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Homelessness in California

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Through Poverty

California has the highest percentage of unsheltered homeless people among all U.S. states, with two-thirds of its homeless population sleeping on the streets, in encampments, or in their cars. Nearly one in four homeless people in the U.S., and 45% of unsheltered homeless people, live in California. Even those who are sheltered are so insecurely: 90% of homeless adults in California spent at least one night without shelter in a six-month period.

5% of California schoolchildren are homeless (this includes students who are "temporarily doubled-up" at another family's home).

A statewide housing shortage drives the homelessness crisis. A 2022 study found that differences in per capita homelessness rates across the United States are not due to differing rates of mental illness, drug addiction, or poverty, but to differences in the cost of housing. West Coast cities including San Francisco, Los Angeles, and San Diego have homelessness rates five times as high as areas with much lower housing costs like Arkansas, West Virginia, and Detroit, even though the latter locations have high burdens of opioid addiction and poverty. California has the second lowest number of housing units per capita, and an estimated shortage of one million homes that are affordable to the lowest income renters. Another 2022 study found that moderate decreases in rents would significantly reduce homelessness. A 2023 study published by the University of California, San Francisco also found that the high cost of housing was the greatest obstacle to reducing homelessness.

From 2007 to 2023, California's homeless population grew more than any other state's. While the national homeless population decreased by 18% between 2010 and 2020, California's increased by 31%. This trend continued from 2020 to 2022, when California's homeless population grew by 6% while the rest of the country saw an increase of less than 0.5%. A 2021 survey revealed that 19% of Californians reported that they or someone close to them had experienced homelessness in the previous five years.

36% of homeless people in California are categorized as "chronically homeless"—which means "they have a long-standing disability that significantly impedes their ability to live independently and have been unhoused for a consecutive year or on at least four occasions within a three-year period." The remaining 64% are categorized as "experiencing short-term homelessness" though many may have been homeless for similar durations without meeting the disability criterion for chronic homelessness.

80% of homeless people in California are adults not with children; 40% of those are aged 50 and older. 14% are families with children. 7% are unaccompanied young people (defined as being under age 25). Homelessness in California disproportionately affects African Americans, Native Americans, and Pacific Islanders. One in four homeless people who used a homeless service provider were black, despite making up only 5% of California's population.

Health aspects

From 2019 to 2020, homeless people were hospitalized in California 237,541 times and made 658,644 emergency department visits. This represents about 3% of hospital encounters in California hospitals.

Among homeless adults in California, 45% describe their health as "poor or fair," and 60% report having a chronic disease.

In March 2019 The Atlantic reported on outbreaks of tuberculosis and typhus in homeless shelters throughout California. These outbreaks have been described as a "public-health crisis" and a "disaster" by public health officials who are concerned they might spread into the general population.

Street medicine is defined as "health and social services developed specifically to address the unique needs and circumstances of the unsheltered homeless, delivered directly to them in their own environment." Street medicine programs deliver health services directly to unsheltered people in their environments. These services include chronic condition diagnosis, disease management, and preventive medicine. As of 2021 there were at least 25 street medicine programs operating in California. While the average program serves 615 patients and conducts 2,352 patient visits annually, most programs operate at a smaller scale, serving fewer than 500 patients and conducting fewer than 500 visits.

A representative survey found that 82% of homeless adults had experienced a mental health condition at some point, 66% currently experience symptoms of mental illness, and 27% had required mental health hospitalization.

The survey revealed that 65% had used illegal drugs regularly at some point, and 62% had experienced periods of heavy drinking. While 57% had received treatment for substance use disorder, current substance use remains significant: 31% use methamphetamines, and 16% report alcohol abuse. 20% had required medical attention for an overdose. 24% saw their substance use as a problem. Among those using drugs or alcohol regularly, 20% want treatment but cannot access it.

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