title: Homelessness

text: "How the Other Half Lives" and Jack London's "The People of the Abyss" (1903) discussed homelessness and raised public awareness, which caused some changes in building codes and some social conditions. In England, dormitory housing called "spikes" was provided by local boroughs. By the 1930s in England, there were 30,000 people living in these facilities. In 1933, George Orwell wrote about poverty in London and Paris, in his book "Down and Out in Paris and London". In general, in most countries, many towns and cities had an area that contained the poor, transients, and afflicted, such as a "skid row". In New York City, for example, there was an area known as "the Bowery", traditionally, where people with an alcohol use disorder were to be found sleeping on the streets, bottle in hand.


title: Homelessness

text: In the 1960s in the UK, nature and growing problem of homelessness changed in England as public concern grew. The number of people living "rough" in the streets had increased dramatically. However, beginning with the Conservative administration's Rough Sleeper Initiative, the number of people sleeping rough in London fell dramatically. This initiative was supported further by the incoming Labour administration from 2009 onwards with the publication of the 'Coming in from the Cold' strategy published by the Rough Sleepers Unit, which proposed and delivered a massive increase in the number of hostel bed spaces in the capital and an increase in funding for street outreach teams, who work with rough sleepers to enable them to access services.


title: Homelessness

text: Scotland saw a slightly different picture, with the impact of the right to buy ending in a devastating drop in available social housing, something that has never ever recovered. The 1980s and the 1990s resulted in an ever increasing picture of people becoming homeless, with very few rights to provide access to allow change.


title: Homelessness

text: However this picture changed in Scotland from 2001, as the Scottish Parliament came into place. It was agreed by all parties that a ten-year plan to eradicate homelessness by the end of 2012 would be implemented. The minister of housing met with the third sector and Local Authorities every 6 weeks, checking on progress, whilst consultations brought about legislative change, alongside work to prevent homelessness. There was a peak in applications around 2005, but from there onwards figures dropped year on year for the next 8 years. However, with a focus on the broader numbers of people experiencing homelessness, many people with higher levels of need got caught in the system. Work from 2017 started to address this, with a framework currently in place to work towards a day where everyone in Scotland has a home suitable to meet their needs.


title: Homelessness

text: In 2002, research showed that children and families were the largest growing segment of the homeless population in the United States, and this has presented new challenges to agencies.


title: Homelessness

text: In the US, the government asked many major cities to come up with a ten-year plan to end homelessness. One of the results of this was a "Housing First" solution. The Housing First program offers homeless people access to housing without having to undergo tests for sobriety and drug usage. The Housing First program seems to benefit homeless people in every aspect except for substance abuse, for which the program offers little accountability. An emerging consensus is that the Housing First program still gives clients a higher chance at retaining their housing once they get it. A few critical voices argue that it misuses resources and does more harm than good; they suggest that it encourages rent-seeking and that there is not yet enough evidence-based research on the effects of this program on the homeless population. Some formerly homeless people, who were finally able to obtain housing and other assets which helped to return to a normal lifestyle, have donated money and volunteer services to the organizations that provided aid to them during their homelessness. Alternatively, some social service entities that help homeless people now employ formerly homeless individuals to assist in the care process.


title: Homelessness

text: Homelessness has migrated toward rural and suburban areas. The number of homeless people has not changed dramatically but the number of homeless families has increased according to a report of HUD. The United States Congress appropriated $25 million in the McKinney-Vento Homeless Assistance Grants for 2008 to show the effectiveness of Rapid Re-housing programs in reducing family homelessness. In February 2009, President Obama signed the American Recovery and Reinvestment Act of 2009, part of which addressed homelessness prevention, allocating $1.5 billion for a Homeless Prevention Fund. The Emergency Shelter Grant (ESG) program's name was changed to Emergency Solution Grant (ESG) program, and funds were re-allocated to assist with homeless prevention and rapid re-housing for families and individuals.


title: Homelessness

text: Gentrification is a process in which a formerly affordable neighborhood becomes popular with wealthier people, raising housing prices and pushing poorer residents out. Gentrification can cause or influence evictions, foreclosures, and rent regulation.


title: Homelessness

text: Increased wealth disparity and income inequality causes distortions in the housing market that push rent burdens higher, making housing unaffordable.


title: Homelessness

text: In many countries, people lose their homes by government orders to make way for newer upscale high-rise buildings, roadways, and other governmental needs. The compensation may be minimal, in which case the former occupants cannot find appropriate new housing and become homeless.


title: Homelessness

text: Mortgage foreclosures where mortgage holders see the best solution to a loan default is to take and sell the house to pay off the debt can leave people homeless. Foreclosures on landlords often lead to the eviction of their tenants. "The Sarasota, Florida, "Herald Tribune" noted that, by some estimates, more than 311,000 tenants nationwide have been evicted from homes this year after lenders took over the properties."


title: Homelessness

text: Rent regulation also has a small effect on shelter and street populations. This is largely due to rent control reducing the quality and quantity of housing. For example, a 2019 study found that San Francisco's rent control laws reduced tenant displacement from rent controlled units in the short-term, but resulted in landlords removing 30% of the rent controlled units from the rental market, (by conversion to condos or TICs) which led to a 15% citywide decrease in total rental units, and a 7% increase in citywide rents.


title: Homelessness

text: A substantial percentage of the US homeless population are individuals who are chronically unemployed, or have trouble managing their expenses. This can lead to poverty. Factors that can lead to economic struggle include neighbourhood gentrification (as previously discussed), drug addiction or gambling addiction, job loss, debt, chronic overspending of money, loss of money and/or assets due to divorce, death of breadwinning spouse, being denied jobs due to discrimination, living off of welfare or disability income, and many others.


title: Homelessness

text: Poverty is a significant factor in homelessness. Alleviation of poverty, as a result, plays an essential role in eliminating homelessness. Some non-governmental organizations (NGOs) have studied ‘unconditional cash transfers’ (UCTs) to low-income families and individuals to reduce poverty in developing countries. Despite their initial concern about UTC’s potential negative effects on the recipients, the researchers found promising results. The study in Kenya found that the assisted households increased their consumption and savings. While the families spent more for their food and food security, they did not incur any expenses on unnecessary goods or services. This study shows that a proper approach to poverty could effectively eliminate this factor as part of a solution to homelessness. Providing access to education and employment to low-income families and individuals must also be considered to combat poverty and preventing homelessness.


title: Homelessness

text: It is not surprising that many researchers have identified that “Homelessness is closely connected to decline in physical and mental health”. Most people who use homeless shelters on a frequent basis face multiple disadvantages, such as increased prevalence of physical and mental health problems, disabilities, addiction, poverty, and discrimination. Studies have shown that homeless people have a high level of morbidity and mortality. Moreover, they suffer from a wide range of medical problems, including serious infectious diseases, e.g., tuberculosis, HIV/AIDs and STDs, addictions, and mental illnesses. Notably, the lack of access to adequate medical care for homeless people adversely affects the healthcare system as well. Homeless people often obtain their care in hospital emergency departments, partly due to their inability to pay for medical services. Statistics demonstrate that the homeless are admitted to a hospital five times more than the general public and stay under care much longer. Their prolonged hospital stays impose a significant cost to the healthcare system and deprives others from receiving their timely healthcare.


title: Homelessness

text: Studies show that preventive and primary care (which homeless people are not receiving) substantially lower the overall healthcare costs. Unfortunately, in terms of providing adequate treatment to homeless people with respect to their mental illness, the healthcare system’s performance has not been promising, either. It is apparent that a comprehensive solution to homelessness must include an effective approach to providing healthcare to homeless people.


title: Homelessness

text: Disabilities, especially where disability services are non-existent, inconvenient, or poorly performing can impact a person's ability to support house payments, mortgages, or rent, especially if they are unable to work. Traumatic brain injury is one main disability that can account for homelessness. According to a Canadian survey, traumatic brain injury is widespread among homeless people and, for around 70% of respondents, can be attributed to a time "before the onset of homelessness"


title: Homelessness

text: Being afflicted with a mental disorder, including substance use disorders, where mental health services are unavailable or difficult to access can also drive homelessness for the same reasons as disabilities. A United States federal survey done in 2005 indicated that at least one-third of homeless men and women have serious psychiatric disorders or problems. Autism spectrum disorders and schizophrenia are the top two common mental disabilities among the U.S. homeless. Personality disorders are also very prevalent, especially Cluster A. Substance abuse can also cause homelessness from behavioral patterns associated with addiction, that alienate an addicted individual's family and friends, who could otherwise provide support during difficult economic times.


title: Homelessness

text: A history of experiencing domestic violence can also attribute to homelessness. Compared to housed women, homeless women were more likely to report childhood histories of abuse, as well as more current physical abuse by male partners.


title: Homelessness

text: Gender disparities also influence the demographics of homelessness. The experiences of homeless women and women in poverty are often overlooked, however, they experience specific gender-based victimization. As individuals with little to no physical or material capital, homeless women are particularly targeted by male law enforcement, and men living on the street. It has been found that "street-based homelessness dominates mainstream understanding of homelessness and it is indeed an environment in which males have far greater power (O'Grady and Gaietz, 2004)." Women on the street are often motivated to gain capital through affiliation and relationships with men, rather than facing homelessness alone. Within these relationships, women are still likely to be physically and sexually abused.


title: Homelessness

text: Social exclusion related to sexual orientation, gender identity or expression, or sex characteristics can also attribute to homelessness based on discrimination. Relationship breakdown, particularly in relation to young people and their parents, such as disownment due to sexuality or gender identity is one example.


