Why are there so many unsheltered homeless people on the West Coast of the US?

Homelessness in Anaheim, California. Image: Getty.

One-quarter of homeless people in the U.S. live in California, despite Californians making up only 12 per cent of the population.

Not only is homelessness more common on the West Coast: it is also more visible, because a higher proportion of homeless people are unsheltered. In the U.S., 24 per cent of homeless people sleep outside, in vehicles or somewhere else not meant for human habitation. But that varies greatly from place to place: in California, 68 per cent of homeless people are unsheltered, compared to just 5 per cent in New York.

Visitors to the West Coast may be shocked to find the tents that line cities from San Diego to Seattle. Like a modern-day “Grapes of Wrath,” the tents are a stark reminder of the suffering of the thousands living outside, homeless.

What’s to blame for such high numbers of unsheltered homeless on the West Coast? The reason isn’t drug use, mental health problems or weather. Rather, it is due to the extreme shortage of affordable housing.

Life unsheltered

As a physician and researcher who provides medical care for people experiencing homelessness, I have seen firsthand how devastating homelessness is to health.

Being unsheltered is terrifying, humiliating and isolating. People living without shelter lack access to toileting facilities, sinks and showers. They have no way to store or prepare food and no protection from the elements. Hunger is common.

Sleeping in makeshift beds or on the ground, they get little sleep. They must contend with having their possessions stolen. They face frequent forced moves, which disrupt relationships and make it difficult for family, friends or service providers to find them.

People who are unsheltered are at high risk of physical and sexual abuse. If they struggle with substance use disorders, their use of drugs and alcohol occurs in public, leaving them open to arrest. There are no places to refrigerate or store medicines, no place to receive mailed appointment reminders or a visit from a visiting nurse, no place to dress a wound or plug in medical equipment like oxygen. Without access to hygiene facilities, they are at high risk for communicable diseases like hepatitis A.


Unaffordable housing

Some assume that homelessness is so common on the West Coast because people move here when they become homeless, but the data does not support this. Most people experience homelessness close to where they lost their housing. My team’s research in Oakland found that 81 per cent of older adults who are homeless became homeless in the Bay Area. Only 10 per cent had lost their housing outside of California.

Instead, the high rate of homelessness can be attributed to the lack of affordable housing in these regions. The West Coast suffers from rising costs of rental housing, stagnant incomes for low-wage workers and a decline in federal support for affordable housing. For example, California has gained 900,000 renter households since 2005, but lost $1.7bn in state and federal funding for affordable housing.

Extremely low-income households – defined as those with income less than 30 per cent of the area median income – are at the highest risk of homelessness. Nationally, there are only 35 units available for every 100 extremely low-income households.

In the West, these shortages are more severe: Nevada has 15 units available for every 100 extremely low-income households; California has 21.

In 2017, for the first time in 13 years, Los Angeles opened its wait list for housing choice vouchers. These vouchers allow households to pay 30 per cent of their income in rent, with the rest paid by the government. There were 600,000 applicants for just 20,000 spots on the list, highlighting the enormous unmet need.

Who pays for homeless services

Why are people on the West Coast so much more likely to be unsheltered than homeless people in other parts of the country? It reflects differing government priorities .

New York City, where there is a legal right to shelter, spends approximately $17,000 per homeless person per year on homeless services. Massachusetts spends approximately $14,000 per year. Los Angeles, by contrast, spends approximately $5,000.

With enormous numbers of people living outside, West Coast cities are scrambling for solutions. Some cities, like Seattle, have created sanctioned homeless encampments, bringing hygiene facilities and other services. However, the U.S. Interagency Council on Homeless cautions that this approach is costly and doesn’t provide a solution to homelessness.

Other cities are following San Francisco’s example and creating navigation centres, homeless shelters with added services. Unlike typical shelters, these centres allow people to come in groups, bring pets and belongings and stay all day.

Many areas have passed tax increases to fund new housing and services. These efforts show modest success but continue to struggle against the unfavorable housing conditions that lead people to become homeless in the first place.

So where can we go from here? There are solutions to homelessness, but, in my view, these will not succeed without solving the affordable housing crisis that is the underlying cause of homelessness.

For people who are chronically homeless and have disabling conditions, permanent supportive housing is highly effective. This type of subsidised housing offers supportive services, without the requirement that people be sober or engaged in medical care. Studies show that expanding permanent supportive housing has reduced the number of people experiencing homelessness in many parts of the country.

