Health Policy Brief

Health Policy Analysis Brief

This brief was written by a Ph.D. student in Austin and shared with Save Austin Now for distribution.

The purpose of this health policy analysis brief is to examine Mayor Adler’s decision to allow the reversal of the previous camping laws in Austin public areas and parks and to evaluate how these camps impact the health of both the homeless population and the rest of the community.

Policy Issue

Defining the Issue

In years prior, the homeless population of Austin was limited to seeking shelter at the Austin Resource Center for the Homeless (ARCH) or the Salvation Army Shelter. On October 17, 2019 Austin’s City Council made revisions to the city ordinance that permits camping in all public areas. The new ordinance is located in Section 9-4-11 of the City Code and is entitled Camping and Obstruction in Certain Public Areas Prohibited (Council Direction, n.d.). Although this ordinance is intended to set limits on where the homeless setup camp, the rules and regulations are not being followed. Campgrounds are being made under bridges of interstates, on the side of busy streets, and in high-population areas. Although failure to abide by these limitations can result in a Class C misdemeanor and fine, “the vast majority of unhoused defendants failed to show for court, leading to warrants and arrests (Bova, 2020).”

Public Health Problem Associated with the Issue

The largest health risk to allowing deregulated homeless camps is the increased risk of transmitting communicable diseases. According to research from Liu et al. (2020, p.2), “living in crowded conditions [and] have greater exposure to pathogens, which increases the risk of tuberculosis and diarrheal illnesses.” Liu et al. (2020) also reports an increase in other communicable diseases amongst the homeless population such as lice, hepatitis, syphilis, invasive streptococcal infections and HIV. An estimated 3.4% of the homeless population is infected with HIV compared to 0.4% in the general population, the prevalence rate of Hepatitis is 24% in the homeless population as compared to 2% in the general population, and tuberculosis has an incidence 46 times higher in the homeless as compared to those who live in stable housing (Grief & Miller, 2017). Having such a large number of people in one condensed area also increases their risk of contracting COVID-19 and spreading it to others in the community. Those experiencing homelessness have a mortality rate that is 5-10 times higher than that of the general population (Tsai & Wilson, 2020). The homeless are at a greater risk of infecting others because they typically relocate from one area to another, thus making it harder to contain the virus (Tan & Chua, 2020). Those in homeless camps are also less likely to have access to showers or hygiene supplies and have limited access to health care, making them more susceptible to illnesses. Although several members of the homeless camps reside in tents, they are still exposed to the outdoor elements which increase their risk of experiencing other health conditions such as insect bites, hypothermia and heatstroke.

Along with communicable diseases, the homeless camps also increase the risk of pedestrian vs. vehicle accidents and fires. Most of these camps are assembled on busy highways and intersections. The inhabitants of these camps often do not have transportation and are required to walk to their destinations. Drivers of vehicles may not be paying attention, vision may be limited, or sometimes the camp residents are wandering the streets, causing an accident to occur. The location of these homeless camps, as well as the vast amount of litter accumulated, and the use of propane tanks also creates an increased risk of fires amongst the campsites. Not only do these fires put the lives of the homeless at risk, but they also jeopardize the safety of the rest of the city if the fire were to spread. A large fire occurred last February and firefighters state that the fire was a “much more dangerous situation given it was underneath a bridge and the amount of trash there (Oaks, 2020).”

Current Political Feasibility

The Austin homeless camps have caused friction against many members of the city council, those who reside in the city, and the homeless population. Although the majority of people would like to see an increase in support for those experiencing homelessness, most also agree that the current policy allowing unlimited camps needs to change and be reverted. Even Mayor Adler, who initiated the ordinance, states “it’s not working (Autullo, 2021).” Governor Greg Abbott has also stated his support for changing the current policy and has said: “Contrary to what Austin leaders think, no one has a right to urinate and defecate wherever they want. Homelessness promoted by Austin has also endangered public safety (Autollo, 2021).” Having support from the mayor and governor is a good first step in facilitating change. The long-term goal would be to aid the homeless population in managing their mental and physical health disparities so they may get jobs and become productive members of society. The barriers in achieving this goal would be financial responsibilities, the willingness of participation from those living in the camps, and the availability of free housing.

Proposed Solutions

When I was living in San Antonio, I completed volunteer hours at a homeless community called Haven for Hope. This community provided on-site apartment homes in exchange for residents working in different areas of the community such as the kitchen, janitorial services, and the childcare center. In addition to having access to a safe home, those in the program were also compensated a small wage for their work. At Haven for Hope, they also had a job resource center, food pantry, and childcare. Medical, psychiatric and substance rehabilitation services were also offered. Although San Antonio still has some homeless residents living on the streets, I do see how the implementation of Haven for Hope has improved the outcomes for those who have been accepted into the program. Since Haven for Hope opened in 2010, 13,000 individuals have transitioned from homelessness to living in permanent or supportive housing and the number of homeless people living on the streets has decreased by 81% (Haven for Hope, 2019).  I believe an option like Haven for Hope would be beneficial to the homeless citizens of Austin. Residents would be given an option to earn the right to live in a safe and stable home. They would also be offered resources to ensure they learn basic life skills to be independent outside of the community. While they are living in the facilities, they will have access to proper health care that would improve their prognoses and decrease the likelihood of spreading potential communicable diseases to others.

Although a community like Haven for Hope is an ideal solution to improving homelessness and transmission of diseases associated with living in overcrowded areas, it is very expensive and would likely take a while to implement. In the meantime, alternative solutions include having dedicated homeless camping areas. If Austin needed additional space for the homeless to live and the outdoors were the only option, it would be beneficial to have designated, spacious areas to camp. It would also be important to have a limit on how many people can reside in one area. Law enforcement would likely have to be involved in order to enforce this and to also manage litter, fires, and sanitary practices. These designated areas would ensure that the camping sites are effectively separated to decrease transmission of communicable diseases amongst its residents and would also be in a safe area where motor vehicle vs pedestrian accidents are less likely.

Summary

Steve Adler and the City Council’s decision to allow homeless camps has had a negative impact on the physical and mental health of those residing in the camps and the city of Austin as a whole. Save Austin Now has initiated the policy change that is needed, but it is ultimately up to Austin voters to produce the change. Reinstating the camping laws would not only improve health outcomes in the homeless population, but it would also decrease the likelihood of others in the city being affected and has the potential to positively impact the number of hospitalizations and resources needed to provide adequate care to all Austinites.