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Secure housing is out of reach for many Minnesotans. African Americans, American Indians, veteran, children and youth age 24 and younger and youth who identify as lesbian, gay, bisexual, transgender (LGBT) are particularly over-represented among the homeless population. Minnesota is facing a housing crisis. Home prices increased 8.9% from 2017 to 2018 alone with homes in Minnesota 26% more expensive than homes in neighboring states. In the rental market, a healthy vacancy rate is 5%, but in Minnesota the statewide rate ranges from 2.2% to 4% in the Twin Cities metro. Nearly one-third of homeless adults are employed. In the 2018 study, 30% of homeless adults reported having some type of employment; 13% were employed full time. Widespread changes over the past several decades have resulted in incomes not keeping pace with the cost of housing.
The disconnect between incomes and the cost of housing undermines the state’s ability to improve educational outcomes for our children, build a stronger workforce, improve health, and reduce disparities. Availability of affordable housing is still a critical issue. People experiencing homelessness is up 10% from 2015. Homeless adults increased from 2015, particularly among those 55 and older up 25%. Most of the homeless population has a chronic mental or physical health condition.
Research reveals a complex set of links between homelessness and health. People who are homeless are poorly nourished, they are unable to get proper rest, when they get sick they are unable to engage in proper health practices (such as following a drug or treatment regime), they live in group settings and are exposed to communicable diseases, frequent moves and instability threaten their health, they are unable to maintain a healthy social network necessary for good health, they are vulnerable to a higher level of physical and sexual violence, inadequate social programs trap people in their homelessness, and a downward cycle of despair along with sleep deprivation can lead to chronic depression and serious mental health concerns.
Homeless people of Minnesota face significant barriers to the most basic health needs, such as nutrition, safety, and shelter; and the barriers are even greater when it comes to meeting additional health needs, such as those requiring health services.
Preventing homelessness in Minnesota means that families and individuals are helped to reduce their likelihood of becoming homeless and avoid crises that, without intervention, would precipitate a loss of housing. Ending homelessness means that if a family or individual does become homeless, we will have a crisis response system to assess their needs and quickly provide them the opportunity to access stable housing. It does not mean that no one will experience homelessness ever again.
In 2015, an estimated 15,000 people were homeless on any given night in Minnesota, with nearly 40,000 Minnesotans experiencing homelessness that year. More than 19,600 Minnesotans experience homelessness on any given night in 2018; 50,600 experienced homelessness over the course of the year. The number of Minnesotans experiencing homelessness, included African Americans, American Indians, veterans, children and the elderly population.
African Americans and American Indians are far more likely to be homeless than members of other races. African Americans make up 39% of homeless adults, but only 5% of adults statewide. American Indians make up 8% of homeless adults, compared to 1% statewide. The vast majority of Minnesota Veterans identify as white 94%; smaller proportions identify as African American 3% or American Indian 1%. However, within the specific population of Veterans experiencing homelessness, 26% identify as African American and 8% identify as American Indian, illustrating large racial disparities among Veterans experiencing homelessness. Children and youth age 24 and younger are equal to levels counted in 2015; together, they represent nearly half of the homeless population 46%.
Homeless children and youth face a variety of health concerns. Among parents whose children were with them, 25% said that at least one of their children had an emotional or behavioral problem, and 12% had at least one child with a chronic or severe physical health problem (Wilder Research, 2016).There was a notable increase in the number of older adults in Twin Cities metro emergency shelters, where the number of older adults increased by 21% since 2012. Issues facing the aging population in general exist for older adults who are homeless but are magnified due to the difficult circumstances and conditions associated with being homeless. For instance, older homeless adults were more likely than other homeless adults to report a chronic health condition.
The number of homeless Minnesotans with a chronic health condition is over (51%). The most common reported were high blood pressure 30%, asthma 20%, other respiratory problems 12%, other heart or circulatory problems 11%, and diabetes 9%. More than half 60% of homeless adults report a significant mental illness. This includes being diagnosed with at least one of the following: anxiety or panic disorder 42%, major depression 39%, bipolar disorder 22%, personality disorder such as antisocial or obsessive-compulsive disorders 5%, schizophrenia 7%, or other paranoid or delusional disorders 6%. One in five 21% homeless adults has been diagnosed with a substance abuse disorder. This includes either alcohol abuse 16% or drug abuse 14%, disorders. Eighty-three percent of homeless adults have either significant mental illness, chronic health condition, substance abuse disorder, or evidence of a traumatic brain injury. Forty-four percent have more than one of those conditions. Until a health care problem becomes life threatening, a homeless individual will probably choose shelter or food before seeking medical care. These priorities must be considered when dealing with the homeless population.
A general rule for housing affordability, especially for lower-income households, is that housing should cost no more than 30%, of monthly income. In a 2018 study data show that the most common reasons adults left their last housing were because they were evicted 39%, they could not afford their housing 38%, and over half 56%, of those experiencing homelessness said they had difficulty finding housing because there was nothing they could afford. The lack of employment and income are key reasons why people become homeless and primary barriers to becoming stably re-housed. Nearly one-third 31%, report losing a job or having their hours cut as a reason for losing housing, and 38%, of homeless adults report a lack of job or income as a main barrier to obtaining housing. Almost two-thirds of homeless adults are unemployed. The median length of time people has been unemployed is 23 months, which is unchanged since 2012.
Safe, affordable and healthy housing is one of the most fundamental requirements for good health, but also a means to reducing systemic health inequities and in some cases may lower associated long-term healthcare costs. Shelter is a basic need for optimal health. Studies have shown that investing in homelessness prevention costs less than it does to keep someone on the streets (National Council on Welfare, 2011). The argument is that if we shifted the focus to prevention and housing, we would not only be responding appropriately and compassionately to a problem that harms individuals, families and communities, but we would also be saving money.
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