title: Homelessness

text: Natural disasters, including but not limited to earthquakes, hurricanes, tsunamis, tornadoes, and volcanic eruptions can cause homelessness. An example is the 1999 Athens earthquake in Greece, in which many middle class people became homeless, with some of them living in containers, especially in the Nea Ionia earthquake survivors container city provided by the government; in most cases, their only property that survived the quake was their car. Such people are known in Greece as "seismopathis", meaning earthquake-struck.


title: Homelessness

text: War or armed conflict can create refugees fleeing the violence. Whether they be either domestic or foreign to the country, the number of migrants can outstrip the supply of affordable housing, leaving some section of this population to be homeless.


title: Homelessness

text: Transitions from foster care and other public systems can also impact homelessness; specifically, youth who have been involved in, or are a part of the foster care system, are more likely to become homeless. Most leaving the system have no support and no income, making it nearly impossible to break the cycle, and forcing them to live on the streets. There is also a lack of shelter beds for youth; various shelters have strict and stringent admissions policies.


title: Homelessness

text: Although uncommon, some choose to be homeless as a personal lifestyle choice. There are different reasons why someone would choose to become homeless. They may not want to contribute to a capitalist society, which includes having a job, spending and owing money, and paying taxes to the government. The main aspect of freeganism is anti-consumerism, and avoiding spending excessive amounts of money at all costs. Some see homelessness as more 'free' than living in a house or apartment, and prefer being in nature, as well as away from other people. Some may have had a traumatic experience in a house or apartment, such as a fire, and feel safer outside, being able to survey their surroundings.


title: Homelessness

text: The basic problem of homelessness is the need for personal shelter, warmth, and safety. Other difficulties include:


title: Homelessness

text: People experiencing homelessness face many problems beyond the lack of a safe and suitable home. They are often faced with reduced access to private and public services and vital necessities:


title: Homelessness

text: There is sometimes corruption and theft by the employees of a shelter, as evidenced by a 2011 investigative report by FOX 25 TV in Boston, wherein a number of Boston public shelter employees were found stealing large amounts of food over a period of time from the shelter's kitchen for their private use and catering. Homeless people are often obliged to adopt various strategies of self-presentation in order to maintain a sense of dignity, which constrains their interaction with passers-by, and leads to suspicion and stigmatization by the mainstream public.


title: Homelessness

text: Homelessness is also a risk factor for depression caused by prejudice. When someone is prejudiced against people who are homeless, and then becomes homeless themselves, their anti-homelessness prejudice turns inward, causing depression. "Mental disorders, physical disability, homelessness, and having a sexually transmitted infection are all stigmatized statuses someone can gain despite having negative stereotypes about those groups." Difficulties can compound exponentially. A study found that in the city of Hong Kong over half of the homeless people in the city (56%) had some degree of mental illness. Only 13% of the 56% were receiving treatment for their condition leaving a huge portion of homeless untreated for their mental illness.


title: Homelessness

text: The issue of anti-homeless architecture came to light in 2014, after a photo displayed hostile features (spikes on the floor) in London, and took social media by storm. The photo of an anti-homeless structure was a classic example of hostile architecture, in an attempt to discourage people from attempting to access or use public space in irregular ways. However, although this has only recently came to light, hostile architecture has been around for a long time in many places. An example of this is a low overpass that was put in place between New York City and Long Island. Robert Moses, an urban planner, designed it this way in an attempt to prevent public buses from being able to pass through it.


title: Homelessness

text: Health care for homeless people is a major public health challenge. When compared to the general population, people who are homeless experience higher rates of adverse physical and mental health outcomes. Chronic disease severity, respiratory conditions, rates of mental health illnesses and substance use are all often greater in homeless populations than the general population. Homelessness is also associated with a high risk of suicide attempts. Homeless people are more likely to suffer injuries and medical problems from their lifestyle on the street, which includes poor nutrition, exposure to the severe elements of weather, and a higher exposure to violence. Yet at the same time, they have reduced access to public medical services or clinics, in part because they often lack identification or registration for public healthcare services. There are significant challenges in treating homeless people who have psychiatric disorders because clinical appointments may not be kept, their continuing whereabouts are unknown, their medicines may not be taken as prescribed, medical and psychiatric histories are not accurate, and other reasons. Because many homeless people have mental illnesses, this has presented a crisis in care.


title: Homelessness

text: The conditions affecting homeless people are somewhat specialized, and have opened a new area of medicine tailored to this population. Skin conditions, including scabies, are common, because homeless people are exposed to extreme cold in the winter, and have little access to bathing facilities. They have problems caring for their feet, and have more severe dental problems than the general population. Diabetes, especially untreated, is widespread in the homeless population. Specialized medical textbooks have been written to address this for providers.


title: Homelessness

text: Due to the demand for free medical services by homeless people, it might take months to get a minimal dental appointment in a free-care clinic. Communicable diseases are of great concern, especially tuberculosis, which spreads more easily in crowded homeless shelters in high-density urban settings. There has been ongoing concern and studies about the health and wellness of the older homeless population, typically ages 50 to 64 and older, as to whether they are significantly more sickly than their younger counterparts, and if they are under-served.


title: Homelessness

text: A 2011 study led by Dr. RebeccaT. Brown in Boston, conducted by the Institute for Aging Research (an affiliate of Harvard Medical School), Beth Israel Deaconess Medical Center, and the Boston Health Care for the Homeless Program found the elderly homeless population had "higher rates of geriatric syndromes, including functional decline, falls, frailty, and depression than seniors in the general population, and that many of these conditions may be easily treated if detected". The report was published in the Journal of Geriatric Internal Medicine. There are government avenues which provide resources for the development of healthcare for homeless people. In the United States, the Bureau of Primary Health Care has a program that provides grants to fund the delivery of healthcare to homeless people. According to 2011 UDS, data community health centers were able to provide service to 1,087,431 homeless individuals. There are also many nonprofit and religious organizations which provide healthcare services to homeless people. These organizations help meet the large need which exists for expanding healthcare for homeless people.


title: Homelessness

text: There have been significant numbers of unsheltered persons dying of hypothermia, adding impetus to the trend of establishing warming centers, as well as extending enumeration surveys with vulnerability indexes.


title: Homelessness

text: In 1999, Dr. Susan Barrow of the Columbia University Center for Homelessness Prevention Studies reported in a study that the "age-adjusted death rates of homeless men and women were four times those of the general U.S. population and two to three times those of the general population of New York City". A report commissioned by homeless charity Crisis in 2011 found that on average, homeless people in the UK have a life expectancy of 47 years, 30 years younger than the rest of the population.


title: Homelessness

text: People experiencing homelessness are at a significant increased risk to the effects of extreme weather events. Such weather events include extreme heat and cold, floods, storm surges, heavy rain, and droughts. While there are many contributing factors to these events, climate change is driving an increasing frequency and intensity of these events. The homeless population is considerably more vulnerable to these weather events, due to their higher rates of chronic disease, and lower socioeconomic status. Despite having a minimal carbon footprint, homeless people unfortunately experience a disproportionate burden of the effects of climate change.


title: Homelessness

text: Homeless persons have increased vulnerability to extreme weather events for many reasons. They are disadvantaged in most social determinants of health, including lack of housing and access to adequate food and water, reduced access to health care, and difficulty in maintaining health care. They have significantly higher rates of chronic disease including respiratory disease and infections, gastrointestinal disease, musculoskeletal problems and mental health disease. In fact, self-reported rates of respiratory diseases (including asthma, chronic bronchitis and emphysema) are double that of the general population.


title: Homelessness

text: The homeless population often live in higher risk urban areas, with increased exposure and little protection from the elements. They also have limited access to clean drinking water, and other methods of cooling down. The built environment in urban areas also contributes to the "heat island effect", the phenomenon whereby cities experience higher temperatures due to the predominance of dark, paved surfaces, and lack of vegetation. Homeless populations are often excluded from disaster planning efforts, further increasing their vulnerability when these events occur. Without the means to escape extreme temperatures and seek proper shelter, and cooling or warming resources, homeless people are often left to suffer the brunt of the extreme weather.


title: Homelessness

text: The health effects that result from extreme weather include exacerbation of chronic diseases and acute illnesses. Pre-existing conditions can be greatly exacerbated by extreme heat and cold, including cardiovascular, respiratory, skin and renal disease, often resulting in higher morbidity and mortality during extreme weather. Acute conditions such as sunburn, dehydration, heat stroke, and allergic reactions are also common. In addition, a rise in insect bites can lead to vector-borne infections. Mental health conditions can also be impacted by extreme weather events as a result of lack of sleep, increased alcohol consumption, reduced access to resources and reduced ability to adjust to the environmental changes. In fact, pre-existing psychiatric illness has been shown to triple the risk of death from extreme heat. Overall, extreme weather events appear to have a "magnifying effect" in exacerbating the underlying prevalent mental and physical health conditions of homeless populations.


title: Homelessness

text: In 2005, Hurricane Katrina, a category 5 hurricane, made landfall on Florida and Louisiana. It particularly affected the city of New Orleans and the surrounding areas. Hurricane Katrina was the deadliest hurricane in the US in seven decades, with more than 1,600 confirmed deaths, and more than 1,000 people missing. The hurricane disproportionately affected marginalized individuals, and individuals with lower socioeconomic status (i.e., 93% of shelter residents were African–American, 32% had household incomes below $10,000/year and 54% were uninsured). The storm nearly doubled the number of homeless people in New Orleans. While in most cities, homeless people account for 1% of the population, in New Orleans', the homeless account for 4% of the population. In addition to its devastating effects on infrastructure and the economy, the estimated prevalence of mental illness and the incidence of West Nile Virus more than doubled after Hurricane Katrina in the hurricane-affected regions.


