Affluent Seattle has one of the highest numbers of unhoused people in the United States. In 2021 an estimated 40,800 people experienced homelessness in Seattle and King County during the year, not counting the significant number of "hidden" homeless people doubled up with friends or living in and out of cheap hotels. In Skid Road Josephine Ensign uncovers the stories of overlooked and long-silenced people who have lived on the margins of society throughout Seattle's history. How, Ensign asks, has a large, socially progressive city like Seattle responded to the health and social needs of people marginalized by poverty, mental illness, addiction, racial/ethnic/sexual identities, and homelessness? Through extensive historical research, Ensign pieces together the lives and deaths of those not included in official histories of the city. Drawing on interviews, she also shares a diversity of voices within contemporary health and social care and public policy debates. Ensign explores the tensions between caregiving and oppression, as well as charity and solidarity, that polarize perspectives on homelessness throughout the country