There is an interesting divide developing among some of America’s most urban cities. It is with a mixture of both apathy and disgust that places like Seattle, Portland, and Los Angeles are bringing their concerns to the public, and allowing the citizens to cast their votes.

It’s not about marijuana, nor cars, nor taxes. It’s about something much more human: the homeless.

The plight of the homeless person is suddenly being put up for a vote. Should they be supported, or should their actions of desperation to find food and shelter be considered criminal acts? Should we the people help them or should we push them farther away from society in hopes that we don’t have to be reminded about how bad it can get?

According to many voters, the answer appears to be “both.” As reported in a recent article by The Washington Post: “even though many Americans support increased government aid to homeless people, they also support laws that effectively make homelessness a crime. What’s more, the news media’s approach to reporting on homeless people can activate disgust, increasing public support for policies that make it difficult for the homeless to pull themselves out of poverty and get off the street.”

It’s about time we stop shaming the poor and homeless and start helping them. Capitalism might not want everyone to succeed, but when a society is created to protect everyone under its umbrella (including those that may not contribute what capitalism deems to be “useful” skills), you may be surprised at just how beneficial it can be for the community as a whole.

By looking at both local and international examples, through evidence-based practice, let us deconstruct the stigma and look at the importance of helping the homeless find shelter, food, and support.

Breaking down the numbers

When considering the number of single people and families that are affected by homelessness every year, it’s important to do so through a wide, intersectional lens. Homelessness is an aspect of society that can intersect with many other subjects: from policing, infrastructure, disease and population health, to the local workforce and economy. People of color, LGBTQIA, and other marginalized identities are often more susceptible to being homeless sometime during their lives due to their identity or circumstances.

There are some important statistics to consider when analyzing the current population of people that are homeless. According to a survey conducted by the Housing and Urban Development (HUD) department in January 2013, and reported by NationalHomeless.org:

• HUD found 610,042 individuals to be homeless on a single night in January 2013. – Most homeless persons (85%) are individuals, while 15% of homeless persons are in family households.
• 33% of all homeless people were youths under the age of 24. About 110,000 of them are LGBTQIA youth.
• 57,849 veterans, overwhelmingly 92% male, were homeless on a single night in January 2013. 60% were residing in shelters or transitional housing programs, while 40% were without shelter.
• 48% of homeless individuals (without families) were found to be living without shelter.
• Families experiencing homelessness made up 50% of those who were sheltered.
• Five states, California (22%), New York (13%), Florida (8%), Texas (5%), and Massachusetts (3%), accounted for more than half of the homeless population in the United States in 2013.
• The federal minimum wage is stagnant at $7.25 an hour. In no U.S. city can a full-time minimum wage worker afford to rent a single or two bedroom home. That is because wages have stayed stagnant while housing costs have skyrocketed.
• About 1.5 million people will experience homelessness every year.

Popular perceptions

Surprisingly, despite legal attempts to make sleeping in public and panhandling illegal, the majority of the public (65% according to a survey conducted by Scott Clifford and Spencer Piston) supports the idea of providing subsidized housing for the homeless. Clifford and Piston believe this dual approach to providing support while also criminalizing people who are homeless is due to a broad feeling of disgust. Although the homeless community is diverse in upbringing, race, origin, and health, much of the media portrays the community as a health hazard.

Clifford, writing for The Washington Post, states: “Disgust is a key component of what psychology often calls the ‘behavioral immune system’ — a set of psychological mechanisms that help prevent contact with pathogens. Our behavioral immune system is overly cautious, however. We tend to perceive others who look atypical as potential sources of disease. Homeless people often lack access to proper healthcare and sanitation, and they are often covered by the media in ways that refer to disease. As a result, they may be perceived as pathogen threats.”

But this is where the key concern lies: the lack of access to proper healthcare and sanitation is setting this group up for failure. By providing free or subsidized housing, as well as free clinics and healthcare facilities, many members of the homeless community could benefit and become active members of their communities again.

The power of shelter and support

Looking at homelessness through this new lens — of social support and free accessible healthcare — it’s easy to see just how beneficial these programs can be. However, there is an important underlying condition: the housing and healthcare provided needs to be without conditions.

Currently, many homeless shelters are funded or run by church organizations. They require the people that live there to abide by their standards of living: no alcohol, strict curfews, and no “sinful” activities. However, this only creates bigger problems, as it creates a conflict of interest for those providing shelter and public health officials. Religion also restricts who has access to that care, and often leaves out the LGBTQIA youth who were kicked out of their homes, as well as others who are discriminated against regularly by these institutions and churches.

Additionally, putting restrictions on drug and alcohol consumption can cause people who suffer from addiction to avoid those shelters, which in turn increases their risk of overdosing or being exposed to unsafe conditions while on the streets.

Conditional housing might appear innocent on the surface, but a number of studies have shown that these conditions often do the opposite of what they intend. Instead, shelters and healthcare centers should focus on a “harm-reduction” or “no-conditions” approach offering people who are suffering from addiction the freedom of choosing how and when they want to end their harmful behaviors.

One facility in New York City actively adapted the approach of opening up a “one-stop-shop” for health care services for addicts in the community — including a free needle exchange, screenings, and mental health services — with the intent of providing a “harm-reduction” approach. Evidence from these facilities, as well as years of evidence from similar facilities around the United States, has shown just how beneficial this approach can be to the opioid and “overdose epidemic” that is currently sweeping the American population. For the homeless population, facilities like this one can provide the essential help they need, without the added stigma a religious facility might create.

As for shelter, it is also important to provide a “no-conditions” housing initiative that is run by a non-biased agency: whether the local government or an interfaith organization. A study done in Toronto, Canada, proved just how powerful providing shelter can be for those suffering from alcoholism while on the streets. According to the study: “A Housing First” approach, where homeless people with mental illness are provided with a place to live without preconditions such as sobriety or seeing a psychiatrist, coupled with intensive case management, helps to reduce alcohol-related problems.” After 30 days in the program, those participating in the study saw a 53% drop in days experiencing alcohol-related problems, and the housing allowed many of those participating a safe environment to process and treat their mental illness.

Countless studies have proven the effects of providing shelter, food, and support to the community, but one of the best case studies comes from the state of Utah. Typically a more Republican state, Utah’s capitol of Salt Lake City created and implemented a housing plan for their growing homeless community in 2005. It directly targeted the population of “chronically homeless” (those that have been homeless for over a year, or homeless on-and-off for the past four years and now suffer from a debilitating condition). In 2015, they were able to decrease the population of the chronically homeless in their state by 91%. All of it was thanks to their “Housing First” initiative.

However, the benefits extend far beyond simply helping an at-risk population. It also benefits the health and wellbeing of the general public. In addition, the cost of treating the homeless can cost thousands of dollars a year, but providing them homes at little to no cost is surprisingly cheaper.

Follow the evidence

Other cities that are struggling with a rising homeless population — such as Portland, Seattle, Los Angeles, and other large metropolitan cities — could greatly benefit from following the examples of Toronto and Utah.

Yet instead, many of these cities are working against their better interest (and the interest of the general public in terms of public health) by not investing in housing first, and instead forcing their homeless population further into isolation and away from town. This increases the risks of spreading diseases, but also decreases an entire population’s access to help and aid. It creates further stigma for a population of people that is suffering the most under capitalism and forces them into a spiral of worsening conditions without no support.

Evidence-based practice shows that treating the homeless without conditions, and doing so with shelter and support in mind, is the best way to curb the rising concern around homelessness. The public needs to place their misunderstood perceptions aside and pressure our lawmakers into addressing this problem and aiding those that need our help the most.