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Stemming the rise of Latinx homelessness: lessons from Los Angeles County

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  • AltaMed Institute for Health Equity

Abstract

This report describes a needs assessment of Latinx persons at-risk for or who are actively homeless in Los Angeles County. We conducted interviews with stakeholders (n = 24) who work in homeless services, research, and policy. Themes from these interviews were categorized into domains along the continuum of homeless services. Language barriers and citizenship/documentation status impeded Latinxs’ success in the rental market, increasing risk of homelessness. To engage Latinxs in outreach and services, use of familiar, local, and culturally competent institutions was described as critical. Shelters were underutilized due to concerns of family separation, or misconceptions about shelter use among non-citizen Latinxs. Rapid rehousing mechanisms were poorly suited for Latinx immigrants with limited access to public resources. To increase housing resources, engaging local providers who can obtain community buy-in for affordable housing was described as important. Overall, tailored services from trusted agencies in the Latinx community are critical to address service disparities.
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Journal of Social Distress and the Homeless
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Stemming the rise of Latinx homelessness: lessons
from Los Angeles County
Melissa Chinchilla & Sonya Gabrielian
To cite this article: Melissa Chinchilla & Sonya Gabrielian (2019): Stemming the rise of Latinx
homelessness: lessons from Los Angeles County, Journal of Social Distress and the Homeless,
DOI: 10.1080/10530789.2019.1660049
To link to this article: https://doi.org/10.1080/10530789.2019.1660049
Published online: 05 Sep 2019.
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BRIEF REPORT
Stemming the rise of Latinx homelessness: lessons from Los Angeles County
Melissa Chinchilla
a
and Sonya Gabrielian
b
a
AltaMed Institute for Health Equity, Los Angeles, CA, USA;
b
VA Greater Los Angeles and Department of Psychiatry & Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA, USA
ABSTRACT
This report describes a needs assessment of Latinx persons at-risk for or who are actively
homeless in Los Angeles County. We conducted interviews with stakeholders (n= 24) who
work in homeless services, research, and policy. Themes from these interviews were
categorized into domains along the continuum of homeless services. Language barriers and
citizenship/documentation status impeded Latinxssuccess in the rental market, increasing
risk of homelessness. To engage Latinxs in outreach and services, use of familiar, local, and
culturally competent institutions was described as critical. Shelters were underutilized due to
concerns of family separation, or misconceptions about shelter use among non-citizen
Latinxs. Rapid rehousing mechanisms were poorly suited for Latinx immigrants with limited
access to public resources. To increase housing resources, engaging local providers who can
obtain community buy-in for aordable housing was described as important. Overall, tailored
services from trusted agencies in the Latinx community are critical to address service disparities.
ARTICLE HISTORY
Received 11 January 2019
Revised 30 June 2019
Accepted 18 August 2019
KEYWORDS
Homelessness; Latinxs;
immigrants; Latino; homeless
services
Introduction
Homelessness is a national concern and for many
municipalities a local crisis. Los Angeles County has
one of the largest number of homeless individuals
(i.e. persons lacking a nighttime residence (HUD
Exchange, 2012,2015))ofanyregioninthenation.
On a single night in 2019, 58,938 individuals were
homeless in Los Angeles (LAHSA, 2019); many
more were at risk for experiencing homelessness. Per-
sons self-identifying as Latinx comprise 49% of the
countys population, and 37% of the homeless popu-
lation (LAHSA, 2019). Further, Latinxs are likely to
be underestimated in homeless counts; they are
more likely to live outside of traditional homeless
spaces (e.g. homeless shelters and encampments),
often crowding multiple families into single resi-
dences in lieu of using homeless services (Burr,
Mutchler, & Gerst, 2010;Krivo,1995; Myers & Lee,
1996). This group relies heavily on social networks,
using public services at lower rates than other racial/
ethnic groups (Conroy & Heer, 2003;Molina-Jackson,
2008). Latinx experiencing homelessness or at risk for
becoming homeless comprise an overlooked, particu-
larly vulnerable population. Research on these groups
remains scant, primarily framed under the misleading
notion of a relative lack of homelessness (Conroy &
Heer, 2003; Lee, Tyler, & Wright, 2010;Molina-Jack-
son, 2008). This research contributes to our knowl-
edge of the Latinx experience through a needs
assessment of Latinx persons at-risk for or who are
actively homeless.
