Health Programs Other Programs
Housing Programs Food Programs
1%
Differenttypesofprogramsareoperatedbyquitedif-
ferenttypesofagencies(figure4.6).Secularnonprofit
agencies dominate in the housing category, offering
60percentofallprograms,whilereligiousnonprofits
dominateinthefoodcategory,offering55percentof
theseprograms.Healthprogramsareaboutevenlysplit
betweengovernmentandnongovernmentagencies,with
secularnonprotsdominatingamongthenongovernment
agenciesthatofferhealthprogramsforhomelessclients.
Governmentagenciesareleastlikelytooperatefood
programs(5percentofthoseprograms)andmostlikely
toofferhealthprograms(51percentofhealthprograms).
Secularnonprotsarethemostprominenttypeofagency
amongotherprogramsofferinghomelessassistance,which
includeoutreachprograms,drop-incenters,housingand
financialassistanceprograms,andotherprograms.For-
protorganizationsplayalmostnoroleinoperatinghome-
lessassistanceprograms(1percentinhousing,health,and
otherprograms,andnothinginfoodprograms).
Funding Sources
Giventhedifferenttypesofagenciesoperatinghomeless
assistanceprograms,itshouldnotbesurprisingthatcon-
siderabledifferencesalsoexistacrossprogramtypesinthe
extenttowhichtheyrelyonprivatefundingorfunding
fromgovernmentsources(federal,state,orlocal)tosup-
porttheiroperations.Figure4.7showsthesedifferences
astheproportionofprogrambudgetsthatcomefrom
governmentfunding;privatefundingmakesupthebal-
anceofeachprogramsbudget.
Foodprogramsarethemostlikelytorelysolelyonpri-
vatefunding,andtoreportthattheyusenogovernment
funds(truefor51percentoffoodprograms).Theyare
alsotheleastlikelytobefullysupportedbygovernment
funds(6percent).Conversely,healthprogramsarethe
leastlikelytorelysolelyonprivatefundingsources(only
12percentoperateentirelywithoutgovernmentfunding)
andthemostlikelytobefullysupportedfromgovern-
mentsources(55percent).
Inbetweenarehousingandothertypesofhomeless
assistanceprograms.One-fourthofallhousingprograms
forhomelessclientsarefullysupportedbygovernment
funds,andaboutequalproportionsrelyentirelyonpri-
vatefunds(23percent)orreceiveuptohalfoftheirbud-
getfromgovernmentsources(22percent).Thefinal
30percentofhousingprogramsreceivefromhalfto
almost all of their support from government funds.
Otherhomelessassistanceprogramsaresplitquiteevenly
amongtheone-thirdthatrelyentirelyonprivatefund-
ing,the34percentthatarecompletelysupportedbygov-
ernment,andtheone-thirdwhoselevelofgovernment
supportfallssomewhereinbetween.
The value of in-kind contributions from private
sourcesarenotincludedinthesegures.Formanypro-
grams,thesecontributionscanbeofconsiderablevalue
andincludefood,rent-freebuildings,equipment,and
volunteertimetoperformcriticalprogramfunctions.
Population Focus
Somehomelessassistanceprogramsareopentoanyone
who wants to use them, while other programs are
designedspecicallytoserveonlycertaintypesofpeople.
Populationfocusmaybedefinedinseveraldifferent
ways.Onecommonwayisbyhouseholdtype,includ-
ingmenbythemselves,womenbythemselves,house-
holdswithchildren,andyouthbythemselves.Other
commonwaysarebythespecialpopulationgroups,such
asveterans,youth,victimsofdomesticviolence;orcon-
ditionorserviceneed,suchasalcohol,drug,ormental
healthproblems,orHIV/AIDS,thataprogramisspecif-
icallydesignedtohelp.NSHAPCprogramstaffwere
askedtoreporteachhouseholdtypethattheirprogram
serves.Inanotherseriesofquestions,programrepresen-
tativesdescribedanyspecializationsorparticularfocuses
thattheirprogrammighthave.Thissectionreportshow
programsdescribethetypesofclientstheyserveonthese
differentdimensions.Sincemanyprogramsreportserv-
ingmorethanonehouseholdtype,andalsoreporthav-
ing a focus on more than one special population,
condition,orserviceneed,thestatisticsforeachtypeof
programusuallysumtomorethan100percent.
Household Type
Figure4.8reportsthetypesofhouseholdsthatprograms
serve.Averynoticeablepatternisthatfoodprograms
arethemostinclusiveofallhouseholdtypes,with84per-
centormoresayingtheyservemenandwomenbythem-
selvesandbothfemale-headedandotherfamilieswith
children.Housingprogramsarethemostspecialized.For
instance,43 percent servetwo-parentfamilieswithchil-
dren,61 percentservemenbythemselves,and68to
69 percent serve women by themselves and female-
headedhouseholdswithchildren.Ofcourse,manyserve
morethanoneofthesehouseholdtypes.Thesepatterns
maybeduetoprogrampolicy(i.e.,theprogramwillnot
takeparticulartypesofclients)orsimplytothefactthat
fewornoclientsofaparticulartypecometotheprogram
forservice.
Nine out of ten health programs serve men and
womenbythemselves,butonlysixintenserveanyfam-
ilieswithchildren.Shelterandotherhousingprograms
aretheleastlikelytoexpectunaccompaniedyouthto
usetheirprograms,butalloftheotherprogramtypes
alsodonotexpecttoservemanyofthisgroup.
Special Population or Special Need
Respondentswereaskedwhethertheirprogramhada
particular focuson one or more special populations.
Thesemightincludeapopulationgroup,suchasvictims
ofdomesticviolence,runawayyouth,andveterans;or
specialconditionsorspecialneeds,suchasmentalhealth
problems(withoutalcoholand/ordruguse),alcohol
and/ordruguse(withoutmentalhealthproblems),both
alcohol/drug and mental health problems, and
HIV/AIDS.
Halfofthosenaminganyspecialfocusnamedonly
onefocus,17percentnamedtwofocuses,and33percent
named three or more focuses. The most commonly
namedspecialfocuswasother(25percent).Abouthalf
(48percent)ofprogramrepresentativesdidnotreport
anyspecialfocus;foodprogramswerethemostlikelyand
healthprogramsweretheleastlikelytosaytheyhadno
specialfocus.
F I G U R E 4 . 7
Program Reliance on Government Funding
Source: Weighted NSHAPC data representing programs operating during an average week in February 1996. Housing programs include
emergency, transitional, permanent housing, and voucher programs; food programs include pantries, soup kitchens, and mobile food programs;
health programs include general health, mental health, alcohol/drug, and HIV/AIDS programs; other programs include outreach, drop-in centers,
60
50
40
30
20
10
0
23
30
22
25
51
33
11
6
21
12
55
14
12
33
21
34
P
e
r
c
e
n
t
a
g
e
Proportion of Budget That Is Government Funding: None 150% 5190% 100%
Figure4.9identiesspecialpopulationgroupsreported
asaprogramsfocus,andfigure4.10doesthesamefor
programfocuswithrespecttoconditionorserviceneed.
Overall,figure4.9showsthatone-thirdorfewerpro-
gramsnamedaspecialpopulationgroupasafocus.The
groupmostfrequentlynamedbyalltypesofprogramsis
victimsofdomesticviolence,followedbyveterans(18
and14percent,respectively,ofallprograms,shownin
thefirstbarineachcluster).Therearesomeimportant
variationsbyprogramtype,withhousingprogramsbeing
themostlikelytonamevictimsofdomesticviolenceas
aspecialpopulationfocus(28percentdoso),andhealth
programsbeingmostlikelytoidentifyveteransasaspe-
cialpopulationfocus(32percentdoso).Nomorethan
10 percentofprogramsidentifyaspecialfocusonyouth,
regardlessofprogramtype.
Figure 4.10 shows the proportion of programs
respondingthattheyhaveafocusonservingclientswith
particularspecialneeds.Overall,peoplewithalcohol,
drug,ormentalhealthproblems,aloneorincombina-
tion,areaspecialfocusfor17to19percentofprograms.
Healthprogramsarebyfarthemostlikelytoreportthese
focuses.Almosthalfofhealthprogramssaytheyhavea
specialfocusonclientswithmentalhealthproblemsonly,
andalmosthalfreportaspecialfocusonclientswith
mental health problems plus accompanying alcohol
and/ordruguse.Morethanone-thirdofhealthprograms
haveaspecialfocusonpersonswhousealcoholordrugs,
F I G U R E 4 . 8
Types of Households Served by Homeless Assistance Programs
100
80
60
40
20
0
61
93
90
83
91
79
68
90
62
91
43
27
24
60
66
11
Men by Women by Female-Headed Others with Unaccompanied
Themselves Themselves with Children Children Youth
P
e
r
c
e
n
t
a
g
e

