Before the COVID-19 pandemic even reached the U.S., California was already in the midst of a public health crisis. It’s not surprising that California, the largest state, has the nation’s biggest homeless population. But while about 1 in 9 Americans live in California, roughly 1 in 4 homeless Americans live there. California’s total homeless population was at 161,548 as of January 2020, an increase of 17% since 2018. Despite continued government efforts to resolve the situation, the crisis has only worsened with the massive unemployment brought about by pandemic lockdown measures. “I believe we have 20,000 more on the streets since the last count,” Reverend Andy Bales, president and CEO of the Union Rescue Mission in Skid Row,” said last month at a State of the Homelessness event hosted by the Los Angeles Homeless Services Authority. “I don’t think we could have done worse in addressing homelessness”.

A 2018 United Nations report compared the tent encampments of San Francisco to the slums of New Delhi and Mexico City, declaring the crisis a “violation of human rights”. Indeed, California continues to lead the nation with the highest share of homeless residents who are unsheltered at 70%, compared to just 5% in New York state. That category includes those who live on sidewalks, in tent encampments, in abandoned buildings, in cars, or anywhere else outdoors. The rest are considered sheltered but without permanent housing, meaning they are staying in emergency shelters, transitional housing programs, or safe havens, according to a recent report by CapRadio. People living without shelter lack access to toilet facilities, sinks, and showers; they have no way to store or prepare food and no protection from the elements; their possessions are frequently stolen; they are also at high risk of physical and sexual abuse. Those experiencing homelessness are also at high risk for communicable diseases like hepatitis A. According to a 2019 U.S. News report, Deaths on the street rose 76% in LA and 75% in Sacramento between 2014 and 2019, Murders and rapes increased by 13% and 61% between 2017 and 2018. And 2019 data show that both deaths and homicides are continuing to rise rapidly. Those most suffering from homelessness include minorities, the elderly, women escaping spousal abuse, and the mentally ill. 

So how did it get so bad? One of the more enduring myths is that the vast majority of the California homeless population traveled there from other states, incentivized by California’s generous government assistance. Government officials on both sides of the aisle have perpetuated this, including California Governor Gavin Newsom (D-CA) who claimed in an Axios interview that "The vast majority" of San Francisco’s homeless people'' also come in from - and we know this - from Texas. Just [an] interesting fact." According to Fact Checker Politifact’s research, this is untrue. San Francisco’s Point in Time Homeless Counts that are conducted once every two years have consistently shown that a large majority of people surveyed said they lived in San Francisco prior to becoming homeless. The 2019 report found 70% had lived in the city; 22% in another California county and only 8% out-of-state. Of that 70%, more than half reported living in San Francisco for a decade or more before losing their home. "The data shows [Newsom’s statement] is completely and totally incorrect," said Jennifer Friedenback, executive director of San Francisco-based Coalition of Homelessness. Similarly, according to 2016 research published by medical professors at the University of California, San Francisco conducted in Oakland, California, 81% of older adults who are homeless became homeless in the Bay Area. Only 10% had lost their housing outside of California.

The problem is also not a lack of funding. In fact, other states like Mississippi have been more effective at reducing homelessness while spending far less money. State and local officials have pledged billions in recent years to help, but voters remain frustrated by a lack of visible progress. For example, the funds acquired from Proposition 63, a successful 2004 ballot initiative that taxed millionaires for homeless mental health programs were used by city workers with mental illness in their families to attend lunchtime yoga classes, rather than to provide treatment for the seriously mentally ill. In 2016, L.A. voters raised  $1.2 billion when they voted to tax themselves to build 10,000 housing units for the homeless. Because each unit costs between $600,000 and $700,000 to build, only about 60% of those units could end up being built. According to Bales, who pushes for the construction of building cheaper units that are quick to build for 44,000, “I’ve been in planning meetings where people said, ‘Everybody deserves a granite countertop,’ but that isn’t going to work for 44,000 people,” said Bales. 

The crisis, in actuality, can be attributed to a multitude of factors. California has one of the nation’s highest housing costs, second only to Hawaii. According to the Zillow Home Index Value, California’s median home price is nearly $700,000. And in San Francisco and San Mateo, the median price is nearly $1.5 million. About 1.3 million Californian renter households are considered “extremely low income,” making less than $25,000 a year, according to a report by the California Housing Partnership. These financially strapped households can barely afford the state’s escalating rents and are most at risk of falling into homelessness. 

Other experts attribute the crisis to the liberalization of drug laws and California’s opposition to mandatory treatment for mental illness and drug addiction. “I’ve rarely seen a normal able-bodied able-minded non-drug-using homeless person who’s just down on their luck,” L.A. street doctor Susan Partovi told journalist Michael Shellenberg. A 2019 report in the L.A. Times appears to substantiate this point. The L.A. Times examined more than 4,000 questionnaires taken as part of 2019’s point-in-time count and found that about 76% of individuals living outside on the streets reported being, or were observed to be, affected by mental illness, substance abuse, poor health, or a physical disability. Their analysis aligns with a national study released by the California Policy Lab at the University of California, Los Angeles (UCLA), which found even higher rates in most categories. It also found that a mental health “concern” affected 78% of the unsheltered population and substance abuse “concern,” 75%. The L.A. Times found that 50% of unsheltered people had two disabilities at the same time and 26% had three all at once - a condition known as tri-morbidity. UCLA researchers found tri-morbidity in half the population they studied. The UCLA study also found that, among those who had been homeless for more than three years, 92% had a physical health condition. According to John Snook, who runs the Treatment Advocacy Center, which advises states on mental health and homelessness policy around the country, the key towards solving the crisis is for the state to require non-voluntary mental health care. “There’s a provision that says Medicaid will now pay for beds in psychiatric hospitals, it’s a no-brainer,” said Snook. 

During his campaign for governor of California, Gavin Newsom promised his administration would tackle California’s homelessness crisis head-on, making it a top priority after past governors had largely left the problem to local governments to solve. Newsom also promised 3.5 million new units by 2025, which is 580,000 units per year, to create a homelessness czar with the power of a cabinet secretary to focus on prevention, rapid rehousing, mental health, and more permanent supportive housing. Newsom has not kept his campaign promises. Under his leadership, the number of people living outdoors has increased rapidly. In June, the governor let a package of housing reform measures die. In August, he announced would not appoint a homelessness czar. Data also indicates that less housing will be built this year than in any other year over the last decade. 

But some progress is being made. Last week, the Los Angeles City Council, pursuant to a settlement of a federal lawsuit, has appeared to be getting close to an agreement to provide shelter for thousands of people experiencing homelessness. 

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