The knowledge gap of Latinx homelessness is juxta-
posed to an increase in homeless persons self-identify-
ing as Latinx, low-rates of homeless service use by this
group, and distinct social vulnerabilities by this popu-
lation (e.g. language barriers and citizen/documen-
tation status). While Latinxs made up 35% of the
homeless population in 2017, only 30% were engaged
by initial outreach and 21% placed in permanent hous-
ing (LAHSA, 2018). Latinxs are more likely to be rst
time homeless compared to other racial/ethnic groups,
and more likely to experience homelessness with chil-
dren (Flaming, Burns, & Carlen, 2018) and as part of
an intergenerational household (Homelessness Policy
Research Institute, 2018). In Los Angeles County,
nearly 40% of Latinxs are foreign born, 61% of whom
are not naturalized citizens (U.S. Census, 2017).
Foreign-born Latinxs are three times as likely to lack
a high school degree than native-born Latinxs and
have lower median earnings (Burd-Sharps, et al.,
2017). Further, only about 35% of foreign born Latinxs
are English procient (Pew Research Center, 2017).
Language as well as non-citizenship status add
additional complexity to Latinxsneeds; non-citizens
and persons who are undocumented often do not qua-
lify for public benets (Ku & Bruen, 2013) and trans-
lation services are frequently needed adjunctive to
services they do qualify for.
With increasing recognition that housing is a key
determinant of health with notable economic and
social costs (USICH, 2015), it is critical to understand
the needs of Latinxs at risk of or currently experiencing
© 2019 Informa UK Limited, trading as Taylor & Francis Group
CONTACT Melissa Chinchilla mechinchilla@altamed.org VA Greater Los Angeles, 11301 Wilshire Blvd, Los Angeles, CA 90073, USA
This article has been republished with minor changes. These changes do not impact the academic content of the article.
JOURNAL OF SOCIAL DISTRESS AND THE HOMELESS
https://doi.org/10.1080/10530789.2019.1660049
homelessness. To identify unique challenges and gaps
in service provision for these persons, we conducted
a needs assessment in Los Angeles County, a region
with one of the largest native and foreign born Latinx
populations (U.S. Census, 2017). We interviewed ser-
vice providers across the County, including persons
working in aordable housing and homeless services,
legal advocates, researchers, and leaders in govern-
ment, philanthropy, and homelessness policy. As
described by key informants, this report presents key
challenges for Latinxs at risk of or experiencing home-
lessness and oers recommendations to address this
populations distinct housing and service needs.
Methods
Between July and October 2018, one author (MC)
interviewed 24 key informants (45 min/interview)
across Los Angeles County. Participants were identied
using reputation-based snowball sampling. Key local
service providers working to address homelessness
were invited to participate in the study; they were sub-
sequently asked to recommend other participants that
would be appropriate. Most (n= 20) of the interviews
were conducted in person; the remainder (n= 4) were
conducted by telephone. All interviews were adminis-
tered in English by one author (MC). Verbal consent
was obtained. Interviewees consisted of eleven men
and thirteen women, including mid- to senior-level
stain aordable housing and service provision (n=
8), research and policy (n= 5), local government (n=
4), philanthropy (n= 6), and legal services (n= 1).
Interviews were conducted until thematic saturation
was reached (Namey, Guest, McKenna, & Chen, 2016).
