Last month, Judge David Carter ordered Los Angeles officials to find shelter for all homeless people in downtown L.A. by October 2021. This follows Mayor Eric Garcetti’s call for spending $1 billion to address the area’s homelessness crisis. These are unprecedented actions that speak to the significant and tragic state of homelessness in Los Angeles, but they reflect urban tensions that have deep roots. The long history of American “skid rows” suggests that solving this crisis requires understanding the true dimensions of the problem and the diverse needs of homeless people, something we have long failed to do.

In the late 19th century, transient workers uprooted by industrialization gathered in cities near job opportunities. The shabby districts they occupied came to be known as skid rows, a name they kept for more than 100 years. Skid rows were primarily home to single men and contained inexpensive lodging, restaurants and bars. Those men who couldn’t afford lodging received help from religious missions, which offered sermons, meals and overnight accommodations. Many police stations and later municipal shelters also offered a place to sleep for a night.

During the Great Depression, as formerly working-class people joined the homeless, crushing need outstripped existing systems of assistance and long bread lines wrapped along city sidewalks as encampments sprouted up everywhere possible, including New York City’s Central Park. President Franklin D. Roosevelt started the Federal Transient Program, a system of shelters designed to keep homeless individuals and families off the streets. This bold program acknowledged that homeless people often lacked the local residency required to access relief programs and funded assistance for localities to distribute.

Yet, even as Roosevelt’s New Deal helped create a federal government-provided social safety net for the first time, programs such as Social Security targeted people with a stable life and home address — which made them ill-suited to help those Americans on skid row.

Instead, on the nation’s skid rows, most assistance came in the form of alcoholism treatment programs, owing to a misunderstanding of the diverse population living there. During the 1940s, when addiction studies were in their infancy, homelessness was seen as “end-stage alcoholism,” even though some on skid row were not especially heavy drinkers and many had taken up heavy drinking only after becoming homeless. This one-size-fits-all approach did little to help people who needed medical care, mental health treatment, job training or those who worked regularly, but did not earn enough to pay for housing.

Yet, instead of addressing the complex roots of homelessness, most of the public outrage about skid rows came from better-off Americans wanting to avoid the homeless having an impact on their lives. Politicians and business owners in districts abutting skid rows complained that their property values suffered due to the presence of homeless people. Homeowners worried about their safety and the trauma their children experienced watching human suffering daily.