Category Archives: Homeless

Weak Links in the Chain

Posted on by
Reply

Resilience has become almost a buzzword with regard to how communities handle adversity and disasters, albeit a very useful buzzword. It focuses our attention on how we can better prepare for and cope with such events. The question of the moment is how the concept of resilience applies to our response to coronavirus.

One of many hospitals in Chicago, all of which have visitor restrictions in place due to the coronavirus pandemic.

I am not and never have been a public health expert, though, as an urban planner and adjunct planning professor, I have often worked with such people. I say this because I want to be clear about the prism through which I am viewing the coronavirus pandemic as a public health disaster. What I bring to the task is decades of work, particularly as a research manager, in the subfield of hazards planning. I am known for deep expertise in hazard mitigation and planning for post-disaster recovery. In this article, I am reaching into that toolbox to help identify what we need to learn from the current crisis.

Specifically, part of what has become the standard approach to hazard mitigation planning is vulnerability analysis, the process of identifying what in plain English are weak links in the chain of community capabilities and capacities to manage and recover from a disaster. Every community, every nation has strengths and weaknesses built into its systems, which are really an ecosystem of economic, social, institutional, environmental, governmental, and other elements of the community that comprise the way the community functions in both sunny times and days of turmoil and dysfunction. How well can that community or nation restore itself, rebuild, adapt, and learn from its experiences? One of the most fundamental elements of success, for example, is trust in government and community leadership, something that is being tested right now in the U.S. That leadership can either greatly enable and empower or greatly hinder the capacity for effective response to, and planning for recovery from, a given disaster.

But my focus here is on what a vulnerability analysis of our response to COVID-19, the disease caused by the novel coronavirus, might include. I say “might” because I do not pretend that what follows is comprehensive. It is merely suggestive. A more comprehensive list would best emerge from a summit of leaders and experts when it is time to decide on the lessons learned from this disaster. For now, leaders are rightly focused on using existing authorities and capacities to control the spread of the disease.

The main point of a vulnerability assessment is to identify potential points of failure relative to the hazard under consideration. For instance, with hurricanes or floods, we would want to know what roads or bridges would collapse or become impassable. We would also want to know the locations of substandard housing that might suffer damage or destruction or endanger its occupants. There are dozens of other examples of potential points of failure that I could list here, but presumably, you get the idea.

With the novel coronavirus, we are dealing with an invisible hazard that inflicts suffering and death on people, not buildings or structures, and—most importantly—for which there is not yet an identified cure or vaccine. Most people do not die, and many suffer only mild symptoms, but the spread of the disease is of radical concern in part through the slow rollout of testing kits in the U.S., which exacerbates an existing inability to know precisely who is infected, especially since many people test positive who are asymptomatic, that is, not exhibiting clear symptoms of the disease. Vulnerability depends on various factors, most notably, but not exclusively, age. Respiratory and other existing conditions can elevate that vulnerability, while some older people may be tough enough physically to weather the assault. Thus, identifying and classifying real and potential victims is a business fraught with uncertainty.

Given all that, where are the weak links in our communities? Many can be readily identified from the more routine aspects of vulnerability assessments, starting with governmental capacity:

  • To what extent has the city, state, or the federal government prepared and established capacity for anticipating the problem and quickly enabling the appropriate responses? It is perfectly logical to expect that greater capacity should exist at higher levels of government that have greater resources at their disposal.
  • What is the level of political maturity among the electorate, and the political will for undertaking and enforcing difficult but necessary decisions in a crisis?

The biggest questions surrounding coronavirus seem to relate to institutional capacity, some of which can obviously be enhanced or supported through governmental capacity, for example, in procuring and distributing the personal protective equipment, ventilators, and temporary hospital beds needed by the regional “hot spots” for virus outbreaks, which at the moment include New York, but also a frightening spike in confirmed cases and deaths in the last few days in Louisiana, possibly tied to the huge crowds attending Mardi Gras in New Orleans. These have led to Gov. Jon Bel Edwards issuing a stay-in-place order similar to those in effect in California, Illinois, and New York. Among obvious questions in a vulnerability assessment going forward:

  • What hospital capacity exists for treating large increases in numbers of patients in a future pandemic? This includes emergency room capacity, intensive care units, and other essential elements of the treatment process, as well as the ability to expand access to protective gear. It also involves the adequacy of skilled professionals to work with this increased patient load.
  • What capacity exists to monitor, work with, and even thin the population of crowded jails and prisons, where social distancing is effectively an oxymoron, and the potential for rapid spread of disease can amount to a death sentence for those confined behind bars?
  • What are the sanitary and patient care conditions in local nursing homes, and how effectively are they regulated? Nursing homes and similar facilities for elderly medical care have in some cases become virtual incubators for the spread of coronavirus, leading to situations where relatives can no longer visit.

