The Next City
September 1, 1998
In the 1960s and 1970s, homelessness was virtually unknown in North America, the term not even in public parlance. In 1964, Columbia University researchers scoured four Manhattan parks to count those sleeping there: They found one man. Likewise, in Chicago, Vancouver, Los Angeles, Montreal, and other major cities, homelessness was the exception and not the rule. In the 1960s, big city newspapers rarely ran stories on the homeless, unlike the last decade when they averaged one homeless story every two days. Until the 1980s, the homeless were not part of a widespread phenomenon; they were exceptional hard-luck cases.
Then these exceptions became the rule. Not because poverty suddenly increased — it didn’t. Not because welfare was drastically reduced — generally welfare became more generous. Not much because mental institutions suddenly released their patients — the deinstitutionalization of mental patients that took place in the 1960s and early 1970s explains a small fraction, perhaps one-tenth or one-twentieth, of the torrent of homelessness that engulfed our major cities in the 1980s.
One factor, and one factor alone — changes in housing policy — accounts for the immense rise of homelessness: Governments outlawed much of what was then the bottom end of the housing market — the derelict apartment buildings, seedy hotels, and rooming houses — while legalizing vagrancy. In this way, and with only the best of intentions, governments replaced a vast supply of substandard, but low-cost housing with a much vaster, much more substandard, and much lower-cost supply of housing in the form of our streets, back alleys, and parks.
Before the government inadvertently converted our public spaces into sleeping quarters, poor people — including alcoholics and the mentally ill — lived in low-rent districts, muddling along as best they could. Those poorer still doubled up with them, or sublet rooms in exchange for cash or household services, typically babysitting for women, odd jobs for men. There was nothing particularly noble about most of these arrangements: The poor who put up still needier relatives on their living room couches would have preferred the space for themselves; those put up often felt dependent and unwelcome, and, had they the wherewithal, many would have left their position of servitude. Nevertheless they made do, keeping up appearances and maintaining relations, however poorly. Relatively few people relied on shelters.
Then came urban renewal, a euphemism for slum clearance that levelled much of the low-quality housing stock across the continent. Newark and New York City lost almost half of their low-rent housing between 1970 and 1990; New York City’s Bowery, with 10,000 beds in 1965, had but 3,000 in 1980. In the 1970s and 1980s, Chicago lost 20 per cent of its low-rent housing; of the 10,000 spaces in the Loop area’s cubicle hotels, 600 remained. By the early 1980s, Toronto lost virtually all of its 500 flophouse beds; by the end of the decade, it had lost one-third of its rooming houses. Between the mid-1970s and the late 1980s, the number of unsubsidized low-cost units fell 54 per cent in the typical large U.S. metropolitan area. Public housing — once a shining hope — failed utterly in housing the very poor.
While the stock of low-cost housing declined, the cost and difficulty of living on the cheap increased. Welfare recipients who doubled up with family members faced benefit reductions, giving them and their families reasons to drift apart. Rent control legislation, which stopped apartment building construction, backfired on the poor. While it kept rents low, a surplus of apartment seekers gave landlords the luxury of picking and choosing tenants: In competition with stable tenants able to pay rent on time and unlikely to damage property, the down-and-out had no chance. The housing shortage and rising land prices also spurred gentrification of old neighborhoods that housed the destitute, leading to their eviction. Even tenant rights legislation backfired. Because it prevented landlords from evicting the prostitutes, drug dealers, and rowdy tenants who caused good tenants to leave, they stopped renting to anyone with the potential to be troublesome. When governments extended rent control and tenant rights to rooming houses and single-room occupancy hotels, and tightened housing regulations to force landlords to better maintain the dwindling stock of decaying housing, the landlords themselves vacated. Much of the low-income housing was lost to fires, often arson was suspected.
With so much low-rent housing demolished, and so much of the balance reserved for respectable tenants, the poorest of the poor had no place to go but the streets, newly freed up through the repeal of vagrancy laws. To those with addictions, this dark cloud had a silver lining: Without accommodation costs, they could devote more of their meagre income to their habit.
Those we call homeless are not a homogeneous lot and, often, not even homeless. In many cities, the majority of panhandlers, squeegee kids, and other street people that we come across have fairly conventional abodes. Meanwhile, the majority of the truly homeless escape our view: In a 1989 study of Chicago’s homeless, interviewers found most to be “neat and clean” and only 20 per cent to panhandle or take handouts. Most homeless do not make a career of it: They find themselves on the street following some unmanageable stress — the death or illness of a loved one, the breakup of a relationship, debt, and legal problems top the list — and then they pull out of it. Yet most remain deeply disturbed. According to a recent study of Toronto’s homeless by the Clarke Institute of Psychiatry, two-thirds have a lifetime diagnosis of mental illness, and two-thirds suffer from alcohol and substance abuse. Only one homeless person in seven in this highly vulnerable population suffers from neither.
Although most are mentally ill, few are seriously so. Only about 10 per cent of the homeless population has suffered from some severe mental illness, most often not the schizophrenia we associate with the homeless but a dark depression. While most of the severely ill lack proper treatment, few belong in institutions. The vast majority of mentally ill people, today as before deinstitutionalization, live in the community. Only today we’ve made the pavement the only practical housing choice for all too many of them.
