Ungoverned and Out of Sight: Public Health and the Political Crisis of Homelessness in the United States

If health policy truly seeks to improve population health and reduce health disparities, addressing homelessness must be a priority Homelessness is a public health problem. Nearly a decade after the great recession of 2008, homelessness rates are once again rising across the United States, with the number of persons experiencing homelessness surpassing the number of individuals suffering from opioid use disorders annually. Homelessness presents serious adverse consequences for physical and mental health, and ultimately worsens health disparities for already at-risk low-income and minority populations. While some state-levelpolicies have been implemented to address homelessness, these services are often not designed to target chronic homelessness and subsequently fail in policy implementation by engendering barriers to local homeless policy solutions. In the face of this crisis, Ungoverned and Out of Sight seeks to understand the political processes influencing adoption of best-practice solutions to reduce chronic homelessness in US municipalities. Drawing on unique research from three exemplar municipal case studies in San Francisco, CA, Atlanta, GA, and Shreveport, LA, this volume explores conflicting policy solutions in the highly decentralized homeless policy space and provides recommendations to improve homeless governancesystems and deliver policies that will successfully diminish chronic homelessness. Until issues of authority and fragmentation across competing or misaligned policy spaces are addressed through improved coordination and oversight, local and national policies intended to reduce homelessness may notsucceed.