The success of permanent supportive housing has been overshadowed by increases in people becoming newly homeless due to the lack of affordable housing. In my view, preventing and ending homelessness will require a commitment to creating housing that is affordable to all.

Margot Kushel, Professor of Medicine, University of California, San Francisco.

This article was originally published on The Conversation. Read the original article.

 
 
 
 

How the rise of anti-crime politics caused lasting harm to Black Americans

"I see an awareness that has developed in the Black community in the last 10 years or so about how deeply racist the criminal justice system has become," James Forman Jr. says. (David McNew/Getty Images)

The police killing of George Floyd, and the protest movement that emerged from it, has reinvigorated a national conversation around reinventing criminal justice policy in the United States.

At the same time, reports that violent crime is rising in many US cities have resurrected talk of the much-disputed “Ferguson effect,” a theory put forward by law enforcement professionals, and some researchers, who argued that police slowdowns in the wake of the first wave of Black Lives Matter protests resulted in elevated rates of violent crime. President Donald Trump is trying to weaponise this narrative, paired with images of federal officers clashing with protesters in the streets of Portland, to wage a 1968-style backlash election campaign.

“People who want to mobilise a lock-them-up style of either policing or prosecution have tried to weaponise those short-term increases,” says James Forman Jr., professor of law at Yale Law School. “Criminologists will say you have to be very, very cautious about short-term movement [in crime statistics]. We don't know whether or not what we're seeing right now [with violent crime increasing] is going to sustain itself. But the fact is, it's here and people are talking about it.”

In 2018, Forman won the Pulitzer Prize in nonfiction for his book Locking Up Our Own: Crime and Punishment in Black America. Drawing on his experience as a public defender in Washington, DC, he traced the emergence of anti-crime politics in late 20th century Black communities. Forman showed how newly empowered Black politicians fought for policies they believed would protect and uplift Black Americans, but inadvertently contributed to mass incarceration. 


CityMetric recently caught up with Forman to discuss crime trends, where he sees reason for hope in this moment and how the Black political class’s attitude toward crime and punishment has shifted since the latter part of the 20th century. 

This interview has been edited and condensed. 

There is talk right now about a resurgence of crime and violence in American cities. We saw similar, more localised concerns after the initial 2015 Black Lives Matter protests in Ferguson and Baltimore. Do you fear this could reinvigorate the kind of politics you describe in your book among segments of the Black community and political class?

I fear that it could be reinvigorated nationally and also in the Black political class. Look at the political conversations that are happening in Atlanta right now, for example, a city that also has seen a short-term uptick in crime as it is a site of a lot of protests about George Floyd and Breonna Taylor on the national level, as well as Rayshard Brooks and Ahmaud Arbery more locally in Georgia.

I think that you can already see in some of the language of the local elected officials this idea that we have to be very careful about pulling back. [They are saying] “while the protesters may make some valid points, we can't risk returning to the ‘80s and ‘90s.” Those decades really traumatised the United States, and particularly traumatised Black communities. There's a deep fear about returning to the levels of the violence that we saw in the crack years.

You write a lot about class divides among Black Americans, where middle income and elite Black people don't suffer as much from extremely punitive policies. They also have closer ties to the politicians who are creating these policies. There are very specific groups of people, even in marginalised communities, whose voices are heard.  As a result of these dynamics, you write about Black politicians fighting for things like mandatory minimum prison sentences or against decriminalising marijuana. Is there still that disconnect between those who suffer the most from criminal justice policies and those who are actually heard in political discourse?  

Let me just say a caveat, that when we talk about class divisions in the Black community it's important to hold two truths in our head at the same time. Bruce Western and others have shown the way in which class, educational status, income can dramatically reduce the likelihood of being hardest hit by the criminal system – namely incarcerated. Middle class and upper middle class Black people get some measure of protection. It's also true at the same time that Black people of all classes are worse off relative to their class counterparts in the white community. 

One area where class is least protective is policing and police stops. The police do not know how many degrees you have. They don't know how much money you have in your bank account. I want to be very clear that in making this point about class, I'm not making the argument that race or racism don't matter in this context. 

In terms of how it plays out now, I see an awareness that has developed in the Black community in the last 10 years or so about how deeply racist the criminal justice system has become. Twenty or 30 years ago they had a consciousness, but there's levels of understanding. Many of the people I write about in the book wanted to promote the interests of the Black community. They weren't motivated by indifference or callousness. When presented with mounting evidence of how awful this system has been in Black lives, they're reconsidering and recalibrating. 

