Ungoverned and Out of Sight: Urban Politics and America's Homeless Crisis

Abstract

Chronic homelessness has severe implications for health disparities. Black Americans are four times as likely and Hispanic Americans are two times more likely to experience homelessness compared to white Americans (Fusaro, Levy, and Shaefer 2018). Homelessness contributes to high rates of chronic disease, adverse behavioral health outcomes, increased mortality, and lower rates of educational and job attainment over the life course (Fazel, Geddes, and Kushel 2014). Longer durations of homelessness are associated with high mortality rates, adverse behavioral health outcomes and chronic medical conditions; moreover, persons experiencing chronic homelessness are more likely to remain homeless as length of homelessness increases (Henwood, Byrne, and Scriber 2015; S. Kertesz et al. 2016). Homelessness and chronic-homelessness hit large metropolitan areas especially hard over the past two decades (Bishop et al. 2017a). Unsheltered homelessness, which is primarily long-term homelessness, is increasing again for the first time in ten years (Bishop et al. 2017a).

Most research on homelessness focuses on empirical research identifying best practices for solutions to chronic homelessness. However, there is a wide gap in the literature investigating the political processes shaping the processes leading to the development of these best practices. This dissertation seeks to understand the political decision-making processes influencing adoption of best-practice solutions to reduce chronic homelessness. Homelessness is a unique case of a health issue that is governed by an almost entirely decentralized system – both historically and today (Jarpe, Mosley, and Smith 2018). The history of devolution and decentralization in homelessness governance makes it a unique policy space where various actors work in different ways to establish different types of policies that all attempt to manage homelessness to different ends.

This dissertation argues that homelessness policy, specifically policies seeking solutions to long-term or chronic homelessness, are governed in four separate and distinct policy arenas: the state, local government, economic elites, and homeless service providers. The separation and conflict between these structural interests in policy goals and policy processes result in increased challenges to establishing and implementing effective solutions to end chronic homelessness. Challenges include limited state-level support such as financial resources and/or administrative burdens due to misaligned policy goals; inequity in political participation that may exclude at-risk populations; and, finally, limited involvement by municipal governments in many cases, which may constrain homeless programming by limiting resources and policymaking authority.

This research finds that structural changes incentivizing re-centralization of homelessness governance in conjunction with increased municipal policy capacity may be required to promote coordination across the different policy spaces to overcome collective action problems and develop effective solutions to long-term homelessness.