69
76
84
26
andslightlylessthanone-thirdofhealthprogramshave
aspecialfocusonclientswithHIV/AIDS.
Occupancy Levels of
Shelter/Housing Programs
Shelter/housingprogramsgenerallyreportoccupancy
levelsinthe70percentrange(table4.1).Programsserv-
inghomelessfamiliesreport73percentoccupancyfor
most of the year. The slightly higher winter rate of
77percentfortheseprogramsisstatisticallybutprobably
notsubstantivelysignificant.Programsservingsingle
homelessmenand/orwomenreportoccupancylevelsof
67 to69 percentinthespring,summer,andfall,andsig-
nificantlyhigheroccupancyinthewinter(76 percent).
Thethreereasonsgivenmostfrequentlyforbeingless
thanfullaredeclineinneed,seasonalchanges,andthat
the people seeking shelter do not meet program
criteria/restrictions.Giventhatmanyprogramsappearin
bothcolumnsoftable4.1sincetheyservebothfamilies
andsinglemenand/orwomen,itisnotsurprisingthat
theirreasonsforless-than-fulloccupancylevelsaresimilar.
Location of Homeless
Assistance Programs
Abouthalf(49percent)ofallhomelessassistancepro-
gramsarefoundincentralcities.Ruralcommunities
F I G U R E 4 . 9
Special Population Focus of Homeless Assistance Programs
40
30
20
10
0
18
14
14
28
11
15
8
7
10
7
9
4
13
17
32
Domestic Violence Runaway Youth Veterans
P
e
r
c
e
n
t
a
g
e
All Programs Combined Housing Programs Food Programs Health Programs Other Programs
offerthenextlargestshareofprograms(32percent),and
suburban/urbanfringecommunitiesofferthesmallest
shareofprograms(19percent)(figure4.11).However,
becausecentralcityprogramsservemoreclients,on
average,alargershareofprogram contactshappenin
centralcities(57percent)thaninsuburbanandrural
areas (20 and 23 percent of all program contacts,
respectively).
3
Centralcity,suburban,andrurallocationsalsovary
considerablyintermsofwhichprogramsreportthemost
contacts.Foodprogramsreportthemostcontactsinboth
centralcitiesandsuburbanareas(57and65percentof
programcontactsinthoseareas,respectively),whilein
ruralareasfoodprogramcontactscompriseonly31per-
centofprogramcontacts(gure4.12).Theshareofpro-
gramcontactsthatoccurinshelter/housingprogramsare
similarforcentralcityandsuburbanareas(23and21per-
cent,respectively),butareonly11percentofcontactsin
ruralareas.Incontrast,contactswithotherprograms
predominateinruralareas(50percentofcontacts),but
makeuponly16percentofcontactsincentralcitiesand
11percentofcontactsinsuburbanareas.
F I G U R E 4 . 1 0
Special Needs Focus of Homeless Assistance Programs
Mental Substance Only Mental Illness HIV/AIDS
Illness Only Abuse and Substance Abuse
All Programs Combined Housing Programs Food Programs Health Programs Other Programs
50
40
30
20
10
0
19
11
19 19
44
23
17
10 10
36
46
18 18 18
23
14
9
32
13 13
P
e
r
c
e
n
t
a
g
e
3
Programcontactsarethesumofallprogramestimatesofpeoplethey
expectedtoserveonanaveragedayinFebruary1996.Thephraseprogram
contactsisusedtoremindthereaderthattheseestimatescontainan
unknownandunknowableamountofduplication,aspeoplecouldand
manydousemorethanoneprograminaday.Notealsothatthesegures
differfromthegeographicdistributionofhomelessclientsbecausethey
reectall clients,homelessornot.
Availability of Services within
NSHAPCs 76 Sampling Areas
Sofar,thischapterhasexploredhomelessassistancepro-
gramsandservicesatthenationallevelandthroughthe
broadgeographicaldesignationsofcentralcities,suburban
areas,andruralareas.NSHAPCalsohasthecapacityto
examinevariationsinprogramsandprogramcontacts
withinthesurveys76primarysamplingareas(calledsam-
plingareashereafter).
4
Programcontactinformationcan
TA B L E 4 . 1
Shelter/Housing Utilization and Inf ormation on Turnaways
ProgramsServingFamilies ProgramsServing
with Children SingleAdults
(69 percent of all shelter/ (78 percent of all shelter/
housingprograms) housingprograms)
Occupancy
Percentoccupiedinwinter 77(%) 76(%)
Percentoccupiedinspring 73 69
Percentoccupiedinsummer 73 67
Percentoccupiedinautumn 73 69
Reasons for Operating at Less Than
Full Capacity
Neverlessthanfull 26 20
Ofremainder,percentciting:
a
Declineinneed 35 40
Seasonalchanges 32 35
Changeinprogramparticipationcriteria 5 3
Newfacilitiesaddedelsewhere 3 4
Economic/jobmarketchanges 11 11
Changeinprogramfundingorcapacity 10 9
Peopledidnotmeetprogram
criteria/restrictions 32 34
Other 23 19
Source: UrbanInstituteanalysisof1996NSHAPC mailsurveydata.
a
Programscouldgivemorethanonereason.
F I G U R E 4 . 1 1
Distribution of Programs Compared with Program Contacts
among Communities of Diff erent Types
49%
32%
19%
57%
23%
20%
Feburary 1996. Includes all programs, of every type.
Central Cities Suburbs Rural Areas
Programs Program Contacts
4
AppendixAprovidestwolistsoftheseareas:listA.1,orderedalpha-
beticallywithintype(28largestMSAs,24small-andmedium-sizedMSAs,
24groupsofruralcounties),andlistA.2,orderedbythesizeofthesam-
besegmentedtorevealtheproportionofserviceswithina
samplingareathatareshelter/housingprogramcontacts,
foodprogramcontacts,healthprogramcontacts,andother
programcontacts.Further,programcontactinformation