Interviewees were asked to speak to the experiences
of Latinx vulnerable to and actively experiencing
homelessness. A semi-structured interview guide was
used, with questions aimed to understand unique fea-
tures of Latinxsexperiences with homelessness
(including persons at risk for experiencing homeless-
ness and those who were actively homeless); central
eorts tailored to meet this populations distinct
needs; and resource gaps and policy roadblocks that
are barriers to serving Latinxs at risk for becoming
homeless or Latinx who are homeless.
Interviews were audio recorded and detailed eld-
notes were taken. In lieu of verbatim transcription,
eldnotes were reviewed and amended with the audio
recordings (Halcomb & Davidson, 2006). Fieldnotes
were coded by the primary author (MC) and organized
into templated summaries. The primary author
engaged in iterative discussion of analyses with the
co-author (SG). Based on interview questions and par-
ticipant responses, themes from the interviews were
organized into four core domains along the continuum
of homeless services found in the literature (Wong,
Park, & Nemon, 2006): homelessness risk, outreach
and service engagement, shelters, rapid rehousing,
and permanent housing. The Massachusetts Institute
of Technology Institutional Review Board approved
all study activities.
Results
Below, we describe key themes that highlight distinct
vulnerabilities for the Latinx population along the con-
tinuum of homeless services.
Risk of homelessness
Participants working in legal services, aordable
housing, and homeless service provision noted that
non-citizens and monolingual Latinxs have a particu-
larly dicult time in the rental market, increasing
their risk for experiencing homelessness. English
only documents, including leases and eviction notices,
make it dicult for monolingual Spanish speakers to
understand rental agreements. Monolingual renters
may sign a rental lease without fully comprehending
what it contains and inadvertently violate a stipula-
tion they were unaware of. Participants noted
instances in which rentersin eorts to aord rental
costsunintentionally violated their leases by allow-
ing someone not on their original agreement to
move into their unit with them. Further, participants
working in legal services stated that immigrant renters
(regardless of language status) are often unaware of
their rights, do not know how, or are afraid to assert
them. In particular, participants reported that undo-
cumented immigrants (i.e. individuals lacking docu-
ments for legal immigration or residency) and
mixed-status households are less likely to ght an
eviction or illegal rent increase, fearing landlord reta-
liation through the involvement of Immigration and
Customs Enforcement.
Participants working in homeless services also
described elderly non-citizen Latinxs as being at high
risk of becoming homeless. These individuals qualify
for few public benets. In addition, low wages, unstable
income, and remittances to ones home country during
working years make this population unlikely to have
retirement savings. If individuals do not have social
support networks to assist them, participants feared
that this group is likely to enter homelessness with lim-
ited options for housing or other social services.
Outreach and service engagement
Participants stated that outreach workers have wit-
nessed an increase in the number of Latinxs on the
street, but fewer entering service agencies to receive
support. Homeless service providers and outreach
workers believed that a reluctance to engage in services
was tied to cultural dierences in how Latinxs interpret
homelessness. Several participants stated that Latinxs
2M. CHINCHILLA AND S. GABRIELIAN
are hesitant to identify themselves as homeless. When
oered services, Latinxs were described as refusing
assistance and expressing prideand/or shame.Par-
ticipants noted that Latinxs are also less likely to seek
services from traditional homeless providers and
more likely to identify themselves as experiencing
homelessness in non-traditional settings, including
community clinics and churches. For Latinxs, famili-
arity of and trust in local institutions appears to be
key to service engagement. Institutions with established
reputations in the community may be most successful
in encouraging service participation.
Once individuals are connected to services, a lack
of bilingual staand translation of documents
makes service enrollment dicult for monolingual
Spanish speakers. In addition to language barriers, a
lack of knowledge regarding the service system can
pose challenges. For example, many participants
noted that Latinx immigrants often do not engage
with public assistance for fear of being labeled a pub-
lic charge.According to the U.S. Citizenship and
Immigrations Services, a public charge is a noncitizen
that the government believes has or is likely to become
primarily dependent on government assistance
(USCIS, 1999). If an individual aims to seek U.S. citi-
zenship, being labeled a public charge can lead to
ineligibility. Participants working in housing and ser-
vice provision, local government, and legal services
noted widespread fear among the Latinx immigrant
community that any program providing public assist-
ance will negatively aect their immigration status.