title: Homelessness

text: Homeless people may find it difficult to document their date of birth or their address. Due to the fact that homeless people usually have no place to store possessions, they often lose their belongings, including identification and other documents, or find them destroyed by police or others. Without a photo ID, homeless persons cannot get a job or access many social services, including healthcare. They can be denied access to even the most basic assistance: clothing closets, food pantries, certain public benefits, and in some cases, emergency shelters. Obtaining replacement identification is difficult. Without an address, birth certificates cannot be mailed. Fees may be cost-prohibitive for impoverished persons. And some states will not issue birth certificates unless the person has photo identification, creating a Catch-22. This problem is far less acute in countries that provide free-at-use health care, such as the UK, where hospitals are open-access day and night and make no charges for treatment. In the U.S., free-care clinics for homeless people and other people do exist in major cities, but often attract more demand than they can meet.


title: Homelessness

text: Homeless people are often the victims of violent crime. A 2007 study found that the rate of violent crimes against homeless people in the United States is increasing. A study of women veterans found that homelessness is associated with domestic violence, both directly, as the result of leaving an abusive partner, and indirectly, due to trauma, mental health conditions, and substance abuse.


title: Homelessness

text: Conditions such as alcoholism and mental illness are often associated with homelessness. Many people fear homeless people, due to the stigma surrounding the homeless community. Surveys have revealed that before spending time with the homeless, most people fear them, but after spending time with homeless people, that fear is lessened, or is no longer there. Another effect of this stigma is isolation.


title: Homelessness

text: The stigmas of homelessness can thus be divided into three major categories in general: (1) attributing homelessness to personal incompetency and health conditions (e.g., unemployment, mental health issues, substance abuse, etc.); (2) seeing homeless people as posing threats to one's personal safety; and (3) de-sanitizing homeless people (i.e., seeing them as pathogens). Past research has shown that those types of stigmas are being reinforced through the fact that one is homeless and have a negative impact on effective public policymaking in terms of reducing homelessness. When a person lives on a street, many aspects of their personal situations, such as mental health issues and alcoholism, are more likely to be exposed to the public as compared to people who are not homeless and have access to resources that will help improve their personal crises. Such lack of privacy inevitably reinforces stigma by increasing observations of stereotypes for the public. Furthermore, media often attributes those personal crises to the direct cause of crimes, further leading the public to believe that homeless people are a threat to their personal safety. Many also believe that contacts with homeless people increase their chance of contracting diseases given that they lack access to stable, sanitary living conditions. Those types of stigmas are intertwined with each other when shaping public opinions on policies related to the homeless population, resulting in many ineffective policies that do not reduce homelessness at all. An example of such ineffective but somewhat popular policies is imposing bans on sleeping on the streets.


title: Homelessness

text: Relying on the famous contact hypothesis, researchers argue that increasing contact between the homeless population and non-homeless population is likely to change public opinions on this out-group and make the public more well-informed when it comes to policymaking. While some believe that the contact hypothesis is only valid on the condition that the context and type of contact are specified, in the case of reducing discrimination against the homelessness population, some survey data indicate that the context (e.g., the proportion of the homeless population in one's city) and type of contact (e.g., TV shows about the homelessness population or interpersonal conversations about homelessness) do not produce much variation as they all increase positive attitudes towards homeless people and public policies that aid this group. Given that the restrictions of contexts and types of contact to reduce stigma are minimal, this finding is informative and significant to the government when it comes to making policies to offer institutional support for reducing discrimination in a country and for gauging public opinions on their proposed policies to reduce homelessness.


title: Homelessness

text: In western countries such as the United States, the typical homeless person is male and single, with the Netherlands reporting 80% of homeless people aged 18–65 to be men. Some cities have particularly high percentages of males in homeless populations, with men comprising eighty-five percent of the homeless in Dublin. Non-white people are also overrepresented in homeless populations, with such groups two and one-half times more likely to be homeless in the U.S. The median age of homeless people is approximately 35.


title: Homelessness

text: In 2005, an estimated 100 million people worldwide were homeless. The following statistics indicate the approximate average number of homeless people at any one time. Each country has a different approach to counting homeless people, and estimates of homelessness made by different organizations vary wildly, so comparisons should be made with caution.


title: Homelessness

text: The number of homeless people worldwide grew steadily in 2005. In some developing countries such as Nigeria and South Africa, homelessness is rampant, with millions of children living and working on the streets. Homelessness has become a problem in the countries of China, India, Thailand, Indonesia, and the Philippines despite their growing prosperity, partly due to migrant workers who have trouble finding permanent homes.


title: Homelessness

text: Determining the true number of homeless people worldwide varies between 100 million and 1 billion people based on the exact definition used. Refugees, asylum-seekers, and internally displaced persons can also be considered homeless in that they, too, experience "marginalization, minority status, socioeconomic disadvantage, poor physical health, collapse of social supports, psychological distress, and difficulty adapting to host cultures" such as the domestic homeless.


title: Homelessness

text: In the past twenty years, scholars such as Tipple and Speak have begun to refer to homelessness as the "antithesis or absence of home" rather than rooflessness or the "lack of physical shelter." This complication in the homelessness debate further delineates the idea that home actually consists of an adequate shelter, an experienced and dynamic place that serves as a "base" for nurturing human relationships and the "free development of individuals" and their identity. Thus, the home is perceived to be an extension of one's self and identity. In contrast, the homeless experience, according to Moore, constitutes more as a "lack of belonging" and a loss of identity that leads to individuals or communities feeling "out of place" once they can no longer call a place of their own home.


title: Homelessness

text: This new perspective on homelessness sheds light on the plight of refugees, a population of stateless people who are not normally included in the mainstream definition of homelessness. It has also created problems for researchers because the nature of "counting" homeless people across the globe relies heavily on who is considered a homeless person. Homeless individuals, and by extension refugees, can be seen as lacking lack the "crucible of our modern society" and lacking a way of actively belonging to and engaging with their respective communities or cultures. As Casavant demonstrates, a spectrum of definitions for homelessness, called the "continuum of homelessness", should refer to refugees as homeless individuals because they not only lose their home, but they are also afflicted with a myriad of problems that parallel those affecting the domestic homeless, such as "[a lack of] stable, safe and healthy housing, an extremely low income, adverse discrimination in access to services, with problems of mental health, alcohol, and drug abuse or social disorganization". Refugees, like the domestic homeless, lose their source of identity and way of connecting with their culture for an indefinite period of time.


title: Homelessness

text: Thus, the current definition of homelessness unfortunately allows people to simplistically assume that homeless people, including refugees, are merely "without a place to live" when that is not the case. As numerous studies show, forced migration and displacement brings with it another host of problems including socioeconomic instability, "increased stress, isolation, and new responsibilities" in a completely new environment.


title: Homelessness

text: For people in Russia, especially the youth, alcohol and substance use is a major cause and reason for becoming and continuing to be homeless. The United Nations Centre for Human Settlements (UN-Habitat) wrote in its "Global Report on Human Settlements" in 1995: "Homelessness is a problem in developed as well as in developing countries. In London, for example, life expectancy among homeless people is more than 25 years lower than the national average."


title: Homelessness

text: Poor urban housing conditions are a global problem, but conditions are worst in developing countries. Habitat says that today 600 million people live in life- and health-threatening homes in Africa, Asia, and Latin America. For example, more than three in four young people had insufficient means of shelter and sanitation in some African countries like Malawi. "The threat of mass homelessness is greatest in those regions because that is where population is growing fastest. By 2015, the 10 largest cities in the world will be in Asia, Latin America, and Africa. Nine of them will be in developing countries: Mumbai, India – 27.4 million; Lagos, Nigeria – 24.4; Shanghai, China – 23.4; Jakarta, Indonesia – 21.2; São Paulo, Brazil – 20.8; Karachi, Pakistan – 20.6; Beijing, China – 19.4; Dhaka, Bangladesh – 19; Mexico City, Mexico – 18.8. The only city in a developed country that will be in the top ten is Tokyo, Japan – 28.7 million."


title: Homelessness

text: In 2008, Dr. Anna Tibaijuka, executive director of UN-HABITAT, referring to the recent report "State of the World's Cities Report 2008/2009", said that the world economic crisis we are in should be viewed as a "housing finance crisis" in which the poorest of poor were left to fend for themselves.


title: Homelessness

text: Transitional housing provides temporary housing for certain segments of the homeless population, including the working homeless, and is meant to transition residents into permanent, affordable housing. This is usually a room or apartment in a residence with support services. The transitional time can be relatively short, for example, one or two years, and in that time the person must file for and obtain permanent housing along with gainful employment or income, even if Social Security or assistance. Sometimes transitional housing programs charge a room and board fee, maybe 30% of an individual's income, which is sometimes partially or fully refunded after the person procures a permanent residence. In the U.S., federal funding for transitional housing programs was originally allocated in the McKinney–Vento Homeless Assistance Act of 1986.


title: Homelessness

text: Foyers are a specific type of transitional housing designed for homeless or at-risk teens. Foyers are generally institutions that provide affordable accommodation as well as support and training services for residents. They were pioneered in the 1990s in the United Kingdom, but have been adopted in areas in Australia and the United States as well.


title: Homelessness

text: Supportive housing is a combination of housing and services intended as a cost-effective way to help people live more stable, productive lives. Supportive housing works well for those who face the most complex challenges – individuals and families confronted with homelessness who also have very low incomes or serious, persistent issues such as substance use disorder, addictions, alcohol use disorder, mental illness, HIV/AIDS, or other serious challenges. A 2021 systematic review of 28 interventions, mostly in North America, showed that interventions with highest levels of support led to improved outcomes for both housing stability, and health outcomes.