Many of these questions also lead us to questions of economic vulnerability, which also pertain to social equity. Restaurants in states that have instituted closures of public places where people normally congregate in large numbers have laid off thousands, possibly millions of workers—the numbers change by the day—who often work for hourly wages and need every hour to pay the rent. Workers in the gig economy, the tourist economy, and the travel industry are all similarly vulnerable in varying ways. One result, even under normal circumstances, is that many of these workers, some of whom are also undocumented immigrants, are reluctant to take sick days because they have no paid sick leave. Often, they also have no paid health insurance, or cannot afford it.

That, in itself, needs eventually to be recognized by the United States as a source of pandemic at worst, or a threat to public health, at best. Take, for example, the story of a McDonald’s worker who shared the news that he went to work ill, vomited when he ran to the restroom, but was afraid to call in sick because a missed paycheck was a threat to his economic security. How often does that happen, and how reassuring can it possibly be to customers who even think about the potential consequences? Is anyone attempting to gather data on this problem? A worker rights organization, Arise Chicago, has been fighting for better protection for workers on this front for several years, and won passage of a Cook County ordinance in 2016, but the battle continues. At the moment, these workers either are laid off because of restaurant closures, or are adapting to the temporary new world in which their employers can sell takeout, drive-out through, or delivery.

But whether it is hotel, restaurant, or transportation workers (such as taxi and Uber drivers), among others, the vulnerability lies in the harsh facts that drive them to show up for work despite illness because of their lack of paid sick leave or medical coverage. Nowhere in America can an honest vulnerability assessment of future pandemics ignore these socioeconomic imperatives. Economic facts drive health impacts, which in turn drive at least some of the questions surrounding health care capacity. In this sense, one can see how identifying all the weak links in the chain of vulnerability means recognizing the interrelationships between the various categories of vulnerability I listed initially.

This description of the process could go on for many more pages, but it may be more important to let the complexity and interdependence of it all inspire further thought. With that in mind, let me offer a few other items for consideration:

  • Given the inability of some parts of the population to accept the necessity of temporary restrictions, how well prepared are we to control the wayward behavior of the few, even as the majority of our citizens show adequate consideration for others around them? What are we prepared to do about them?
  • In the event of a lockdown, what are we prepared to do for victims of domestic abuse who are suddenly trapped inside their homes with abusive partners, parents, or relatives? Do we have institutional capacity to remove them to safer quarters and the ability to answer their calls for help? Sheltering in place is hardly likely to make an abuser more sympathetic.
  • How well are we positioned to assist those suffering from mental illness, for whom isolation may increase propensity for depression and suicide?
  • In what ways can we respond to the needs of homeless people, for whom the spread of a pandemic disease may increase due to proximity and unhealthy circumstances?

There are some very hopeful signs of creative thinking on these issues in local and state governments, if not in the White House. For example, the City of Chicago has reached agreement with several hotels to use hotel rooms as isolation rooms for victims of COVID-19, with the city paying for the capacity in advance. This relieves hospital capacity, to some degree, but it also provides some employment for hotel workers who would otherwise be idling at home because of the shutdown of the hospitality industry as both leisure travel and conventions grind to a halt. The workers will provide food in the kitchens and undertake other safe duties, while trained public health personnel deal directly with the quarantined patients. The hotels stay open, some workers stay employed, and some strain is removed from medical facilities. Some members of the Chicago City Council are now calling for the use of vacant public housing units for the same purposes.

Likewise, some otherwise closed YMCA facilities will begin accommodating the homeless while providing necessary social distancing. All of these are creative solutions that can emerge from identifying the weak links in the chain, and can provide cornerstones for sound planning for resilience in the face of future public health emergencies.

In short, let’s all keep our thinking caps on. We’re going to need them not just this time, but for the future as well.

Jim Schwab

Taking Stock of Recent Disasters

Posted on by
Reply

Photo by Jeff Clevenger

We learn from disasters as we recover from them, but each disaster teaches slightly different things. Sometimes the lessons are significant and historic; in others, one community is learning what others already know or should have learned from their own past events. Some years are relatively quiescent, as 2018 so far seems to be. And some become relentless slogs, like 2017.

Adam Smith, lead scientist for the National Oceanic and Atmospheric Administration’s National Centers for Environmental Information, noted in a plenary panel in July for the 2018 Natural Hazards Workshop, in Broomfield, Colorado, that the tally for 2017 disasters had exceeded $200 billion. This is more than 40 percent of the tally so far of billion-dollar disasters for the entire decade beginning in 2010. Simply put, with three major hurricanes—Harvey, Irma, and Maria—striking parts of the southern U.S., followed in short order by some of the most expensive wildfires in California history, it was a wild, taxing year in the world of emergency management.