This belief prevents individuals experiencing or at
the brink of experiencing homelessness from seeking
and accepting assistance. However, not all public pro-
grams label someone a public charge and those that
do fall into two categories: (1) receipt of public cash
assistance for income maintenance, or (2) institutio-
nalization for long-term care at government expense
(USCIS, 1999). Participants working in legal services
indicated that a lack of information leads many immi-
grants to view all services as presenting a risk to their
status in the U.S. These participants believed there is a
need for increased partnership between homeless ser-
vice providers and legal counsel.
Shelters
Participants working in research and policy, local gov-
ernment, and homeless services noted underutilization
of shelters by Latinx and gave several reasons why.
First, Latinxs are more likely to experience homeless-
ness as part of a family unit and spaces in family shel-
ters were described as limited. Second, Latinxs appear
to avoid shelters because they believe the Department
of Children and Family Services will remove their chil-
dren from the household if identied as homeless.
Third, participants noted that Latinxs report discrimi-
nation in the shelter system both by staand other
shelter participants. Fourth, for undocumented indi-
viduals, rumored immigration raids and the threat of
deportation are additional reasons to avoid shelter
use. Lastly, as with other homeless services, partici-
pants believed that Latinxs are reluctant to identify
themselves as homeless and harbor negative percep-
tions of the shelter system.
Rapid rehousing
Rapid rehousing is intended to support individuals in
achieving and maintaining stable housing by provid-
ing short-term rental assistance and social services.
Rapid rehousing funds assist homeless persons for a
maximum of 24 months. However, most providers
aim to taper services by 6 months to spread funds
among a larger number of program participants
(USICH, 2018). If a provider is not able to serve the
number of individuals stated in their funding contract,
the provider may not be considered competitive for
future funding. However, a providers ability to per-
form well is related to the population it serves.
According to participants working in homeless ser-
vices, it is particularly dicult to use rapid rehousing
mechanisms to serve Latinx immigrants who have
limited access to public resources. This group is also
more likely to struggle with inconsistent employment
and low wages, generally requiring longer-term assist-
ance to assure stabilization. Furthermore, some rapid
rehousing providers do not feel equipped to handle
immigrantsunique needs; participants working for
providers largely serving Spanish-speaking popu-
lations reported increases in referrals from other
providers.
Permanent housing
Participants working in aordable housing noted that
the majority of aordable units for homeless popu-
lations are designed for single persons. They stated
that this design is a signicant challenge when serving
Latinxs, whose households are frequently intergenera-
tional and who are more likely to experience homeless-
ness as a family unit. Larger units are needed to keep
these families intact. Further, participants working in
aordable housing and housing policy noted that
obtaining support for aordable housing construction
can be dicult in Latinx communities. They attributed
this problem to a lack of knowledge regarding how
aordable housing works, a fear that new development
will drive gentrication, and a lack of visible Latinx lea-
dership championing aordable housing developments
in their communities. Participants who work in aord-
able housing described local leadership as essential to
assure trust in the process of aordable housing devel-
opment. However, they acknowledged that appli-
cations for housing development funds give no
advantage to organizations that work and have a
relationship with the community that they propose to
JOURNAL OF SOCIAL DISTRESS AND THE HOMELESS 3
build in. They asserted that having local providers
develop housing is key to addressing local resistance
and obtaining community buy-in.
Discussion
Latinx persons at risk for homelessness or who are
actively homeless have distinct social vulnerabilities,
including immigration status, cultural and language
barriers, and economic vulnerability. Our needs assess-
ment points to several ways that policymakers and ser-
vice providers can better address the needs of high-risk
Latinxs by tailoring homeless services and providing
these through trusted agencies in the Latinx
community.