title: Homelessness

text: In South Australia, the state government of Premier Mike Rann (2002–2011) committed substantial funding to a series of initiatives designed to combat homelessness. Advised by Social Inclusion Commissioner David Cappo and the founder of New York's Common Ground program, Rosanne Haggerty, the Rann government established Common Ground Adelaide, building high-quality inner city apartments (combined with intensive support) for "rough sleeping" homeless people. The government also funded the Street to Home program and a hospital liaison service designed to assist homeless people admitted to the emergency departments of Adelaide's major public hospitals. Rather than being released back into homelessness, patients identified as rough sleepers were found accommodation backed by professional support. Common Ground and Street to Home now operate across Australia in other States.


title: Homelessness

text: Most countries provide a variety of services to assist homeless people. Provisions of food, shelter, and clothing and may be organized and run by community organizations, often with the help of volunteers, or by government departments. Assistance programs may be supported by government, charities, churches, and individual donors. However, not all homeless people can access these resources. In 1998, a study by Koegel and Schoeni of a homeless population in Los Angeles, California, found that a significant minority of homeless did not participate in government assistance programs, with high transaction costs being a likely contributing factor.


title: Homelessness

text: While some homeless people are known to have a community with one another, providing each other various types of support, people who are not homeless also may provide them friendship, relational care, and other forms of assistance. Such social supports may occur through a formal process, such as under the auspices of a non-governmental organization, religious organization, or homeless ministry, or may be done on an individual basis.


title: Homelessness

text: The United States Department of Labor has sought to address one of the main causes of homelessness, a lack of meaningful and sustainable employment, through targeted training programs and increased access to employment opportunities that can help homeless people develop sustainable lifestyles. This has included the development of the United States Interagency Council on Homelessness, which addresses homelessness on the federal level in addition to connecting homeless individuals to resources at the state level. All individuals who are in need of assistance are able, in theory, to access employment and training services under the Workforce Investment Act (WIA), although this is contingent upon funding and program support by the government.


title: Homelessness

text: Homeless people can also use waste management services to earn money. Some homeless people find returnable bottles and cans and bring them to recycling centers to earn money. They can sort out organic trash from other trash or separate out trash made of the same material (for example, different types of plastics, and different types of metal). In addition, rather than picking waste at landfills, they can also collect litter found on/beside the road to earn an income.


title: Homelessness

text: Street newspapers are newspapers or magazines sold by homeless or poor individuals and produced mainly to support these populations. Most such newspapers primarily provide coverage about homelessness and poverty-related issues and seek to strengthen social networks within homeless communities, making them a tool for allowing homeless individuals to work.


title: Homelessness

text: The 2010 passage of the Patient Protection and Affordable Care Act could provide new healthcare options for homeless people in the United States, particularly through the optional expansion of Medicaid. A 2013 Yale study indicated that a substantial proportion of the chronically homeless population in America would be able to obtain Medicaid coverage if states expanded Medicaid under the Affordable Care Act.


title: Homelessness

text: In 1985, the Boston Health Care for the Homeless Program was founded to assist the growing numbers of homeless living on the streets and in shelters in Boston and who were suffering from a lack of effective medical services. In 2004, Boston Health Care for the Homeless in conjunction with the National Health Care for the Homeless Council published a medical manual called "The Health Care of Homeless Persons", edited by James J. O'Connell, M.D., specifically for the treatment of the homeless population. In June 2008 in Boston, the Jean Yawkey Place, a four-story, building, was opened by the Boston Health Care for the Homeless Program. It is an entire full-service building on the Boston Medical Center campus dedicated to providing healthcare for homeless people. It also contains a long-term care facility, the Barbara McInnis House, which expanded to 104 beds and is the first and largest medical respite program for homeless people in the United States.


title: Homelessness

text: In Los Angeles, a collaboration between the Ostrow School of Dentistry of the University of Southern California and the Union Rescue Mission shelter offer homeless people in the Skid Row area free dental services.


title: Homelessness

text: Studies on the effects of intensive mental health interventions have demonstrated some improvements in housing stability and to be economically beneficial on cost-analysis.


title: Homelessness

text: Permanent supportive housing (PSH) interventions appear to have improvements in housing stability for people living with homelessness even in long-term.


title: Homelessness

text: In 2013, a Central Florida Commission on Homelessness study indicated that the region spends $31,000 a year per homeless person to cover "salaries of law enforcement officers to arrest and transport homeless individuals – largely for nonviolent offenses such as trespassing, public intoxication or sleeping in parks – as well as the cost of jail stays, emergency room visits and hospitalization for medical and psychiatric issues. This did not include "money spent by nonprofit agencies to feed, clothe and sometimes shelter these individuals". In contrast, the report estimated the cost of permanent supportive housing at "$10,051 per person per year" and concluded that "[h]ousing even half of the region's chronically homeless population would save taxpayers $149 million over the next decade – even allowing for 10 percent to end up back on the streets again." This particular study followed 107 long-term-homeless residents living in Orange, Osceola or Seminole Counties. There are similar studies showing large financial savings in Charlotte and Southeastern Colorado from focusing on simply housing the homeless."


title: Homelessness

text: Los Angeles conducted a competition promoted by Mayor Eric Garcetti soliciting ideas from developers to use bond money more efficiently in building housing for the city's homeless population. The top five winners were announced on 1 February 2019 and the concepts included using assembly-ready molded polymer panels that can be put together with basic tools, prefabricated 5-story stack-able houses, erecting privately financed modular buildings on properties that do not require City Council approval, using bond money to convert residential garages into small apartments which are then dedicated to homeless rentals, and the redeveloping of Bungalow-court units, the small low-income iconic buildings that housed 7% of the city's population in the 1920s.


title: Homelessness

text: In the neighborhood of Westlake, Los Angeles, the city is funding the first transitionally homeless housing building using "Cargotecture", or "architecture built from repurposed shipping containers." The Hope on Alvarado micro-apartment building will consist of 4-stories of 84 containers stacked together like Lego bricks on top of a traditionally constructed ground floor. Completion is anticipated by the end of 2019.


title: Homelessness

text: Voting for elected officials is important for the homeless population to have a voice in the democratic process.


title: Homelessness

text: There are also many community organizations and social movements around the world which are taking action to reduce homelessness. They have sought to counteract the causes and reduce the consequences by starting initiatives that help homeless people transition to self-sufficiency. Social movements and initiatives tend to follow a grassroots, community-based model of organization – generally characterized by a loose, informal and decentralized structure, with an emphasis on radical protest politics. By contrast, an interest group aims to influence government policies by relying on more of a formal organizational structure. These groups share a common element: they are both made up of and run by a mix of allies of the homeless population and former or current members of the homeless population. Both grassroots groups and interest groups aim to break stereotyped images of homeless people as being weak and hapless, or defiant criminals and drug addicts, and to ensure that the voice of homeless people and their representatives is clearly heard by policymakers.


title: Homelessness

text: Homeless shelters can become grounds for community organization and the recruitment of homeless individuals into social movements for their own cause. Cooperation between the shelter and an elected representative from the homeless community at each shelter can serve as the backbone of this type of initiative. The representative presents and forwards problems raises concerns and provides new ideas to the director and staff of the shelters. Examples of possible problems are ways to deal with substance use disorders by certain shelter users, and resolution of interpersonal conflicts. SAND, the Danish National Organization for Homeless People, is one example of an organization that uses this empowerment approach. Issues reported at the homeless shelters are then addressed by SAND at the regional or national level. To open further dialogue, SAND organizes regional discussion forums where staff and leaders from the shelters, homeless representatives, and local authorities meet to discuss issues and good practices at the shelters.


title: Homelessness

text: There are a number of homeless organizations that support homeless veterans, an issue most commonly seen in the United States.


title: Homelessness

text: Non-governmental organizations house or redirect homeless veterans to care facilities. Social Security Income/Social Security Disability Income, Access, Outreach, Recovery Program (SOAR) is a national project funded by the Substance Abuse and Mental Health Services Administration. It is designed to increase access to SSI/SSDI for eligible adults who are homeless or at risk of becoming homeless and have a mental illness or a co-occurring substance use disorder. Using a three-pronged approach of Strategic Planning, Training, and Technical Assistance (TA), the SOAR TA Center coordinates this effort at the state and community level.


title: Homelessness

text: The United States Department of Housing and Urban Development and Veterans Administration have a special Section 8 housing voucher program called VASH (Veterans Administration Supported Housing), or HUD-VASH, which gives out a certain number of Section 8 subsidized housing vouchers to eligible homeless and otherwise vulnerable US armed forces veterans. The HUD-VASH program has shown success in housing many homeless veterans. The support available to homeless veterans varies internationally, however. For example, in England, where there is a national right to housing, veterans are only prioritized by local authority homelessness teams if they are found to be vulnerable due to having served in the Armed Forces.


title: Homelessness

text: Under the Department of Labor, the Veterans' Employment and Training Service (VETS) offers a variety of programs targeted at ending homelessness among veterans. The Homeless Veterans' Reintegration Program (HVRP) is the only national program that is exclusively focused on assisting veterans as they reenter the workforce. The VETS program also has an Incarcerated Veterans' Transition Program, as well as services that are unique to female Veterans. Mainstream programs initiated by the Department of Labor have included the Workforce Investment Act, One-Stop Career Centers, and a Community Voice Mail system that helps to connect homeless individuals around the United States with local resources. Targeted labor programs have included the Homeless Veterans' Reintegration Project, the Disability Program Navigator Initiative, efforts to end chronic homelessness through providing employment and housing projects, Job Corps, and the Veterans Workforce Investment Program (VWIP).