The more important characteristics of the homeless — whether or not they’re mentally ill — are that they have fewer work skills, fewer social skills, and less resourcefulness than the housed population. They have difficulty maintaining relationships with friends and family. Almost half reported that they could rely on “no one” in their lives. Only four per cent were married or in common-law relationships. All this speaks to their lack of community and numbing sense of isolation — conditions that, above all, explain much of the social pathology that is homelessness. Being society’s least valued members, they are the first to be fired, the last to be hired, those most shunned in civil society, modern lepers.
Those who live on the streets do not appear as a line item in government books, except for the odd outreach program. Neither do taxpayers take a direct hit. Some resent, others pity, the panhandlers; some fear the talkers and ravers that they encounter, but most see the homeless as an unsettling but cost-free fixture on the urban landscape.
Failing to deal with homelessness is a false economy, quite apart from the great moral costs of turning our backs on this defenceless population. The homeless cast a pall on our use of our cities, prompting parents and their children to abandon the public parks they frequent, pedestrians to avoid places they might be accosted, and merchants to relocate. The homeless show up big time in our penal system — 30 per cent have spent time in police stations or jail in the previous year — and in our health care budget.
As shown in a study published in June in the New England Journal of Medicine — the first extensive documentation of the impact of homelessness on the health care system — the homeless have been exacting a silent toll on a society that ignores their plight. The homeless at New York City’s public hospitals stayed an average of 4.1 days longer, and cost an average of $2,414 more per admission, than low-income patients who had homes. One group of psychiatric patients, whom clinicians believed couldn’t be discharged safely, averaged 70 days more than otherwise called for. At the city’s flagship Bellevue Hospital, nearly half the admissions were homeless. “The homeless account for less than one-half of one per cent of the city’s population, but they are having a huge impact on the health care system,” said Sharon Salit, the report’s lead author. “The extra costs for a single hospital admission are as much as the annual welfare rental allowance for a single individual in New York.”
About half the homeless admissions required treatment for mental illness or substance abuse, and half for skin disorders, respiratory complaints, trauma, and parasites – problems generally regarded as preventable among other populations. “For want of a place to clean between their toes, change their shoes and socks, and elevate their feet when they get swollen, homeless patients get infections in their feet” that often become a chronic condition called cellulitis, said Dr. Lewis Goldfrank, Bellevue’s director of emergency medicine. “We almost never see that among people who have homes.” A 1996 study of Los Angeles’s homeless warned that TB could reach epidemic proportions.
The homeless need medical care, especially psychiatric care. We must generously fund outpatient programs: Just as nobody would release Alzheimer’s patients onto the streets without adequate treatment and supervision, we cannot let these vulnerable people fend for themselves. We must also ensure that those few who are a danger to themselves or to the public receive compassionate care inside an institution. But most of all, the homeless need homes and an end to their alienation, without which their condition cannot improve. Most homeless advocates, while understanding the need for more housing, too often seek quick-fix solutions in government housing, forgetting that the last thing the homeless need is to be warehoused in anonymous public housing supervised by a faceless government bureaucracy. We must require the homeless to engage the rest of us.
The way out of homeless begins by backing out of the same path that created it. We must restore vagrancy laws, both to safeguard the public sphere for us all and to require housing for those unable to properly look after themselves. To shelter those evicted from the streets, welfare must provide the down-and-out with housing vouchers that can be used anywhere, not just in shelters but in exchange for that couch in a relative’s living room. (To discourage a black market, each voucher should identify its recipient and be dated, and the landlords, rooming houses, and others who accept vouchers without housing the voucher recipient should be liable to fines.) Generous vouchers will minimize substandard housing.
To encourage friends and relatives to take the homeless in and other landlords to re-enter the business, we must throw out rules preventing easy evictions of tenants who disturb the peace or otherwise fail to meet their obligations to their neighbors and the landlord (even publicly funded hostels and shelters routinely evict or refuse to admit disorderly occupants). This accountability will prod some of today’s homeless — whom the Clarke Institute found to be more aggressive, antisocial, moody, irritable, and less open to taking responsibility for change — to get along with those around them, as their counterparts once did.
While the government re-regulates the use of public spaces, it should deregulate the housing market to let the homeless find inexpensive housing niches for themselves. The largest sources of appropriate housing — ones that many municipalities wrongly ban — are basement apartments and other occupancies in residential districts.
Because most homeless individuals are neat, clean, and nonviolent, many would find shelter in middle- and lower-class residences willing to set aside some space in exchange for the housing voucher. Such a relationship would especially appeal to homeowners on fixed incomes, who find themselves single and perhaps frail in a large home, and who themselves need a little income and an occasional helping hand with household chores.
We live in times of plenty, with the means and the obligation to humanely look after our most unfortunate members of society. In helping others, we will also help ourselves through more hospitable streets, a healthier society, and the personal gratification of doing our share to help people who have fallen on hard times, and not always from sins of their own making.