In part, this needs assessment highlights barriers
faced by non-citizen Latinxs, including legal residents
and undocumented individuals. This high-risk group
often does not qualify for public benets and has a
shortfall of resources (Marrow, 2012; Metchniko,
Naughton, & Periyakoil, 2018; Van Natta et al.,
2019). Increased partnerships between legal aid and
homeless services may assist with immigration con-
cerns and assessment of service qualication, particu-
larly in light of proposed changes to public change
designation (Artiga, Gareld, & Damico, 2018).
Further, the number of housing programs that non-
citizens qualify for are extremely limited. Given this
challenge, alternative housing models, including shared
housing, may prove useful. Municipalities may also
explore how to use local funds, not limited by federal
policies, to increase resources for non-citizens. Lastly,
building trust in immigrant communities is valuable
for encouraging non-citizens to engage in homeless
services, and is associated with use of public benets
and even cooperation with law enforcement (Potoch-
nick, Chen, & Perreira, 2017; Theodore & Habans,
2016).
In the domain of homelessness prevention, eorts
would benet from stronger, bilingual, and culturally-
competent education for Latinx renters; important
topics include tenant rightsincluding information
regarding illegal rent increases and evictionsas well
as mechanisms to remove evictions from rental
records. Prevention must also address overcrowding
an issue prevalent in the Latinx community (Burr
et al., 2010; Myers & Lee, 1996); doubled up households
live on the edge of homelessness, but under current
policies do not qualify for homeless services.
Across the continuum of homeless services, Latinxs
are less likely to self-identify as homeless and are often
reluctant to engage with social services. To address
these barriers, homeless outreach and service provision
could be embedded in local institutions that Latinxs
trust, e.g. medical clinics and churches. Information
about homeless services should be delivered in English
and Spanish and more attention could be paid to
culturally relevant interventions that consider the cul-
tural primacy of family. In addition, eorts to decrease
stigma and raise public awareness about the prevalence
and causes of homelessness within Latinx communities
may prove valuable.
While this study was conducted in Los Angeles
County, we suspect that other regions with signicant
Latinx populations experience similar challenges to
serving Latinx who are at risk for becoming homeless
or actively homeless. Additional research, including
consumer perspectives and needs assessments of com-
munities in other geographic regions, that increases
our understanding of this vulnerable population and
establishes best practices will be critical for improving
outcomes for this high-risk group.
Acknowledgments
This project was supported by the University of California,
Los AngelesLatino Public Policy Initiative. Dr. Chinchilla
was supported by Massachusetts Institute of Technologys
Priscilla King Gray Public Service Center and VA Oce of
Academic Aliations through the Health Service Research
and Development Post-Doctoral Fellowship. Dr. Gabrielian
was supported in part by VA HSR&D CDA 15-074. The con-
tents do not represent the views of the U.S. Department of
Veterans Aairs or the United States Government.
Disclosure statement
No potential conict of interest was reported by the authors.
Notes on contributors
Melissa Chinchilla, PhD, MCP, MS, is a Research Scientist at
AltaMed Institute for Health Equity and was previously a
Post-Doctoral Fellow in Health Services Research and Devel-
opment at the Veteran Administration of Greater Los
Angeles. She earned her doctorate in Urban Studies and
Planning from Massachusetts Institute of Technology, a
masters in City and Regional Planning from the University
of California, Berkeley, and a masters in Health Policy Man-
agement from the University of California, Los Angeles. Dr.
Chinchillas research rests at the intersection of housing,
health, and community development.
Sonya Gabrielian, MD, MPH, is a psychiatrist and health
services researcher at the VA Greater Los Angeles and
UCLA David Geen School of Medicine. She is the Acting
VA Research Director of the VA/UCLA Center of Excellence
for Veteran Resilience and Recovery; an investigator at the
VA HSR&D Los Angeles Center of Innovation and the
VISN22 Mental Illness Research, Education, and Clinical
Center; an Aliated Researcher at the National Center on
Homelessness Among Veterans; and an Assistant Professor
in the UCLA Department of Psychiatry. Her research and
clinical practice aim to improve housing retention and com-
munity functioning among homeless persons with serious
mental illness.