title: Homelessness

text: Homelessness in Egypt is a significant social issue affecting some 12 million people in the country. Egypt has over 1,200 areas designated for irregular dwellings that do not conform to standard building laws, allowing homeless people to build shacks and other shelters for themselves.


title: Homelessness

text: Reportedly, in Egypt, homelessness is defined to include those living in marginal housing. Some scholars have stated that there is no agreed upon definition of homelessness in Egypt due to the difficulties government would face if an official definition were accepted.


title: Homelessness

text: According to UNICEF, there are 1 million children living on the streets in Egypt. Other researchers estimate the number to be some 3 million. Homelessness NGOs assisting street children include those such as Hope Village Society, and NAFAS. Other NGOs, such as Plan International Egypt, work to reintegrate street children back into their families.


title: Homelessness

text: Homelessness in South Africa dates back to the apartheid period. Increasing unemployment, lack of affordable housing, social disintegration, and social and economic policies have all been identified as contributing factors to the issue. Some scholars argue that solutions to homelessness in South Africa lie more within the private sphere than in the legal and political spheres.


title: Homelessness

text: There is no national census on homeless people in South Africa, researchers instead rely on individual studies of homeless persons in particular cities. The South African homeless population has been estimated at 200,000 people from a diverse range of backgrounds. Most South African municipalities primarily view homelessness as a social dependency issue, responding with social interventions.


title: Homelessness

text: One study found that three out of four South African metropolitan municipalities viewed homelessness primarily as a social dependency issue, responding with social interventions. At the same time, homeless South Africans indicated that the most important thing the municipality could assist them with was employment and well-located affordable housing.


title: Homelessness

text: In 2011, there were approximately 2.41 million homeless adults and 179,000 homeless children living in the country. However, one publication estimated that there were one million homeless children in China in 2012.


title: Homelessness

text: Housing in China is highly regulated by the Hukou system. This gives rise to a large number of migrant workers, numbering at 290.77 million in 2019. These migrant workers have rural Hukou, but they move to the cities in order to find better jobs, though due to their rural Hukou they are entitled to fewer privileges than those with urban Hukou. According to Huili et al., these migrant workers "live in overcrowded and unsanitary conditions" and are always at risk of displacement to make way for new real estate developments. In 2017, the government responded to a deadly fire in a crowded building in Beijing by cracking down on dense illegal shared accommodations and evicting the residents, leaving many migrant laborers homeless. This comes in the context of larger attempts by the government to limit the population increase in Beijing, often targeting migrant laborers. However, according to official government statistics, migrant workers in China have an average of of living space per capita, and the vast majority of migrant workers have basic living facilities such as heating, bathing, refrigerators, and washing machines.


title: Homelessness

text: Several natural disasters have led to homelessness in China. The 2000 Yunnan earthquake left 92,479 homeless and destroyed over 41,000 homes.


title: Homelessness

text: Homelessness among people with mental health problems is 'much less common' in China than in high-income countries, due to stronger family ties, but is increasing due to migration within families and as a result of the one-child policy. A study in Xiangtan found at least 2439 schizophrenic people that have been homeless on a total population of 2.8 million. It was found that "homelessness was more common in individuals from rural communities (where social support services are limited), among those who wander away from their communities (i.e., those not from Xiangtan municipality), and among those with limited education (who are less able to mobilize social supports). Homelessness was also associated with greater age; [the cause] may be that older patients have 'burned their bridges' with relatives and, thus, end up on the streets."


title: Homelessness

text: During the Cultural Revolution a large part of child welfare homes were closed down, leaving their inhabitants homeless. By the late 1990s, many new homes were set up to accommodate abandoned children. In 1999, the Ministry of Civil Affairs estimated the number of abandoned children in welfare homes to be 66,000.


title: Homelessness

text: According to the Ministry of Civil Affairs, China had approximately 2,000 shelters and 20,000 social workers to aid approximately 3 million homeless people in 2014.


title: Homelessness

text: From 2017 to 2019, the government of Guangdong Province assisted 5,388 homeless people in reuniting with relatives elsewhere in China. The Guangdong government assisted more than 150,000 people over a three-year period.


title: Homelessness

text: In 2020, in the wake of the COVID-19 pandemic, the Chinese Ministry of Civil Affairs announced several actions of the Central Committee in response to homelessness, including increasing support services and reuniting homeless people with their families. In Wuhan, the situation for homeless people was particularly bad, as the lockdown made it impossible for homeless migrants to return to other parts of the country. The Wuhan Civil Affairs Bureau set up 69 shelters in the city to house 4,843 people.


title: Homelessness

text: The Universal Declaration of Human Rights defines 'homeless' as those who do not live in a regular residence due to lack of adequate housing, safety, and availability. The United Nations Economic and Social Council Statement has a broader definition for homelessness; it defines homelessness as follows: 'When we are talking about housing, we are not just talking about four walls and a roof. The right to adequate housing is about security of tenure, affordability, access to services and cultural adequacy. It is about protection from forced eviction and displacement, fighting homelessness, poverty and exclusion. India defines 'homeless' as those who do not live in census houses, but rather stay on pavements, roadsides, railway platforms, staircases, temples, streets, in pipes, or other open spaces. There are 1.77 million homeless people in India, or 0.15% of the country's total population, according to the 2011 census consisting of single men, women, mothers, the elderly, and the disabled. However, it is argued that the numbers are far greater than accounted by the point in time method. For example, while the Census of 2011 counted 46.724 homeless individuals in Delhi, the Indo-Global Social Service Society counted them to be 88,410, and another organization called the Delhi Development Authority counted them to be 150,000. Furthermore, there is a high proportion of mentally ill and street children in the homeless population. There are 18 million street children in India, the largest number of any country in the world, with 11 million being urban. Finally, more than three million men and women are homeless in India's capital city of New Delhi; the same population in Canada would make up approximately 30 electoral districts. A family of four members has an average of five homeless generations in India.


title: Homelessness

text: There is a shortage of 18.78 million houses in the country. Total number of houses has increased from 52.06 million to 78.48 million (as per 2011 census). However, the country still ranks as the 124th wealthiest country in the world as of 2003. More than 90 million people in India make less than US$1 per day, thus setting them below the global poverty threshold. The ability of the Government of India to tackle urban homelessness and poverty may be affected in the future by both external and internal factors. The number of people living in slums in India has more than doubled in the past two decades and now exceeds the entire population of Britain, the Indian Government has announced. About 78 million people in India live in slums and tenements. 17% of the world's slum dwellers reside in India. Subsequent to the release of "Slumdog Millionaire" in 2008, Mumbai was a slum tourist destination for slumming where homeless people and slum dwellers alike could be openly viewed by tourists.


title: Homelessness

text: Homelessness increased following the wave of Soviet immigration in 1991. As many as 70 percent of homeless people in Tel Aviv are immigrants from the former Soviet Union, nearly all of them men. According to homeless shelter founder Gilad Harish, "when the recession hit Israel in the early 90s, the principle of 'last in, first out' kicked in, and many Russian immigrants lost their jobs. Being new to the country, they didn't have a strong family support system to fall back on like other Israelis do. Some ended up on the street with nowhere to go."


title: Homelessness

text: The number of homeless people in Israel grew in the 2000s, and the Association for Civil Rights in Israel claimed that the authorities were ignoring the issue.


title: Homelessness

text: Some 2,000 families in Israel lose their homes every year after defaulting on their mortgage loans. However, a law amendment passed in 2009 protects the rights of mortgage debtors and ensures that they are not evicted after failing to meet mortgage payments. The amendment is part of a wider reform in the law in the wake of a lengthy battle by the Association for Civil Rights in Israel and other human rights groups.


title: Homelessness

text: In 2007, the number of homeless youth was on the rise. More than 25% of all homeless youth in 2007 were girls, compared to 15% in 2004. A report by Elem, a non-profit organization that helps youth at risk, pointed to a 5% rise in the number of youths either homeless or wandering the streets late at night while their parents worked or due to strained relations at home. The organization estimated that in 2007 it provided programs or temporary shelter to roughly 32,000 youths in some 30 locations countrywide.


title: Homelessness

text: In 2014, the number of homeless individuals in Israel was estimated at 1,831, about 600 of whom were living on the streets of Tel Aviv. This makes up 0.02% of the country's population, a low figure compared to other developed nations. In July 2015, the Welfare Ministry estimated the number of homeless to be between 800 and 900, including 450 receiving services and treatment from their municipalities but continuing to live on the streets. Elem claimed the true figure was much higher. In December 2015, a large study by the Welfare Ministry found that 2,300 people in Israel were homeless.


title: Homelessness

text: Homeless people in Israel are entitled to a monthly government stipend of NIS 1,000. In addition, there are both state-run homeless shelters operated by the Welfare Ministry and privately run shelters.


title: Homelessness

text: Adi Nes, an Israeli photographer, has brought public attention to the issue by taking pictures of Israel's homeless.


title: Homelessness

text: Homelessness in Japan () is a social issue primarily affecting middle-aged and elderly males. Homelessness is thought to have peaked in the 1990s as a consequence of the collapse of the Japanese asset price bubble and has largely fallen since then.


title: Homelessness

text: According to the "Special Act in regards to Supporting the Autonomy of the Homeless Population" (), the term "homeless" is defined as "those who utilize city parks, river banks, roads, train stations, and other facilities as their place of stay in order to live their daily lives".


