Homelessness and Health

By Lance Chilton

Lacking a home causes bad health–physical problems and early death, subjection to violence, emotional and psychiatric problems, exposure to the false allure of substance use. The parallel is also true: Physical and mental ill health and substance use all make it more likely that the sufferer becomes homeless, especially in a society that has failed to recognize that access to housing and to health care are human rights and necessities.

Some of our fellow citizens place the blame for a person’s homelessness on that individual (blaming the victim): “If only they would…”

  • Be more responsible!
  • Get a job!
  • Realize how terrible using chemical substances is!
  • Pull themselves together!
  • Go somewhere else!

Proposed solutions for homelessness are often simplistic:

  • Let them camp on the streets!
  • Allow encampments (in someone else’s neighborhood).
  • Provide a home for each person experiencing homelessness.
  • Give each homeless person a housing voucher.
  • Bus everyone out to the homeless shelter near Double Eagle Airport every evening.
  • Create an encampment for the homeless out in the desert and require that each homeless person go there…

The problem of the unhoused among us is multifaceted and almost surely lacks a unitary solution, perhaps like climate change and immigration issues. A multi-pronged approach, imbued with humanity rather than blame, will undoubtedly be necessary, taking into account the many forms of trauma that have been experienced–and continue to be experienced—by people living on the streets, in their cars, in that West Mesa shelter, on relatives’ couches.

Prospective pediatricians are urged by their teachers to embrace “Trauma-Informed Care,” to help troubled children with the question, “What happened to you?” rather than “What’s wrong with you?” Our society needs to take a similar approach to people experiencing homelessness, by asking “What happened?” and responding to each person’s answer to that question.

It is clear that people experiencing homelessness are markedly less healthy than the housed population. Anita Córdova, Chief Advancement Director for Albuquerque Health Care for the Homeless, recently spoke with a group of Albuquerque Democrats about some of the health problems homeless people face. Among the factors leading to bad outcomes, Ms. Córdova listed uncertain nutrition, lack of sleep and constant stress, exposure to temperature extremes, lack of hygiene facilities, lack of safety on the streets or in overcrowded shelters, extreme poverty. Ms. Cordova showed data indicating that the average age at death for an unhoused New Mexico population is between 33 and 40 years for females and between 37 and 46 years for males–as compared with overall US life expectancy of 74.2 years for males and 79.9 years for females in 2020.

Consider these stats, also gathered by Ms. Córdova. As compared with a sheltered population, those who are homeless:

  • Are more than four times as likely to suffer from a physical ailment (84% of the unsheltered vs. 19% of sheltered)
  • Are nearly 1.5 times more likely to report a mental health condition (78% vs. 50%)
  • Are over five times more likely to have a substance abuse condition (75% vs. 13%).
  • Are 25 times more likely to report all three conditions at the same time (50% vs. 2%).

In my view, the administration of Mayor Keller has worked diligently to find solutions to the problems faced by the homeless in Albuquerque. They have seen some small successes, including the foundation of the Albuquerque Community Safety department to provide non-criminalizing answers to individuals and the opening of the Gateway Center. Also, they appear to have headed off the explosion of COVID in homeless shelters that has occurred elsewhere.

And Ms. Córdova’s institution, Albuquerque Health Care for the Homeless, has done yeoman’s work ameliorating the conditions leading this population to disability and early death.