LAS VEGAS — Maurice Clark huddled in his tent alongside dusty railroad tracks as two homeless-outreach staff started asking him questions to find out whether or not he would qualify free of charge or sponsored housing.
Did he use medicine? 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 trustworthy with the 2 surveyors he’d by no means met earlier than, who have been flanked by cops as they recorded his responses from a questionnaire on a pill.
“I’ve done some crazy things to survive, but I’m, like, I’m going to say no because there’s these officers right there,” he mentioned, recalling the encounter on a fall afternoon exterior his tent.
“I’m a Black man in America, so asking this stuff hits a little bit different.”
Nationwide homelessness specialists and native leaders say such private questions exacerbate racial disparities within the ranks of the nation’s unhoused, significantly as extra folks experiencing homelessness compete for scarce taxpayer-subsidized housing amid a deepening affordability disaster.
Vulnerability questionnaires have 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 susceptible, 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 folks 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 folks.
Black folks make up 13.7% of the general U.S. inhabitants but account for 32.2% of the nation’s homeless inhabitants. White folks, together with some folks of Hispanic descent, make up 75% of the nation and symbolize 55% of America’s homeless.
“It’s racist in a systemic way,” 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. “If you’re a white person, the more likely you are to rank higher than if you’re a Black person, so you’re more likely to get selected for housing.”
Vulnerability surveys took off after President Barack Obama in 2009 signed into regulation sweeping guidelines requiring the nation’s native homelessness companies, referred to as Continuums of Care and at present numbering 381, to undertake a technique to evaluate the vulnerability of homeless folks to obtain federal housing and homelessness funding. Cities and counties predominantly adopted a survey referred to as VI-SPDAT, which remains to be utilized by an estimated two-thirds of homeless companies, even because it has been discovered to favor white folks and rank Black folks decrease.
Some specialists 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 prison justice system, limitations 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 programs to cut back racial disparities and assist extra Black folks get housing.
In Los Angeles, officers are launching an effort to make use of synthetic intelligence to raised assess whether or not somebody must be prioritized for placement, partly by overpolicing of Black folks and discrimination in well being care. In Las Vegas, officers are revamping their vulnerability evaluation to offer greater scores for systemic issues together with incarceration. In Austin, Texas, officers are testing a system to account for folks displaced by gentrification.
“We need to own the racism that is embedded in our systems,” mentioned Quiana Fisher, vp of homelessness response programs for the lead company in Travis County, Texas, which incorporates Austin. “It’s not just about the tool — it’s about funding, and it’s about program outcomes. Even if it’s unintentional, we have created a homeless response system that is rooted in racism.”
The evaluation instrument was first examined in Boston, the place members of the homeless inhabitants have been extra more likely to be white, male, and have a extreme psychological sickness or substance use dysfunction. Black folks, in the meantime, usually tend to be homeless due to financial causes, reminiscent of poverty or joblessness, and are much less more likely to have a document of medical care because of greater uninsurance and fewer use of well being care.
“This whole system was piloted on this older white population in Boston, so it does a poor job of capturing the needs of Black folks, who don’t tend to be as sick as white folks — they’re more broke,” Dones mentioned. “The initial thought was to prioritize these people because they’re going to die sooner. It was trying to tackle mortality, but it wound up in racism.”
In consequence, white individuals are extra more likely to acquire housing as a result of they have an inclination to attain extra factors on vulnerability assessments that rank illness greater, together with histories of continual illness, dependancy, psychological sickness, and emergency room visits and hospitalizations, in accordance with nationwide surveys. Black folks, in the meantime, are much less more likely to have medical health insurance or medical diagnoses and to disclose their illnesses, and are extra mistrustful because of biases within the well being care system. “Black folks are less likely to seek care, even with coverage, due to 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 folks into homelessness, together with placement in foster care and better charges of eviction and joblessness. However as soon as homeless, serving to Black folks get into steady housing turns into extra elusive.
In Los Angeles County, residence to extra homeless folks than every other county within the nation, 31% of homeless individuals are Black, although the general Black inhabitants accounts for 9%. In Austin, Black folks account for practically 32% of the homeless inhabitants, in contrast with 7.6% total. And in Clark County, which incorporates Las Vegas, Black folks symbolize 42% of the homeless inhabitants however simply 12% of the general inhabitants.
“We’ve failed to capture the complex vulnerabilities of our marginalized groups. We’re asking all these questions, but we created a waiting list 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 staff that ought to rank him excessive within the queue — he lacked steady housing, has been homeless for practically 4 years, and has no job or dependable revenue.
He’d frequented emergency rooms and had been to jail, pleading responsible to a felony theft crime he mentioned he didn’t commit, and several other occasions for possession of medication and paraphernalia, he informed them. He used methamphetamine, principally to be alert at evening when it turned 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 nervous he’d be focused for taking recyclables or partaking in prostitution. “I’ve done it to get a room for a night. It’s like a last resort,” he mentioned.
