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Posts Tagged ‘Mortality’

Los Angeles California: Homelessness Capital of the United States Mortality Study

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Overview by Teresa Paterson, Intern Fall 2021

A recent study published in the American Journal of Public Health shows that deaths among people experiencing homelessness (PEH) in Los Angeles County almost doubled from 2015 to 2019, increasing from 741 to 1,267 over the course of 5 years.

The study used Point-in-Time homeless counts (extremely flawed data, but all the public information that advocates have available) to obtain data on changes in numbers of PEH in the County, as well as additional demographic surveys to have a breakdown based on age, gender, and race/ethnicity. They then used medical examiner data in order to estimate general mortality trends among PEH as well as cause-specific mortality trends compared to the general LA County population.

Based on this data, the study found PEH had an almost 3 times higher risk of mortality compared to the general population of LA County. This disparity was even higher when looking at specific causes of death: PEH were 35 times more likely to die of drug overdoses; 15.3 times more likely to die of traffic injury; 14.3 times more likely to die of homicide, and 7.7 times more likely to die of suicide. Additionally, while the study found that White PEH had a higher mortality rate than Black PEH, they also stated that Black people accounted for 34% of homeless compared to 9% of the general population. The authors suggest that both the over-representation of Black people among PEH and their lower mortality rate compared to White PEH were likely a result of racism and discrimination – Black PEH were more likely to become homeless due to socioeconomic conditions tied to systemic racism while White PEH were more likely to accumulate a combination of mental, behavioral, and physical conditions over time before becoming homeless.

Having a better understanding of mortality trends among PEH is crucial for governments to create and implement more effective public health policies that address the dangers of homelessness. LA County used the results of this study to inform the establishment of a homeless mortality prevention initiative. The study demonstrated that drug overdoses increased by 69% from 2015-2019, becoming the leading cause of death in 2017. Given the increased risk of drug overdoses, the initiative decided to prioritize policies that improved substance use disorder services and increased interim and permanent housing options for people receiving treatment for substance use disorder.

If governments want their policies to truly address the needs of PEH in their community and to prevent deaths, they must have accurate data and knowledge of the dangers PEH face as a result of homelessness. Homelessness is a matter of life or death; this study drives home the serious health impacts homelessness has on PEH and the urgency for governments to take immediate action to end homelessness.

For 2021, Shine a Bright Light on the Dark Truth About Homelessness

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A year-end reflection from Bobby Watts, CEO of the National Health Care for the Homeless Council, and Donald Whitehead Jr., Executive Director of the National Coalition for the Homeless

Thirty years ago, the truth that homelessness is not inevitable led to the first Homeless Persons’ Memorial Day, held each year on December 21 — the first day of winter and the longest night of the year. The observance of Homeless Persons’ Memorial Day, which is now held in more than 100 cities in the U.S. and other nations, began through a partnership of the National Health Care for the Homeless Council and the National Coalition for the Homeless with three objectives: 1) to shine a bright light on the dark truth that homelessness kills; 2) to ensure that those who died are not forgotten; and 3) to mobilize action to end what is often a death sentence — homelessness.

For too many people experiencing homelessness, each commemoration may be their last. Thousands of Americans experiencing homelessness die prematurely and unnecessarily in the world’s richest nation. Communities of color, especially African American and Native American populations, experience homelessness and die at disproportionate rates from this painful and persistent reality. In 2020, Homeless Persons’ Memorial Day was marked by the twin hopes of defeating a worldwide pandemic and achieving a more perfect union in the U.S. with racial justice that is long overdue. 

A public policy change from 40 years ago was largely responsible for creating the present-day scale of homelessness — and different public policies can end it. The rise in homelessness coincides with cutting more than three-quarters of the federal funding between 1979 and 1982 that makes housing affordable for poor people. The budget cuts were not a matter of the country not being able to afford the subsidies, but of ideology. We know this because at around the same time, federal subsidies for homeownership — which overwhelmingly go to the wealthy — increased dramatically, to the point where they now are six times greater than rental subsidies for the poor. This shift in priorities proved to be, quite literally, a death sentence for the most vulnerable.

Society measures what society treasures, and that unfortunately does not always include people experiencing homelessness. We do not know the number of people who die without a home because only a few localities conduct a systematic count. Thanks to two cities that do systematically count homeless deaths, we know they have increased substantially. In New York City, homeless deaths grew by more than 50 percent between 2008 and 2018, and in Los Angeles County, homeless deaths doubled between 2014 and 2019. Several organizations have worked together to create a Homeless Mortality Toolkit to encourage and equip more cities and counties to measure the true scope of the problem and to design interventions that work. We should count our neighbors without homes because people without homes count.

Throughout 2020, COVID-19 taught us an indisputable fact: housing is health care. The critical link between housing and health was further underscored when the Centers for Disease Control issued a moratorium on evictions. The moratorium, which had been slated to end on December 31, has been extended until January 31. If the moratorium ends, almost five million households will be at risk of eviction. If that happens, one study estimates these evictions would cause an additional 10,700 excess deaths nationally.

Homeless deaths are not inevitable. The President-Elect is the first in 40 years to propose that funding for affordable housing be available at a level where every qualifying household receives rental subsidies. That means we need to be speaking up. Urge your public officials to end the national shame of homelessness now.

Let the 2020 Homeless Persons’ Memorial Day be our last.

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