Op-ed: Being unsheltered while homeless is a major health risk—why do we allow this?
Planes fly over the large encampment of homeless residents in San Jose's Columbus Park multiple times a day, as the campsite is just blocks away from Mineta San Jose International Airport. File photo.

California Gov. Gavin Newsom recently announced a plan to channel historic sums of money to address homeless encampments. If that money is to help those communities, it is vital to spend it where it will do the most good. To find those areas we suggest something radical: Talk to people to learn their needs.

Hundreds of Santa Clara County residents live in the Columbus Park encampment, next to the Mineta San Jose International Airport, yet few of us know anything about them. This ignorance is problematic for all of us — for those who are struggling and suffering outdoors, without food, water, bathrooms, and basic health necessities, and for those who could craft policies that would alleviate their suffering.

Other than the biennial point-in-time count, Santa Clara County makes no systematic effort to assess the needs of those experiencing homelessness. As a community, we can do better. In October 2021, we partnered with the Santa Clara County Public Defender’s Office to conduct an assessment of the needs of the community living in the Columbus Park encampment.

During this process, we interviewed 48 current residents, and here’s what we learned: The average length of time that people living in the park have been without formal housing is 7 years and 3 months. Eighty-five percent of people had lived on the streets for more than two years. Although many were new to Columbus Park — 85% had moved there during the pandemic — they were not new to Santa Clara County. In fact, 44% were natives, and 78% have lived here for more than a decade.

The substantial majority of residents were people of color — 72% — and they were disproportionately likely to identify as sexual minorities (LGBTQ, gender-nonconforming).

Their basic needs for hygiene, food and water are largely met via a piecemeal network of nonprofit organizations, and community and church groups. Few of the people we surveyed mentioned any formal support from local government agencies. More than 60% of respondents said they had never been enrolled in the county’s housing program waiting list (VI-SPDAT).

The vast majority of people we met expressed a strong desire for housing, medical care and job opportunities. For them, being homeless isn’t a lifestyle choice. They do not lack the skills or ability to live indoors, but the typical setup of most shelters fails to meet their needs. To thrive indoors, they said they need privacy, accommodation for their accessibility needs, space for beloved pets, and crucially, a sense of independence.

Our work surveying this community on their needs revealed drastic health inequities and areas for improvement. But more than anything, it demonstrated the need for a public health perspective on the ground. It may seem pretty basic to ask community members about their needs, but regions across the country do not study their encampment populations in this fashion. Rather, it is one-size-fits-all and ad hoc. And as a result, we do not always settle on the best interventions, let alone implementation strategies.

Structured needs assessments like the one we conducted at encampments are required to understand these disparities and address them appropriately. By integrating a public health approach that focuses on understanding the roots behind these disparities, we can begin to address the issues through public policies and improve the lives of these individuals.

The authors of this op-ed are Santa Clara County Supervising Public Defender Andy Gutierrez; Santa Clara University Assistant Professor of Public Health Jamie Chang; and public health students Sureena Mann and Karina Gonzales-Lopez.

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