And Clark wasn’t forthcoming with outreach staff concerning the particulars of his drug use or involvement with regulation 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. Regularly fleeing regulation enforcement sweeps along with his tent, hauling it alongside busy prepare tracks, he’s excessive at occasions, and infrequently in a state of chaos and worry that may scramble his reminiscence or make him afraid of arrest. He didn’t share with them his occasional ideas of suicide or his well being considerations, together with probably having diabetes.
“They asked me about drugs, I was like, um, I don’t know,” Clark mentioned. “Like I’m supposed to tell them I got addicted to meth or sold my body for a meal and hotel room? I had no idea where this information was going or what it was being 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 below a bridge on a latest October afternoon. He mentioned he has taken the questionnaire twice. It led nowhere.
“They asked me, have I been incarcerated? And I said yes. I’ve been to prison too many times. And I have mental health 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 called and asked what happened with my housing. They said I didn’t score high enough,” he mentioned. After getting his blood strain checked by a road drugs nurse, he shrugged, saying he may wind up again within the emergency room, as he retreated below the bridge.
“No matter what society says today, things ain’t never going to change,” he mentioned.
‘I Don’t Know What the Answer Is’
How communities assign factors to homeless folks and rank them for housing is the largest downside.
The most typical questionnaire deployed by communities across the nation, the VI-SPDAT, assigns factors meant to gauge the vulnerability of an individual residing on the streets. Specialists 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 is not a reliable instrument, and Black men consistently score the lowest for vulnerability, so they are deprioritized for housing — to get housing, you really need to score high,” mentioned Courtney Cronley, a College of Tennessee researcher who analyzed the vulnerability evaluation. Her findings have 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 crushed up? Have you ever threatened to hurt your self or anybody else within the final 12 months?
Does anybody drive you or trick you to do issues that you don’t want to do? Do you alternate intercourse for cash? Run medicine?
Specialists who examine the vulnerability questionnaire additionally level out that the racial or ethnic background of surveyors typically doesn’t replicate that of the folks being questioned, which may result in inaccurate outcomes if a respondent doesn’t really feel secure or perceive the survey’s goal.
Some cities and counties are creating surveys that native homeless companies hope will slender racial disparities.
Clark County deployed a brand new vulnerability evaluation in June after a 2023 secret-shopper venture discovered the system was not connecting homeless folks with housing or providers, particularly folks of shade.
“We failed in every category,” Barnes mentioned. Previously homeless folks fanned out on the streets and within the tunnels to check whether or not the housing questionnaire resulted in offering housing for essentially the most susceptible. “All we were doing is counting people.”
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 folks factors in 4 classes to get greater within the queue for housing: whether or not somebody is pregnant or a mum or dad; whether or not they have a substance use dysfunction, continual well being situation, or psychological well being prognosis; whether or not they’re 55 or older; and whether or not they have dedicated a felony or violent crime.
“Because you’re not going to get approved for a job or housing if they run a background check and there’s a criminal record,” she mentioned, “so we want to address that in our housing system.”
Nonetheless, Barnes isn’t positive Clark County will get it proper this time. As of mid-November, extra homeless Black folks have been ready for housing than white folks. In line with native knowledge obtained via public data requests, practically 1,500 Black individuals are within the county’s housing queue, in contrast with roughly 1,000 white folks.
“I don’t know what the solution is,” Barnes mentioned. “To be honest, the numbers may spike again.”
Los Angeles County, the place an estimated 75,000 folks expertise homelessness, is making a weighted instrument to assign extra factors for elements that disproportionately have an effect on folks of shade.
If somebody has been incarcerated or detained by regulation enforcement, as an alternative of getting one level, a homeless individual would rating 5, transferring them up on the housing record, mentioned Eric Rice, a social scientist and professor on the College of Southern California.
“We are assigning more points 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 every other group. New HIV diagnoses for Black adults have been eight occasions these of white folks, in accordance with analysis by KFF, a well being data 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 more likely to fall into homelessness as a white individual.
The county’s homelessness company, in accordance with Fisher, checked out traditionally Black neighborhoods in Austin that had been gentrified and scored homeless folks greater in the event that they’d lived in these areas however have been now homeless.
“If you lived in a place that was previously redlined or now gentrified, you got a point for that,” Fisher mentioned. The survey additionally gave factors for involvement within the prison justice system, as a result of Black individuals are extra more likely to get arrested or jailed, she mentioned.
Some specialists say the concept of utilizing a instrument to rank folks ought to disappear altogether.
As an alternative, communities ought to have flexibility to tailor their housing sources based mostly 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 folks and outreach staff via a one-on-one method that may be extra attentive to particular person wants and native housing situations, which may higher decide whether or not somebody must be moved to the highest of the housing record.
Kenion additionally inspired federal, state, and native governments to reimagine their method to prioritizing folks for housing based mostly not on vulnerability however financial elements like revenue, historical past of eviction, or having a felony document. She argued communities ought to dedicate extra sources to stem the move of Black folks into homelessness.
“If we don’t manage to stop that,” she mentioned, “this is just going to keep getting exponentially worse.”
This text was produced by KFF Well being Information, which publishes California Healthline, an editorially unbiased service of the California Well being Care Basis.