title: Homelessness

text: Names for the homeless in Japan include (, from the English "homeless"), ( meaning "wandering person"), ( meaning beggar), and (, from German ). More recently, ( "person who sleeps outside") and ( "laborer who sleeps outside") have been used to avoid negative connotations associated with the word "homeless".


title: Homelessness

text: There are approximately 4.5 million homeless people in the Philippines, about 3 million of them in Manila.


title: Homelessness

text: One fifth of the total population of the European Union – totalling 91.4 million people – are still at risk of poverty or social exclusion, and access to housing remains difficult for many Europeans. According to a Eurostat survey, three-in-100 people say they have already had to live with relatives on a temporary basis while one-in-100 people say they have already lived on the street, in emergency or temporary accommodation or in a place not suitable for housing.


title: Homelessness

text: Homelessness in Switzerland is a known social issue, however, there are few estimates as to the number of Swiss people affected. Homelessness is less visible in Switzerland than in many other Western countries. The majority of homeless people in Geneva are Swiss or French, with a minority from other countries.


title: Homelessness

text: One Swiss study found that 1.6 percent of all patients admitted to psychiatric wards were homeless. The study reported that social factors and psychopathology are independently contributing to the risk of homelessness.


title: Homelessness

text: In 2014, Swiss authorities reportedly began allowing homeless people to sleep in fallout shelters built during the Cold War.


title: Homelessness

text: There are a number of centers for providing food for the homeless, including the Suneboge community center.


title: Homelessness

text: Homelessness across the UK is a devolved matter, resulting in different legislation, frameworks, and even definitions, from country to country.


title: Homelessness

text: Since the late 1990s, housing policy has been a devolved matter, and state support for homeless people, together with legal rights in housing, have therefore diverged to a certain degree. A national service, called Streetlink, was established in 2012 to help members of the public obtain near-immediate assistance for specific rough sleepers, with the support of the Government (as housing is a devolved matter, the service currently only extends to England).


title: Homelessness

text: The annual number of homeless households in England peaked in 2003–04 at 135,420 before falling to a low of 40,020 in 2009–10. In 2017–18, there were 56,600 homeless households, which was 60 per cent below the 2003–04 peak, and 40 per cent higher than the 2009–10 low. The UK has more than 120,000 children in temporary accommodation, a number which has increased from 69,050 children in 2010.


title: Homelessness

text: In 2007 the official figures for England were that an average of 498 people slept rough each night, with 248 of those in London.


title: Homelessness

text: Homelessness in England since 2010 has been rising. By 2016 it is estimated the numbers sleeping rough had more than doubled since 2010. The National Audit Office say in relation to homelessness in England 2010–17 there has been a 60% rise in households living in temporary accommodation and a rise of 134% in rough sleepers. It is estimated 4,751 people bedded down outside overnight in England in 2017, up 15% on previous year. The housing charity Shelter used data from four sets of official 2016 statistics and calculated 254,514 people in England were homeless.


title: Homelessness

text: The Homelessness Reduction Act 2017 places a new duty on local authorities in England to assist people threatened with homelessness within 56 days and to assess, prevent and relieve homelessness for all eligible applicants including single homeless people from April 2018. Before the 2017 HRA, homeless households were defined and measured as those who were owed a 'main homelessness duty' by local authorities. But since 2018, the definition of homeless households has broadened as households are owed a new relief duty and a prevention duty. The main homelessness duty definition has not been changed by the 2017 HRA. However, these households are now only owed a main duty if their homelessness has not been successfully prevented or relieved. In 2019–20, 288,470 households were owed the new prevention or relief duties, which is four times the number of households owed the 'main duty' in 2017–18 prior to implementation of the Homelessness Reduction Act.


title: Homelessness

text: The picture in Scotland is considerably different, with law that entitles everyone to a roof over their head if they are homeless. This accommodation is often in the form of somewhere temporary, until something permanent becomes available. Though across the course of 2022 this will change, reducing the use of temporary accommodation, in line with the Homeless and Rough Sleeping Action Group (HARSAG) recommendations. Currently people are spending an average of 199 days(April 2020 to March 2021)in temporary accommodation before being housed in somewhere permanent.


title: Homelessness

text: Most recently updated in October 2020, Scotland is working to eradicate homelessness through the 'Ending Homelessness Together' action plan. It is anticipated that with this, alongside a focus on prevention, and Local Authorities working with the third sector on plans known as Rapid Rehousing Transition Plans, that people will no longer be homeless for any length of time.


title: Homelessness

text: In terms of figures, in 2020/21, there were 42,149 people in homeless households – 30,345 adults and 11,804 children in Scotland. This was a drop of 9% from the previous year, though it is unclear if this was partly due to statistics being collected differently during the start of the pandemic.


title: Homelessness

text: After Franklin D. Roosevelt took over the presidency from Herbert Hoover in 1933, he oversaw passage of the New Deal, which greatly expanded social welfare, including providing funds to build public housing. This marked the end of the Great Depression. However, the number of homeless people grew in the 1980s, when Ronald Reagan decimated the public housing budget in the 1980s, including the federally funded affordable housing production put in place by the New Deal. By the mid-1980s, there was a dramatic increase in family homelessness. Tied into this was an increasing number of impoverished and runaway children, teenagers, and young adults, which created a new substratum of the homeless population (street children or street youth).


title: Homelessness

text: In 2015, the United States reported that there were 564,708 homeless people within its borders, one of the higher reported figures worldwide.


title: Homelessness

text: Housing First is an initiative to help homeless people reintegrate into society, and out of homeless shelters. It was initiated by the federal government's Interagency Council on Homelessness. It asks cities to come up with a plan to end chronic homelessness. In this direction, there is the belief that if homeless people are given independent housing to start, with some proper social supports, then there would be no need for emergency homeless shelters, which it considers a good outcome. However this is a controversial position.


title: Homelessness

text: There is evidence that the Housing First program works more efficiently than Treatment First programs. Studies show that having the stability of housing through the Housing First program will encourage homeless people to focus on other struggles they are facing, such as substance abuse. Meanwhile, Treatment First programs promote an "all or nothing" approach which require clients to participate in programs applicable to their struggles as a condition for housing assistance. Treatment First utilizes a less individualistic approach than Housing First and solutions are created under one standard rather than fit to each client's specific needs.


title: Homelessness

text: In 2009 it was estimated that one out of 50 children or 1.5 million children in the United States would experience some form of homelessness each year.


title: Homelessness

text: In 2010 in New York City, where there were over 36,000 homeless people in 2009, there was a mobile video exhibit in the streets showing a homeless person on a screen and asking onlookers and passersby to text with their cellphones a message for him, and they also could donate money by cellphones to the organization Pathways to Housing. In September 2010, it was reported that the Housing First Initiative had significantly reduced the chronic homeless single person population in Boston, Massachusetts, although homeless families were still increasing in number. Some shelters were reducing the number of beds due to lowered numbers of homeless, and some emergency shelter facilities were closing, especially the emergency Boston Night Center. In 2011, the Department of Veterans Affairs Supportive Services for Veterans Families Initiative, SSVF, began funding private non-profit organizations and consumer cooperatives to provide supportive services to very low-income veteran families living in or transitioning to permanent housing.


title: Homelessness

text: In 2019, in an interview with CBS News, scholar Sara Goldrick-Rab said that her study on college student homelessness found that "[n]early one in ten college students said they were homeless in the last year, meaning they had at least one night where they did not know where they were going to sleep."


title: Homelessness

text: According to the count by the Puerto Rico Department of Family, in January 2017 there were 3,501 homeless persons in the territory. The study shows that 26% of this population live in the capital, San Juan. Other municipalities percentage of this population was Ponce with 6.3%, Arecibo with 6%, Caguas with 5.3%, and Mayagüez with 4.7%. Results from the study determined that 76% of the homeless population were men and 24% were women and that both men and women populations, were on average age, 40 years old. This steadily increasing population, might have increased more drastically as a result of Hurricane María which caused over 90 billion dollars in damage to the island of Puerto Rico.


title: Homelessness

text: Data provided by the Department of Community Social Development of San Juan, indicates that in 1988 the number of homeless in the municipality was of 368, while in 2017 there are about 877 persons without a home. While the average age for the overall homeless population is 40 years old for both women and men, in San Juan the median is 48 years for men and 43 years for women. Other data obtained showed that more than 50% have university level education. Also it revealed that 35% of men and 25% of women have relapsed more than four times after unsuccessful attempts to reinsert themselves socially. Reasons given to wander are varied with the most common causes being drug abuse (30.6%), family problems (22.4%), financial or economic problems (15.0%), and others such as unemployment, mental health problems, domestic violence, evictions, or lack of support when released from prison.


title: Homelessness

text: In Australia the Supported Accommodation Assistance Program (SAAP) is a joint Commonwealth and state government program which provides funding for more than 1,200 organizations which are aimed to assist homeless people or those in danger of becoming homeless, as well as women and children escaping domestic violence. They provide accommodation such as refuges, shelters, and half-way houses, and offer a range of supported services. The Commonwealth has assigned over $800 million between 2000 and 2005 for the continuation of SAAP. The current program, governed by the Supported Assistance Act 1994, specifies that "the overall aim of SAAP is to provide transitional supported accommodation and related support services, in order to help people who are homeless to achieve the maximum possible degree of self-reliance and independence. This legislation has been established to help the homeless people of the nation and help rebuild the lives of those in need. The cooperation of the states also helps enhance the meaning of the legislation and demonstrates their desire to improve the nation as best they can." In 2011, the Specialist Homelessness Services (SHS) program replaced the SAAP program.