ORCID
Melissa Chinchilla http://orcid.org/0000-0001-7546-0827
4M. CHINCHILLA AND S. GABRIELIAN
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Some definitions of homelessness include doubling up—living with others because of economic hardship or housing loss. Doubling up can have negative consequences that should be addressed, but the U.S. Department of Housing and Urban Development’s methods for enumerating homelessness exclude these arrangements, and Department of Education counts of doubling up include only school children. We provide a new method for measuring doubled-up homelessness in the total population using American Community Survey public use microdata. Using this method, we find that 3.7 million people in the U.S. population were doubled up in 2019 and show significant differences in doubling up by geography, race and ethnicity, marital status, educational attainment, school enrollment, and employment status, and compare these findings with research on sheltered and unsheltered homelessness. Notably, rates of Hispanic/Latinx doubled-up homelessness were high, in contrast to their rates of literal homelessness, and some rural areas with low rates of sheltered and unsheltered homelessness had high rates of doubling up. To aid in future research and policy, supplemental materials provide open-source tools for replicating the measure. Findings suggest that policies addressing homelessness and housing insecurity consider those experiencing doubled-up homelessness and that the current measure can assist in those efforts.
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Black Americans are overrepresented in Veteran and non-Veteran homeless populations. Community integration remains a problem for many Veterans after they obtain housing, and Black Veterans may encounter additional difficulties due to systemic racism. However, no prior study has specifically examined whether there are racial differences in community integration; similarly, no study has considered racial differences in psychosocial correlates of community integration in homeless Veterans. Knowledge of these factors could inform the development of culturally congruent rehabilitative interventions for Black Veterans. Semi-structured clinical interviews were administered to Black (N=99) and White (N=49) homeless Veterans to examine relations among psychiatric symptoms, motivation, and community integration domains (e.g., social integration, work productivity, and independent living). There were no significant racial differences in independent living or work productivity. Black Veterans had better social integration with family compared to White Veterans. In addition, psychiatric symptoms were more strongly correlated with social integration for Black than White Veterans. The association between motivation and work productivity was also stronger for Black Veterans. Recovery-oriented interventions could harness family connections and better target psychiatric symptoms to improve community integration for Black Veterans. Work productivity may improve from interventions aimed at enhancing motivation for Black Veterans.
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Using the 2016–2020 point-in-time homeless count data, this study investigates neighborhood characteristics associated with the levels of and changes in unsheltered homeless population density in Los Angeles. The results show that unsheltered homeless people in the study area are heavily concentrated in and around the city center, and in neighborhoods with greater access to shelters and lower socioeconomic status. Notably, neighborhoods closer to the city center experienced a relatively large increase in unsheltered homelessness during the study period, implying a persistent spatial concentration of unsheltered homelessness. The results consistently indicate that residential land share, Hispanic resident share, and the number of bridges in the baseline year are significant predictors of relative changes in unsheltered homelessness in subsequent years, whereas access to shelters and poverty rates are not. This study’s findings provide several important policy implications that could potentially help prevent and mitigate unsheltered homelessness.
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This study seeks to understand characteristics that predict use of Head Start family services by Latinx families. Head Start requires programs to offer services that are tailored to individual family needs. While the offer of services is important, what is critical is the use of these services. Few studies have explored whether families access services when offered and how the contextual risk around the family predicts their likelihood of uptake, especially for Latinx families who are increasingly enrolling in Head Start programs. This study examines patterns of service use by cumulative risk and by individual risk factors. Results indicate that Latinx families with more risk are more likely to use services, as well as use more of them. Findings related to specific individual types of risk were mixed. We include a discussion of Head Start’s comprehensive service delivery model as it relates to service use for Latinx families.