But our attention fades quickly. Right now, there are no equivalent disasters seizing our attention, but in time there will be. The people who remain painfully aware that recovery is a long, slow process are those directly affected, and even many of them will not fully grasp the ways in which past location choices and patterns of development have brought them to this pass. Many had no choice anyway. Our communities are frequently full of social inequities that compromise the life choices of the poor and disabled. In other cases, the losses inflicted on neighborhoods are the result of hubris on the part of developers, city officials, and homeowners themselves. It does not hurt, approximately one year after these combined events, to look at what we know so far about the recovery following them.

Apparently, the U.S. General Accountability Office (GAO), an arm of Congress, agreed that the time was ripe for review because it has released a study, 2017 Hurricanes and Wildfires: Initial Observations on the Federal Response and Key Recovery Challenges. Because of the severity of challenges in Puerto Rico, one may note from the graph below, reproduced from the report, that Hurricane Maria by far entailed the largest federal expenditures.

In spite of that level of effort, Puerto Rico has engendered the most significant criticism of the performance of the Federal Emergency Management Agency (FEMA). Maria struck Puerto Rico and the U.S. Virgin Islands (USVI) after Harvey had already drenched and flooded coastal Texas, and Irma had swept through much of Florida.

FEMA teams managing the distribution of water, and meals for hundreds of semi-trucks at an incident Support Base in Seguin, Texas. Photo by Dominick Del Vecchio – Aug 29, 2017

The report notes that, as a result, FEMA resources were severely stretched by then, only to have wildfires in California add to the pressure, though the personnel assigned in the last case were small compared to the hurricanes (as is typically the case). Adding to the challenge, Puerto Rico and USVI are offshore and were also poorly prepared for a Category 4 hurricane. Puerto Rico had already suffered years of neglect of crucial infrastructure, was burdened with oppressive debts, and was by far the least prosperous target of the 2017 storms. All this, combined with some incredibly inept public relations from the White House, led to a perfect storm in which nearly 3,000 people have died directly or indirectly as a result of the disaster. To my knowledge, that is a number exceeded in U.S. history only by the 1900 hurricane in Galveston, which killed more than twice as many people. The difference is that, in Puerto Rico, most people died because of blocked transportation, loss of electricity, and similar problems with critical facilities that prevented adequate transportation or medical attention in many isolated communities in the interior of the mountainous island.

Exactly what we learn from Puerto Rico remains to be seen. It is worth noting, in my view, that far more prosperous Hawaii has coped well with admittedly less-challenging disasters in recent years, in large part because state government has practiced response and committed resources to the problem. I say this despite being aware of gaps in Hawaii recovery planning that merit further attention. But if Puerto Rico is a logistical challenge for mainland responders, Hawaii is even more remote but better prepared. The difference in economic circumstances, however, is a dramatic and powerful variable in this comparison, as is Hawaii’s statehood. It is also worth noting that Hawaii is a long chain of islands, and storms (or volcanoes) never affect all at the same time. Effectively, that has always meant that emergency resources in Hawaii have been able to be moved from one or more islands to another that has been hit by a storm. All of Puerto Rico was devastated almost on the same day, with internal transportation, communications, and electric power nearly brought to a standstill, making access to many villages nearly impossible.

If Puerto Rico, followed closely by USVI, is the direst case for long-term recovery, there nonetheless remain serious challenges in Texas, not only in Houston but in dozens of other counties along the Gulf Coast. A recent Washington Post article used the term “Harvey homeless” to describe thousands of Texas families living in whatever parts of their flooded homes they have salvaged while struggling to accumulate the resources to repair the rest. They live with mold, dust, and any other environmental contaminants that endure in essentially unusable parts of their homes. In all, according to the Texas Department of Public Safety, at least 175,000 Texas homes were “badly damaged” by Hurricane Harvey, and 80 percent lacked flood insurance, thus relying on much smaller federal disaster payments (averaging $4,203) than flood insurance would have afforded. If there is one powerful lesson in Texas, it concerns public education on the value of flood insurance, particularly in the many areas outside the 100-year floodplain. Unfortunately, much of the public retains the illusion that flood insurance is either unnecessary or unavailable outside the legally defined floodplain. Yet Harvey’s 60 inches of rain in some parts of metropolitan Houston left vast areas beyond the regulatory flood boundaries under water because water does not care about such artificial boundaries. It goes where gravity compels it to go. Moreover, years of loose land-use regulation over the past half-century of rapid growth have expanded the floodplain and put numerous neighborhoods in greater danger than they faced in the past.

Moreover, as John Henneberger, executive director of the nonprofit advocacy group Texas Housers, noted in his keynote at the Natural Hazards Workshop, Texas does not have a noteworthy history of attention to social equity in disaster recovery. Henneberger called for a new model of disaster recovery in which we seek to use recovery planning to overcome racial and economic inequities, stating that “the legal framework already exists” in federal programs like Community Development Block Grant—Disaster Recovery (CDBG-DR) to “overcome inequalities,” but the rules are not always followed. Thus, his top recommendation for reform was simply to “obey the law” regarding the conditions that apply to state and local use of CDBG-DR funds.

