LAS VEGAS — Maurice Clark huddled in his tent alongside dusty railroad tracks as two homeless-outreach employees started asking him questions to find out whether or not he would qualify without cost or backed housing.
Did he use medication? Had he ever been in jail? What number of occasions had he been to an emergency room? Had he been attacked on the streets? Tried to hurt himself? Engaged in intercourse for cash?
Clark didn’t really feel comfy being sincere with the 2 surveyors he’d by no means met earlier than, who had been flanked by law enforcement officials as they recorded his responses from a questionnaire on a pill.
“I’ve executed some loopy issues to outlive, however I’m, like, I’m going to say no as a result of there’s these officers proper there,” he mentioned, recalling the encounter on a fall afternoon exterior his tent.
“I’m a Black man in America, so asking these items hits slightly bit completely different.”
Nationwide homelessness consultants and native leaders say such private questions exacerbate racial disparities within the ranks of the nation’s unhoused, notably as extra individuals experiencing homelessness compete for scarce taxpayer-subsidized housing amid a deepening affordability disaster.
Vulnerability questionnaires had been created to find out how seemingly an individual is to get sick and die whereas homeless, and the system has been adopted extensively across the nation over the previous decade to assist prioritize who will get housing. The extra a homeless individual is perceived to be weak, the extra factors they rating on the questionnaire and the upper they transfer within the housing queue. The surveys are being singled out for worsening racial disparities by systematically inserting homeless white individuals on the entrance of the road, forward of their Black friends — partly as a result of the scoring awards extra factors for utilizing well being care, and depends on belief within the system, each of which favor white individuals.
Black individuals make up 13.7% of the general U.S. inhabitants but account for 32.2% of the nation’s homeless inhabitants. White individuals, together with some individuals of Hispanic descent, make up 75% of the nation and symbolize 55% of America’s homeless.
“It’s racist in a systemic means,” mentioned Marc Dones, a California-based coverage director on the College of California-San Francisco and a lead researcher for one of many nation’s largest research analyzing the Black homeless inhabitants. “In the event you’re a white individual, the extra seemingly you’re to rank larger than in case you’re a Black individual, so that you’re extra prone to get chosen for housing.”
Vulnerability surveys took off after President Barack Obama in 2009 signed into legislation sweeping guidelines requiring the nation’s native homelessness companies, generally known as Continuums of Care and at present numbering 381, to undertake a technique to evaluate the vulnerability of homeless individuals to obtain federal housing and homelessness funding. Cities and counties predominantly adopted a survey known as VI-SPDAT, which continues to be utilized by an estimated two-thirds of homeless companies, even because it has been discovered to favor white individuals and rank Black individuals decrease.
Some consultants argue it’s time to toss the vulnerability evaluation altogether and look not solely at well being and social wants but additionally systemic racism, poverty, involvement within the legal justice system, obstacles to housing, and different financial drivers that affect, and in some instances trigger, homelessness. A number of U.S. communities are revamping their vulnerability evaluation techniques to scale back racial disparities and assist extra Black individuals get housing.
In Los Angeles, officers are launching an effort to make use of synthetic intelligence to higher assess whether or not somebody ought to be prioritized for placement, partially by taking a look at overpolicing of Black individuals and discrimination in well being care. In Las Vegas, officers are revamping their vulnerability evaluation to present larger scores for systemic issues together with incarceration. In Austin, Texas, officers are testing a system to account for individuals displaced by gentrification.
“We have to personal the racism that’s embedded in our techniques,” mentioned Quiana Fisher, vp of homelessness response techniques for the lead company in Travis County, Texas, which incorporates Austin. “It’s not simply concerning the instrument — it’s about funding, and it’s about program outcomes. Even when it’s unintentional, now we have created a homeless response system that’s rooted in racism.”
The evaluation instrument was first examined in Boston, the place members of the homeless inhabitants had been extra prone to be white, male, and have a extreme psychological sickness or substance use dysfunction. Black individuals, in the meantime, usually tend to be homeless due to financial causes, equivalent to poverty or joblessness, and are much less prone to have a report of medical care on account of larger uninsurance and fewer use of well being care.
“This entire system was piloted on this older white inhabitants in Boston, so it does a poor job of capturing the wants of Black people, who don’t are typically as sick as white people — they’re extra broke,” Dones mentioned. “The preliminary thought was to prioritize these individuals as a result of they’re going to die sooner. It was making an attempt to sort out mortality, nevertheless it wound up in racism.”