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Our paper explores how legal status stratification shapes the health and health care of low-income patients with chronic illnesses in the U.S. healthcare safety net. Drawing on data from over two years of ethnographic fieldwork at urban safety-net clinics, we examine efforts by Complex Care Management (CCM) teams to stabilize patients with uncontrolled chronic illnesses through primary care-integrated support. We show that stratified citizenship and geographic variability correspond to different possibilities for health care. We suggest an approach to immigration as a structural determinant of health that accounts for the complex, stratified, and changing nature of citizenship status. We also highlight how geographical differences and interactions among local, state, and federal policies support the notion that citizenship is stratified across multiple tiers with distinctive possibilities and constraints for health. While county-based health plans at each of the study sites include residents with varying legal status, lack of formal legal status remains a substantial obstacle to care. Many immigrants are unable to take full advantage of primary and specialty care, resulting in unnecessary morbidity and mortality. In some cases, patients have returned to their country of origin to die. While CCM teams provide an impressive level of support to assist immigrant patients in navigating healthcare and immigration bureaucracies, legal and geographic stratification limit their ability to address broader aspects of these patients’ social context.
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Local-level immigration enforcement generates fear and reduces social service use among Hispanic immigrant families but the health impacts are largely unknown. We examine the consequence of 287(g), the foundational enforcement program, for one critical risk factor of child health-food insecurity. We analyze nationally representative data on households with children from pooled cross-sections of the Current Population Survey Food Supplemental Survey. We identify the influence of 287(g) on food insecurity pre-post-policy accounting for metro-area and year fixed-effects. We find that 287(g) is associated with a 10 percentage point increase in the food insecurity risk of Mexican non-citizen households with children, the group most vulnerable to 287(g). We find no evidence of spillover effects on the broader Hispanic community. Our results suggest that local immigration enforcement policies have unintended consequences. Although 287(g) has ended, other federal-local immigration enforcement partnerships persist, which makes these findings highly policy relevant.
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The authors exploit a unique sample of Mexican-born persons in Los Angeles to investigate whether the apparent dearth of Hispanic homeless (the “Latino paradox”) can be explained as a methodological bias. They test two hypotheses: (Hypothesis 1) there will be no significant difference between the homeless rate (HR) for this sample compared to Los Angeles County and (Hypothesis 2) Mexican-born homeless persons are as likely as others to sleep in nontraditional settings. Rejecting both hypotheses, we find that the HR for this sample is nearly 7 times greater than for the entire county and that Mexican-born homeless are more likely to sleep in nontraditional settings. The authors conclude that Mexican-born homeless may be systematically undercounted in homeless samples because they are more likely to exist outside traditional homeless spaces.
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The new homelessness has drawn sustained attention from scholars over the past three decades. Definitional inconsistencies and data limitations rendered early work during this period largely speculative in nature. Thanks to conceptual, theoretical, and methodological progress, however, the research literature now provides a fuller understanding of homelessness. Contributions by sociologists and other social scientists since the mid-1990s differentiate among types of homelessness, provide credible demographic estimates, and show how being homeless affects a person's life chances and coping strategies. Agreement also exists about the main macro- and micro-level causes of homelessness. Active lines of inquiry examine public, media, and governmental responses to the problem as well as homeless people's efforts to mobilize on their own behalf. Despite the obstacles faced when studying a stigmatized population marked by high turnover and weak anchors to place, recent investigations have significantly influenced homelessness policy. A greater emphasis on prevention should further strengthen the research-policy nexus.
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The Universal Declaration of Human Rights recognizes the inherent dignity, the equal and unalienable rights to be universally protected for all humans irrespective of race, color, gender, language, religion, political or other opinion, national or social origin, property, birth or other status. Though this includes the right to dignity-conserving care for terminally ill unauthorized immigrants, access to quality end-of-life care eludes them. Most of the estimated 11.3 million unauthorized immigrants either entered the country without the knowledge of the U.S. Immigration and Customs Enforcement, or were admitted on a temporary visa and stayed past its expiration date. Unsafe living conditions, occupational hazards, lack of access to routine healthcare, and scarceness of a social and financial support system, fear of deportation, discrimination and incarceration limit healthcare access of unauthorized immigrants. Lack of access to preventative primary care encounters often results in this population's dependence on acute emergency services for treatment. Lack of opportunity for advance care planning discussions and lack of eligibility to hospice services commonly contributes to poor end of life care. As unauthorized immigrants approach the last days of life, they often end up dying alone in a foreign country, away from their loved ones, with little-to-no psychosocial support in their final moments. This article provides an overview on end-of-life care for unauthorized immigrants and makes recommendations for potential strategies to providing humane care and support to this vulnerable population.