canbeusedtocalculatearateof programcontactsper
10,000 clientsin poverty,whichisagoodmeasureforcom-
paringthelevelofserviceavailabilityacrosssamplingareas
ofverydifferentsizes(e.g.,acitywithmorethanamil-
lionpeopleandaruralareaofafewthousandpeople).
5
Distribution of Program Contacts
within Sampling Areas
Allotherthingsbeingequal,onemightexpectthesam-
plingareaswiththelargestpopulationtoprovidethemost
homelessassistanceprogramcontacts.Toexaminethis
expectation,gure4.13aarrayseachofthisstudys76 pri-
marysamplingareasfromlefttorightaccordingtothesize
ofitspopulation(largestontheleft,smallestontheright).
6
Eachbarshowsthetotalestimatednumber of programcon-
tactsonanaveragedayinFebruary1996,
7
combining
programcontactsofalltypes.
Fromthisfigureonecanseethattheexpectedrela-
tionshipofmoreprogramcontactsinthelargersampling
areasisgenerallytruebutthereareexceptions.Theaver-
ageestimatednumber of program contactsper sampling
area isabout17,600onanaveragedayinFebruary1996.
Buttheestimatednumbersofprogramcontactsrange
fromahighofabout186,000toalowofnothing(for
twosamplingareasthathadnoprogramsofanykind)
(table4.2).Andvariationexistsevenatthehighestend.
Forexample,providersinthelargestsamplingareaesti-
mateonlyabouttwo-thirdsthenumberofprogramcon-
tacts(about123,000)asdoprovidersinthenextlargest
samplingarea(about186,000).
Toexaminehowmuchpopulationsizeaccountsfor
thedifferencesobservedinfigure4.13a,theestimated
number of programcontactsper 10,000 peopleisemployed.
Figure4.13bshowsthisrateforeachofthe76sampling
areas,arrayedinthesameorderasgure4.13a.Theaver-
ageestimatedrateof programcontactsper 10,000 popula-
tion inasamplingareais122.Theuseofacommon
denominator(10,000people)reducesthedifferences
amongsamplingareasquiteabit.Nowonecanseethat
someofthesmallersamplingareasinthemiddleand
towardtherightofthefigureappeartoprovidemore
F I G U R E 4 . 1 2
Distribution of Program Contacts across Diff erent Types of Communities
23%
57%
4%
16%
11%
31%
50%
8%
21%
65%
11%
3%
Housing Food Health Other
Central Cities Suburbs Rural Areas
plingareastotalpopulationin1996.Theorderofsamplingareasingures
4.13,4.14,and4.15followstheA.2order.
5
Intworuralsamplingareas,CATIinterviewscouldnotdiscoverany
homelessassistanceprogramsatall.Resultsforthesetwoareasareshown
inthefollowingguresaszeros.
6
The28largestMSAsarethe28leftmostbars.However,veruralareas
havemorepopulationthanveofthemedium-andsmall-sizedMSAs,so
theremainingbarsdonotdividecleanlyintothe24medium-andsmall-
sizedMSAsandtheruralsamplingareas.
7
Thereaderisnotexpectedtofolloweachsamplingareathrougheachofthe
panelsingures4.13,4.14,and4.15.Rather,theseguresprovideanoverall
visualimpressionofthelargevariationacrosssamplingareasinthelevelof
programcontactsofalltypes(gure4.13),theshareofallprogramsfalling
withinagivenprogramtype(gure4.14),andtheshareofhousing/shelter
programsfallingwithinemergency,transitional,permanent,andvoucherpro-
grams.Fordetailedinformationoneachsamplingarea,seeHomelessness:
Programsand thePeopleTheyServeTechnical Report,chapter17andits
appendixtables.
unitsofhomelessassistanceservicespercapitathando
someofthelargestsamplingareas.
Yetanotherwaytolookatthesedataistoaskwhether
thevariabilityinservicelevelscanbeaccountedforbythe
sizeofasamplingareaspopulation in poverty,andnotjust
bythetotalnumberofpeopleinthesamplingarea.There
issomereasontoexpectthatservicesshouldberelated
topoverty,andthenumberofpoorpeopleinasampling
areaisthebestmeasureofneedthatisavailableforall
76samplingareas.Somesamplingareascouldhavealot
ofpeoplebutnotverymanypoorpeople,whilesome
smallersamplingareasmightactuallyhavemorepoor
peoplethansomelargerareas.Thereforeasecondrate
wasconstructedforeachsamplingareaitsrateof pro-
gramcontactsper 10,000 poor people. Figure4.13cshows
theresults.
Theaverageestimatedrateof program contactsper
10,000 poor peopleinasamplingareais1,437.Therate
ofcontactsper10,000poorpeoplereducesevenfurther
thelevelofvariabilityinserviceprovisionamongthe
largestsamplingareasattheleftofthegraph.Thevari-
abilityinthemiddleofthegraph(medium-andsmall-
sizedmetropolitanareas)appearstohaveincreasedin
relationtothatingure4.13b.Themostlyruralareasto
therightoffigures4.13band4.13cappeartohavethe
greatestvariabilitywhicheverrateisused.
Fromthethreegraphsinfigure4.13onecandraw
theconclusionthatthebiggestsamplingareas,which
comprisethenationsbiggestcities,donotalwaysprovide
themostserviceson a per capita basis,eventhoughthey
obviouslyprovideverylargenumbersofservices.One
canalsoconcludethatagreatdealofintercommunity
variabilityremainsintheprovisionofhomelessservices,
even after controlling for levels of population and
poverty.Thislevelofvariabilityprobablystemsfrom
importantdifferencesinphilosophies,policies,resources,
andexperienceamongcommunities.
Distribution of Services within Sampling
Areas by Program Type
Thenextissuetobeexaminedishowthetotalestimated
numberofprogramcontactswithineachsamplingareaare
distributedamongthefourmajorprogramtypesofshelter/
