Kalofonos Ippolytos, McCoy Matthew
HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA.
UCLA/VA Center for Excellence for Veteran Resilience and Recovery in Homelessness and Behavioral Health, Los Angeles, CA 90073, USA.
Pathogens. 2023 Mar 18;12(3):482. doi: 10.3390/pathogens12030482.
The coronavirus disease 2019 (COVID-19) pandemic rendered congregate shelter settings high risk, creating vulnerability for people experiencing homelessness (PEH). This study employed participant observation and interviews over 16 months in two Veteran encampments, one located on the grounds of the West Los Angeles Veteran Affairs Medical Center (WLAVA) serving as an emergency COVID-19 mitigation measure, and the other outside the WLAVA gates protesting the lack of onsite VA housing. Study participants included Veterans and VA personnel. Data were analyzed using grounded theory, accompanied by social theories of syndemics, purity, danger, and home. The study reveals that Veterans conceptualized home not merely as physical shelter but as encompassing a sense of inclusion and belonging. They sought a Veteran-run collective with a harm reduction approach to substance use, onsite healthcare, and inclusive terms (e.g., no sobriety requirements, curfews, mandatory treatment, or limited lengths of stay). The twin encampments created distinct forms of community and care that protected Veterans from COVID-19 infection and bolstered collective survival. The study concludes that PEH constitute and belong to communities that provide substantial benefits even while amplifying certain harms. Housing interventions must consider how unhoused individuals become, or fail to become, integrate into various communities, and foster therapeutic community connections.
2019年冠状病毒病(COVID-19)大流行使集体庇护场所成为高风险环境,给无家可归者带来了脆弱性。本研究在两个退伍军人营地进行了为期16个月的参与观察和访谈,一个位于西洛杉矶退伍军人事务医疗中心(WLAVA) grounds,作为一项紧急的COVID-19缓解措施,另一个在WLAVA大门外,抗议退伍军人事务部缺乏现场住房。研究参与者包括退伍军人和退伍军人事务部人员。采用扎根理论对数据进行分析,并结合疾病共发、纯洁、危险和家的社会理论。研究表明,退伍军人将家不仅仅概念化为物质庇护所,还包括包容感和归属感。他们寻求一个由退伍军人管理的集体,对药物使用、现场医疗保健和包容性条款(例如,没有清醒要求、宵禁、强制治疗或有限的停留时间)采取减少伤害的方法。这两个营地形成了独特的社区和关怀形式,保护退伍军人免受COVID-19感染并增强了集体生存能力。研究得出结论,无家可归者构成并属于那些即使在放大某些伤害的同时也能带来实质性益处的社区。住房干预措施必须考虑无家可归者如何融入或未能融入各种社区,并促进治疗性的社区联系。