The Homeless In Rural America Are Often Undercounted, Underserved : Shots - Health News Homelessness is often considered an urban problem. But rural Americans often experience homelessness as well. Advocates struggle to reach homeless rural residents and connect them with services.

Unsheltered And Uncounted: Rural America's Hidden Homeless

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NOEL KING, HOST:

Homelessness is often considered a problem that affects cities, but one-third of rural Americans say homelessness is a problem in their communities as well - that's according to a recent poll by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. In rural eastern Kentucky, homelessness is a growing problem, as the region's addiction crisis pushes more and more people into need. Mary Meehan of member station WEKU recently found a number of homeless people living in the country on the outskirts of Lexington, Ky.

MARY MEEHAN, BYLINE: Charles Bowers is folding into the passenger seat of my Honda Fit. He's a tall man with a wild beard. We're going to visit rural homeless camps around Fayette County, Ky.

So do these camps have names?

CHARLES BOWERS: No. Bush (ph) (laughter). We don't ever...

MEEHAN: Bowers had been living in these wooded areas, hidden from view, until he recently moved into an apartment. Bowers goes by the nickname Country, fitting for someone who figures he's spent at least half of his 51 years living outside.

BOWERS: A lot of the people in the world don't realize that they one paycheck away from being out here with us.

MEEHAN: He says it's a hard and sometimes dangerous life.

BOWERS: We'll go by where my hut was, where my wife died at.

MEEHAN: Cindy Harrison died of hypothermia last year while he slept beside her. They were together 13 years.

BOWERS: She was a Cherokee Indian. Old high cheek bones, old gray hair - she was beautiful.

MEEHAN: Even after that tragedy, Bowers didn't get out of the camps right away. He says he's an alcoholic and couldn't quit on his own.

BOWERS: I tried to quit drinking out here. I'll tell you what - them seizures, I've had four or five in a day before.

MEEHAN: Right.

BOWERS: And they ain't no fun.

MEEHAN: Those working with the rural homeless say it's a largely hidden problem, and a social safety net stressed by the region's profound addiction crisis means it's a growing problem as well. Jimmy Scott is volunteer coordinator for the Saving Grace Homeless Shelter in Letcher County. It's located in the rural southeast edge of Kentucky. He sees a sad pattern again and again - people may lose a car; without transportation, they lose a job.

JIMMY SCOTT: When their options finally run out, you know, some of them are in tents, even, outside.

MEEHAN: That can have a huge effect on health. Research shows that the unsheltered homeless often live far shorter lives than other Americans. Polly Ruddick runs Lexington's Homelessness Prevention program and has worked with local officials around the state on the issue. She says many are blind to what is happening in their own communities.

POLLY RUDDICK: I had mayors, I had judge-executives flat-out tell me to my face, my community does not have homeless people. And my response was, yes, you do - you just either choose to ignore it or you really don't see it.

MEEHAN: Some of the region's communities now have fewer ways to help as the opioid crisis strains resources. Ginny Ramsey runs the Catholic Action Center in Lexington. A decade ago, she says someone in the shelter who came from a rural place would often find somebody back home who would take them in - not anymore.

GINNY RAMSEY: The safety nets that have been in place are leaking. They always have leaked, but they're getting shredded.

MEEHAN: At the Hope Center across town, officials are trying to change that. They're building a sober community with 48 apartments. Development director Carrie Thayer shows off the work in progress.

CARRIE THAYER: These down here - we have three classrooms, community rooms.

MEEHAN: She says it was clients who had completed the Hope Center's recovery program who pushed hard for the apartments.

THAYER: And at the Hope Center, we're all about, you know, what our clients would need to rebuild their lives. And hands down - a safe, affordable place to live.

MEEHAN: The studio apartments have hardwood floors and big windows; some look out on a horse pasture. The first residents will move in later this summer. Country Bowers also has his own apartment now and is sober. He works for the Catholic Action Center on outreach and advocacy - that includes visiting the camps he called home not too long ago.

BOWERS: When it rains, this creek gets plum up here. It gets deep.

MEEHAN: Stopping in front of a thicket of bushes, he lifts a hand as a signal.

BOWERS: That's what you're looking for out right there, you know. It ain't as thick as I would like it, but you can - still can't see it.

MEEHAN: Barely visible is a patch of blue tent framed by bushes. Bowers spots another tent and moves on. He has many friends out here he calls brothers.

BOWERS: We're going down here. My brother might be down here. He's been out here a lot of years, I'll tell you.

MEEHAN: He's helping his brothers in a new way - one tent at a time, he helps bring this hidden problem into view. I'm Mary Meehan in Fayette County, Ky.

KING: That NPR reporting comes to us through a partnership with the Ohio Valley ReSource.

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