Among all homeless clients, 71 percent were interviewed in central cities, 21 percent in suburban areas, and 9 percent in rural areas (table 2.9). This distribution does not vary by whether or not the client is in a family household, nor would it change if one included the children as well as their parents in the analysis. Homeless clients are thus much more likely to live in central cities than the U.S. poor population, 41 percent of whom live in central cities, 35 percent in the suburbs and urban fringe areas, and 23 percent in rural areas outside of metropolitan statistical areas (figure 2.16).

Central city and rural clients do not differ in their sex distribution (71 and 77 percent male), but suburban clients are significantly less likely to be male (55 percent). Suburban clients are also more likely to be white non-Hispanics (54 percent) than clients from either central cities (37 percent) or rural areas (42 percent).

In general, rural homeless clients have experienced fewer and shorter episodes of homelessness during their lifetimes. Fifty-five percent of rural clients have been homeless for three months or less, compared with 22 to 27 percent of central city and suburban homeless clients. In addition, only 27 percent have been homeless for more than a year, compared with 48 percent of central city and 49 percent of suburban clients.

A larger proportion of central city clients (21 percent) report staying in places not meant for habitation than is true for suburban (12 percent) or rural clients (4 percent). Clients from central cities are more likely than those from suburban/urban fringe and rural areas to have used a soup kitchen (68 percent, 50 percent, and 45 percent, respectively) and a drop-in center in their lifetime (30 percent, 18 percent, and 14 percent, respectively). The lack of availability of these programs outside of central cities most likely affects these results.

Central city homeless clients are considerably poorer than other homeless clients. Clients' median income is $250 in central cities, $395 in suburban areas, and $475 in rural areas. Fifteen percent of central city clients report no income over the last 30 days compared with only 6 to 7 percent of other clients.

Rural homeless clients report less access to medical care. Forty-seven percent of rural clients say they needed to see a doctor or nurse in the last year but were not able to do so, compared with 22 percent of homeless clients in both central cities and suburban/urban fringe areas.

Similar proportions (64 to 68 percent) of central city, suburban, and rural clients have a current mental health and/or alcohol and/or drug problem. However, clients from central cities are more likely (25 percent) than those in suburban areas (17 percent) to have current problems with both mental health and alcohol and/or drug use. And clients in both central cities and suburban areas are more likely than rural clients (11 percent) to have such problems.

Thirty-three percent of suburban homeless clients, 24 percent of those from central cities, and 12 percent of those from rural areas report being physically or sexually abused before the age of 18. Incarceration follows the opposite pattern, with the suburbs lowest and rural areas highest. Sixty-four percent of clients from rural areas have spent time in juvenile detention, jail, or state or federal prison, compared with 55 percent of those from central cities and 44 percent from suburban areas.

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