Public Health

In Rural Areas, Homeless People Are Harder To Find — And To Help

Homeless residents often live outdoors in tents in rural Kentucky. Rarely pitched out in the open, like this one in Lexington, most are hidden in thick bushes of wooded areas.
Homeless residents often live outdoors in tents in rural Kentucky. Rarely pitched out in the open, like this one in Lexington, most are hidden in thick bushes of wooded areas.
Credit / Mary Meehan/WEKU
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Charles Bowers takes long, quick strides down a worn, dirt path and stops in front of a tall thicket of bushes. He lifts a hand to signal that he’s spied something.

He’s leading me on a tour of camps made by homeless people in wooded corners of Fayette County, Kentucky, and there, slightly up the hill, is a patch of blue. A tent.

He keeps his voice low to avoid startling those inside.

“That’s what you are looking for right there. It ain’t as thick as I would like, but you still can’t see it,” he says, pointing out what he would look for in a campsite in his homeless days, just a few months ago.

Bowers is tall with a wild beard flecked with gray. His nickname, “Country,” is fitting for someone who figures he’s spent at least half of his 51 years living outside.

Bowers had been living in these wooded areas, hidden from view, until he recently got sober and moved into an apartment.

He says it’s a hard and sometimes dangerous life, living in the elements. He’s seen tragedy out here, witnessing the death of his wife, and of a good friend.

Bowers says he’s met all kinds of people living in camps, and they have all kinds of reasons for being there.

“A lot of people in the world don’t realize it, but they are one paycheck away from being out here with us,” he says.

Invisible problem

Homelessness is often considered an urban phenomenon. But those who work on homeless issues in Kentucky, say rural homelessness is a growing problem, too. That’s true across the state and across the country. The Robert Wood Johnson Foundation, NPR, and the Harvard T.H. Chan School of Public Health reported in May that one in three rural Americans say homelessness is a problem in their communities.

And in many rural places around the country, the ongoing addiction epidemic strains the social safety net, which advocates say puts more rural people at risk of becoming homeless. But the scattered and hidden nature of homelessness in rural places makes it an especially hard problem to measure and address.

Polly Ruddick, who runs the office of Homelessness Prevention and Intervention in Lexington, Ky., has worked for years on homeless advocacy in rural eastern Kentucky. She says that many elected officials in rural areas are not aware there are homeless people in their communities.

“I had mayors and I had judge executives say right to my face, ‘My community does not have homeless people.’ ” says Ruddick. “And my response was, ‘Yes you do. You just either choose to ignore it or you really don’t see it.’ ”

Support for the homeless in small communities is sometimes provided by churches, she says. But they often lack the money and manpower to create a solution equal to the problem. Ruddick says even counting the rural homeless is challenging, especially if there isn’t a community shelter or established outreach system.

“They are invisible,” she says.

Rural funding disadvantage

David Lipsetz, CEO of the Housing Assistance Council, a Washington, D.C.-based non-profit, says most data on the homeless population in the United States is based on “point in time” counts. That means that most local agencies serving the homeless conduct a count of homeless people in their communities during the last 10 days in January when the weather turns cold and people are most likely to seek shelter.

Vast rural spaces and the lack of shelter systems in rural areas makes such a count “largely inaccurate” in rural areas, he says. There needs to be a better model, he says, adding that the Department for Housing and Urban Development’s annual assessment of homelessness did not even include a rural designation in its data collection until recently.

These point-in-time counts determine how federal funding from multiple agencies is allotted to communities, he says, leaving rural counties at a disadvantage.

“The national conversation about housing is almost always based on a number of very large cities with housing pressures,” he says. That leaves the pressures of supply and demand of affordable housing in rural areas often unexplored.

A study from the Institute for Children, Poverty and Homelessness earlier this year took a different research tactic to measure homelessness and found that it is growing in rural places.

According to the report, the number of public school students identified as homeless is rising. The majority of these children, 88%, live in cities, suburbs, and towns. In recent years, however, the highest rate of growth for student homelessness has been in rural America. Between the 2013–14 and the 2016–17 school years, the number of homeless students in rural areas increased by 11% to over 162,000 students.

Josef Kannegaard, principal analyst for the Institute for Children, Poverty and Homelessness, says some of the highest rates of student homelessness are found in western states such as Montana, Wyoming and Nebraska.

He says better information is needed.

“We are still really in kind of the discovery and awareness phase” through much of the country, he says. Once the scope of the problem is known, he says, solutions for the unique challenges of rural homelessness will come next.

Both Lipsetz and Kannegaard say that many people in rural areas who lose housing are doubling up, living with family or friends, sleeping on couches.

But people who work with the rural homeless in Kentucky say many of their clients no longer have that option and they are forced to live outside in camps or in cars.

