Homelessness and AIDS

Orange County, California, located south of Los Angeles, is extensively known for dwelling among theme parks such as Disneyland and Knott's Berry Farm. Particularly during the late 2000s, homelessness developed into an increasingly sententious issue in the county. Homeless campaigners in the county asses that there are between 12,000 and 15,000 homeless persons throughout the county on any given night (Anonymous, 2004). Perhaps because of the lack of recognition of homelessness as a significant issue, there remains relatively little policy intervention regarding emergency shelter, affordable housing, or other issues specifically associated with homelessness. Across the County, for example, there are only about 1,000 shelter beds available (Orange County HIV Planning Advisory Council, 2006). There has not been a co-ordinated County effort to address homelessness, with many programs extremely vulnerable to the changing nature of federal, state, and private charitable funding sources.

Research on homelessness in Orange County has indicated that it is both similar and distinct from homelessness occurring in urban, metropolitan, 'inner-city' areas, such as the Skid Row areas of cities. Similarly to studies of inner-city homeless populations, samples drawn from the Orange County homeless population are largely male and unmarried, with large proportions of newly homeless such as people homeless for less than a year. A large proportion of these homeless persons have lived in the County for long periods of time, many living in the area for five years or longer (Gurza, 2002).

For the layperson, when the topic is an infectious agent that produces human suffering and death, the question of origin becomes confused with the idea of responsibility. In a lot of civilizations, epidemics are seen as unnatural happenings caused by a variety of taboo infringements. Yet in modem Western cultures, victim responsibility and presenting disease as a reprimand from God are common. All through history, sickness has frequently been held liable on "outsiders," as defined by race, ethnicity, religion, or nationality. In Western cultural concepts, the disease is considered unnatural, and the genesis of disease is best placed as far from "people like us" as possible. "Outsiders" may be humans who are different, or better yet, some other animal species (Weber Et Al., 2006).

By accepting this orthodox view of disease causation, individuals and communities may unwittingly contribute to the spreading of AIDS. Such a view assumes that individuals, even impoverished minority groups members, have adequate resources to lead a healthy life and to engage in personal AIDS risk reduction (Weber Et Al., 2006). The development of the third anti-camping ordinance occurred during the same period that the county began massive budget cuts in response to the largest municipal bankruptcy case in U.S. history. The bankruptcy, which resulted from massive losses emanating from a risky municipal investment pool caused service cutbacks across departments and services and translated into direct service and monetary support cutbacks for Orange county's low-income residents. Because homelessness is fundamentally defined by lack of housing, housing is the essential foundation for ending homelessness. If we expect to end homelessness, we cannot merely divide the current resource pie differently, a strategy that inevitably pits one group against another (singles vs. families vs. youth vs. veterans). Such an approach also pits housing against shelter and housing against services. We need a massive national commitment public and private to ensure affordable housing for all. Housing is a basic human right, without which people cannot lead stable, connected lives. Housing is essential, but it is not sufficient. Housing alone, without attention to health, behavioral health, employment and education, and other supports, will continue to result in instability and recurrent homelessness for many people.

A report by the Bassuk Center on Homeless and Vulnerable Children and Youth found that services are equally important ”the other half of the equation that can provide stability and prevent future homelessness. We all need services. Health care is a service. Childcare is a service. Transportation is a service. So are case management, substance abuse treatment, and supported employment. Housing alone cannot address the myriad complex challenges facing so many people living in poverty and experiencing homelessness. We must find a way to ensure that services are available, accessible, and affordable across the lifespan. With such comprehensive supports, how can we expect housing alone to end homelessness in a way that is real, deep, and sustainable? If we focus on housing alone, we will never end homelessness. after decades of research and practice innovation, we never seem to generate the political will to fund such programs at levels necessary to meet the need. We celebrate housing 50 people here and a hundred there, and we should. But we continue not to do enough for the hundreds of thousands of individuals, families, and youth still experiencing homelessness each night in America.

More importantly, we have yet to focus our full attention on homelessness prevention. Homelessness prevention means more than just intervening at eviction court and providing a short-term housing subsidy to stabilize a family who is about to be thrown out of their place. While that may be one important strategy, true prevention will require research to understand who is at most risk for becoming homelessness. Then it will require going as far upstream as possible to provide that person or family with the appropriate supports ”financially, emotionally, and otherwise to ensure that they do not slip into homelessness. It will require immense creativity of a type that we have not yet mobilized in our national response to homelessness. Prevention will require a big view that can look across multiple systems housing, healthcare, homelessness, education, child welfare, criminal justice, employment, and many others to identify pathways into homelessness, then design solutions that catch people before they fall. That is hard work. And it is work that many in the homelessness sector have said is not their job.

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