Housing First is three times more deadly than Shelter First

There is a tragic struggle going on amongst homeless advocates.  In one camp, there are the Housing First aficionados.  Their solution for the homeless is to provide housing to all homeless as the very first step.  Get them into housing, then figure out what they need.  

In the other camp are those who insist on providing shelter first.  Just get them in off the streets.  A final shelter solution can then be crafted.  

Aside from it never having been shown to be effective, a major drawback to the Housing First strategy is that it is massively expensive and dreadfully slow.  The homes or housing units cost hundreds of thousands of dollars to build and the population of the homeless always grows faster than the supply of housing.  Oh, and the moral hazard issue of course.

But the pathologically altruistic are enormously invested in the Housing First strategy.  After all, it is somebody else's money that is being wasted.  

There are many good evidentiary and reason based arguments to be made, but there has been a dearth of good hard empirical data.  

I am seeing the first such in 'The world doesn’t care': Homeless deaths spiked during pandemic, not from COVID. From drugs. by Christal Hayes.  

Data that tracks both the number of people experiencing homeless and those who die is difficult to verify. Many U.S. cities don’t make such data public, and the ones that do note the counts are probably severely lower than reality, especially in cities such as L.A. where much of the homeless population lives outdoors and not in shelters.

But publicly available data shows New York’s homeless population is the highest in the country, at about 70,000 people. Los Angeles follows with more than 66,000. Despite that, the number of deaths in both cities at the start of the pandemic were vastly different.

Los Angeles saw 1,988 homeless people die from April 2020 to the end of March 2021. In a similar period – July 2020 to the end of June 2021 – 640 people died in New York, about a third of what L.A. saw.

But in both cities, drug overdoses increased by about 80% and were listed as the leading cause of death.

Experts note the differences in mortality probably is the result of two key issues: Los Angeles has a much older homeless population and many live outdoors, which makes it harder to access services and health care.

In fact, at least 252 homeless people in L.A. County were found dead on sidewalks and another 56 in tents, 101 on streets and alleyways, 95 in county parks and 25 on railroad tracks or train platforms in that time period, according to an analysis of data obtained by USA TODAY from the Los Angeles County Coroner.

“It’s an apples-to-oranges comparison,” said Gary Blasi, a professor emeritus at UCLA law school who specializes in homelessness and evictions. “You are 12 times more likely to be housed in a shelter in New York. And simply being inside allows so much, from a clean shower and good night’s sleep to a small sense of stability and relief from that hopelessness.”

New York is a Shelter First city and Los Angeles is, notoriously, a Housing First city.  Yes, there will always be definitional and data capture issues, but the more three-fold differential in deaths between LA and NYC is striking even though they have roughly the same size of homeless population.  

From Michael Shellenberger.  

Click to enlarge.