Department of Sociology, Columbian College of Arts & Sciences, George Washington University, Washington, DC 20052, USA.
Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA.
Int J Environ Res Public Health. 2023 Feb 13;20(4):3265. doi: 10.3390/ijerph20043265.
When COVID-19 began to spread in the United States, the first public health orders were to hunker down at home. But for the vulnerable people experiencing homelessness, especially those sleeping outdoors, retreating to a private dwelling was not possible. This suggests that places with greater homelessness would also have elevated COVID-19 infections. This paper examines how spatial variation in unsheltered homelessness was related to the cumulative number of cases and deaths from COVID-19. Although Continuums of Care (CoCs) with more households receiving welfare, without internet service, and more disabled residents had a higher rate of COVID-19-related cases and deaths, CoCs with more unsheltered homelessness had fewer COVID-19-related deaths. More research is needed to explain this counterintuitive result, but it may reflect the bicoastal pattern of homelessness which is higher where government intervention, community sentiment, and compliance with rules to promote the common welfare are greater. In fact, local politics and policies mattered. CoCs with more volunteering and a higher share of votes for the 2020 Democratic presidential candidate also had fewer COVID-19 cases and deaths. Yet, other policies did not matter. Having more homeless shelter beds, publicly assisted housing units, residents in group quarters, or greater use of public transportation had no independent associations with pandemic outcomes.
当 COVID-19 在美国开始传播时，第一批公共卫生命令是在家中避难。但对于无家可归的弱势群体，尤其是那些睡在户外的人来说，回到私人住所是不可能的。这表明无家可归者人数较多的地方 COVID-19 感染率也会更高。本文研究了无家可归者的空间差异与 COVID-19 病例和死亡人数的累积数量之间的关系。尽管接受福利救助、没有互联网服务和残疾居民较多的连续护理区（CoC）的 COVID-19 相关病例和死亡人数较高，但无家可归者较多的 CoC 的 COVID-19 相关死亡人数较少。需要进一步研究来解释这一反直觉的结果，但这可能反映了无家可归者分布的双海岸模式，即政府干预、社区情绪和遵守促进共同福利的规则更高的地方，无家可归者更多。事实上，地方政治和政策很重要。志愿者更多、2020 年民主党总统候选人选票份额更高的 CoC 的 COVID-19 病例和死亡人数也更少。然而，其他政策并不重要。拥有更多的无家可归者收容床位、公共援助住房单元、居住在集体宿舍的居民或更多使用公共交通工具与大流行结果没有独立的关联。