housing,food,health,andother.Theresults,shownin
figure4.14,revealgreatvariationintheproportionof
servicecontactsinsamplingareaswithinshelter/housing,
food,health,andotherprogramtypes.
Figure4.14adshowsfourpanels,oneeachforshelter/
housing,food,health,andotherprogramcontacts.The
average proportion of program contacts reported by
shelter/housingprogramsis24percent,byfoodprograms
is 49 percent, by health programs is 5 percent, and
byotherprogramsis19 percent(table4.2givesmeans,
highs,lows,andstandarddeviations).Incomparingparts
(a)through(d)offigure4.14,onecanseethepredomi-
nanceoffoodprogramcontactsandtherelativepaucity
ofhealthprogramcontacts.Foodprogramcontactscom-
TA B L E 4 . 2
Statistics f or Program Contacts on an Average Day in February 1996 in Primary Sampling Areas
Standard
Average High Low Deviation
For Figure 4.13
Aggregateprogramcontacts(4.13a) 17,600 186,000 0 29,600
Programcontacts/10,000population(4.13b) 122 660 0 103
Programcontacts/10,000poorpeople(4.13c) 1,437 9,000 0 1,858
For Figure 4.14
Percentageofallcontactsthatareshelter/housingcontacts(4.14a) 24% 100% 0% 17%
Percentageofallcontactsthatarefoodprogramcontacts(4.14b) 49% 90% 0% 23%
Percentageofallcontaactsthatarehealthprogramcontacts(4.14c) 5% 59% 0% 18%
Percentageofallcontactsthatareotherprogramcontacts(4.14d) 19% 92% 0% 18%
For Figure 4.15
Shelter/housingprogramcontacts/10,000poorpeople(4.15a) 195 860 0 153
Emergencyshelterprogramcontacts/10,000poorpeople(4.15b) 81 405 0 66
Transitionalhousingprogramcontacts/10,000poorpeople(4.15c) 49 238 0 52
Permanenthousingprogramcontacts/10,000poorpeople(4.15d) 40 453 0 72
Voucherdistributionprogramcontacts/10,000poorpeople(4.15e) 26 445 0 39
Source: WeightedNSHAPCdatarepresentingprogramsoperatingduringanaverageweekinFebruary1996.Housingprogramsincludeemergency,
transitional,permanenthousing,andvoucherprograms;foodprogramsincludepantries,soupkitchens,andmobilefoodprograms;healthprograms
includegeneralhealth,mentalhealth,alcohol/drug,andHIV/AIDSprograms;otherprogramsincludeoutreach,drop-incenters,nancial/housingassis-
tance,andother.
priseatleast40percentofallprogramcontactsinmost
samplingareas(only17ofthe74areaswithanyservices
havelessthan40percentoftheirprogramcontactsat
foodprograms,andone-thirdhavemorethan60percent
ofprogramcontactsatfoodprograms).Incontrast,only
fivesamplingareashaveasmuchas20percentofpro-
gramcontactsoccurringathealthprograms,andmost
havelessthan10percentinthehealtharea.
Thegreatestvariabilityoccursinsmallermetropolitan
areasandruralareas,whicharethemostlikelytohaveeither
much moreofaconcentrationinaparticulartypeofservice
thanistruenationally,ormuch lessofaconcentration.Some
F I G U R E 4 . 1 3
Program Contacts in a Primary Sampling Area by Overall Population,
per 10,000 Population, and per 10,000 Living in Poverty
a
200000
180000
160000
140000
120000
100000
80000
60000
40000
20000
0
NSHAPCPrimary Sampling Area
(a) Aggregate Program Contacts
10000
9000
8000
7000
6000
5000
4000
3000
2000
1000
0
(c) Program Contacts per 10,000 People Living in Poverty
700
600
500
400
300
200
100
0
(b) Program Contacts per 10,000 Population
a
Primary sampling areas are listed in order of population size from largest on the left to smallest on
the right. Sampling areas appear by name in the same order in appendix A.2.
F I G U R E 4 . 1 4
Program Contacts in a Primary Sampling Area, by Program Type
a
100
80
60
40
20
0
(a) Percentage of All Program Contacts That Occur at Housing/Shelter Programs
100
80
60
40
20
0
(b) Percentage of All Program Contacts That Occur at Food Programs
100
80
60
40
20
0
(d) Percentage of All Program Contacts That Occur at
Other Homeless Assistance Programs
100
80
60
40
20
0
(c) Percentage of All Progam Contacts That Occur at Health Programs
a
Primary sampling areas are listed in order of population size from largest on the left to
smallest on the right. Sampling areas appear by name in the same order in appendix A.2.
ofthesesamplingareashaveallorvirtuallyalloftheirpro-
gramcontactsinhousingprograms,othershavealloralmost
alltheircontactsinotherprograms(suchasoutreach,
drop-in,orhousing/nancialassistanceprograms),anda
fewhaveasignicantshareinhealthprograms.
Distribution within Sampling Areas
of Contacts with Different Types
of Shelter/Housing Programs
Shelter/housingprogramdistributionsinsamplingareas
reflectverydifferentdecisionsaboutwheretoinvest
homelesshousingresources.Thisanalysisusesarateof
shelter/housingprogramcontactsper10,000poorpeo-
ple.Figure4.15providesthisinformation,firstforall
shelter/housingprogramtypes(figure4.15a),andthen
separatelyforeachtypeofshelterandhousingprogram
(emergencysheltergure4.15b;transitionalhousing
figure 4.15c; permanent housing for the formerly
homelessfigure4.15d;andvouchersfortemporary
sheltergure4.15e).
Theestimatednationalrateofprogramcontactswith
alltypesofshelterandhousingprogramsforhomeless
peopleis195/10,000poorpeople.I nadditiontothe
twosamplingareaswithnoprogramsofanykind,one
