Homelessness in Huntsville: No, it’s not mental health

This week we cover some facts about Huntsville’s unhoused population and trends. And we discuss the actual cause of homelessness. 

Huntsville is home to an estimated 600 unhoused people. (This is almost certainly a massive undercount.)

And this number is rising.

Between Aug 2022-Aug 2023 affordable housing was the #1 request to the United Way 211 line, comprising 26% of calls. 64% of those callers were on the verge of homelessness when they called/

Cost of homelessness

Between various grants to nonprofits and the HHA budget, the City of Huntsville spends at least $1m/year fighting homelessness. 

But that estimate doesn’t come close to the total cost of homelessness to taxpayers. 

Various studies estimate that chronic homelessness costs taxpayers somewhere between $30,000 and $100,000 per person, per year. 

But even that is an underestimate, because the costs are so diffuse that they’re impossible to accurately quantify. 

These costs include, but are not limited to:

• Earlier death
• More infectious diseases 
• Earlier, longer, and more frequent hospitalizations
• More frequent trips to emergency departments
• Higher rates of chronic and expensive-to-treat health conditions including high blood pressure, diabetes, and asthma
• Higher rates of mental illness and substance abuse and greater severity of symptoms 

Negative outcomes for young children who experience homelessness, including:

• Developmental delays
• High levels of anxiety
• Poor lifetime health outcomes
• Inadequate preventative medical care
• Higher levels of emotional and behavioral problems
• Academic underachievement and delays
• Disproportionate exposure to abuse, including sexual trauma 

Why?

1. Chronic stress. No door to lock. Police are as likely to arrest for vagrancy or whatever as to investigate crimes. Not shocking that studies show unhoused people experience more frequent assaults and thefts. Which means they live in constant fear. They often cannot sleep soundly. This fear, trauma, and sleep deprivation creates the exact kind of chronic, unhealthy stress that causes a person’s brain and body to break down more quickly. 
2. Even in shelters, people often can’t sleep due to the schedule, noise, light, or hard surface. And they often lose or have their belongings stolen. 
3. Unhoused people also often have no safe place to properly store their medications, which are often stolen, thrown out by police in sweeps, or expire due to exposure to heat and/or sunlight. 
4. They also have trouble bathing and keeping their wounds clean and bandaged

For these reasons and more, “The longer a person experiences homelessness, the harder it is to exit.” (Homelessness is a Housing Problem p 54)

What causes homelessness?

When I posted a link to this talk in the Huntsville subreddit, a few people helpfully posted some myths about homelessness in the comments. These include:

• “While I agree that [affordable housing] would go a long way to help homelessness it would most definitely not solve it. Most of those going into housing need support, jobs, training (work and life), treatment (substance, mental), etc.”
• “Mental health issues are the ultimate cause [of homelessness]”
• “Poverty. That is the answer.”

Disability, stagnant wages

Main cause of homelessness

Facts: 

Research does show a correlation between the following individual factors and homelessness:

• Being male
• Being unmarried
• Having low income
• Being older
• Being non-white
• Identifying as LGBTQ, especially among youth
• Having low levels of family support
• Having depression
• Experiencing mental illness or other psychiatric disorders
• Using or abusing drugs and/or alcohol
• Having a criminal record and/or history of incarceration

All of these factors can and do contribute to homelessness at the level of the individual.

But none of these individual factors can be the main cause of homelessness. Nor can all of the factors combined explain homelessness.

That’s because none of these factors correlates with rates of homelessness. 

You’ve heard correlation is not causation. Wearing a jacket is correlated with dropping temps. But I can’t make it colder outside by wearing a jacket. 

Thus you can have correlation without causation. But you cannot have causation without correlation. If two things don’t have a relationship, then they obviously can’t have a causal relationship. 

Let’s look at each individual risk factor, one-by-one.

Unemployment/under-employment

1. 2021 University of Chicago study: 53 percent of people living in homeless shelters and 40 percent of unsheltered people were employed. A more recent CA study found 40% of unhoused individuals were engaged in paid work. 
2. Comparing cities across the US, there’s no connection between employment and homelessness rates.

Severe mental illness/addiction/disability

1. Most PEH don’t have addiction or mental illness and most people suffering from addiction and/or serious mental illness do not become homeless (Homelessness is a Housing Problem p 53)
2. Between 25 and 40 percent of unhoused people have a substance use disorder (Homelessness is a Housing Problem p 52) However, that’s among the individual (i.e., non-family) homeless population. Rates lower among unhoused families. And that rate is only about three times higher than the US population, 7.4%.
3. Substance abuse and illicit drug use explain just 6% of the variation in rates of homelessness between states. “These findings are consistent with past research, which has found that drug use and dependency are not related to overall levels of homelessness.” (Homelessness is a Housing Problem p 88) 
4. There’s also no correlation between a state’s rates of severe mental illness and/or disability and their rates of homelessness
5. California is home to 30 percent of all those experiencing homelessness and 50 percent of those experiencing unsheltered homelessness in the U.S. Many blame California’s homelessness problems on high rates of mental health and substance-use problems. But California does relatively well on these measures. States with the highest rates of mental health and substance-use problems — like West Virginia — have some of the lowest rates of homelessness. source

Poverty

1. Cities with less poverty actually tend to have more homelessness than cities with more poverty (Homelessness is a Housing Problem)
2. “At the level of the city, homelessness thrives amid affluence, not poverty.” (Homelessness is a Housing Problem p 81)

Stagnant wages

1. Cities with higher median wages actually tend to have more homelessness than cities with lower median wages (Homelessness is a Housing Problem)
2. Home prices have increased 1,608% since 1970, almost 1000% faster than inflation generally (644%). 

If you walk away with nothing else from this hour, I want you to remember at least one of the following three facts:

1. A lack of affordable housing is the number-one cause of homelessness in the US. 
2. Simply building a lot more affordable housing in high-demand cities, and continuing to build in line with demand, would permanently fix most instances of homelessness
3. There is no way to permanently reduce US rates of homelessness in the US without building a lot more affordable housing in high-demand cities

Expensive housing causes homelessness just like a lack of food causes hunger 

Simply making food cheaper and keeping it cheap solves the vast majority of hunger

There’s no way to solve hunger without expanding access to inexpensive food

Expensive housing is the main cause of homelessness

Studies:

There’s a strong consensus among most researchers who study the causes of homelessness that the cost of housing is, by far, the biggest contributor to rising homelessness. 

This includes a landmark report published earlier this year from the Benioff Homelessness and Housing Initiative at the University of California, San Francisco. 

• The single deepest study on homelessness in America in decades
• The largest representative study of homelessness since the mid-1990s
• The first large-scale representative study to use mixed methods (surveys and in-depth interviews)

The authors: “High housing costs left participants vulnerable to homelessness. While participants faced many barriers to returning to housing, the primary one was cost.”

“Virtually every study of intercommunity variation in homelessness rates identifies rent costs as a significant predictor of homelessness.” (Homelessness is a Housing Problem p 56)

At least three studies connect a one percent increase in median rent to an increase in rates of homelessness:

• Study one found a one percent increase in the rate of homelessness. 
• Study two found a 0.9 percent rise in the rate of homelessness.  
• Study three found a 0.9 to 1.2 percent rise in the rate of homelessness. 

Looking at the data, it appears Huntsville is no exception. 

Both housing prices and the number of unhoused individuals began to rise around 2016.  

How to solve homelessness