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Background <p>People experiencing unsheltered homelessness (PEUH) face ongoing barriers to accessing basic resources, such as food, water, sanitation, and healthcare. While it is well-understood that the COVID-19 pandemic further exacerbated pre-pandemic conditions, less is known about how conditions shifted once the pandemic subsided.</p> Methods <p>We employed a repeated cross-sectional, modified version of the HOUSED BEDS survey among a convenience sample of PEUH (<i>N</i> = 991) in the greater Los Angeles area between January 1, 2022 and December 31, 2024 to assess access to basic resources for survival by people experiencing unsheltered homelessness during and after the COVID-19 pandemic. Univariate and bivariate analyses were conducted.</p> Results <p>Following the pandemic, several significant differences in access to basic resources were observed between the during- and post-pandemic samples: food and water security decreased (Food: 70.8% during vs. 61.2% post, <i>p</i> = 0.002; Drinking water: 77.2% vs. 67.6%, <i>p</i> = 0.001), as did having health insurance (83.9% vs. 75.8%, <i>p</i> = 0.009). However, self-reported incidences of open defecation were also observed to be lower in the population surveyed following the pandemic (90.4% during vs. 81.4% post-pandemic, <i>p</i> &lt; 0.001). Relatedly, a correlated increase in reported bathroom access (20.6% vs. 26.0%, <i>p</i> = 0.053) and decrease in primary care access (18.6% vs. 14.8%, <i>p</i> = 0.2) were observed. Outreach services were provided to few respondents throughout (34.5%); however, rates of physical health outreach were found to be lower in the post-pandemic group (10.5% vs. 6.7%, <i>p</i> = 0.032) despite all other forms of outreach experiencing little change over this same time period.</p> Conclusion <p>These findings highlight the importance of continuing to support PEUH even after the pandemic has subsided. Implementing more long-term, institutionalized policy and infrastructure is essential for supporting this population during and after public health emergencies.</p>

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Changes in access to basic needs among people experiencing unsheltered homelessness in Los Angeles County during and after the COVID-19 pandemic: a large-scale repeated cross-sectional survey

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月20日

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  • Sean Yan,
  • Audrey Irvine,
  • Clarice U. Akunwafo,
  • Trevor A. Pickering,
  • Corinne T. Feldman,
  • Alexis Coulourides Kogan

摘要

Background

People experiencing unsheltered homelessness (PEUH) face ongoing barriers to accessing basic resources, such as food, water, sanitation, and healthcare. While it is well-understood that the COVID-19 pandemic further exacerbated pre-pandemic conditions, less is known about how conditions shifted once the pandemic subsided.

Methods

We employed a repeated cross-sectional, modified version of the HOUSED BEDS survey among a convenience sample of PEUH (N = 991) in the greater Los Angeles area between January 1, 2022 and December 31, 2024 to assess access to basic resources for survival by people experiencing unsheltered homelessness during and after the COVID-19 pandemic. Univariate and bivariate analyses were conducted.

Results

Following the pandemic, several significant differences in access to basic resources were observed between the during- and post-pandemic samples: food and water security decreased (Food: 70.8% during vs. 61.2% post, p = 0.002; Drinking water: 77.2% vs. 67.6%, p = 0.001), as did having health insurance (83.9% vs. 75.8%, p = 0.009). However, self-reported incidences of open defecation were also observed to be lower in the population surveyed following the pandemic (90.4% during vs. 81.4% post-pandemic, p < 0.001). Relatedly, a correlated increase in reported bathroom access (20.6% vs. 26.0%, p = 0.053) and decrease in primary care access (18.6% vs. 14.8%, p = 0.2) were observed. Outreach services were provided to few respondents throughout (34.5%); however, rates of physical health outreach were found to be lower in the post-pandemic group (10.5% vs. 6.7%, p = 0.032) despite all other forms of outreach experiencing little change over this same time period.

Conclusion

These findings highlight the importance of continuing to support PEUH even after the pandemic has subsided. Implementing more long-term, institutionalized policy and infrastructure is essential for supporting this population during and after public health emergencies.