Study shows involuntary displacement of people experiencing homelessness may cause significant spikes in mortality, overdoses and hospitalizations

New model suggests encampment sweeps, bans and move-along-orders could contribute to 15-25% of deaths in this population over 10 years

RESEARCH TRIANGLE PARK, N.C. — Involuntary displacement of people experiencing homelessness will likely lead to a substantial increase in morbidity and mortality over a 10-year period, according to a new study from a multidisciplinary group of researchers.

The study, published today in the Journal of the American Medical Association (JAMA), found that practices such as encampment sweeps, bans, move-along-orders and cleanups that forcibly relocate individuals away from essential services will lead to substantial increases in overdose deaths, life threatening infections and hospitalizations.

In coordination with the National Healthcare for Homeless Council, the Centers for Disease Control and Prevention (CDC) and the National Foundation of the CDC, a multidisciplinary group of researchers developed a simulation model projecting the long-term health effects of involuntary displacement of people experiencing homelessness who inject drugs using data from 23 U.S. cities.

In hundreds of different projections, the model showed no feasible scenario, in any city, where continual involuntary displacement improves health outcomes. Instead, the practice would likely result in a significant increase in morbidity, mortality and a shortened life expectancy, the study found.

“Our research shows that these widespread practices that forcibly displace people are clearly impacting the health of this population, particularly when it comes to increasing their overdose risk, so much so that it actually decreases the life expectancy of the entire population,” said Josh Barocas, M.D., associate professor at the University of Colorado Anschutz Medical Campus and corresponding author. “Modeling studies like ours give us a sense of whether we’re headed in the right or wrong direction. Our study showed that displacement could directly result in a quarter of deaths of this population. This tells us that this practice is taking us in the wrong direction if we want to solve issues around homelessness and substance use disorders.” 

Researchers also found displacement increased overdose deaths, hospitalizations, injection-related infections and hindered access to medications for opioid use disorder along with other detrimental impacts. 

“These findings highlight the consequences of involuntary displacement and the dire need to increase access to housing and other support services for people experiencing homelessness,” said Alex Kral, Ph.D., Distinguished Fellow at RTI International and co-author of the study. “We hope this evidence can inform policies that reduce negative health outcomes.”  

Read the full study

Learn more about RTI’s research on interventions for opioid use disorders