The Economic Consequences of Homelessness in The US

are disproportionally represented in homeless youth populations. Lesbian, gay,
bisexual, transgender, queer, and questioning (LGBTQ) youths represent between 30%
and 45% of the overall homeless youth population, as compared with an estimated 5%
to 10% of the overall youth population. LGBTQ homeless youths are significantly more
likely than their heterosexual homeless youth counterparts to have major depressive
episodes, posttraumatic stress disorder, suicidal ideation, and at least one suicide
attempt. In addition, they have increased rates of sexual and violent victimization.
Homeless youths are also three times more likely to be pregnant, to have impregnated
someone, or to already be a parent.
Many homeless youths seek health services only when peer advice and self-care are no
longer effective, and minor, treatable injuries often escalate into more severe health
problems. This problem is compounded by limited access to health care among
homeless youths, who frequently use drop-in centers that provide free, instant health
care and emergency rooms that often fail to offer the necessary level of care and are
much more expensive than the services of a primary care physician. Access to
preventative health care directly affects young people’s ability to safely and successfully
exit the streets.
Similarly, housing instability and homelessness among children and families is a
significant issue, with an estimated 2.5 million children (one in every 30) experiencing
homelessness in a given year. Child and family homelessness is likely undercounted in
national surveys, as many families “double up” with friends or relatives and may
withhold information about their housing instability to avoid stigma. Furthermore, an
estimated 51% of homeless children are younger than 6 years and may not be
accurately counted, as they do not attend school. Risk factors for family homelessness
include inadequate social support, domestic violence, a history of children being placed
in foster care, parental drug or alcohol use, parental mental illness, and racial/ethnic
minority family background. As a corollary, children who experience family
homelessness are at risk of higher stress levels, health problems, and need for pediatric
health care during and after such adverse episodes. Homeless children display mental
health symptoms requiring clinical evaluations at a rate of two to four times that of their
low-income housed peers, and they often exhibit developmental or cognitive delays.
Research indicates that 90% of mothers experiencing homelessness have been
exposed to at least one form of severe traumatic stress, and between 20% and 50% of
women cite intimate partner violence as the cause of their homelessness.
Ending homelessness is a public health issue, as those experiencing homelessness
have high rates of chronic mental and physical health conditions, co-occurring
disorders, and barriers to care, such as inability to access care when needed or comply
with prescribed medications. The correlation between disabilities and homelessness is
high, with almost 20% of individuals experiencing homelessness in 2016 reporting a
severe mental illness and 17% reporting a chronic substance use problem. Research on
personal and structural barriers in accessing treatment for co-occurring substance use
and mental health disorders indicates that individuals experiencing homelessness or
those with criminal justice involvement often have fewer treatment resources, lack
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