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UCLA study finds homelessness increases mortality rate of COVID-19

UCLA researchers found that people experiencing homelessness were significantly more likely to die of COVID-19-related causes in the United States. (Noah Danesh/Daily Bruin)

By Victoria Li

April 5, 2021 4:26 p.m.

Correction: The original version of this article's headline incorrectly stated that experiencing homelessness increases COVID-19 morbidity rates. In fact, experiencing homelessness increases COVID-19 mortality rates.

This post was updated April 5 at 6:39 p.m.

People experiencing homelessness are at an increased risk of dying because of COVID-19, UCLA researchers found.

In the United States, people experiencing homelessness are 30% more likely to die from COVID-19 than the general population regardless of age, according to a March UCLA-led preliminary report. In Los Angeles County, they were 50% more likely to die, according to the study.

People experiencing homelessness are often exposed to COVID-19 because of crowded living environments such as encampments, which make it difficult to follow public health guidelines and protect themselves from the virus, said Kathryn Leifheit, the lead author on the study and an epidemiology postdoctoral researcher at UCLA.

They often lack consistent access to clean running water needed to maintain hand hygiene, she added.

Existing underlying medical conditions in people experiencing homelessness also contribute to the elevated mortality rate, said Chelsea Shover, an assistant professor in the division of general internal medicine and health services research and a co-author on the study. Poor healthcare access makes it difficult for people experiencing homelessness to receive treatment if they contract COVID-19, Shover added.

The research has not yet been peer-reviewed, but the researchers wanted to publish it as soon as possible to support policies prioritizing people experiencing homelessness for the COVID-19 vaccine, Shover said.

The pandemic forced many organizations to adapt their health services for people experiencing homelessness out of safety concerns for both clients and volunteers, said Shanaya Sidhu, co-chair of health education at the UCLA Mobile Clinic Project.

The UCLA Mobile Clinic Project used to hold free weekly clinics at two locations in Los Angeles, but only one location has reopened since the pandemic and social services are still provided virtually, said Sidhu, a third-year human biology and society student. However, online appointments are not always accessible for people experiencing homelessness, Sidhu added.

[Related link: UCLA faculty discuss interplay between COVID-19 pandemic, barriers to health care]

In addition to limiting access to health care, not being sheltered could negatively impact a person’s immune system, Leifheit said.

“Your body does a better job fighting off an infection when you’re well nourished and when you’re not stressed, things that people experiencing homelessness don’t have the luxury of,” Leifheit said.

COVID-19 vaccine availability could help change these outcomes, Leifheit said.

“Bringing vaccines to a population that truly needs them the most … is very important in terms of (achieving) health equity,” Leifheit said.

People experiencing homelessness became eligible to receive COVID-19 vaccines in California on March 15.

The expanded eligibility has streamlined vaccination campaigns for people experiencing homelessness in Los Angeles, Shover said. Healthcare workers were previously unable to vaccinate younger people living in encampments because of age requirements, but the expanded eligibility will allow them to vaccinate anyone present at a site, Shover added.

However, recent sweeps on encampments have impeded vaccination campaigns and put many people experiencing homelessness at greater risk, Shover said. More than 200 individuals were displaced from an encampment at Echo Park Lake in East Los Angeles last week, which resulted in protests and conflict with police, according to The Bruin.

The Centers for Disease Control and Prevention previously recommended against clearing encampments during the pandemic, because moving such large groups of people around increases their risk of exposure to COVID-19 and disrupts relationships between people experiencing homelessness and health care providers, Shover said. Some of the individuals living at Echo Park Lake were set to receive their second dose of the vaccine but will now be difficult for vaccination teams to find, Shover added.

“Right now, our best tool is the vaccine, and pouring all of our effort and resources into getting as many people vaccinated is the most important thing,” Shover said.

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