Study Shows Involuntary Displacement of People Experiencing Homelessness May Cause Significant Spikes in Mortality, Overdoses and Hospitalizations

Study Shows Involuntary Displacement of People Experiencing Homelessness May Cause Significant Spikes in Mortality, Overdoses and Hospitalizations

April 10, 2023

Today the Journal of the American Medical Association (JAMA) published a study that shows encampment sweeps, bans, move-along orders and cleanups that forcibly relocate individuals away from essential services will lead to substantial increases in overdose deaths, hospitalizations and life-threatening infections as well as hinder access to medications for opioid use disorder (along with other detrimental impacts).

We have seen a national trend of increased unsheltered homelessness. This study indicates that encampment sweeps are the wrong approach to this crisis. We must provide street medicine, medical outreach, substance use treatment, and harm reduction services, as well as focus on addressing the heart of the issue — these individuals need housing, not ongoing displacement. Too many individuals are losing their lives due to bad policy.”
Courtney Pladsen, Director of Clinical and Quality Improvement at NHCHC and co-author.

A multidisciplinary group of researchers led by Josh Barocas, MD, associate professor at the University of Colorado Anschutz Medical Campus, in coordination with the National Health Care for the Homeless Council (NHCHC), the Centers for Disease Control and Prevention (CDC) and the CDC Foundation, developed a simulation model projecting the long-term health effects of involuntary displacement of people experiencing homelessness who inject drugs using data from 23 U.S. cities.

They used city- and national-level data to closely model what the population looks like in real life, including their overdose risk and mortality. They then modeled two scenarios over a 10-year time period: no continual displacement and continual involuntary displacement of this population.

In hundreds of different projections, the model showed no feasible scenario—in any city—where continual involuntary displacement has a neutral impact or improves health outcomes. Instead, the practice would likely result in a significant increase in morbidity, mortality and a shortened life expectancy, the study found. The model suggests encampment sweeps, bans and move-along orders could contribute to 15-25% of deaths among the unsheltered population over 10 years.

This is a seminal study that demonstrates how the criminalization of homelessness harms the health and shortens the lives of a vulnerable population of people condemned by poverty to sleep on our cities’ streets, particularly for African Americans and people of color,” says David Peery, Co-chair National Consumer Advisory Board, and co-author on the study. “We now show that homeless encampment sweeps, which displace and scatter unhoused people, compound their trauma and suffering and lead to increased hospitalizations, overdoses and deaths.

Continual displacement modeling from all 20 cities revealed the following:

  • 151% increase in overdose mortality
  • 11% reduction in life expectancy
  • 50% increase in hospitalizations
  • 6% increase in serious injection related infections (SIRI) mortality
  • 38% decrease in Medication for Opiate Use Disorder (MOUD) initiations
Historic forced displacement events have caused categorical harm, loss of community, safety and culture,” says Alaina Boyer, NHCHC Director of Implementation Research and co-author on the study. “Forced displacement due to encampment sweeps results in the same harm with negative impacts to health, safety, and trust. Without responsible and effective coordination of services and placement into permanent supportive housing, these results show this type of disruption is detrimental to the health of those experiencing unsheltered homelessness

Forcible encampment sweeps and laws that criminalize the existence of human beings are wrong and are a violation of human rights. Our prior fact sheet outlined the harms of encampment sweeps, and this study only confirms what people experiencing homelessness already knew: forcible displacements cause people to be disconnected from health care services and increase their risk of overdose and death.

Local jurisdictions that currently are sweeping encampments should cease displacements and instead focus on connecting individuals to permanent housing, health care and support services as needed.

Learn more about the harmful impact of encampment sweeps on our website.

NHCHC Contact

Lindsey Turner, Communications Manager

About the National Health Care for the Homeless Council 

The National Health Care for the Homeless Council, based in Nashville, is the premier national organization working at the nexus of homelessness and health care. Grounded in human rights and social justice, the NHCHC’s mission is to build an equitable, high-quality health care system through training, research, and advocacy in the movement to end homelessness.  

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