Consequently, white persons are extra prone to achieve housing as a result of they have a tendency to attain extra factors on vulnerability assessments that rank illness larger, together with histories of persistent illness, habit, psychological sickness, and emergency room visits and hospitalizations, in response to nationwide surveys. Black individuals, in the meantime, are much less prone to have medical insurance or medical diagnoses and to disclose their illnesses, and are extra mistrustful on account of biases within the well being care system. “Black people are much less prone to search care, even with protection, on account of medical racism,” Dones mentioned.
Native leaders say a part of the issue is changing into homeless within the first place and financial disadvantages that drive extra Black individuals into homelessness, together with placement in foster care and better charges of eviction and joblessness. However as soon as homeless, serving to Black individuals get into secure housing turns into extra elusive.
In Los Angeles County, dwelling to extra homeless individuals than another county within the nation, 31% of homeless persons are Black, although the general Black inhabitants accounts for 9%. In Austin, Black individuals account for practically 32% of the homeless inhabitants, in contrast with 7.6% general. And in Clark County, which incorporates Las Vegas, Black individuals symbolize 42% of the homeless inhabitants however simply 12% of the general inhabitants.
“We’ve did not seize the complicated vulnerabilities of our marginalized teams. We’re asking all these questions, however we created a ready record to nowhere,” mentioned Brenda Barnes, who leads the Southern Nevada Homelessness Continuum of Care.
Streets of Las Vegas
Greedy his toothbrush after cleansing up in his tent on a latest morning, Clark, 45, recalled taking his housing questionnaire this 12 months. He ticked off responses to outreach employees that ought to rank him excessive within the queue — he lacked secure housing, has been homeless for practically 4 years, and has no job or dependable earnings.
He’d frequented emergency rooms and had been to jail, pleading responsible to a felony theft crime he mentioned he didn’t commit, and a number of other occasions for possession of medicine and paraphernalia, he informed them. He used methamphetamine, largely to be alert at night time when it grew to become harmful. Was he ever assaulted? Sure, particularly in maturity since changing into homeless in 2020.
In actuality, he hustled typically for a dime, and he anxious he’d be focused for taking recyclables or participating in prostitution. “I’ve executed it to get a room for an evening. It’s like a final resort,” he mentioned.
And Clark wasn’t forthcoming with outreach employees concerning the particulars of his drug use or involvement with legislation enforcement, that he’d offered his physique for intercourse, that he’d skilled abuse. He couldn’t recall all the small print of his medical historical past both. Frequently fleeing legislation enforcement sweeps together with his tent, hauling it alongside busy practice tracks, he’s excessive at occasions, and sometimes in a state of chaos and concern that may scramble his reminiscence or make him scared of arrest. He didn’t share with them his occasional ideas of suicide or his well being considerations, together with presumably having diabetes.
“They requested me about medication, I used to be like, um, I don’t know,” Clark mentioned. “Like I’m supposed to inform them I obtained hooked on meth or offered my physique for a meal and resort room? I had no thought the place this info was going or what it was getting used for.” After he took the survey, no housing got here.
Even those that do reply actually discover themselves competing for a restricted provide of reasonably priced housing. John Harris was sleeping underneath a bridge on a latest October afternoon. He mentioned he has taken the questionnaire twice. It led nowhere.
“They requested me, have I been incarcerated? And I mentioned sure. I’ve been to jail too many occasions. And I’ve psychological well being struggles,” mentioned Harris, 59, who has been out and in of sober residing shelters however nonetheless makes use of methamphetamine. He has been a repeat customer to emergency rooms, and on an October afternoon recorded a hypertension studying that put him in danger for a coronary heart assault — elements that ought to rating factors for vulnerability.
“I known as and requested what occurred with my housing. They mentioned I didn’t rating excessive sufficient,” he mentioned. After getting his blood strain checked by a road drugs nurse, he shrugged, saying he could wind up again within the emergency room, as he retreated underneath the bridge.
“It doesn’t matter what society says at present, issues ain’t by no means going to alter,” he mentioned.
‘I Don’t Know What the Resolution Is’
How communities assign factors to homeless individuals and rank them for housing is the most important drawback.
The commonest questionnaire deployed by communities across the nation, the VI-SPDAT, assigns factors meant to gauge the vulnerability of an individual residing on the streets. Consultants say this mannequin was by no means examined as a housing evaluation instrument, nor meant to find out whether or not somebody will get into housing.
“This isn’t a dependable instrument, and Black males constantly rating the bottom for vulnerability, so they’re deprioritized for housing — to get housing, you actually need to attain excessive,” mentioned Courtney Cronley, a College of Tennessee researcher who analyzed the vulnerability evaluation. Her findings had been revealed in 2020 within the Journal of Social Misery and Homelessness.
