Portland and Multnomah Counties switched about 300 people from community care to motels during the pandemic. (ftfoxfoto / Adobe Stock)
Eric Tegethoff, Public Intelligence Service – OR
March 18, 2021
By Isobel Whitcomb for Yes! media.
Broadcast version of Eric Tegethoff for the Oregon News Service, which is for the YES! Cooperation between media and public intelligence services
PORTLAND, Ore. – Jeff Smith’s life began all over in a roadside motel with brown stucco walls and yellow awnings. Smith has not been housed in nearly 10 years, and prior to the COVID-19 pandemic, he ricocheted between the Portland, Oregon homeless shelters. There he would sleep in overcrowded rooms that were only a short break from the streets. Every day between 5 and 6 a.m. he had to walk according to the rules of the animal shelter, only to be back in line at 5:30 p.m., hoping to get a bed that evening.
In addition to the relentless stress of finding a safe place to rest, Smith had battled thyroid cancer for the past five years. During this time, he also had three heart attacks, cellulitis, and an infection at the base of his spine. Oregon’s Medicaid program took him to the hospital between shelters for blood tests, surgery, and radioactive iodine therapy.
By the end of the five years, Smith was less and less concerned with his medical care – he just didn’t have the energy or the will. He was still making most of his doctor’s appointments but had completely stopped taking the medication he needed to survive. “I gave up,” says Smith.
Then, a few months after the pandemic, his case worker at the local nonprofit Do Good Multnomah told him about an experimental housing initiative: Across Portland, The Portland / Multnomah County Joint Office for Homeless Services rented hotels to protect those who were not accommodated and at risk of severe coronavirus.
The county was not alone in this initiative. When the pandemic began, urban areas across the country, from Seattle to New York City, struggled to find alternatives to the crowded homeless shelters where the novel coronavirus was rapidly spreading. Hotels emptied by the blow of the pandemic on the travel industry seemed the logical solution.
At first Smith hesitated to take a room. He had made friends with social workers in downtown and did not want to leave them. He was also concerned about the mental stress of isolation. But at the request of his caseworker, he accepted. He’s glad he did. “This place is a lifesaver,” says Smith. In his room he was able to make up for years of sleep loss. He can shower whenever he wants. He has his own toilet.
Most importantly, he must have privacy and the stability to access medical care. Every day he uses his new Chromebook to check his medical records. He has a place to keep the 31 pills he needs every day; The clerks on site remind him to take the medication in good time and to drive him to his doctor’s appointments.
“I wouldn’t be alive if I had cancer and heart attacks on the street,” says Smith. “I wish I could find everyone in Multnomah County and thank them.”
How the placement affects health
Even outside of a pandemic, homelessness takes an extreme toll on health. A 2018 study published in The lancet found mortality rates 3 to 11 times higher in uninhabited populations. Other studies suggest This discrepancy persists even when researchers monitor socioeconomic class and pre-existing health conditions. “You’re exposed to the elements, extreme stress and trauma,” said Deborah Padgett, professor at New York University’s Silver School of Social Work and an expert on housing and homelessness. No wonder people’s health suffers under these conditions.
Traditional accommodation and housing programs often require participants to meet certain criteria, such as: B. Sobriety or enrollment in substance abuse treatment. Curfews can make it impossible to feel at home, and crowded rooms affect sleep and the feeling of security. Housing attorneys have long called for change within the Protection system. By providing privacy and stability, hotel accommodations are an unexpected answer to that call. Early research suggests that the new shelters didn’t just lead to a decrease in COVID-19 cases. Overall, they lead to better health outcomes.
When King County, Washington, which includes Seattle, first moved more than 700 people to hotels in April 2020, the impact was almost immediate. The service providers who were entrusted with the operation of the emergency shelters called the district and reported that their residents looked better in a happy mood and slept better. “They’ve been successful,” says Gregg Colburn, a real estate professor who studies Affordable Access to Housing at the University of Washington in Seattle.
Colburn conducted a study with researchers from the University of Washington and King County that looked at the experiences of hotel accommodation residents. The researchers interviewed 22 people living in the hotels and nine employees of housing service providers, the city of Seattle and King County. People in the hotels reported better hygiene, less anxiety and less substance use. They pursued hobbies that ranged from watching TV to hiking and fishing.
COVID-19 cases have decreased compared to traditional shelters. Of the 383 people who lived in the hotel accommodations, the researchers observed six cases of COVID-19 between April 2020, when the participants were taken to the hotels, and September 8 this year. Over the same period, the researchers observed 49 cases among 926 people living in community shelters. As mental health improved, emergency shelters also became less dependent on police intervention. For a group of participants, 911 calls to the local police dropped 80% after moving to a hotel.
The success of hotel accommodation does not surprise researchers and advocates in the world of housing access. Research has long supported the idea of ”living first” – moving people to long-term housing before being challenged to navigate healthcare, social work, and drug abuse treatment. A 2020 study found that people are housed in permanent supportive housing received more mental health care: Average of 37.3 visits per year, compared with 19.7 for those not in permanent housing. They also experienced 38% fewer mental emergencies. Similarly, researchers in Glasgow in 2019 found that people housed in permanent supportive housing had 37%. had 37% fewer visits to the emergency room than their unhodged counterparts and 24% fewer hospital stays.
It is important to note that the researchers in this second study did not see any improvement in the health reported by the participants themselves. It makes sense: These improvements can be difficult to see in studies of permanent supportive shelter, says Maria Raven, chief medical officer at the University of California’s San Francisco Medical Center. People often step into permanent supportive homes with a litany of health problems that often go undiagnosed, says Raven. And after years of chronic homelessness, it may be impossible to completely reverse the effects of chronic health conditions. “You are not in the primary or secondary prevention phase,” says Raven. “At this point, permanent supportive housing helps control people’s illnesses.”
Smith, for example, is being looked after more consistently than ever before on the street. That’s the humane and necessary thing, says Raven: “When someone is sick and vulnerable, we let them house and house.”
Hotels as living space for the future
“As tragic as COVID was, this is an incredible opportunity for the homeless response system,” says Colburn. “We can try something that we would never have gotten money for before the pandemic.”
As of now, the hotel accommodations are not permanent supportive accommodations, says Colburn. The accommodation they are providing is temporary. That could change. King County plans to purchase up to a dozen hotels with sales tax revenues with the aim of permanently accommodating 2,000 people – nearly half of the currently unoccupied population – in rooms. In October 2020 Legislators in Oregon approved $ 65 million for a project that will transform hotels into permanent supportive housing.
Smith looks to the next steps in his life. He just got a photo ID. He is currently applying for social security. (“So I’ll be a real person,” he says.) And a month ago he got his own dog – a caramel-colored, fat-belly puppy he named Legend. He’s never had a pet and is crazy about the dog he named out of hope for his future. “He’s going to be part of the legend of how Jeff got a house,” says Smith.
In an ideal world, Smith would move into LeBron James’ guest room. But right now he’s looking forward to moving to a place with roommates, his own roll of toilet paper, and a room where Legend can learn basics that he could never have imagined without the hotel and Multnomah County’s unconditional offer of protection .
“It took me a long time to get to this place where I could fight for my life again,” says Jeff
I still fight all the time. “
Isobel Whitcomb wrote this article for YES! magazine. Whitcomb is a journalist and lives in Portland, Oregon. Her work on health and the environment has been published in the New York Times, Slate and Bay Nature Magazine. Check out their work: www.IsobelWhitcomb.com.
