Home Health Equity Housing

Staggering and Persistent Racial Disparities in Homelessness

Rates of homelessness among Black American, American Indian or Alaska Native, and Native Hawaiian and Pacific Islander groups were more than double the rates of homelessness among White and Asian groups.

Guest Authors Naquia Unwala, Phillip M. Singer, Timothy B. Creedon, Brian Mullin, Benjamin Lê Cook, Charley E. Willison
living camp for someone experiencing homelessness

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Homelessness is a critical public health issue, affecting over 3.5 million Americans annually. People experiencing homelessness have higher rates of chronic and communicable diseases, and mental health disorders. Unhoused individuals also face higher all-cause mortality than housed individuals. Because homelessness is such a strong determinant of health, it deserves the same careful tracking and evaluation as other areas of health.

The risk of homelessness varies significantly by race. Black Americans are four times more likely to experience homelessness compared to White Americans. Racial disparities in homelessness are a product of exclusionary housing policies, including neighborhood zoning-segregation and redlining, which were designed to protect housing supply for White Americans. Excluding people of color from property ownership created severe generational wealth disparities, exacerbating risks of housing insecurity and homelessness.

Despite this reality, we have little comprehensive, longitudinal data on rates of homelessness across racial and ethnic groups. Our team gathered archived data from the U.S. Department of Housing and Urban Development (HUD) to create a unique dataset of annual rates of sheltered homelessness by race and ethnicity.

Between 2007 and 2017, Black American, American Indian or Alaska Native (AI/AN), and Native Hawaiian and Pacific Islander (NH/PI) populations were far more likely to experience homelessness than non-Hispanic Whites. The total rates of homelessness among Black American, AI/AN, and NH/PI groups were more than double the rates of homelessness among White and Asian groups. Even the lowest rate of homelessness among Black Americans (1.4%) was more than 4 times greater than the highest rate of homelessness for non-Hispanic Whites. We also found that disparities in homelessness among people of color continued to increase and persist across the entire study period.

Our results highlight the urgent need for targeted interventions for particular groups, especially communities of color.

We found mixed results among Hispanic/Latino populations. Importantly, rates in homelessness among Hispanic/Latino individuals fell below the rate of homelessness among non-Hispanic/Latino individuals over the time-period. However, Hispanic/Latino families continue to experience homelessness at a much higher rate than non-Hispanic White and Asian families. A critical issue to note is that Hispanic/Latino families are likely to be undercounted in measures of homelessness due to stigma and social service restrictions related to immigration status; cultural/language barriers; or from experiencing homelessness in less visible ways (e.g., doubling up).

Our results highlight the urgent need for targeted interventions for particular groups, especially communities of color. Variations in need and risk of homelessness should be reflected by federal, state, and local interventions. In 2021, the Biden Administration allocated a historic 5 billion dollars to HUD to address housing insecurity. While essential, this spending needs to be focused on the populations that most need access to these funds and housing options to reduce disparities in rates of homelessness.

In order to identify communities most at-risk and create targeted interventions, HUD and affiliated federal agencies need additional resources and tools to improve the systematic collection of data about populations and individuals that are experiencing homelessness. Poor-quality, incomplete data have hampered local efforts to reduce homelessness. The federal government can create incentives for subnational governments to participate in data collection and provide infrastructure and funding for jurisdictions to be able to carry out these policy tasks.

The Biden Administration can also address restrictive zoning laws. Zoning neighborhoods for single-family housing, only in certain, primarily White neighborhoods, sustains residential segregation. It has also led to decreased supply of affordable housing, and increasing housing costs. Federal incentives to reduce restrictive local-zoning laws may influence rates of homelessness among communities of color.

Photo via Getty Images

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Naquia Unwala

Guest Author

Naquia Unwala is a research associate in the Public Health Governance Lab at Cornell University. She received her undergraduate degree at the University of Michigan School of Public Health, and will be attending Georgetown University School of Medicine starting in Fall 2023. Her research interests include the effects of public health politics on homelessness and housing insecurity, refugee and immigrant health, and disaster responses.

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Phillip M. Singer

Guest Author

Phillip M. Singer is an assistant professor in the Political Science Department at the University of Utah. He researches health politics and policy in the United States.

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Timothy B. Creedon

Guest Author

Timothy B. Creedon was a research scientist at the Health Equity Research Lab when this work was completed.

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Brian Mullin

Guest Author

Brian Mullin specializes in quantitative analysis and uses his expertise to answer questions concerning health policy using raw data. Brian graduated from Boise State University with a degree in economics. His previous work experience includes Senior Research Analyst for the state of Idaho. He also worked as a Senior Programmer for Abt Associates, a Senior Data Analyst for Neighborhood Health Plan, and a Senior Data Analyst for the Mental Health Services Program for Youth in the Greater Boston Area. Most recently, Brian worked as a Senior Medical Economics Analyst for the Boston Medical Center HealthNet Plan/Well Sense Health Plan.

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Benjamin Lê Cook

Guest Author

Benjamin Lê Cook is the director of the Health Equity Research Lab at Cambridge Health Alliance, an associate professor in the Department of Psychiatry at Harvard Medical School, and a visiting clinical associate professor at the Albert Einstein College of Medicine in the Bronx, NY. He holds a Ph.D. in health policy from Harvard University and an MPH in health behavior and health education from UNC Chapel Hill. Dr. Cook is a health services researcher focused on improving quality of life, and access and quality of treatment for individuals living with mental illness and substance use disorder. His NIH, AHRQ- and Foundation-funded research tracks healthcare disparities in the U.S. and the impacts of health reform on disparities, seeks to understand discrimination in the patient-provider interaction, and evaluates the impact of hospital-based interventions on health equity. As Director of the Health Equity Research Lab, he also oversees research on criminal justice and mental health, transgender health, opioid use treatment evaluation, integrated behavioral health care, and the promotion of community-engaged research partnerships. Dr. Cook has experience mentoring students and faculty at all levels in health disparities and health system evaluation.

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Charley E. Willison

Guest Author

Charley E. Willison  is an assistant professor of public health at Cornell University. She is a political scientist studying the relationships between local politics, intergovernmental relations, and public health political decision-making, with a primary focus on homelessness. Dr. Willison’s 2021 book, Ungoverned and Out of Sight: Public Health and the Political Crisis of Homelessness in the United States (Oxford University Press) examines why municipalities may use evidence-based approaches to address chronic homelessness in their jurisdictions or not. Her book won the 2022 Dennis Judd Best Book Award, which recognizes the best book on urban politics (domestic or international) published in the previous year.

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