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. 2024 Apr 25;24(1):1159.
doi: 10.1186/s12889-024-18681-w.

Involuntary displacement and self-reported health in a cross-sectional survey of people experiencing homelessness in Denver, Colorado, 2018-2019

Ashley A Meehan  1 , Katherine E Milazzo  2 , Michael Bien  3 , Samantha K Nall  4 , Katherine Diaz Vickery  5 , Emily Mosites  6 , Joshua A Barocas  4
Affiliations

Involuntary displacement and self-reported health in a cross-sectional survey of people experiencing homelessness in Denver, Colorado, 2018-2019

Ashley A Meehan et al. BMC Public Health. .

Abstract

Background: The number of people experiencing unsheltered homelessness in the U.S. is increasing. Municipalities have responded with punitive responses such as involuntary displacement (i.e., encampment sweeps, move along orders), but little is known about the impact of involuntary displacement on health. The purpose of this study was to investigate the association between broadly defined experiences of involuntary displacement and self-reported health conditions among people experiencing homelessness.

Methods: We used logistic regression models to generate odds ratios using publicly available data from a cross-sectional sample of people experiencing homelessness in Denver, Colorado, during September 2018-February 2019. Hosmer-Lemeshow Goodness of Fit tests were used to assess model fit.

Results: Among 397 people experiencing homelessness, involuntary displacement was significantly associated with self-reported infectious diseases (adjusted odds ratio (aOR) 2.09, 95% CI 1.27, 3.41), substance and alcohol use (aOR 2.83; 95% CI 1.70, 4.73), climate-related conditions (aOR 2.27; 95% CI 1.35, 3.83), and worsening mental health (aOR 2.00; 95% CI 1.24, 3.24) after controlling for potential confounders. No statistically significant associations were identified between involuntary displacement and injuries, musculoskeletal issues, chronic conditions, and chronic mental and emotional issues.

Conclusions: This research quantifies the association between involuntary displacement and multiple infectious and non-infectious health outcomes. While city officials attempt to grapple with increasing unsheltered homelessness, it is important to understand what harms are occurring that are associated with current policies. Our research adds to the growing body of literature that involuntary displacement is a harmful response to unsheltered homelessness. Alternative approaches focused on connections to housing and social services should be prioritized.

Keywords: Health equity; Homelessness; Involuntary displacement.

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Conflict of interest statement

AAM is a graduate student who received course credit for sections of this analysis and early drafts of this manuscript. She is a part-time, paid employee of The Cloudburst Group, a firm providing technical assistance to recipients of funds from the U.S. Department of Housing and Urban Development (HUD) but completed this manuscript without payment and outside of her role at The Cloudburst Group. Additionally, she is a part-time, unpaid research intern supporting the National Health Care for the Homeless Council. This work was completed outside of her role with National Health Care for the Homeless Council. KDV’s time on this publication was supported by the National Institute of Diabetes and Digestive And Kidney Diseases of the National Institutes of Health under Award Number K23DK118117. JAB’s time on this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under award numbers K01DA051684 and DP2DA051864.

References

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