County Board of Health Declares Homelessness a ‘Public Health Crisis’

Providing emergency shelter to the region’s homeless before bad weather hits could save lives and protect the health of the community, University of Washington School of Public Health Dean Hilary Godwin told the King County Board of Health on Thursday.

“Without shelter, people suffer and can die – unnecessarily,” Godwin said. “Their health problems can worsen over time, without access to supportive services, making it even more challenging to eventually enter housing. Well-planned emergency shelter can fill this gap.”

Godwin was one of several UW faculty and students who played roles at Thursday’s Board of Health meeting, where the board ultimately agreed to declare homelessness a “public health crisis” and issued guidelines for local government agencies to address the “imminent threats to the health, well-being and survival of unsheltered people.”

King County and Seattle declared an “emergency” three years ago, but some say that has not been enough. The number of unsheltered homeless people in the county has doubled between 2014 and 2018, while 169 homeless people died last year.

Homeless populations face risks from infectious diseases such as hepatitis A, Group A Streptococcus and Shigella. A current cluster of HIV infections has been reported among a homeless population in north Seattle. About 70 percent of surveyed homeless people in King County report one or more chronic health conditions, such as physical disabilities, chronic substance use, and severe mental health conditions.

Godwin acknowledged that emergency shelter is not a cure for homelessless, but argued that it is a necessary interim step. “It is nearly impossible to effectively deliver health care or supportive services for this scope of problems when people live outdoors in scattered and insecure locations,” Godwin said. “I urge you to adopt [the guidelines and recommendations] and send a powerful message for all of us to do better. The UW School of Public Health will be honored to share its expertise to support this effort.”

The effort to declare homelessness a public health crisis was led by Bill Daniell, a lecturer at the UW School of Public Health and associate professor emeritus of environmental & occupational health sciences. He is one of three health professionals on the County Board of Health.

Also speaking during public testimony was Amy Hagopian, an associate professor of health services and global health. “Homelessness is the defining image of our city, which is now the poster child for the cruel and brutal effects of income inequality,” she said. “This city seems to be driven by this one metric – which is exit to permanent housing, whereas I think it’s not the only goal nor should it be. It’s not achievable without sufficient capacity and the means to access it.”

Hagopian said the guidelines in Daniell’s proposal promote other goals such as dignity, self-respect, self-governance, safety and health.

Sabrina McClimans, a health studies student at UW Bothell who has been homeless and has struggled to find affordable housing in the past, also urged the board to adopt the guidelines. “That’s 169 deaths that you have the potential to prevent this coming season,” she told the board.

After the meeting, McClimans said Daniell reminded her that their work isn't finished. Advocates now have to push for implementation of the guidelines.

"These words without action will do nothing to prevent future deaths," McClimans said. "I stressed to the Board of Health that they have the power to accomplish this goal. The reality is that they cannot enact these policies alone. One thing that the events of Thursday taught me is that for such wide-sweeping policy to be adopted, it takes a multitude of voices. I also learned that even as just a UW Bothell student, my voice mattered."