Risk Factors of Homelessness

Drugs, poverty, lack of housing, and mental health concerns are just a few of the many causes for a person to become homeless in California. Many in California are currently suffocating under the rapidly rising cost of living and most of those people don't even have extra extenuating factors (Krivkovich et al., 2023). Drug or alcohol abuse is seen in about 50% of the homeless population (Santa Maria et al., 2018). Many unsheltered homeless are struggling with mental health problems such as schizophrenia or PTSD (Llerena, Gabrielian, Green, 2018) and homeless youth are suffering from substance abuse and trauma (Dawson et al., 2020). Others note that almost 60% have been incarcerated and many of those bounce back and forth between the prison system and living on the streets (Ward, 2021). 

Alexis Krivkovich, a senior partner of McKinsey & Company's Bay Area office, and Kunal Modi, a partner of McKinsey & Company who serves federal, state, and local governments in the U.S. to promote economic opportunities, delve into who is at risk for homelessness and how COVID-19 and other factor have affected the homeless community and those at risk in order to help make effective solutions. This article seems to be directed to policymakers, as well as those who wish to help the homeless community. Despite many years of efforts to help the homeless community, there has not been a single approach that was completely effective because the cause is decades of systemic issues, such as gaps in the mental healthcare system, a growing substance-use crisis, and a racial wealth gap.  Krivkovich and Modi's research suggests five key facts that could accelerate solutions to this crisis: the homeless experience varies and requires different interventions, prevention is critical, early intervention could prevent homelessness, the crisis response system is fragmented, and affordable housing is important. Between October 2021 and November 2022, the University of California, San Francisco conducted a massive study that unpacks the root causes of homelessness in California. It was discovered that 70% of the representatives believed that if their monthly rent decreased by $300 - $500, they would not be on the streets and 82% believed that a one-time payment of $5,000 - $10,000 would have helped them (Kushel, Moore, et al, 2023). Krivkovich and Modi suggest that solutions should not treat homelessness as one issue but instead as three distinct challenges; providing financial security for the at-risk population, improving coordination among the response agencies, and investing in intensive care. 

(Naomi Milan)

Carol Dawson-Rose, Ph D from UCSF School of Nursing, was the correspondence for this study conducted by 14 well established authors. 9 from UCSF School of Nursing, 1 from UCSF School of Medicine, 3 from Larkin Street Youth Services in San Francisco and 1 from the University of Miami Florida. They examined the prevalence and correlates of 3 potential factors in 100 homeless transitional age youth (TAY) aged 18-24 in San Francisco, trauma, substance use and multiple mental health symptoms. Their intended audience is for political officials and policy makers, but also to people interested in the mental illness of the homeless community. The Substance Abuse and Mental Health Services Administration funded this study that found a correlation between high rates of substance use and current mental health symptoms (Dawson et al., 2020). They interpreted this correlation as homeless TAY not having access to necessary resources in processing trauma. Dawson and her team report extensively on the troubles homeless TAY face in San Francisco such as accessing shelter, medical help and even employment due to lack of education on available resources (2020). This article can be compared to Samantha Brown and other's study that found certain levels of social support systems can be linked to increased characteristics of substance use with heroin and marijuana being significant correlates (Brown et al., 2020). 

(Drew Barajas)

This article, written by six PhD recipients, talks about how drug use is a big problem for homeless young people and can make them sick or even cause them to die. This study's intended audience is medical students and professionals. In this study, the authors figure out how often homeless young people use drugs and what things in their daily lives make them more likely to use drugs. They looked at 66 homeless young people in Houston, Texas, who were between 18 and 25 years old and asked them about their drug use every day. This study found that a lot of them used drugs  and that this could predict if they were more likely to stay homeless long term (Santa Maria et al., 2018). This article shares the sentiment seen in the article Sociodemographic and substance use characteristics… as both articles highlight the effects of drugs and how they affect the homeless in California. 

(Joshua Wagar)

In this peer reviewed article, authors Kathia Llerena, Sonya Gabrielian and Michael F. Green conducted a study aiming to further understand the relationship psychotic disorders have on clinical symptoms, community function and cognitive impairment in the unsheltered homeless community in Los Angeles, Ca. The 3 authors belong to the Department of Veteran Affairs Mental Illness Research, Education and Clinical Center in LA and UCLA Semel Institute for Neuroscience & Human Behavior. They write for an audience of policy makers, scientists/educators and for citizens of CA who have an interest in the underlying causes of the homeless population. This 2018 study consisted of 76 homeless veterans who have both a history of psychotic diagnosis and enrolled in a supported housing program (Llerena et.al., 2018). Their findings showed, experiencing more days spent in unsheltered locations was related to cognitive deficits in overall cognition, visual learning and social cognition. These findings allow for policy makers to focus their future policies on increasing access of care specific to cognitive care in this community. LAHSA's 2023 Los Angeles Homeless Count, counted for 2,016 unsheltered veterans compared to only 680 who are sheltered (2023). The increase difference in unsheltered homeless and sheltered numbers are seen not only in veterans but in all of LA's homeless population (LAHSA, 2023). 

(Drew Barajas)

Ethan Ward, a former LAist unhoused community reporter, discusses the different causes of homelessness and the issues they face. This is geared towards LAist readers and those interested in learning more about helping the LA homeless community. Some causes include poverty, lack of affordable housing, mental health, substance abuse, and LGBTQ+ kids rejected from their families. The Los Angeles Homeless Service Authority (LAHSA), discovered that the continual rise in homelessness results from stagnant income, rising house prices, lack of mental health services, and mass incarceration: 60% of the homeless population has cycled through the criminal justice system (LAHSA, 2020). The LAHSA homeless count discovered there are 46,260 homeless people in LA, a 10% rise from 2022 (LAHSA, 2023).

(Naomi Milan)