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Homelessness represents an enduring national tragedy, one that is unequivocally linked to trauma. The research evidence indicates a cyclical relationship between trauma and homelessness in which trauma functions as a cause of homelessness and the experience of being homeless results in chronic exposure to multifaceted sources of trauma. The effects of such exposure can be devastating for homeless persons, especially considering the vulnerability and lack of social supports often demonstrated by homeless people. The relationship of trauma to homelessness is therefore an important public health concern in need of careful study and coordinated, sustained effort. The present entry explores conceptualization of key issues, prevalence and risk factors of home-lessness, the nature of traumatic experiences associated with homelessness, the effects of trauma for the homeless, and intervention efforts.

Conceptualization

According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, trauma refers to the witnessing or direct experiencing of events that involve actual or threatened death or physical harm or a threat to the bodily integrity of one's self or others. Trauma also involves an individual reaction of extreme fear, helplessness, or horror. Psychological trauma is consistent with this definition and includes a broad range of responses and reactions to threatening, overwhelming, and uncontrollable life events. The nature of trauma is such that it can produce emotional, psychological, or physical distress or harm.

The McKinney-Vento Homeless Assistance Act of 1987 defined a homeless person as someone who lacks a fixed, regular, adequate nighttime residence or someone who dwells in a shelter, transitional program, welfare hotel, or place not typically used for regular sleeping accommodations (e.g., streets, cars, movie theaters, abandoned buildings, etc.). Some experts have expanded the definition of homelessness to include persons who face eviction from a residence or discharge from an institution within one week, persons who are fleeing domestic violence, and persons who are temporarily sharing the housing of others because of economic hardship, loss of housing, or similar reason. Persons in jail or prison are not considered homeless, though many homeless individuals cycle in and out of incarceration.

Prevalence and Risk Factors of Homelessness

The face of homelessness has changed dramatically in recent decades and now includes many more persons of color, families, women, and children. Authoritative estimates have indicated that approximately 3.5 million people in the United States experience homelessness at some point during a given year; 1.35 million (39%) of those individuals are children or adolescents under the age of 18. Data published in 2007 indicated a point-in-time estimate of 744,313 homeless in the United States. Single adults, the majority of them males, represent the largest group of homeless persons in the United States. Homeless families with children have been the fastest-growing segment of new homeless in recent decades. Homeless families make up about 34% of the nation's homeless, and most of these families are headed by women. A 2006 survey of 25 cities indicated that 42% of homeless were African American, 38% were Caucasian (non-Hispanic), 20% were Hispanic, 4% were Native American, and 2% were Asian/Pacific Islander. It is exceedingly difficult to count all homeless people, and the figures typically obtained are likely to be underestimates of actual totals.

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