Homelessness is a life-threatening condition.
That has to be the conclusion drawn from recent reports and studies that underscore the heightened risk of dying homeless people face.
The notion that homeless people tend to die earlier than people with housing is not a new one. Research for years has pointed that out.
But the depth of the problem is reinforced by recent statistics in San Diego and a new study that says it provides “the first detailed and accurate picture of mortality patterns among people experiencing homelessness in the U.S.”
Since January, preliminary data from the San Diego County medical examiner shows 550 homeless people have died throughout the region, according to a report by Blake Nelson of The San Diego Union-Tribune. That’s four times higher than the number of deaths 10 years ago.
“This is the third year in a row to see deaths top 500 as the number of people becoming homeless continues to rise,” Nelson wrote in his Nov. 20 story.
A study released last month by the National Bureau of Economic Research found that non-elderly people experiencing homelessness have 3.5 times the mortality risk of those who are housed, and that a 40-year-old homeless person faces a similar mortality risk to a housed person nearly 20 years older.
The causes of death vary but are similar in San Diego and across the nation: drug overdoses, chronic health problems, accidents, suicides and homicides, among other things.
The bureau’s study was conducted by researchers from the University of Chicago and the University of Oxford. The paper noted that “within the homeless population, employment, higher incomes, and more extensive observed family connections are associated with lower mortality.”
Homeless people are more likely to be male — especially compared with the housed poor — are more likely to be Black, and are more concentrated in the Northeast and West, which the study says reflects the large homeless populations in New York and California.
The study points out that while Black people have a higher mortality risk than White people among the housed population, it’s the reverse within the homeless population. The study found in part that pattern is connected to “a lower prevalence of substance abuse and behavioral health conditions among Black homeless individuals. . .”
The study looked at 140,000 people between the ages of 18 and 54 who were homeless during the 2010 census and tracked them with Social Security Administration records through 2022.
The authors added some cautionary notes about their research. While the subjects of the study were homeless in 2010, the researchers could not determine their living situations at other points in time, and suggested many people likely transitioned between sheltered and unsheltered homelessness.
Further, the researchers pointed to other studies that showed that unsheltered people had a higher risk of dying than sheltered people. But their study showed mortality appeared to be similar between sheltered and unsheltered people in 2010.
The mortality risk for homeless people was fairly consistent among all states with one exception: New York, where the study found the mortality risk was about 13.4 percent lower.
The researchers said New York’s lower risk can’t be attributed to differences in demographics, income or type of homelessness because the study took into account such variables. Nor does it reflect differences in disability status or involvement in safety net programs.
It may be a matter of more resources.
“One possible explanation lies in the generosity of homelessness services in New York, where a court-mandated ‘right to shelter’ policy has increased the availability and quality of shelter beds,” the authors wrote. “. . . Better services could improve the health of people experiencing homelessness.”
California voters strongly support a right to housing, according to a 2021 poll conducted by the Los Angeles Business Council Institute and the Los Angeles Times. Seventy-two percent said they support such a right, while a slim majority — 51 percent — said they would back new taxes for permanent homeless initiatives.
In 2020, Gov. Gavin Newsom vetoed a bill that would have guaranteed a right to housing, expressing concern about its estimated cost of more than $10 billion a year.
Homeless people have different needs but there’s broad agreement it’s most essential to provide them with permanent housing, or at least temporary shelter.
In commenting on the mortality study, Dr. Margot Kushel, a UC San Francisco professor who specializes in the impacts of homelessness on health, told the San Francisco Chronicle that’s the bedrock issue.
Treatments like medication for substance abuse are important but they’re harder to provide when the patient is experiencing homelessness, she said.
A separate study authored by Kushel found older homeless adults in Oakland have a substantial likelihood of dying earlier than housed people in the same age group.
“We’re letting people die because we’re not fixing the underlying crisis,” Kushel said.
For months on end in San Diego, more people have become homeless than homeless people have obtained housing. The Union-Tribune’s Nelson noted health care experts said that means more people on the street with untreated and exacerbated conditions.
“Everyone should be grieving the loss of these neighbors,” Megan Partch, Father Joe’s Villages’ chief health officer told Nelson.
“Until there is enough housing in our community for all of us to thrive, our belief is that this tragedy will continue.”
What they said
Jason Carter, during his eulogy at the tribute service for his grandmother, Rosalynn Carter, which was attended by every living first lady.
“Secretary Clinton and Dr. Biden, we also welcome your lovely husbands.”