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Evaluators often use qualitative research methods, yet there is little evidence on the comparative cost-effectiveness of the two most commonly employed qualitative methods—in-depth interviews (IDIs) and focus groups (FGs). We performed an inductive thematic analysis of data from 40 IDIs and 40 FGs on the health-seeking behaviors of African American men (N = 350) in Durham, North Carolina. We used a bootstrap simulation to generate 10,000 random samples from each data set and calculated the number of data collection events necessary to reach different levels of thematic saturation. The median number of data collection events required to reach 80% and 90% saturation was 8 and 16, respectively, for IDIs and 3 and 5 for FGs. Interviews took longer but were more cost-effective at both levels. At the median, IDIs cost 20–36% less to reach thematic saturation. Evaluators can consider these empirically based cost-effectiveness data when selecting a qualitative data collection method.
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Using data from a representative survey of 2,004 Latinos in four urban counties in the USA, this paper considers a question that has not been systematically investigated: how has increasing police involvement in immigration enforcement impacted the perceptions of the police that are held by immigrant and non-immigrant Latinos? Survey results indicate that many Latinos report fear of police, contributing to their social isolation and exacerbating their mistrust of law enforcement authorities. A substantial portion of Latino respondents report that they would be less likely to voluntarily contact the police if they are the victim of a crime, or to provide information about a crime, because they fear that police would use this contact as an opportunity to investigate their immigration status or that of their friends and family members. We use regression analysis to further analyse the determinants of these responses. Our findings suggest that negative encounters with police involving questions of immigration status and perceived unfair treatment, as well as vulnerabilities due to immigration and documentation status, contribute to social isolation and hesitancy to report crimes to police. These findings have implications for cooperation between police and Latino communities, particularly since local authorities have been enrolled in immigration enforcement.
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Low-income immigrants use public benefits like Medicaid or the Supplemental Nutrition Assistance Program (SNAP, formerly the Food Stamp Program) at a lower rate than low-income native-born citizens. Many immigrants are ineligible for public benefits because of their immigration status. Nonetheless, some claim that immigrants use more public benefits than the native born, creating a serious and unfair burden for citizens. This analysis provides updated analysis of immigrant and native-born utilization of Medicaid, SNAP, cash assistance (Temporary Assistance for Needy Families and similar programs), and the Supplemental Security Income (SSI) program based on the most recent data from the Census Bureau’s March 2012 Current Population Survey (CPS). Low-income (family income below 200% of poverty line) non-citizen children and adults utilize Medicaid, SNAP, cash assistance, and SSI at a generally lower rate than comparable low-income native-born citizen children and adults, and the average value of public benefits received per person is generally lower for non-citizens than for natives. Because of the lower benefit utilization rates and the lower average benefit value for low-income non-citizen immigrants, the cost of public benefits to noncitizens is substantially less than the cost of equivalent benefits to the native-born.
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Emergency shelters, transitional housing, and permanent supportive housing are distinct programmatic responses to address the housing and service needs of the homeless population under the Continuum of Care (CoC) model for homeless service delivery. Using organizational-level data collected from a multi-site survey of 300 homeless residential programs in 14 communities, this study examines the extent to which operationalization of these programs is in accordance with the CoC model. Findings suggest consistency with as well as deviation from the CoC model in the operationalization of homeless residential programs. Recommendations are provided for local community service planning and development that can assure effective delivery of services for meeting the needs of homeless people.