Since the 1980s, Black Americans have been overrepresented among the U.S. homeless population, and this enduring reality (Blacks comprise roughly 40.4 percent of the total U.S. homeless population, but only 12.5 percent of the overall population) has serious implications for population health and health disparities, according to Dr. Marian Moser Jones, associate professor in the University of Maryland School of Public Health.

Dr. Moser Jones conducted a comprehensive review of social and behavioral science research published between from 1985-2015, which addressed a connection between race, racial discrimination, and homelessness or homeless services. Her analysis and findings, meant to inform future policies related to the homeless population, were published in World Medical and Health Policy in June.

“This literature review sought to shed light on a long-ignored issue by investigating the connections between the decades of structural racial discrimination against African Americans and other Black persons, and the fact that Black persons tend to make up a disproportionate share of the U.S. homeless population, explained Dr. Moser Jones.  “The findings strongly suggest that policies to address homelessness cannot be merely colorblind: they must take into account the fact that race – as a social category shaped by both discrimination and cultural factors – influences peoples’ pathways into and out of homelessness.”

People experiencing homelessness are at higher risk of dying early, even when compared to other low-income groups, and suffer disproportionately from chronic health conditions. Racial discrimination continues to negatively affect the health of racial and ethnic minorities within the United States, as documented through a variety of recent studies, and the fact that the U.S. Black population still has an average life expectancy of 3.8 years less than the White population. For these reasons, Dr. Moser Jones suggests that the black homeless population thus likely faces a double dose of vulnerability.

Among the key findings from the literature review:

1. Black and Hispanic/Latino households appear more likely to live in inadequate, crowded housing than others, but Hispanic/Latino households are more likely than black households to “double up” to avoid homelessness.
2. Black homeless adults report higher rates of drug abuse, lower rates of alcohol abuse and psychiatric problems; as well as different types of childhood adversity than White homeless adults.
3. Arrest and incarceration histories appear to differ by race among homeless veterans, women, and youth, with non-White homeless individuals [in these groups] being more likely than White homeless individuals to report arrest or incarceration histories.
4. Black veterans appear to be at greater risk of homelessness than White veterans, and to more greatly benefit from [interventions involving] caseworkers.

Dr. Moser Jones urges that policies and programs which address homelessness need to consider how race as a sociocultural factor, along with racial discrimination, can influence their ability to effectively serve their target populations. Such policies and programs must be designed in a manner that explicitly addresses both Black persons’ general elevated risk for becoming homeless as a result of longstanding discrimination and other factors that have depleted the resources of Black communities, and the different risk profiles of different subgroups. Such an awareness needs to be integrated into objectives, strategies, training, and design of programs.

She also points out that in addition to race, gender, veteran status, and other little-studied factors such as sexual orientation appear to influence pathways into and out of homelessness for different populations. The findings suggest a need for research that not only examines the relationship between race, racial discrimination, and homelessness, but takes into account these other factors and the ways they interact that may lead to homelessness and influence the efficacy of interventions to address it.

Does Race Matter in Addressing Homelessness? A Review of the Literature