Finally, Bloomberg Business Week chose recently to examine the questions surrounding rebuilding after the California wildfires. With a population already approaching 40 million, the state is under intense pressure to build adequate housing amid rising housing costs. California has repeatedly toughened its building codes in response to wildfire threats but faces a legacy problem of homes built under earlier standards. Not often known outside wildfire research circles is the fact that the average home contains seven to eight times the density of combustible materials as the surrounding forest in the wildland-urban interface. That means that every home that catches fire or explodes is a huge matchstick endangering every other home in its immediate vicinity. When one considers that California is unquestionably the most progressive state in tackling wildfire problems, one understands that the problem of retrofitting older homes built to lower building code standards—or none at all in some other western states—is a lingering and potentially very expensive problem. The dilemma serves to illuminate the value of pre-planning for recovery, learning how to seize the “teachable moment” for reform, to reduce the scope of the problem. The article also notes that, if California is to reduce pressure to build in the forest, its cities must be prepared to allow greater density to relieve the housing crisis in a state where a shortage of affordable housing has yielded a concomitant problem of growing homelessness. And so, we see why urban planning needs both to be holistic in its approach to social problems and guided by wise state policy with supporting resources. We all still have a long way to go.

This blog post can never be long enough to explore all these issues in depth. But in coming weeks and months, I hope to delve into specific issues more deeply, share interviews with individual experts, and explore what needs to be done. I am also watching intently for new books that will shed light on new solutions. One just arrived today. Stay tuned.

Jim Schwab

The Night Ministry

Posted on by
Reply

If, like me, you work in the central business district of a major city, you probably cannot escape it. On the way from the CTA train station to the office, a four-block walk, it seems that I pass the homeless on every street corner. One part of me would like to do something for them. Another part knows from experience that some may be very difficult to help. And a third part says that I don’t have the resources to help them all anyway. It is hard to know what to do, so most of us try to tune it out.

But don’t you wonder? How did they all get here? What do they do when the temperature in Chicago plunges to subzero levels? When the winter wind howls and the snow piles up, where do they all go? How long have they been on the streets? Were some of them once young? Are they perhaps younger than they appear?

These are not easy questions, but there are some answers because some people devote their time to finding out—and to helping. In Chicago, one such group is The Night Ministry. These folks have done their homework, but more importantly, they serve. Using vans for the youth and buses for adults, they provide food and toiletries at selected locations around the city, serving without judgment, knowing there are many reasons why youths in particular can become homeless. They also provide social workers for on-site counseling.

Consider the possibilities:

  • The youth is gay and the family has kicked him or her out;
  • They have developed a mental illness that leads to irrational behavior;
  • The home is the site of endless abuse, either physical or substance (alcohol or drugs), or both, so the streets actually seem preferable;
  • The family itself has become homeless due to loss of job or other factors.

Once youths begin life in a shelter, another set of consequences begins to take root. This past Sunday, I watched as the youth of Augustana Lutheran Church, in the Hyde Park neighborhood on the South Side, discussed before a small audience of adults what those might be:

  • You might not get homework done before the lights are out, making success in school problematic.
  • You might feel your homelessness is a family secret that embarrasses you.
  • You lack a safe place to go after school, unlike other kids.
  • You are often hungry, relying on others for food. “It hurts to be hungry,” one said.
  • You become anxious because of the uncertainty surrounding their circumstances.
  • The inability to cook forces reliance on less healthy, cheaper processed foods.
  • You face increased breakdowns in mental health, particularly as the city and state have continued to close mental health facilities.
  • You have no place to wash your clothing.
  • You become tired all the time.
  • You may attempt suicide.

Our grandson, Angel, helps fill zip-lock bags with toiletries for The Night Ministry at Augustana Lutheran Church.

Our grandson, Angel, helps fill zip-lock bags with toiletries for The Night Ministry at Augustana Lutheran Church.

According to The Night Ministry, approximately 25,000 youths in Illinois become homeless over the course of a year; approximately 45 percent of those have chronic homeless experiences. They end up needing help with transportation, going back to school, getting food on a regular basis, even with getting IDs. In short, much of what the rest of us take for granted becomes challenging for them.

I could go on, but you can learn much more from The Night Ministry website, or that of the Chicago Coalition for the Homeless, or you can read “Wherever I Can Lay My Head: Homeless Youth on Homelessness” at the Center for Impact Research.  What I can tell you is that, if you have a few dollars to spare and want to use them to help stop the waste of human potential that youth homelessness represents, The Night Ministry can use your support. They do the work that most of the rest of us lack either the time or the inclination to do, and they do it very well.

Jim Schwab