In June, the U.S. Supreme Court ruled 6 to 3 in City of Grants Pass v. Johnson that arresting and fining people experiencing homelessness who are camping and sleeping in public spaces does not violate their Eighth Amendment rights against cruel and unusual punishment. The decision opened the door for cities and counties, including in California, to begin clearing homeless encampments and imposing penalties for violations.
Margot Kushel, MD, director of the Benioff Homelessness and Housing Initiative as well as the Action Research Center for Health Equity, formerly the Center for Vulnerable Populations, weighs in on the likely impacts in California and across the country.
How many people in California experience homelessness and how much money is spent on homelessness?
On one night in January, there were 181,600 people estimated to be experiencing homelessness in California, but many more experience homelessness over the course of a year.
The state has spent about $4 billion a year on homelessness over the past five years.
Why is homelessness so common in California?
Wherever you look in the U.S., there is a relationship between the availability of low-income housing, income and homelessness. Today in California there are very few units of housing available and affordable for all the low-income people who need them. There are 24 units of housing available and affordable for every 100 extremely low-income households, and that ranks near the bottom for availability. That's why we're near the top for the rate of homelessness.
What is the likely impact of encampment sweeps and arrests after the Supreme Court decision?
If California jurisdictions enact sweeps and criminalize the behavior, it's likely to deepen homelessness. In many places there are already long wait lists for shelter beds. If you put people in jail, even for just two or three days, they'll come out even more traumatized, with even fewer resources and they will still have no place to be. Having a criminal record is a barrier to employment and a barrier to securing housing.
Encampment sweeps and arrests are also likely to damage trust that outreach teams need to help people who experience homelessness, or even simply to find people.
Your research organization, the Center for Vulnerable Populations, recently changed its name to the Action Research Center for Health Equity (ARC)? Why?
The acronym ARC is inspired by Martin Luther King Jr.'s adage that "… the arc of the moral universe is long but it bends toward justice." Over time, language changes, usage changes. The older terminology of vulnerability tends to place attention on individual deficits, but we really focus more on looking at systems and structures that marginalize some people but not others, leading to health disparities. We conduct research to create change.
Are research findings like yours being used in problem solving by policy makers?
Government officials have been interested in making good policies based on research findings, including ours. We have met with people in city governments, with the state legislature and state cabinet members, and with multiple cabinet secretaries at the federal level, as well as with many staffers at the U.S. Departments of Health and Human Services and Housing and Urban Development. The state has used our research to help shape homelessness and Medicaid policy.
Can you name something unanticipated that you learned from the center's research that might surprise readers?
We found in the California Statewide Study of People Experiencing Homelessness that 90% of people in California who were homeless had previously been stably housed here; and, compared to the entire California population, a greater percentage were born in California.
From your research so far, what do you conclude will best help reduce homelessness?
We found in a controlled study among people who were chronically homeless with mental health and substance use issues that subsidized housing with voluntary services offered kept them stably housed and increased their use of appropriate behavioral health services. But in California, there is just not enough housing. We need to develop housing for all income levels and additional incentives to build low-income housing and maintain the properties. We need more subsidies to help people afford housing, but we need more housing.
