In addition to serious disability, the lives of chronically homeless people are compromised by persistent unemployment (Caton et al., 2005), forcing dependence on public entitlements for sustenance, health care, and an eventual exit from homelessness. Few can rely on support from family and friends (Kertesz et al., 2005; Caton et al., 2005), increasing their isolation and decreasing their opportunities for social inclusion.
Veterans constitute about 20 percent of service-using homeless people nationwide (Mojtabai, 2005). The Veterans Administration estimates that about 194,000 veterans were homeless in the United States on a given night in 2005 (GAO, 2006). Approximately 2530 percent can be classified as chronically homeless (Dougherty, 2006).
The client characteristics of people enrolled in programs designed to serve the chronically homeless population indicate that about three out of four are men (Barrow, Soto, & Cordova, 2004; Robert Rosenheck, personal communication based on unpublished data; Collaborative Initiative to End Chronic Homelessness, 2006). The predominance of men among the ranks of homeless single adults is underscored by the NSHAPC study, in which men outnumbered women by about 4 to 1 (Burt et al., 2001).
Although numerically a minority, single homeless women have been found to experience a greater number of stressful life events compared to homeless single men and women with children, and to more often report histories of foster care placement during childhood, domestic violence, psychiatric hospitalization, and sexual violence in adulthood (Zugazaga, 2004). The majority of homeless women are mothers, but many are considered single or unaccompanied adults because they are no longer living with their children (Burt et al., 2001). Mothers who are homeless for more than a year are more likely to lose custody of their children, and therefore they are less likely to qualify for public entitlements (welfare) or other forms of support that may be available to families with children. Compared to other homeless mothers, those living without their children are more likely to have a current substance use disorder (Zlotnick, Robertson, & Tam, 2003; Zlotnick, Tam, & Bradley, 2006). The accumulation of traumas experienced in adulthood by homeless women, including physical assault, rape, incarceration, and long-term homelessness, has been found to be associated with living apart from their dependent children (Zlotnick, Tam, & Bradley, 2006).
Racial and ethnic minorities are overrepresented among sheltered homeless individuals (see NYCDHS, 2006; Kuhn & Culhane, 1998) as well as among users of homeless services (Burt et al., 2001). The client characteristics of people enrolled in programs designed to serve people who are chronically homeless indicate that about half are African American (Barrow, Soto, & Cordova, 2004). Recent studies have underscored the overrepresentation of African Americans among people who are homeless and mentally ill (Whaley, 2002; Folsom et al., 2005), and among those who experience shelter reentry (Min, Wong, & Rothbard, 2004).
Programs designed to serve people who are chronically homeless report that the average age of program participants is the mid to late 40s (Barrow, Soto, & Cordova, 2004; Robert Rosenheck, personal communication based on unpublished data; Collaborative Initiative to End Chronic Homelessness, 2006). There are indications that the population with long-term spells of homelessness is growing older (North et al., 2004; Hahn et al., 2006). In a serial cross-sectional study of homeless adults recruited from San Francisco service programs over a 14-year period, Hahn et al. (2006) reported that over this time span the median age of homeless adults increased significantly from 37 to 46 years, accompanied by a significant increase in the median time homeless from 12 months to more than 39 months.