ATLANTA — Georgia State University researchers are looking at factors that cause people to remain unhoused, especially in more rural parts of the United States.
Rather than looking solely at economic factors, a new study looked beyond money to behaviors and habits that can contribute to what they call “rural homelessness.”
The study found that nearly 54% of those reporting being unhoused had struggled with opioid use disorder and injection drugs.
“Rural houselessness is very much an issue in the United States, and there are unique challenges that come with it, such as lack of awareness and a lack of resources,” School of Public Health Assistant Professor April Ballard, who co-leads GSU’s Center on Health and Homelessness, said. “When you add the opioid epidemic on top of it, it really exacerbates the problem.”
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More specifically, Ballard said the financial factors that accompany opioid use disorder can make housing instability and being unhoused harsher and more uncertain, while also feeding the cycle by “perpetuating drug use as a coping mechanism.”
The study examined how being unhoused and drug use have shifted over the past decades in the United States.
According to the GSU study, understanding the relationship between drug use, drug-related harms and rural houselessness is not keeping pace with similar information in urban areas, such as big cities.
To learn more, GSU researchers surveyed 3,000 people to look at links between drugs and shelter. 53.7% of those surveyed told researchers they’d experienced being unhoused.
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“The United States (US) is currently experiencing multiple drug-related epidemics that disproportionately impact people who experience houselessness,” the study says. “People who use drugs (PWUD) and experience houselessness have overdose mortality rates that are up to 30 times higher than the US general population. Houselessness has also been associated with multiple HIV outbreaks in recent years.”
The study found that use of drugs, which is made more widespread by various “drug-related epidemics,” is strongly tied to the onset and persistence of houselessness. Likewise, experiencing houselessness adds to higher rates of drug use. That issue is now becoming more common in areas outside of large urban population centers.
“These two US crises – houselessness and drug-related epidemics – are now colliding in rural areas of the US,” the study authors found. “While both houselessness and drug-related harms have historically been concentrated in cities, both have gradually expanded to rural regions across the US over the last two decades, and now disproportionately affect these communities.”
Ballard and her fellow researchers said in the study’s results that the increasing availability of narcotics and prescription opioids have “played a major role in the spread of drug-related epidemics,” to rural areas. These epidemics include infections of HIV, hepatitis C and more.
The rural houselessness is also driven by economic disparities in rural areas, like insufficient public housing, among others.
In addition to the study’s examination of links between the opioid epidemic, including use of fentanyl, and being unhoused, the research said counts of how many Americans are homeless may be inaccurate.
“The Rural Opioid Initiative surveyed people about their experiences with homelessness over the past six months, while Point in Time Counts mandated by the federal Department of Housing and Urban Development quantify the number of people experiencing homelessness on a single night in January,” according to GSU. “Despite this methodological difference, Ballard said her study’s findings suggest that Point in Time Counts significantly underestimate homeless populations in rural areas.”
In Georgia, the most recent Point in Time Count showed 12,290 people reported experiencing homelessness in 2024, a HUD document shows. For the Atlanta area, the city’s Point in Time Count from January 2024 reported 2,867 people in 243 neighborhoods in Atlanta were unhoused, an increase from the year before.
That count is split between those in transitional housing, those unsheltered and those in need of emergency shelter. Between those demographics, 64% of the unhoused were sheltered, while 36% were unsheltered, according to the report by Parters for Home.
“The report found more than 770,000 people were experiencing homelessness on a single night in January 2024, an 18% increase from 2023. This report reflects data collected a year ago and likely does not represent current circumstances, given changed policies and conditions,” HUD said in a statement.
The next count of unhoused individuals will be Jan. 22, just over a week away.
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