Unsheltered and at-risk

Compared to urban settings, more rural homeless people are living exposed to the elements.

Ruddick says that many homeless camps in the region she serves are in overgrown, thickly wooded areas and hard to find. Many of those camps also pose a health threat.

Some people have tents, but many build a camp from what they can scavenge, like cardboard, or plastic bags, Ruddick says.

Access to clean water is rare. Human waste is, at best, kept in buckets.

“We clean up a lot of buckets with either human solid waste, or human liquid waste,” she says.

Don’t see the graphic above? Click here.

Conditions like those contribute to disease, such as the Hepatitis A outbreak which has claimed 58 lives in Kentucky so far and sickened approximately 5,000 people, many of them homeless.

According to the National Health Care for the Homeless Council, research shows people without any shelter have, on average, drastically shorter lifespans compared to other Americans, as much as 30 years shorter. And the 2018 homelessness assessment report from the Department of Housing and Urban Development found a greater proportion of rural homeless are unsheltered as compared to suburban and urban homeless populations.

Jimmy Scott is volunteer coordinator and a board member for the Saving Grace Homeless Shelter in Letcher County, in the rural, southeast corner of Kentucky. He says homeless people he encounters might have couch-surfed at first, staying someplace night-to-night with friends or relatives.

But, he says, problems tend to mount. They lose their car. Without available public transportation like a bus, they lose their job.

“When their options are run out, some of them even end up in tents, outside,” Scott says.

When the weather gets bad, things get worse. That is something Charles “Country” Bowers knows all too well. Last year, he lost his wife Cindy Harrison to hypothermia. They were living in a tent.

“We had gone to bed about 4 o’clock in the morning — got up about 9:30. I took the blanket off of her and she was froze,” he said, his voice going soft. “It was rough.”

They had been together for 13 years.

Even after that tragedy, Bowers wasn’t ready to come out of the woods.

“I really don’t like walls too much,” he says. “I never have.”

Repairing the safety net

Compounding the problems of rural poverty, the ongoing addiction crisis is driving more people to homelessness, says Ginny Ramsey who runs the Catholic Action Center, a Lexington shelter that can hold 200 people.

People from rural communities have long drifted into nearby cities like Lexington, she says. A decade ago, if she had someone come to her shelter from a rural place she’d often be able to find somebody back home who would take them in.

That’s not the case anymore.

“The safety nets that have been in place, they are leaking, they have always been leaking,” she says. “Now, they are getting shredded.”

Don’t see the graphic above? Click here.

She says plenty of folks, like Bowers, just can’t make themselves come in from living in the woods or on the streets because of anxiety, PTSD, addiction, or symptoms of mental illness that makes it difficult to be around people, what she calls “general orneriness.”

At Lexington’s Hope Center, another homeless service, development director Carrie Thayer says the increase in opioid use has had a dramatic effect.

Someone can survive as a functional, if struggling, alcoholic for a long time, she says. But drugs like heroin or fentanyl can take people down quickly.

Thayer says Lexington has more affordable housing units available than more rural places. But, she says, much of it is of low quality and in unsafe neighborhoods.

To help offer a safe option, later this summer, the Hope Center is scheduled to open 48 new apartments designed for sober living. At least 60 people have applied to live there already.

Thayer says it has all been made possible by a combination of private donations and local, state, and federal government support.

“When everybody comes together, really amazing things can happen,” she says.

Finding a home, and a cause

“Country” Bowers struggled with alcoholism for year, but he couldn’t quit drinking while living in the woods.

Then a friend died, someone he calls “my brother Ray.” Bowers says the man suffered a heart attack just after they’d gotten up early one morning and had a drink to stave off the shakes.

“I put down the bottle when Ray died,” Bowers says.

It was a little more complicated than that. He went through days of medically supervised detox because he is prone to seizures.

He stayed sober for two weeks, living in the shelter at Lexington’s Catholic Action Center. He spent his days sitting outside the office doors of director Ginny Ramsey.

Eventually, she offered him a job and an apartment.

His new home is in a white wooden house in a poor part of town. He says doesn’t want to show the inside because it needs a good cleaning. His bed was so saggy in the middle he had to put an old door underneath it so it would at least be flat.

Still, he’s grateful. “You take what’s offered,” he says.

He has found a purpose in his loss by sharing his story and advocating for the homeless community. He has appeared at Lexington city council meetings to urge the approval of a mandatory 21-day notice before city workers tear down a homeless camp on public land.

Bowers says he still misses the community he lived with for much of his life:

“When I was out here with them we could all stay together.”


This story was produced by public media’s Ohio Valley ReSource.

ReSource reporter Sydney Boles contributed to this story.

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