ASHLAND, OREGON - JUNE 17, 2019: A man sleeps on a sidewalk bench in front of a shop in Ashland, ... [+]
As the number of people in America without shelter reaches record levels, with more than 653,000 recorded last year, the Supreme Court is deciding a case that would criminalize sleeping in public places. A ruling in favor of enforcing local ordinances against people who sleep and camp in parks and public streets could have sweeping implications for the homeless population.
On one hand, city officials who defend local ordinances say the homeless pose a threat to public health and safety. At the same time, homelessness itself is a public health problem that needs to be grappled with. In the end, the Supreme Court’s ruling could wind up criminalizing homelessness which sidesteps the issue of public health.
Justices heard oral arguments last week in an appeal by the small Oregon city of Grants Pass of a lower court’s ruling that implementing local anti-vagrancy laws against homeless people when there is no shelter space available violates the U.S. Constitution’s Eighth Amendment prohibition on cruel and unusual punishments, Reuters reported.
The justices appeared split along ideological lines.
Several of the conservative justices questioned the lower court’s decision. Chief Justice John Roberts, in particular, raised doubts that homelessness can even be considered a “status” that would be subject to the Eighth Amendment. Furthermore, he seemed to imply that being homeless is temporary when he said “you can remove the homeless status in an instant if you move to a shelter, or situations otherwise change.”
On the other hand, the liberal justices appeared ready to side with the homeless plaintiffs who challenged the city’s laws. They pushed back against the city’s argument that homelessness was not a status protected under the Eighth Amendment.
Given the current composition of the court, it’s likely the conservatives who hold a strong majority of six to three will uphold the local ordinances.
Homelessness As A Public Health Issue
Technically, the Supreme Court is merely evaluating the legality of the local ordinances used against people who camp or sleep in parks and on public streets. But public policy is at least tangentially implicated in the court’s decision, as eviction from one jurisdiction doesn’t make the problem go away. It just means another city or town will have to deal with it.
The status of homelessness is permanent for many and the issue is worsening. According to an article in this month’s Harvard Magazine, on any given night 1 in 500 Americans sleeps in a public place because they lack a private one. This can be in shelters, empty buildings, parks, sidewalks, stairwells, subway entrances or in their cars or tents by the side of the road. In 2023, the highest ever number of homeless people were recorded: 653,104.
Justice Sonia Sotomayor put the problem in stark relief when she asked what would happen to the homeless if they’re evicted from public spaces: “Where are they supposed to sleep? Where do we put them if every city, every village, every town lacks compassion and passes a law identical to this?”
The reasons for homelessness are manifold. They include poverty and lack of affordable housing, but also mental health and substance use disorder issues. The Substance Abuse and Mental Health Services Administration, an agency of the Department of Health and Human Services, describes the social determinants of homelessness in its report, which states that 21% of individuals experiencing homelessness have a serious mental illness and 16% a substance use disorder.
As an ongoing crisis in the U.S., homelessness has severe public health ramifications. A 2018 study of Boston’s unsheltered population concluded that the mortality rate was 10 times greater than that of the general Massachusetts population. The lead author wrote that lack of stable housing correlates with poor physical and mental health.
According to Medium, there are 15.1 million vacant homes in the U.S., which illustrates the paradoxical situation in which so many uninhabited homes dot the landscape while the number of homeless increases to unprecedented levels. But empty homes are usually private property, which may not be expropriated for use by homeless individuals or anyone else for that matter.
While there is consensus among policymakers on the need for supportive housing coupled with intensive case management, regular psychiatric and medical care and assistance with employment and job skills, there are no easy answers to the problem.
A Department of Veterans Affairs program aimed at homeless veterans illustrates how success is achievable through a concerted effort. The VA was able to reduce homelessness by 45% between the program’s inception in 2009 and 2017.
The fact that VAs are nationwide and have a uniquely integrated health system and continuity of care for patients may have contributed to the program’s ability to “work to promote recovery-oriented care for Veterans who are homeless or at risk for homelessness by developing and disseminating evidence-based policies and best practices.” As such, the VA initiative may not be applicable outside of the system within which it is housed.
Besides the VA, with some exceptions at the local level, there’s been a chronic lack of funding and a corresponding paucity of research aimed at studying the root causes and public health impacts of homelessness. Not having a robust evidence base makes it difficult to develop appropriate policies and interventions that sustainably address the problem.