Lots of former elected officials have said to me some version of “I didn't know at the time and I appreciate that you showed us in our full complexity. I appreciate that you showed the pressures we were under. If I had known then what I know now, maybe I would have been less quick to go along with some of these harsh measures.” 

The second thing that has affected the Black political class has been the emerging movements, led by Black people in particular and led by young people. They not only educated leaders, but pressured them and made them understand that there is a political cost. If you're not moved by the moral argument, then you'll be moved by the political argument. You'll be moved by the people protesting outside the office of District Attorney Jackie Lacey in Los Angeles, for example, where Black Lives Matter LA has held, I believe, a year of consecutive protests against a Black district attorney who has had really some of the worst practices.

From what I can tell, she's been pressured by the movement to change some of her positions on important issues like prosecution of low-level drug offenders, for example, and the aggressiveness with which she prosecutes police officers for acts of violence.

What do you make of the calls to defend or even abolish the police?

What I find so compelling about abolition, initially in the prison context and extended to the police as well, is that it shifts the conversation and forces us to go through experiments in which we imagine what it would take to build that world. I think that exercise is very important, because it pushes us further than we are naturally inclined to go. Cultivating a broader imagination is an incredibly important part of this work, because as you know from my book, often it was lack of imagination that caused people to fall back on [punitive policies]. 

That's what caused D.C. Councilmember David Clarke to call the police rather than public health experts when he was overwhelmed with letters about heroin addicts in public space. He was anti-drug war, but he couldn't imagine responding to a call for help with heroin addicts with anything other than police. That's a very common move from even really good and progressive people. 

People who are for defunding, for abolition, are absolutely right about reinvesting that money into alternative structures that support communities. But the reinvestment part doesn't follow naturally from the terms. We might want to come up with a term that captures the new stuff we want to do. I think that's particularly important because one of the reasons Black communities have ended up supporting more police is that Black communities have always wanted their fair share of the resources.

Then, the evidence suggests the United States has too many police officers doing prophylactic, preventative, or stop-and-frisk style policing. The style of policing that leads to district level harassment, pulling people over for no reason. But we have too little investment in the parts of police departments that investigate unsolved crimes. I'm talking about the investigator or the detective who comes to your house after there's been a robbery, an assault, a rape, or homicide. 

As compared to European countries, in the United States we actually underinvest in those parts of our police departments. Jill Leovy’s book Ghettoside shows this in dramatic detail. She describes an LAPD that's stopping and frisking Black drivers wantonly and yet the homicide detectives are still relying on a fax machine and the fax machine is broken. They have to go with their own money to Staples to buy a printer. Meanwhile, other aspects of the department are kitted out in this ridiculous riot gear that makes them look like they're in Fallujah. 

That under investment is particularly damaging to Black communities because we're disproportionately victimised by crime. Because of racism and this allocation of resources, the police are less likely to respond in Black communities. The kids I used to work with in the charter schools in DC, we talk about no snitching, but one of the reasons they would never call the police after they'd been victimised by crime is they would say, “They're not even going to come. You're wasting time.” 

I did a Q&A with Jill Leovy too and her argument is one I've struggled to articulate in our present moment. She argues the state doesn't have a monopoly on violence in low-income Black neighbourhoods, because investigations of violence are deemphasised and crime victims or their loved ones often take retribution into their own hands.  But right now, establishing or preserving the state's monopoly on violence isn't an appealing talking point. 

Yes, this is another thing nobody's talking about. Whatever we're going to do instead of the police has to be accountable to the public. The best, most direct way to have accountability is to have the individuals be public employees. As long as we have 300 million guns in this country at least some of those state employees are going to themselves be armed. It's unreasonable to ask them to do the job without it. Not as many need to be armed as are armed now, but some of them need to be. But they can't be hiding behind union contracts or civil service protections which make it impossible to remove even the worst performing, most abusive officers. 

We can not call them police if we want to. That's semantic, but maybe symbolism matters. But those people have to be state employees. They can work with community-based nonprofits, but there are also communities that don't have as robust of a nonprofit network, and they deserve protection too. These [community] groups have to be accountable to the state and, when they don't exist, the state has to be there. 

Progressives get all the points I just made when it's applied to education. The notion that things be public and accountable to the state is understood when it comes to schools. It's exactly why so many people on the left are opposed to charter schools, because they say they don't have public accountability. They want these things to be a state function. But this point about the difficulty in removing this entirely from the hands of the state is, I think, one that liberals and progressives understand from other contexts.

Jake Blumgart is a staff writer at CityMetric.