Cronley pointed to a spread of questions that exacerbate racial bias and have little to do with qualifying for housing:
What number of occasions have you ever obtained well being care in an emergency room? Have you ever been attacked or overwhelmed up? Have you ever threatened to hurt your self or anybody else within the final 12 months?
Does anybody pressure you or trick you to do issues that you don’t want to do? Do you alternate intercourse for cash? Run medication?
Consultants who examine the vulnerability questionnaire additionally level out that the racial or ethnic background of surveyors typically doesn’t mirror that of the individuals being questioned, which may result in inaccurate outcomes if a respondent doesn’t really feel protected or perceive the survey’s objective.
Some cities and counties are creating surveys that native homeless companies hope will slim racial disparities.
Clark County deployed a brand new vulnerability evaluation in June after a 2023 secret-shopper mission discovered the system was not connecting homeless individuals with housing or providers, particularly individuals of colour.
“We failed in each class,” Barnes mentioned. Previously homeless individuals fanned out on the streets and within the tunnels to check whether or not the housing questionnaire resulted in offering housing for probably the most weak. “All we had been doing is counting individuals.”
Clark County’s new weighted questionnaire now considers how seemingly an individual is to exit homelessness on their very own — as an alternative of how seemingly they’re to die on the streets or within the tunnels.
The brand new system assigns homeless individuals factors in 4 classes to get larger within the queue for housing: whether or not somebody is pregnant or a guardian; whether or not they have a substance use dysfunction, persistent well being situation, or psychological well being analysis; whether or not they’re 55 or older; and whether or not they have dedicated a felony or violent crime.
“Since you’re not going to get permitted for a job or housing in the event that they run a background test and there’s a legal report,” she mentioned, “so we need to tackle that in our housing system.”
Nonetheless, Barnes isn’t certain Clark County will get it proper this time. As of mid-November, extra homeless Black individuals had been ready for housing than white individuals. In accordance with native knowledge obtained via public data requests, practically 1,500 Black persons are within the county’s housing queue, in contrast with roughly 1,000 white individuals.
“I don’t know what the answer is,” Barnes mentioned. “To be sincere, the numbers might spike once more.”
Los Angeles County, the place an estimated 75,000 individuals expertise homelessness, is making a weighted instrument to assign extra factors for elements that disproportionately have an effect on individuals of colour.
If somebody has been incarcerated or detained by legislation enforcement, as an alternative of getting one level, a homeless individual would rating 5, shifting them up on the housing record, mentioned Eric Rice, a social scientist and professor on the College of Southern California.
“We’re assigning extra factors to structural inequities,” mentioned Rice, who helps develop the brand new questionnaire.
Los Angeles County additionally plans to assign extra factors for drug use and for having HIV, which impacts Black males greater than another group. New HIV diagnoses for Black adults had been eight occasions these of white individuals, in response to analysis by KFF, a well being info nonprofit that features KFF Well being Information.
Homelessness coordinators have additionally revamped their vulnerability evaluation in Travis County, Texas, the place a Black resident is six occasions as prone to fall into homelessness as a white individual.
The county’s homelessness company, in response to Fisher, checked out traditionally Black neighborhoods in Austin that had been gentrified and scored homeless individuals larger in the event that they’d lived in these areas however had been now homeless.
“In the event you lived in a spot that was beforehand redlined or now gentrified, you bought some extent for that,” Fisher mentioned. The survey additionally gave factors for involvement within the legal justice system, as a result of Black persons are extra prone to get arrested or jailed, she mentioned.
Some consultants say the concept of utilizing a instrument to rank individuals ought to disappear altogether.
As an alternative, communities ought to have flexibility to tailor their housing sources primarily based on the native wants and demographic make-up of their homeless populations, mentioned Mary Frances Kenion, vp of coaching and technical help on the Nationwide Alliance to Finish Homelessness.
She mentioned communities can domesticate belief between homeless individuals and outreach employees via a one-on-one method that may be extra aware of particular person wants and native housing situations, which may higher decide whether or not somebody ought to be moved to the highest of the housing record.
Kenion additionally inspired federal, state, and native governments to reimagine their method to prioritizing individuals for housing primarily based not on vulnerability however financial elements like earnings, historical past of eviction, or having a felony report. She argued communities ought to commit extra sources to stem the move of Black individuals into homelessness.
“If we don’t handle to cease that,” she mentioned, “that is simply going to maintain getting exponentially worse.”
This text was produced by KFF Well being Information, which publishes California Healthline, an editorially impartial service of the California Well being Care Basis.
ahart@kff.org,
@ahartreports