additionalsamplingareahasnoshelter/housingprogram
contactsatall.
Emergencysheltercontactsper10,000poorpeoplein
thestudysprimarysamplingareasaverage81/10,000.Six
samplingareasoffer150ormoreshelter/housingcontacts
per10,000poorpeople,whileninesamplingareasoffer20
orfeweremergencysheltercontactsper10,000poorpeople
includingfourthatdonotofferany.
Variabilityisevengreateramongprimarysamplingareas
forratesoftransitionalhousing,permanenthousing,and
voucherdistribution.Transitionalhousingcontactswithin
samplingareashaveanationalaverageof49/10,000poor
people, with eight sampling areas offering more than
100 transitionalhousingcontactsper10,000poorpeople
and23offering20orfewer,including13thatoffernone.
Permanenthousingcontactswithinsamplingareashave
anationalaverageof40/10,000poorpeople,withseven
samplingareasofferingmorethan100permanenthousing
contactsper10,000poorpeopleand42offering20or
fewer,including20thatoffernone.
Voucherdistributioncontactswithinsamplingareas
haveanationalaverageof26/10,000poorpeople,with
foursamplingareasofferingmorethan100voucherpro-
gramcontactsper10,000poorpeopleand50offering
20orfewer,includingninethatoffernone.
500
400
300
200
100
0
(d) Permanent Housing Program Contacts
per 10,000 People in Poverty
300
200
100
0
(c) Transitional Housing Program Contacts
300
200
100
0
(e) Voucher Distribution Program Contacts
a
Primary sampling areas are listed in order of population size from largest on the left to smallest on the right.
F I G U R E 4 . 1 5
Rate of Housing/Shelter Program Contacts per 10,000 Poor People, by Type of
Housing Program
a
1000
800
600
400
200
0
(a) Total Shelter/Housing Program Contacts (All Types Combined)
500
400
300
200
100
0
(b) Emergency Shelter Program Contacts
5
ostscript
NSHAPCoffersthefirstopportunitysince1987toexaminehomelessassistance
programsandtheirclientsacrossthenation.Thislandmarksurveyprovidesnation-
allyrepresentativedataabouttheprovidersofhomelessassistanceandthecharac-
teristicsofcurrentlyhomelessandotherpersonswhouseservices,informationthat
isvitaltonationaldiscussionsabouthomelessness.
Thestudyrevealsthatthelevelandtypeofhomelessassistanceprogramsacross
Americaareasdiverseashomelesspeoplethemselves.Thehomelesspeoplethese
programsservehaveverylimitedincomeandotherresources,andacomplexarray
ofneeds.Andhomelesspeoplearepresentinruralareasaswellasurbanandsubur-
banlocations.
Thestudyalsoallowsvaluablecomparisonsbetween1987and1996ofthechar-
acteristicsofhomelesspeopleusingsheltersandsoupkitchensincentralcities.It
showsthatthealreadyhighpercentagesofracialandethnicminoritiesusingthese
servicesin1987becameevenhigherby1996.Althougheducationallevels,income,
andreceiptofavarietyofmeans-testedgovernmentbenefitswerehigherin1996
thanin1987,extremepovertyremainedacentralfactoflifeforhomelessclients,
whoseincomewasgenerallyhalforlessofthefederalpovertylevel.
Since1996,therehavebeenmajorchangestothenational,state,andlocalsocial
welfaresystemsthatarereportedlyhavingsignificantimpactsonAmericaslow-
incomepeople.Theimpactsonhomelesspersons,bothpositiveandnegative,need
tobeidentied.Comparingthendingsofthe1987and1996studieswouldpro-
videimportantguidanceforneededchangestohomelessprogramsandmainstream
socialwelfareprograms.
Inasimilarmanner,communitiesaroundthenationwillneedtoconducttheir
ownstudiestoguidelocalhomelessandmainstreampolicydecisions.Themethod-
ologyusedinthisstudyprovidesproceduresandquestionnairesthatarereadily
adaptableforlocalsurveys.Suchsurveyswouldofferlocalpolicymakersthetwin
advantagesofhavingtheirowndataandbeingabletoseehowlocalprogramsand
serviceuserscomparetothoseinthenationasawhole.
Finally,futurestudiesmightconsiderspecicobjectivessuchastheeffectiveness
ofhomelessassistanceprogramsorestimatesofthenumberofhomelesspeople
thatthissurveywasnotdesignedtoaddress.
A
SHAPCs
rimary ampling reas
Appendix A.1: NSHAPCs
Primary Sampling Areas
Arrayed Alphabetically within Types
28 Largest Metropolitan Areas
Atlanta,GA
Baltimore,MD
Boston,MANH
Chicago,IL
ClevelandLorainElyria,OH
Dallas,TX
Denver,CO
Detroit,MI
Houston,TX
KansasCity,MOKS
LosAngelesLongBeach,CA
Miami,FL
MinneapolisSt.Paul,MNWI
NassauSuffolk,NY
NewYork,NY
Newark,NJ
Oakland,CA
OrangeCounty,CA
Philadelphia,PANJ
PhoenixMesa,AZ
Pittsburgh,PA
RiversideSanBernardino,CA
St.Louis,MOIL
SanDiego,CA
SanFrancisco,CA
SeattleBellevueEverett,WA
TampaSt.PetersburgClearwater,FL
Washington,DCMDVAWV
24 Smaller Metropolitan Areas
Bangor,ME
BergenPassaic,NJ
Birmingham,AL
BoiseCity,ID
Bremerton,WA
Dover,DE
Enid,OK
Indianapolis,IN
Jackson,MI
Kenosha,WI
LasCruces,NM
Lincoln,NE
MelbourneTitusvillePalmBay,FL
NorfolkVirginiaBeachNewportNews,VANC
OklahomaCity,OK
Redding,CA
Sacramento,CA
SaltLakeCityOgden,UT
Savannah,GA
ShreveportBossierCity,LA
Springeld,MA
UticaRome,NY
York,PA
YoungstownWarren,OH
24 Rural Areas (Nonmetropolitan Areas)
LassenCounty,ModocCounty,CA
Chestertown,DeepRivertown,Essextown,Lyme
town,Westbrooktown,CT
BradfordCounty,ColumbiaCounty,DixieCounty,
