It’s not the getting sick that imperils the homeless it’s the inability to get better
All those people would have still been in the hospital in 1985
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Today Ryan Ross joins us to write on the glaring lack of spaces where the unhoused can recover when sick or injured and the need for medical respite shelters around the country.
“It’s not the getting sick that imperils the homeless, it’s the inability to get better,” he says.
“The goal of homeless programs isn’t to put the homeless somewhere we don’t have to see them, but to help people exit homelessness, and that can’t happen with traditional shelters alone.”
Before we get to that the poet Robert Bly has died at the age of 94. Let’s read a couple of his poems.
So too has Gared O’Donnell — of the highly influential and impossible to pin down punk and metal band Planes Mistaken For Stars — died at the age of 44. Let’s listen to one of his songs.
Ok here’s the main thing.
All those people would have still been in the hospital in 1985
by Ryan Ross
For the unhoused, COVID-19 posed something of a paradox.
A highly-transmissible respiratory virus like COVID-19 is particularly dangerous for them. Chronic conditions like COPD and asthma are more prevalent among the homeless, and the congregate living arrangements in shelters and encampments put them at significantly increased risk for communicable diseases like tuberculosis, hepatitis A and B, scabies—and COVID-19.
On the other hand, the response to the pandemic by federal, state, and local governments was more public health-oriented than perhaps any we’ve seen since the height of the AIDS crisis. With the help of federal funding, cities and states across the country covered the cost of hotel and motel rooms for their unhoused populations, in a bid to reduce shelter crowding and give them a safe place to quarantine. For the first time in decades, protecting the homeless was a priority. Thus, the paradox.
These disease-prevention efforts not only controlled the spread of COVID, they also highlighted a desperate need for a key support resource: medical respite shelters. A single medical respite shelter can have a greater positive impact on homelessness, hospitals and the shelter system as a whole, than a brand-new traditional shelter with ten times as many beds. Yet in most cities the strategy for combating homelessness begins and ends with building more traditional shelters; as a result, there are only roughly 80 medical respite facilities in the entire country. This gap is killing people.
In order to fully appreciate the benefits of medical respite shelters, it is necessary to understand just how significant a threat homelessness poses to an individual’s health. Numerous studies have shown that the unhoused have poorer long-term health outcomes relative to the housed population, and the average life expectancy for them is around 50 years—30 years shorter than a housed person.
Homelessness is a precarious existence. Homeless people are routinely subjected to verbal harassment, physical and sexual assault, and theft. An unsheltered man died last week after he was set on fire while he slept in the stairwell of a public housing building in New York City. The de facto criminalization of street living means unsheltered people have, on average, 21 encounters with police per six-month period, which often leads to increased rates of incarceration and in turn makes the prospect of exiting homelessness even more dim.
These are the most attention-grabbing examples of the perils of homelessness. But the true danger, the thing that kills more than anything else, is far less sensational: a lack of space and time to rest and recover from illness. The sheer banality of this danger seems all the more outrageous in the wake of COVID-19, because as we learned during the pandemic, we have the resources to change this, we just choose not to use them.
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