February 25th, 2018

San Diego’s Most Vulnerable Population Suffering From a Public Health Disaster

By Lauryn Pregoni

Imagine trudging through a busy city, pushing all of your belongings in a metal cart day after day, eventually being pushed out to the outskirts of highways and city parks. Day after day you push this cart to new areas, seeking safe space to bathe, eat and sleep. Then imagine when you finally do get space and time to rest and perhaps even pitch up a tent, you return from trying to secure food to see all your belongings being dumped carelessly into the back of a garbage truck.

The homeless population in San Diego encounter situations akin to this on a daily basis. In our society, being homeless has long been synonymous with incompetence and inferiority. In popular discourse, reasons for homelessness rarely highlight failings of institutions and society and rather highlight the individual’s succession of decisions that pushed them to the streets. Many maintain a lack of empathy for homeless individuals, which is evident in the way that the population is treated in San Diego. There is a severe lack of shelter offered to the homeless community; a new city initiative aims only to provide the homeless with a more stable shelter of tents in an abandoned parking lot south of the Balboa Park Golf Course.

In a recent study surveying the homeless population in San Diego, it was estimated that there are approximately 9,116 homeless individuals in San Diego. As of 2015, San Diego had the nation’s fourth highest rate of a homeless population. One would assume that this statistic would embolden city officials to tackle the issues of homelessness in San Diego. However, like most issues regarding homelessness and mental illness in the United States, a blind eye was turned sooner than any type of aid was given.

Homeless individuals are particularly vulnerable when it comes to public health issues. In 2017, 544 individuals in San Diego were infected with Hepatitis A- with the breakout originating in the homeless camps. Hepatitis A is often transmitted through contaminated food, making homeless populations especially susceptible. When one is scraping by leftovers just to survive, contamination is quite possibly the least concern. Public health officials in southern California have had to increase their efforts to administer the vaccine in an effort to combat the outbreak in San Diego’s homeless communities. This effort even led to the city bleaching its streets and sweeping through known homeless camps to dump their belongings. As one can imagine, these efforts can be extremely traumatic to a person who is already on the fringes of society.

This case study poses pertinent questions: how can an outbreak like this be expected to be contained with the majority of the cases are infecting transient individuals? More importantly, how can this outbreak influence San Diego and other areas of the country to provide more clean and accessible housing and food to the growing homeless population? While bleaching the streets can help eradicate infectious disease, providing more preventative options to the homeless community--such as increased accessibility to clean water for drinking and bathing--could potentially eliminate the possibility of another outbreak of similar scale. A recent L.A. Times article criticized the 2014 construction of a $2 million public bathroom on the San Diego waterfront, a neighborhood notorious for homeless encampments. Its point? Simple: that investing that money into multiple public restrooms in the city could have been more beneficial. Having increased access to clean water and the opportunity to bathe could provide the homeless population with immense relief and considerably decrease the possibility of a public health disaster.

Furthermore, San Diego’s homeless population has a large community of veterans, who have expressed that they have been failed by the Veterans Affairs offices that are supposed to help them gain employment and have a stable income. It then comes as no surprise that  homeless veterans may be wary of government intervention in removing their belongings and forcing them to live in a makeshift campground. With San Diego's current efforts to eradicate the city's Hepatitis A outbreak, it looks like this distrust could continue to intensify.

If the public’s perception of homelessness in our society were to become more empathetic, perhaps we would be more efficient and vigilant in dealing with public health issues such as this outbreak. San Diego has a very limited number of shelters for the homeless, compelling them to take refuge in the doorways of businesses and on the sides of canyons. If the city were to implement more permanent or semi-permanent housing options for the homeless population, perhaps the incidence rate of public health outbreaks would decrease. Moreover, building more permanent restrooms and facilities that offer access to clean, running water would help to prevent the possible spread of viruses throughout the community. For a shift in society to take place, more often than not the public perception of the issue has to change. For many San Diegans, homelessness is an evident but covert problem--tourists and residents alike can go throughout their days willfully ignoring displaced people. If residents became more cognizant of the plight of the homeless population, the possibility that more action would be taken could potentially increase. The axiom “it takes a village” can be applied when dealing with a community-based issue such as this one. 



Interested in Ways to Help?

Father Joe’s Villages runs the largest homeless shelter in San Diego. 

PATH (San Diego) is a local non-profit that helps homeless populations. 

Interested in Learning More?

Read about “Housing First,” a program aimed to provide permanent housing for homeless populations.

Read the San Diego County Public Health Department's brief on the outbreak.

Lauryn Pregoni double majored in Anthropology and Sociology with a concentration in Medical Anthropology at Roger Williams University in Bristol, RI. She also served as an Editorial Board Member for the Journal of Undergraduate Ethnography. Upon graduating, she moved west to San Diego, CA, where she is currently interested in the socio-political issues of the border city and public health issues. She plans on pursuing my education in Sociology and Anthropology in graduate school.