Harms of encampment abatements on the health of unhoused people

Abstract

Introduction: Abatements, or “sweeps,” are key instruments used by local governments to address increasing numbers of homeless encampments, but they are controversial, underdocumented, and understudied. To examine how social policies, such as abatements, impact the health of people who are unhoused, we interviewed unhoused people on their recent experiences with local abatement practices. Materials and methods: Between 2018 and 2020, we used community-based participatory research approaches and the docent method to conduct participant-guided, in-depth, semi-structured interviews with unhoused people in Santa Clara County (n ​= ​29). We used grounded theory approaches to analyze interview data. Results: Abatements harmed unhoused people's health through four key mechanisms. First, forced relocation and property seizures stripped people of health resources and necessities (e.g., personal belongings, social support) required to survive unhoused. Second, abatements drove unhoused people into hazardous, isolated, less visible spaces, which increased health risks while reducing access to health outreach workers and support systems. Third, abatements were the grounds for frequent negative encounters between unhoused people and authorities such as law enforcement - interactions that produced anger, stress, and distrust. Finally, distrust of authorities and law enforcement led to people's reluctance to seek or accept formal forms of support and protection. The necessity of self-policing in encampments created cycles of interpersonal violence that resulted in suffering, injury, and premature death. Discussion: Sweeps undermined or directly harmed unhoused people's health, leading to serious health consequences. Common abatement practices are social policies that may be causal factors in the declining health of unhoused people. Improved documentation, reporting, and tracking of abatement practices are needed.