Study shows involuntary displacement of people experiencing homelessness may cause significant spikes in mortality, overdoses and hospitalizations

New model suggests encampment sweeps, bans and move-along-orders could contribute to 15-25% of deaths in this population over 10 years

Peer-Reviewed Publication

UNIVERSITY OF COLORADO ANSCHUTZ MEDICAL CAMPUS

 

VIDEO: JOSH BAROCAS, MD, DISCUSSES THE RESEARCH BEHIND FINDING THAT UP TO 25% OF UNHOUSED PEOPLE WHO USE DRUGS COULD DIE IN 10 YEARS DUE TO INVOLUNTARY DISPLACEMENT POLICIES INCLUDING CAMPING BANS AND SWEEPS. view more 

CREDIT: UNIVERSITY OF COLORADO ANSCHUTZ MEDICAL CAMPUS

AURORA, Colo. (April 10, 2023) – Involuntary displacement of people experiencing homelessness will likely lead to a substantial increase in morbidity and mortality over a 10-year period.

In a study, published today in the Journal of the American Medical Association (JAMA), researchers say practices such as encampment sweeps, bans, move-along-orders and cleanups that forcibly relocate individuals away from essential services will lead to substantial increases in overdose deaths, life threatening infections and hospitalizations.

In coordination with the National Healthcare for Homeless Council, the Center for Disease Control and Prevention (CDC) and the National Foundation of the CDC, a multidisciplinary group of researchers developed a simulation model projecting the long-term health effects of involuntary displacement of people experiencing homelessness who inject drugs using data from 23 U.S. cities. They used city- and national-level data to closely model what the population looks like in real life including their overdose risk and mortality. They then modeled two scenarios over a 10-year time period: no continual displacement and continual involuntary displacement of this population.

In hundreds of different projections, the model showed no feasible scenario, in any city, where continual involuntary displacement improves health outcomes. Instead, the practice would likely result in a significant increase in morbidity, mortality and a shortened life expectancy, the study said.

“Our research shows that these widespread practices that forcibly displace people are clearly impacting the health of this population, particularly when it comes to increasing their overdose risk, so much so that it actually decreases the life expectancy of the entire population,” says Josh Barocas, MD, associate professor at the University of Colorado Anschutz Medical Campus and corresponding author. “Modeling studies like ours give us a sense of whether we’re headed in the right or wrong direction. Our study showed that displacement could directly result in a quarter of deaths of this population. This tell us that this practice is taking us in the wrong direction if we want to solve issues around homelessness and substance use disorders.” 

Researchers also found displacement increased overdose deaths, hospitalizations, injection-related infections and hindered access to medications for opioid use disorder along with other detrimental impacts. 

“It’s estimated that more than 500,000 people are experiencing homelessness in the U.S., and understanding the toll practices such as camping bans and sweeps take on such a substantial population is critical to emphasizing the need for care and services versus literally being swept aside,” says Barocas. “We hope these results inform future policies that actually mitigate the long-term health consequences in this population before it’s too late.” 

 

About the University of Colorado Anschutz Medical Campus

The University of Colorado Anschutz Medical Campus is a world-class medical destination at the forefront of transformative science, medicine, education and patient care. The campus encompasses the University of Colorado health professional schools, more than 60 centers and institutes, and two nationally ranked independent hospitals - UCHealth University of Colorado Hospital and Children's Hospital Colorado - that treat more than two million adult and pediatric patients each year. Innovative, interconnected and highly collaborative, the University of Colorado Anschutz Medical Campus delivers life-changing treatments, patient care and professional training and conducts world-renowned research fueled by over $690 million in research grants. For more information, visit www.cuanschutz.edu.

 

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JOURNAL

JAMA

DOI

10.1001/jama.2023.4800 

METHOD OF RESEARCH

Computational simulation/modeling

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Population-Level Health Effects of Involuntary Displacement of People Experiencing Unsheltered Homelessness Who Inject Drugs in US Cities

ARTICLE PUBLICATION DATE

10-Apr-2023

Health effects of involuntary displacement of homeless individuals who inject drugs

JAMA

Peer-Reviewed Publication

JAMA NETWORK

About The Study: This simulation modeling study of 23 U.S. cities projects that involuntary displacement of people experiencing homelessness who inject drugs may yield substantial increases in morbidity and mortality over a 10-year period. Involuntary displacement is estimated to worsen overdose and hospitalizations, decrease initiations of medications for opioid use disorder, and contribute to deaths. These findings have implications for the practice of involuntary displacement, as well as policies such as access to housing and supportive services, that could mitigate these harms. 

Authors: Joshua A. Barocas, M.D., of the University of Colorado School of Medicine in Aurora, is the corresponding author.

(doi:10.1001/jama.2023.4800)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

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JOURNAL

JAMA