HamiltonCounty,LafayetteCounty,Madison
County,SuwanneeCounty,TaylorCounty,Union
County,FL
APPENDI X
CrispCounty,DoolyCounty,MaconCounty,
MarionCounty,SchleyCounty,SumterCounty,
TaylorCounty,WebsterCounty,GA
ChristianCounty,ClayCounty,EfnghamCounty,
FayetteCounty,MontgomeryCounty,Moultrie
County,ShelbyCounty,IL
BuenaVistaCounty,ClayCounty,Dickinson
County,EmmetCounty,OBrienCounty,Osceola
County,PaloAltoCounty,PocahontasCounty,IA
BathCounty,MenifeeCounty,Montgomery
County,MorganCounty,RowanCounty,KY
UnionParish,LA
CaldwellCounty,DaviessCounty,GrundyCounty,
HarrisonCounty,LinnCounty,LivingstonCounty,
MercerCounty,PutnamCounty,SullivanCounty,
MO
HallCounty,HamiltonCounty,MerrickCounty,
NE
EsmeraldaCounty,MineralCounty,NV
ChavesCounty,LeaCounty,NM
CibolaCounty,McKinleyCounty,NM
IredellCounty,NC
HancockCounty,HardinCounty,PutnamCounty,
WyandotCounty,OH
HaskellCounty,LatimerCounty,LeFloreCounty,
PittsburgCounty,OK
DouglasCounty,OR
BedfordCounty,FultonCounty,Huntingdon
County,JuniataCounty,MifinCounty,PA
AbbevilleCounty,GreenwoodCounty,Laurens
County,McCormickCounty,NewberryCounty,
SaludaCounty,SC
HoustonCounty,HumphreysCounty,Stewart
County,TN
AransasCounty,BeeCounty,LiveOakCounty,
RefugioCounty,TX
AccomackCounty,NorthamptonCounty,VA
BurnettCounty,ClarkCounty,RuskCounty,
SawyerCounty,TaylorCounty,WashburnCounty,
WI
JohnsonCounty,SheridanCounty,WY
Appendix A.2: NSHAPCs
Primary Sampling Areas Sorted by
Population Size, in Descending Order
LosAngelesLongBeach,CA
NewYork,NY
Chicago,IL
Philadelphia,PANJ
Boston,MANH
Detroit,MI
Washington,DCMDVAWV
Houston,TX
Atlanta,GA
Dallas,TX
NassauSuffolk,NY
RiversideSanBernardino,CA
MinneapolisSt.Paul,MNWI
SanDiego,CA
St.Louis,MOIL
OrangeCounty,CA
Pittsburgh,PA
Baltimore,MD
PhoenixMesa,AZ
ClevelandLorainElyria,OH
Oakland,CA
TampaSt.PetersburgClearwater,FL
SeattleBellevueEverett,WA
Miami,FL
Newark,NJ
Denver,CO
SanFrancisco,CA
KansasCity,MOKS
NorfolkVirginiaBeachNewportNews,VANC
Indianapolis,IN
Sacramento,CA
BergenPassaic,NJ
SaltLakeCityOgden,UT
OklahomaCity,OK
Birmingham,AL
Springeld,MA
YoungstownWarren,OH
MelbourneTitusvillePalmBay,FL
ShreveportBossierCity,LA
York,PA
UticaRome,NY
BoiseCity,ID
Savannah,GA
Lincoln,NE
AbbevilleCounty,GreenwoodCounty,Laurens
County,McCormickCounty,NewberryCounty,
SaludaCounty,SC
Bremerton,WA
BedfordCounty,FultonCounty,Huntingdon
County,JuniataCounty,MifinCounty,PA
ChristianCounty,ClayCounty,EfnghamCounty,
FayetteCounty,MontgomeryCounty,Moultrie
County,ShelbyCounty,IL
BradfordCounty,ColumbiaCounty,DixieCounty,
HamiltonCounty,LafayetteCounty,Madison
82 Appendix A
County,SuwanneeCounty,TaylorCounty,Union
County,FL
HancockCounty,HardinCounty,PutnamCounty,
WyandotCounty,OH
Jackson,MI
Redding,CA
Bangor,ME
LasCruces,NM
Kenosha,WI
ChavesCounty,LeaCounty,NM
Dover,DE
BuenaVistaCounty,ClayCounty,Dickinson
County,EmmetCounty,OBrienCounty,Osceola
County,PaloAltoCounty,PocahontasCounty,IA
BurnettCounty,ClarkCounty,RuskCounty,
SawyerCounty,TaylorCounty,WashburnCounty,
WI
HaskellCounty,LatimerCounty,LeFloreCounty,
PittsburgCounty,OK
DouglasCounty,OR
IredellCounty,NC
CrispCounty,DoolyCounty,MaconCounty,
MarionCounty,SchleyCounty,SumterCounty,
TaylorCounty,WebsterCounty,GA
CibolaCounty,McKinleyCounty,NM
CaldwellCounty,DaviessCounty,GrundyCounty,
HarrisonCounty,LinnCounty,LivingstonCounty,
MercerCounty,PutnamCounty,SullivanCounty,
MO
BathCounty,MenifeeCounty,Montgomery
County,MorganCounty,RowanCounty,KY
HallCounty,HamiltonCounty,MerickCounty,NE
AransasCounty,BeeCounty,LiveOakCounty,
RefugioCounty,TX
Enid,OK
AccomackCounty,NorthamptonCounty,VA
LassenCounty,ModocCounty,CA
HoustonCounty,HumphreysCounty,Stewart
County,TN
JohnsonCounty,SheridanCounty,WY
Chestertown,DeepRivertown,Essextown,Lyme
town,Westbrooktown,CT
UnionParish,LA
EsmeraldaCounty,MineralCounty,NV
NSHAPCsPrimarySamplingAreas 83
B
SHAPC
rogram enitions
AprogramwasdefinedforNSHAPCasasetofservices
offeredtothesamegroupofclientsatasinglelocation.
Tobeconsideredaprogram,aproviderhadtoofferser-
vicesorassistancethatwere(1)managedoradminis-
teredbytheagency(i.e.,theagencyprovidesthestaffand
funding);(2)designedtoaccomplishaparticularmission
orgoal;(3)offeredonanongoingbasis;(4)focusedon
homelessclientsasanintendedpopulation(althoughnot
alwaystheonlypopulation);and(5)notlimitedtorefer-
ralsoradministrativefunctions.
Thisdenitionofprogramwasusedinmetropolitan
areas.However,becauseruralareasoftenlackhomeless-
specificservices,thedefinitionwasexpandedinrural
areastoincludeagenciesservingsomehomelessclients
evenifthiswasnotafocusoftheagency.Aboutone-
fourthoftheruralprogramsinNSHAPCwereincluded
asaresultofthisexpandeddenition.
NSHAPCcovered16typesofhomelessassistance
programs,denedasfollows:
Emergency shelter programsprovideshort-termhousing
onafirst-come,first-servedbasiswhereclientsmust
leaveinthemorningandhavenoguaranteedbedfor
thenextnightORprovidebedsforaspeciedperiod
oftime,regardlessofwhetherornotclientsleavethe
building.Facilitiesthatprovidetemporaryshelterdur-