title: Homelessness

text: Homelessness in Indonesia refers to the issue of homelessness, a condition wherein people lack a stable and appropriate place of housing. The number of homeless people in Indonesia is estimated to be up to 3 million people in the country, over 28,000 in Jakarta alone. A number of terms are used to describe homeless people in Indonesia, including "tunawisma", which is used by the government, and "gelandangan", meaning "tramp".


title: Homelessness

text: Squatters and street homeless people are often targeted by police raids who say that homeless people "disturb the attractiveness of the city".


title: Homelessness

text: One cause of homelessness in Indonesia is forced evictions. According to researchers, between the years 2000 and 2005 over 92,000 people were forcefully evicted from their homes.


title: Homelessness

text: Homelessness in New Zealand has been linked to the general issue of lack of suitable housing. The homeless population is generally measured through the country's census and by universities and other academic centres. In 2009, urban homelessness (rough sleepers or improvised dwellings) were estimated at less than 300, while rural homelessness (improvised dwellings) was estimated between 500 and 1000. An additional 8,000–20,000 live in "temporary accommodation unsuited for long-term habitation (caravans, campgrounds, substandard housing and boarding houses)." Homelessness in New Zealand has traditionally been reduced by the provision of state housing, similar to Germany and other developed countries.


title: Homelessness

text: Statistical authorities in New Zealand have expanded their definition of homelessness to include 'people living in improvised shelters', 'people staying in camping grounds/motor camps' and 'people sharing accommodation with someone else's household'.


title: Homelessness

text: The issue is believed to have become increasingly visible in recent years. Media in New Zealand have published an accusatory account of the presence of homeless people in public spaces, positioning homeless men as disruptive threats. Though community members have shown support though writing opinion pieces.


title: Homelessness

text: In late January 2019, the "New York Times" reported rising housing prices to be a major factor in the increasing homelessness in New Zealand so that "smaller markets like Tauranga, a coastal city on the North Island with a population of 128,000, had seen an influx of people who had left Auckland in search of more affordable housing. Average property values in Tauranga had risen to $497,000 from $304,000 in the last five years, and Demographia now rated it among the 10 least affordable cities in the world — along with famously expensive locales such as Hong Kong, San Francisco, Sydney and Vancouver, British Columbia."


title: Homelessness

text: In mid August 2019, the Associate Housing Minister Kris Faafoi and Social Development Minister Carmel Sepuloni announced that the Government would be launching a NZ$54 million program to tackle homelessness in New Zealand. This includes investing $31 million over the next four years for 67 intensive case managers and navigators to work with homeless people and a further $16 million for the Sustaining Tenancies Programme. This funding complements the Government's Housing First programme.


title: Homelessness

text: After the abolition of serfdom in Russia in 1861, major cities experienced a large influx of former peasants who sought jobs as industrial workers in rapidly developing Russian industry. These people often lived in harsh conditions, sometimes renting a room shared between several families. There also was a large number of shelterless homeless. Immediately after the October Revolution a special program of "compression" () was enabled: people who had no shelter were settled in flats of those who had large (4, 5, or 6-room) flats with only one room left to previous owners. The flat was declared state property. This led to a large number of shared flats where several families lived simultaneously. Nevertheless, the problem of complete homelessness was mostly solved as anybody could apply for a room or a place in dormitory (the number of shared flats steadily decreased after large-scale residential building program was implemented starting in the 1960s).


title: Homelessness

text: By 1922 there were at least 7 million homeless children in Russia as a result of nearly a decade of devastation from World War I and the Russian Civil War. This led to the creation of a large number of orphanages. By the 1930s the USSR declared the abolition of homelessness and any citizen was obliged to have a propiska – a place of permanent residency. Nobody could be stripped of propiska without substitution or refuse it without a confirmed permission (called "order") to register in another place. If someone wanted to move to another city or expand their living area, he had to find a partner who wanted to mutually exchange the flats. The right for shelter was secured in the Soviet constitution. Not having permanent residency was legally considered a crime.


title: Homelessness

text: After the breakup of the USSR, the problem of homelessness sharpened dramatically, partially because of the legal vacuum of the early 1990s with some laws contradicting each other and partially because of a high rate of frauds in the realty market. In 1991 articles 198 and 209 of Russian criminal code which instituted a criminal penalty for not having permanent residence were abolished. In Moscow, the first overnight shelter for homeless was opened in 1992. In the late 1990s, certain amendments in law were implemented to reduce the rise in homelessness, such as the prohibition of selling last flat with registered children. In 2002, there were 300,000 homeless people in Moscow.


title: Homelessness

text: Nevertheless, the state is still obliged to give permanent shelter for free to anybody who needs better living conditions or has no permanent registration, because the right to shelter is still included in the constitution. Several projects of special cheap 'social' flats for those who failed to repay mortgages were proposed to facilitate mortgage market.


title: Homelessness

text: In 2022, it was reported that Russian authorities were targeting homeless people to conscript them into the war in Ukraine.


title: Gary M. Heidnik

text: Gary Michael Heidnik (November 22, 1943 – July 6, 1999) was an American criminal who kidnapped, tortured, and raped six women, murdering two of them, while holding them captive in a pit in his basement in Philadelphia, Pennsylvania. He was sentenced to death and executed by lethal injection in July 1999.


title: Gary M. Heidnik

text: Gary Heidnik was born on November 22, 1943, in Eastlake, Ohio, a suburb of Cleveland, to Michael and Ellen Heidnik. He had a younger brother, Terry. After their parents divorced in 1946, the Heidnik children were raised by their mother for four years before being placed in the care of their father and his new wife. Heidnik would later claim he was emotionally abused by his father. He suffered a lifelong problem of bed wetting and said his father would humiliate him by forcing him to hang his stained sheets from his bedroom window, in full view of their neighbors. After his son's arrest, Heidnik's father denied the abuse allegations.


title: Gary M. Heidnik

text: At school, Heidnik did not interact with his fellow students and refused to make eye contact. When a well-meaning, new female student asked, "Did you get the homework done, Gary?", he yelled at her, and told her she was not "worthy enough" to talk to him. Heidnik was also teased about his oddly shaped head, which he and Terry claimed was the result of a young Heidnik falling out of a tree. Nonetheless, Heidnik performed well academically and tested with an I.Q. of 148. With the encouragement of his father, 14-year-old Heidnik enrolled at the Staunton Military Academy in Staunton, Virginia, for two years, leaving before graduation. After another period in public high school, he dropped out and joined the United States Army when he was 17.


title: Gary M. Heidnik

text: Heidnik served in the Army for thirteen months. During basic training, his drill sergeant graded him as "excellent." He applied for several specialist positions, including the military police, but was rejected. He was sent to San Antonio, Texas to be trained as a medic, and did well through medical training. However, he did not stay in San Antonio very long and was transferred to the 46th Army Surgical Hospital in Landstuhl, West Germany. Within weeks of his new posting in Germany, he earned his GED. In August 1962, Heidnik began complaining of severe headaches, dizziness, blurred vision, and nausea. A hospital neurologist diagnosed Heidnik with gastroenteritis and noted that he also displayed symptoms of mental illness, for which he was prescribed trifluoperazine. In October 1962, Heidnik was transferred to a military hospital in Philadelphia, Pennsylvania, where he was diagnosed with schizoid personality disorder and consequently honorably discharged from military service.


title: Gary M. Heidnik

text: Shortly after his discharge, Heidnik became a licensed practical nurse and enrolled at the University of Pennsylvania, only to drop out after a single semester. He worked at a Veterans Administration hospital in Coatesville, but was fired for poor attendance and rude behavior towards patients. From August 1962 until his arrest in March 1987, Heidnik spent time in and out of psychiatric hospitals and had attempted suicide at least thirteen times. In 1970, his mother who had been diagnosed with bone cancer and was suffering the effects of alcoholism, committed suicide by drinking mercuric chloride. His brother Terry also spent time in mental institutions, and attempted suicide multiple times.


title: Gary M. Heidnik

text: In October 1971, Heidnik incorporated a church called the "United Church of the Ministers of God", initially with a mere five followers. In 1975, he opened an account under the church's name with Merrill Lynch. The initial deposit was $1,500. Heidnik eventually amassed over $500,000 (US$ in 2010). By 1986, the United Church of the Ministers of God was prosperous and opulent.


title: Gary M. Heidnik

text: Heidnik used a matrimonial service to meet his future wife, Betty Disto, with whom he corresponded by mail for two years before proposing to her. Disto arrived from the Philippines in September 1985 and married Heidnik in Maryland the following month, on October 3. The marriage rapidly deteriorated after she caught him abed with a trio of other women. Throughout the course of their brief marriage, Heidnik forced his wife to be an onlooker while he performed intercourse with other women. Disto also accused Heidnik of repeatedly raping and assaulting her. With the help of the Filipino community in Philadelphia, she was able to leave Heidnik in January 1986. Unknown to Heidnik until his ex-wife requested child support payments in 1987, he had impregnated Disto during their short marriage. On September 15, 1986, she gave birth to a son, whom she named Jesse John Disto.


title: Gary M. Heidnik

text: Heidnik also had a child with Gail Lincow, a son named Gary Jr. The child was placed in foster care soon after his birth. Heidnik had a third child with another woman, Anjeanette Davidson, who was illiterate and mentally disabled. Their daughter, Maxine Davidson, was born on March 16, 1978, and immediately placed in foster care. Shortly after Maxine's birth, Heidnik was arrested for the kidnapping and rape of Anjeanette's sister, Alberta, who had been living in an institution for the mentally disabled in Penn Township.


title: Gary M. Heidnik

text: In 1976, Heidnik was charged with aggravated assault and carrying an unlicensed pistol after shooting at the tenant of a house he offered for rent, grazing the man's face.


