Changing the debate: Homelessness and health

SR editorial from the March 5, edition of the paper

Staring down one of the worst economies our region and country has ever experienced, we find ourselves scrambling to locate resources — any resources — to keep our basic human services structure upright.

For nearly three decades our community, like others, has found itself on the edge, scraping to maintain the necessary infrastructure — not to solve a problem, but to keep the bottom from falling out.

During that time, our region has maintained basic human services and the creation of affordable housing units through tax increment policies, government funds and the kindness of community members— all of which are stretched to the limits and unable sustainable to keep up with the pace of the problem.

Multnomah County, and possibly the region, must look toward additional revenue streams for services and housing. A housing levy or a bond is a must. Changing the conversation and having a more cohesive analysis of our problem is the other. Without an in-depth overview of the region’s problem when it comes to poverty and homelessness— how can we leverage additional resources for that problem?

The region’s willingness to put the necessary resources into counting individuals on the streets for the Census Bureau, which helps us understand the problem and equals revenue from the federal government, should be applauded. The outcomes have yet to be determined, but on the front end our region is making the right moves.

The general public views homelessness and poverty in different ways. On a personal level, our perspectives are shaped through experience, both positive and negative.  In broader terms, we view homelessness and poverty through the lens of the media, often delivered through a controlled message from the police, the businesses community, advocates, government, etc. Very rarely is it framed in the context of health. That has to change.

Homelessness and health intersect at almost every fundamental level. It spans the trauma of experiencing homelessness, the debilitation of sleep deprivation, and the lack of proper access to daily health care needs. Being homeless literally can break down the mind and body, not to mention the spirit.

Portland is looking at possible models that would determine the vulnerability of individuals on the streets, and if they should be prioritized for housing. Both the city and SR have yet to determine if this kind of model makes sense, but it’s worth exploring.

When the government mandated that service providers prioritize individuals who were chronically homeless (a year or more) through the 10-year plan to end homelessness, they may have opened up a Pandora’s box on how we deal with homelessness for decades to come. This may be the rightful next evolution. In our minds, it makes much more sense to qualify why an individual should be prioritized for housing rather than simply quantify it by how long he or she has been on the streets. Without the proper context, timing means nothing.

Lastly, our region must begin to count individuals who have passed on our streets. It is a no-brainer— both from a humane and policy perspective. SR reporting shows that it costs an estimated $20,000 to implement a data system for the medical examiner’s office to track individuals who have died. Those numbers can lead to leveraging revenue from foundations, hospitals, and policy makers to solve the problem. Without it, we continue to miss opportunities.