ingextremelycoldweather(suchaschurches)and
emergency shelters or host homes for victims of
domesticviolenceandrunawayorneglectedchildren
andyouthwerealsoincluded.
Transitional housingprogramshaveamaximumstayfor
clients of two years and offer support services to
promote self-sufficiency and to help them obtain
permanenthousing.Theymaytargetanyhomeless
subpopulation,suchaspersonswithmentalillnesses,
persons with AI DS, runaway youths, victims of
domesticviolence,homelessveterans,etc.
Permanent housingprogramsforformerlyhomelessclients
providelong-termhousingassistancewithsupportser-
vicesforwhichhomelessnessisaprimaryrequirement
forprogrameligibility.ExamplesincludetheShelter
PlusCareProgram,theSection8ModerateRehabilita-
tion Program for Single-Room Occupancy (SRO)
Dwellings,andthePermanentHousingfortheHandi-
cappedHomelessProgramadministeredbytheDepart-
mentofHousingandUrbanDevelopment(HUD).
Theseprogramsalsoincludespecicset-asidesofassisted
housingunitsorhousingvouchersforhomelessclients
bypublichousingagenciesorothersasamatterofpol-
icy,orinconnectionwithaspecicprogram(e.g.,the
HUD-VA Supported Housing Program, HUD-
VASH).Apermanenthousingprogramforformerly
homelessclientsdoesNOTincludepublichousing,Sec-
tion8,orfederal,state,orlocalhousingassistancepro-
gramsforlow-incomepersonsthatdonotincludeaspe-
cific set-aside for homeless clients, or for which
homelessnessisnotabasiceligibilityrequirement.
Voucher distribution programsprovidehomelessper-
sonswithavoucher,certificate,orcouponthatcan
beredeemedtopayforaspecicamountoftimeina
hotel,motel,orothersimilarfacility.
Programs accepting vouchersprovidehomelesspersons
withtemporaryaccommodationinahotel,motel,
board and care home, or other similar facility in
exchangeforavoucher,certicate,orcoupon.
Food pantry programs are programs that distribute
uncooked food in boxes or bags directly to low-
incomeclients,includinghomelessclients.
Soup kitchen programsincludesoupkitchens,food
lines,andprogramsdistributingpreparedbreakfasts,
APPENDI X
lunches,ordinners.Theseprogramsmaybeorganized
asfoodservicelines,bagorboxlunches,ortables
whereclientsareseated,thenservedbyprogramper-
sonnel.Theseprogramsmayormaynothaveaplace
forindividualstositandeatmeals.
Mobilefood programsareprogramsthatvisitdesignated
streetlocationsfortheprimarypurposeofproviding
foodtohomelessclients.
Physical health careprogramsprovidehealthcareto
homelessclients,includinghealthscreenings,immu-
nizations,treatmentforacutehealthproblems,and
otherservicesthataddressphysicalhealthissues.Ser-
vicesareoftenprovidedinshelters,soupkitchens,or
otherlocationsfrequentedbyhomelessclients.
Mental health careprogramsprovideservicesforhome-
lessclientstoimprovetheirmentalorpsychological
healthortheirabilitytofunctionwellonaday-to-
daybasis.Specificservicesmayincludecasemanage-
ment,assertivecommunitytreatment,intervention
orhospitalizationduringamomentofcrisis,counsel-
ing,psychotherapy,psychiatricservices,andpsychi-
atricmedicationmonitoring.
Alcohol/drugprogramsprovideservicestoassisthomeless
clientstoreducetheirlevelsofalcoholorotherdrug
addiction, or to prevent substance abuse among
homelessclients.Programsmayincludedetoxication
services,soberingfacilities,rehabilitationprograms,
counseling,treatment,andpreventionandeducation
services.
HIV/AIDS programsprovideservicesforhomelessclients
thatspecificallyrespondtothefactthatclientshave
HIV/AIDS, or are at risk of getting HIV/AIDS.
Servicesmayincludehealthassessment,clientdaycare,
nutritionalservices,medications,intensivemedicalcare
whenrequired,health,mentalhealth,andsubstance
abuseservices,referraltootherbenefitsandservices,
andHIV/AIDSpreventionandeducationservices.
Drop-in center programsprovidedaytimeservicespri-
marilyforhomelessclients,suchastelevision,laun-
dryfacilities,showers,supportgroups,andservice
referrals,butdonotprovideovernightaccommoda-
tions.
Outreach programscontacthomelessclientstooffer
food,blankets,orothernecessitiesinsuchsettingsas
onthestreets,insubways,underbridges,andinparks
toassessneedsandattempttoengagetheminservices;
tooffermedical,mentalhealth,and/orsubstance
abuseservices;and/ortoofferotherassistanceona
regularbasis(atleastonceaweek)forthepurposeof
improvingtheirhealth,mentalhealth,orsocialfunc-
tioning,orincreasingtheiruseofhumanservicesand
resources.Servicesmaybeprovidedduringthedayor
atnight.
Migrant housingishousingthatisseasonallyoccupiedby
migratingfarmworkers.Duringoff-seasonperiodsit
maybevacantandavailableforusebyhomelesspersons.
Other programs areprogramsdescribedandofferedby
providersthatmetthebasicNSHAPCdenitionofa
homelessassistanceprogram.Typesofprogramsactu-
allyidentifiedthroughthesurveyincludehousing/
financialassistance(e.g.,fromCommunityAction,
countywelfare,orhousingagencies);EmergencyFood
andShelterProgramagencies;jobtrainingforthe
homeless;clothingdistribution;andotherprograms.
86 Appendix B
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HOMELESSNESS:

