The Wealthier the City, the Fewer the Homeless Shelter Beds; San Jose Tops the List

There is a lot of talk about the homeless these days.  Why are there so many homeless people in this area?  Why are so many of them living outside in the parks and by the creeks?  Why aren’t they in shelters? 

I, for one, am glad so many people are talking about this.  I am a family physician who works with homeless patients, and it matters a lot to me when patients are able to go indoors.  Their health dramatically improves when they can sleep in a warm bed and have regular access to food and clean water.

I recently was reading academic journal articles about studies done in large homeless shelters in other cities in North America.  I decided to look into this.  The department of Housing and Urban Development (HUD) has generated a wealth of information about homeless shelters, transitional housing, and permanent housing for formerly homeless individuals for cities across the nation.

It turns out my suspicions were correct:  San Jose/Santa Clara County has the highest rates of unsheltered homeless in the nation, higher than those in LA, New York, or San Francisco.

Many people think we have more homeless people than other cities.   We do have a lot of homeless people, but not more per capita than many other large cities.  Indeed, New York, San Francisco, Seattle, and Portland all have more homeless residents per capita than we do.  The really striking thing about Santa Clara County is how few shelters we have.   Compared with other large cities in America, Santa Clara County has the lowest ratio of shelter and transitional beds per homeless person.

homelessunshelteredgraphic

There are a number of other reasons why we have so many homeless on the street in San Jose.  Santa Clara County lacks a medical detoxification center and a small number of inpatient drug and alcohol recovery beds.  AB109, Governor Brown’s Public Safety Realignment Act that transferred state prisoners to local prisons had some significant side effects that probably resulted in greater rates of homelessness on our streets.  Of course, the exceptionally high cost of living combined with relatively few low income housing options and a tight rental market contributes to high rates of homelessness; however, it doesn’t particularly mean that the homeless have to be unsheltered.  Other cities with high costs of living (like New York and San Francisco) have lower rates of unsheltered homeless than San Jose.

A recent report found that residents of San Jose have the highest median income in the nation.  Ironically, we rank #1 in two seemingly opposite and unrelated categories: the fewest shelter beds per homeless person, and the highest median income in the nation.

We wondered if those two things were completely unrelated.  We charted cities’ median incomes vs. shelter beds per homeless person, and found that among the large cities in America, as median income rises, shelter beds per homeless person decreases.  It’s a quizzical finding, since cities with more wealth should be able to afford more services for the poor.  Could it be that our Silicon Valley wealth has made us stingier and busier, with a scarcity of time and compassion to care for our cold and hungry outdoor neighbors?

This is an optimistic time as city and county governments are working together to house and improve the lives of the homeless.  To dialogue on these hard questions, I started a blog about homelessness in San Jose.  Take a look and join in the conversation.  SanJoseHomeless.org.

 

 

Angela Bymaster is a family medicine physician who has worked primarily with homeless patients in San Jose for the past 5 years.  

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