title: Gary M. Heidnik

text: In 1978, Heidnik signed out Alberta, the sister of his then-girlfriend Anjeanette Davidson, from the Penn Township mental institution on day leave and proceeded to imprison her in a locked storage room in his basement. After she was found and returned to the hospital, examination revealed that she had been raped and sodomized, and that she had contracted gonorrhea. Heidnik was arrested, charged and convicted of kidnapping, rape, unlawful restraint, false imprisonment, involuntary deviant sexual intercourse, and interfering with the custody of a committed person. The original sentence was overturned on appeal and Heidnik spent three years of his incarceration in mental institutions prior to being released in April 1983, under the supervision of a state-sanctioned mental health program.


title: Gary M. Heidnik

text: After his wife Betty Disto left him in 1986, Heidnik was arrested yet again and charged with assault, indecent assault, spousal rape, and involuntary deviant sexual intercourse.


title: Gary M. Heidnik

text: On November 25, 1986, Heidnik abducted a woman named Josefina Rivera. By January 1987, he had kidnapped another four women, whom he held captive in a pit in the basement of his house at 3520 North Marshall Street in North Philadelphia. The captives, who were all black women, were raped, beaten, and tortured.


title: Gary M. Heidnik

text: One of the women, Sandra Lindsay, died of a combination of starvation, torture, and an untreated fever. Heidnik dismembered her body but had problems dealing with the arms and legs, so he put them in a freezer and labeled them "dog food." He cooked her ribs in an oven and boiled her head in a pot on the stove. Police officers came to his house after his neighbors complained that a nauseating odor was emanating from his residence, but they left the premises after Heidnik explained: "I'm cooking a roast. I fell asleep and it burnt."


title: Gary M. Heidnik

text: Several sources state that Heidnik ground up the flesh of Lindsay, mixed it with dog food, and fed it to his other victims. His defense attorney, Chuck Peruto, said that upon examination of a Cuisinart and other tools in his kitchen, they found no evidence of this. Peruto said that Heidnik made up the story to support the insanity defense. Peruto said that Heidnik started the rumor of cannibalism in public, and that in fact, there was no evidence of anyone eating human flesh.


title: Gary M. Heidnik

text: Heidnik used electric shock as a form of torture. At one point, he forced three of his captives, bound in chains, into a pit. Heidnik ordered Rivera and another woman to fill the hole with water, and then forced Rivera to help him apply electric current from a stripped extension cord to the women's chains. Deborah Dudley was electrocuted to death, and Heidnik disposed of her body in the Pine Barrens in New Jersey.


title: Gary M. Heidnik

text: On January 18, 1987, Heidnik abducted Jacqueline Askins. The youngest of the six victims, Askins was only 18 years old at the time of her abduction. On May 5, 2018, a special report titled "Gary Heidnik's House of Horrors, 30 years later" was aired, and featured an interview in which Askins recounted that Heidnik wrapped duct tape around the mouths of the victims, and stabbed them in their ears with a screwdriver.


title: Gary M. Heidnik

text: On March 23, 1987, Heidnik and Rivera abducted Agnes Adams. The next day, Rivera convinced Heidnik to let her go, temporarily, so she could visit her family. He drove her to a gas station and said that he would wait for her there. She walked to her boyfriend's house; he initially wanted to confront Heidnik, but then decided to call the police instead. The responding officers, noting chafing from chains on her leg, went to the gas station and detained Heidnik. His purported best friend, Cyril ("Tony") Brown, was also arrested. Brown was released on $50,000 bail and an agreement that he would testify against Heidnik. In part, Brown admitted that he had witnessed Lindsay's death in the basement and he also admitted that he had witnessed Heidnik's dismemberment of her body. Shortly after his arrest in April 1987, Heidnik attempted to hang himself in his jail cell.


title: Gary M. Heidnik

text: At Heidnik's arraignment, he claimed that the women were already in the house when he moved in. At trial, Heidnik was defended by A. Charles Peruto, Jr., who attempted to prove that Heidnik was legally insane. Heidnik's insanity claim was successfully rebutted by the prosecution led by Charles F. Gallagher, III. The fact that he successfully amassed approximately $550,000 through his brokerage account was used to prove that he was an astute investor, and therefore not insane. Testimony which was given by his Merrill Lynch financial advisor, Robert Kirkpatrick, was also used to prove Heidnik's mental competence. Kirkpatrick called Heidnik "an astute investor who knew exactly what he was doing." On July 1, 1988, Heidnik was convicted of two counts of first degree murder, six counts of kidnapping, five counts of rape, four counts of aggravated assault and two counts of involuntary deviate sexual intercourse. He was sentenced to death and incarcerated at the State Correctional Institution at Pittsburgh. In January 1989, he attempted suicide with an overdose of prescribed thorazine.


title: Gary M. Heidnik

text: In 1997, Heidnik's daughter, Maxine Davidson White, and his ex-wife, Betty Heidnik, filed a suit in federal court in the Eastern District of Pennsylvania, in which they requested a stay of execution on the basis that Heidnik was not competent enough to be executed. After two years of legal proceedings in various courts, on July 3, 1999, the U.S. District Court for the Eastern District of Pennsylvania issued its final ruling, clearing the way for Heidnik's execution.


title: Gary M. Heidnik

text: Heidnik was executed by lethal injection on July 6, 1999, at the State Correctional Institution – Rockview, in Bellefonte, Pennsylvania and his body was cremated. As of 2022, he was the last person to have been executed by the Commonwealth of Pennsylvania. He remains the third of only three people who have been executed in Pennsylvania since the resumption of the death penalty. The other two were Keith Zettlemoyer in May 1995 and Leon Moser in August 1995.


title: Gary M. Heidnik

text: Heidnik was one of seven real-life murderers upon whom author Thomas Harris based Jame "Buffalo Bill" Gumb, the villain of his 1988 novel "The Silence of the Lambs".


title: Gary M. Heidnik

text: In 2003, the extreme metal band Macabre (band) released a song about Heidnik called Morbid Minister, on their album Murder Metal.


title: Gary M. Heidnik

text: In 2018, the band SKYND released a song which was based on the events, featuring Jonathan Davis from Korn.


title: Gary M. Heidnik

text: On January 16, 2021, the Oxygen Channel aired a two-hour special titled "Monster Preacher," in which two of Heidnik's victims recounted his crimes.


title: Manchineel

text: The manchineel tree ("Hippomane mancinella") is a species of flowering plant in the spurge family (Euphorbiaceae). Its native range stretches from tropical southern North America to northern South America.


title: Manchineel

text: The name "manchineel" (sometimes spelled ""manchioneel"" or ""manchineal""), as well as the specific epithet "mancinella", are from Spanish manzanilla ("little apple"), from the superficial resemblance of its fruit and leaves to those of an apple tree. It is also called beach apple.


title: Manchineel

text: A present-day Spanish name is "", "little apple of death". This refers to the fact that manchineel is one of the most toxic trees in the world: the tree has milky-white sap which contains numerous toxins and can cause blistering. The sap is present in every part of the tree bark, leaves, and fruit.


title: Manchineel

text: "Hippomane mancinella" grows up to tall. It has reddish-grayish bark, small greenish-yellow flowers, and shiny green leaves. The leaves are simple, alternate, very finely serrated or toothed, and long.


title: Manchineel

text: Spikes of small greenish flowers are followed by fruits, which are similar in appearance to an apple, are green or greenish-yellow when ripe. The fruit is poisonous, as is every other part of the tree.


title: Manchineel

text: Manchineel is native to the Caribbean, the U.S. state of Florida, the Bahamas, Mexico, Central America, and northern South America.


title: Manchineel

text: The manchineel tree can be found on coastal beaches and in brackish swamps, where it grows among mangroves. It provides excellent natural windbreaks and its roots stabilize the sand, thus reducing beach erosion.


title: Manchineel

text: All parts of the tree contain strong toxins. Its milky white sap contains phorbol and other skin irritants, producing strong allergic contact dermatitis.


title: Manchineel

text: Standing beneath the tree during rain will cause blistering of the skin from mere contact with this liquid: even a small drop of rain with the milky substance in it will cause the skin to blister. The sap has also been known to damage the paint on cars. Burning the tree may cause ocular injuries if the smoke reaches the eyes. Contact with its milky sap (latex) produces bullous dermatitis, acute keratoconjunctivitis and possibly large corneal epithelial defects.


title: Manchineel

text: Although the fruit is potentially fatal if eaten, no such occurrences have been reported in the modern literature. Ingestion can produce severe gastroenteritis with bleeding, shock, and bacterial superinfection, as well as the potential for airway compromise due to edema.


title: Manchineel

text: When ingested, the fruit is reportedly "pleasantly sweet" at first, with a subsequent "strange peppery feeling ... gradually progress[ing] to a burning, tearing sensation and tightness of the throat." Symptoms continue to worsen until the patient can "barely swallow solid food because of the excruciating pain and the feeling of a huge obstructing pharyngeal lump."


title: Manchineel

text: In some parts of its range, many trees carry a warning sign – for example on Curaçao – while others are marked with a red "X" on the trunk to indicate danger. In the French Antilles the trees are often marked with a painted red band roughly 1 metre (3 ft) above the ground.


title: Manchineel

text: Although the plant is toxic to many birds and other animals, the black-spined iguana ("Ctenosaura similis") is known to eat the fruit and even live among the limbs of the tree.


title: Manchineel

text: The tree contains 12-deoxy-5-hydroxyphorbol-6-gamma-7-alpha-oxide, hippomanins, mancinellin, and sapogenin. Phloracetophenone-2,4-dimethylether is present in the leaves, while the fruits possess physostigmine.