rograms and the eople

39 percent report indicators of mental health

3 percent report more than one source of earned

52 percent of homeless households with children

For 28 percent of homeless clients, their current

21 percent served before theVietnam era (before

33 percent report running away from home and

This study estimates that there are about 40,000

The National Survey of Homeless Assistance Providers and Clients

NSHAPC is based on a statistical sample designed to represent the

NSHAPC involved two major phases: surveying administrators of

Telephone interviews were conducted with representatives of about

NSHAPC covers 16 types of homeless assistance programs: emer-

Telephoneinterviewswith representativesof 6,307 service

Aservice location isthephysicallocationatwhich

Mail surveysfrom5,694 programs

Interviewswith 4,207 clients

For numbers: Ninetypercentconfidenceintervals

For percentages: Almost all simple percentages

Howmanyhomelesspeoplearetherei nmyci ty/

Among homeless households(that is, the one or more people repre-

Homeless clients are predominantly male (68 percent) and nonwhite

Sixty percent of homeless women have minor children, as do

Thirty percent of homeless clients cited insufcient income and

acute infectious conditions (chest infection/cold/

Fifty-four percent of NSHAPC clients are homeless, 22 percent are

Men and women gure very differently in the three subpopulations

There are no signicant racial differences between currently and

Young clients (ages 17 to 24) make up a greater share of currently

Currently homeless clients are more likely than formerly homeless

This study estimates that about 40,000 homeless assistance pro-

Food pantries are the most numerous type of program, numbering

Food pantries expected to have over 1 million program contacts on

Food programs are most likely to be large (37 percent expected

The biggest programs, though few in number, account for very

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