Unprotected homelessness is a public health disaster. In King County and Seattle, homeless people are dying every day, it’s getting worse and preventable. Providing adequate housing or shelter for all homeless people is an essential step in turning.
However, after decades of regional dialogue and failed plans, the gap between adequate housing and the thousands of homeless people in King County is still widening. The King County Regional Homelessness Authority estimates we will need 18,000 additional temporary shelters or shelters by 2027.
Meanwhile, the city of Seattle has become obsessed with “removing” tent and vehicle camps, better known as “sweeps” — more than 900 of which took place in 2022 — even when shelters aren’t available.
Seattle’s Services not Sweeps coalition has launched a campaign to ban sweeping during winter and extreme weather conditions, when outdoor survival is most difficult. Similar to the Seattle winter eviction ban that was enacted prior to the COVID-19 crisis in 2020, this policy would extend eviction protections to homeless people.
As the University of Washington School of Public Health, which has taught, researched, and developed policies on homelessness, we fully support a winter sweeping ban. We also advocate a year-round sweeping ban, at least until Seattle has enough dignified and suitable indoor space for all vulnerable people. Until then, a ban in winter and extreme weather conditions is a health-promoting first step.
Searches do little more than shift visible reminders of homelessness from one neighborhood to another and then shift them back again. However, raids also push people deeper into the shadows, farther from the regions they are familiar with, cutting ties with care providers and road workers. Searches risk losing IDs, paperwork, medication, and social connections. Imagine trying to get out of homelessness, facing constant challenges like this one, and on top of that, the constant threat of losing your flimsy tent, bed covers, or car and everything you own.
Even worse: kill sweeps. A recent study in the Journal of the American Medical Association (JAMA) examined 23 cities, including Seattle, and found that continuous “involuntary displacement” significantly increases hospitalizations and deaths. That’s the last thing Seattle needs. The number of homeless deaths in King County has already doubled that of Washington state. In 2022, they increased even further, and in 2023, so far, they are even higher than in the same period last year.
As public health professionals, we are not the only ones demanding services and accommodation, not cleaning services. The American Public Health Association’s Caucus on Homelessness has spoken out against the forced dismantling of homeless camps without readily available shelters or suitable shelters. The editorial of the JAMA study summarized involuntary displacement as “a worsening of a bad situation”. The lead author of the JAMA study bluntly stated: “Sweeping people is not a solution to #homelessness, it is a form of (costly) state-sponsored violence.”
The King County Board of Health declared in 2018 that homelessness is a public health crisis and poses an imminent threat to the health and survival of vulnerable people. The board urged all King County jurisdictions to quickly provide enough emergency shelters to support all homeless people who are homeless.
In addition, federal jurisprudence has repeatedly required that adequate shelters be in place before removing tents or belongings of those not sheltered. This was confirmed by Ninth Circuit Court judgments against Boise and Grants Pass, and by a December federal court order in San Francisco. Also this week, a King County Superior Court judge ruled that Seattle’s camp clearance policy is unconstitutional in cases where the city uses its overly broad definition of “disability” to mandate the removal and destruction of property without Justify advance notice or accommodation offer – where there is no real disability or imminent danger.
Seattle and King County are nowhere near, and nowhere near, those goals. The Regional Housing Authority’s most recent five-year plan, for example, does not provide a specific timeline to meet current or projected housing needs. Still, Seattle continues its frightening pace of destocking.
You may be wondering: what about all those homeless people who are “denying” housing? hmm First, most Seattle searches are conducted without notice or offers of housing. Second, the City of Seattle’s own statistics confirm that most campers accept offers when it comes to “enhanced” and “non-shared” accommodations, such as tiny house villages or motel accommodations.
Although a mat on the floor of a “shelter” meets the courts’ minimum expectations, it is not enough to help people make the transition from homelessness. Simple “communal” housing offers minimal sanitation and weather protection—usually along with barriers to entry (e.g., exclusion of mates and animal companions), overcrowded sleeping quarters, no privacy, limited possessions, and morning evictions onto the streets. These attitudes are neither healthy nor dignified. Not surprisingly, campers in Seattle often opt out of such accommodations.
To help people stabilize and find proper housing, housing is best when it has 24-hour access and privacy, is open to whole family units and partners, including animal companions, and has connections to case management , health and social services. This is the type of shelter prioritized by both the regional homelessness agency and the health department.
Homelessness stems from unaffordable housing, unlivable minimum wages, disabilities, the impoverishment of medical debt, institutional racism, and other economic system failures. Sustainable solutions require transformative strategies, costly investments and time.
Fortunately, we live in a city with some of the wealthiest people in world history who, if taxed, are able to support solutions. We also have many vacant units that could be made available for residential use.
In the meantime, however, we should at least stop sweeping camps during the coldest and hottest months, when displacement is doing the most damage.
Bill Daniell is a physician, epidemiologist, and associate professor emeritus at the UW School of Public Health. He was a member of the King County Board of Health for seven years.
Amy Hagopian is a professor at the UW School of Public Health, where she taught the school’s homelessness course. She is the elected Chair of the Editorial Board of the American Journal of Public Health.
