A lawsuit settlement with UC Hastings calls for the city to remove 70 percent of the tents in the Tenderloin. (Kevin N. Hume/S.F. Examiner)

Street sweeps endanger the health of the homeless

By Diane Qi, Rani Mukherjee, Kamran Abri

As demands for justice in response to the recent murders of Breonna Taylor, George Floyd and too many others reverberate nationwide, city governments are being pressured to take meaningful action against police violence. In San Francisco, Mayor London Breed responded on June 12 with a roadmap to change policing in The City, including reducing police engagement with homelessness. Yet, The City, in an agreement to a lawsuit filed by University of California, Hastings College of Law, announced plans on the very same day that may contradict London Breed’s stated aim to combat police violence.

The agreement includes a plan to move unhoused people from tents to temporary hotel rooms or sanctioned sleeping sites — a welcome step that may provide long overdue respite for those who have been demanding appropriate shelter during this pandemic. However, the plan also includes a threat to “employ enforcement measures” for those that remain on the streets. The UC Hastings lawsuit, filed on the basis of addressing crowded, unhygienic streets in the Tenderloin, has reignited the question: Is our motive for addressing homelessness to promote the image of clean streets free of unhoused people, even if it means forcibly displacing people? Or do we care for the underlying needs of those on the streets? Indeed, while The City has provided temporary shelter (with no long-term plan) for a few hundred of the at least 1,990 people experiencing unsheltered homelessness in District 6, there is serious concern that the remaining 80% of individuals will be subjected to large-scale street sweeps.

Sweeps are actions carried out by the San Francisco Department of Public Works with the San Francisco Police Department to forcibly move unhoused individuals while often confiscating their tents and belongings. San Francisco utilizes street sweeps to conceal the prevalence of homelessness, largely as a response to fear and stigma towards unhoused people held by businesses and local housed people. Contrary to public messaging, sweeps rarely provide people with mental health services or housing, but instead use city resources to repeatedly move unhoused people between public spaces. In the last two years, near daily use of sweeps has been San Francisco’s most potent tool for masking a documented 17% increase in homelessness in the city from 2017-19. Despite being conducted in the name of “health and safety,” the primary intent of sweeps is not to help, but to hide.

We cannot ignore the role that street sweeps play in perpetuating racist state violence. The unhoused population in San Francisco is disproportionately Black due to racism and racist capitalist structures that, by design, create unequal economic opportunity for Black people. In San Francisco, 5.6% of the general population is Black, yet 37% of the unhoused population is Black; the same racial disparities in homelessness are evident throughout California and nationally, illustrating that homelessness is a manifestation of systemic racism.

Our team at University of California, San Francisco conducted a study surveying health providers about the impact of street sweeps on their unhoused patients. Providers reported that sweeps negatively impact the health of unhoused communities: by creating an environment of instability due to being constantly displaced, by preventing people from establishing stable living routines, and by disrupting community networks that provide social support and safety. Instability caused by sweeps disrupts follow-through with treatment plans and connection with services. Medications and Narcan are confiscated and often never returned, a phenomenon that has also been documented by other groups.

We documented that sweeps exacerbate chronic conditions such as diabetes, prevent management and increase transmission of infectious diseases like HIV, increase unsafe substance use and relapses, and decrease physical mobility through the loss of walkers and wheelchairs. Providers stated that sweeps constitute recurring traumatic experiences that increase mental health crises and destroy trust between unhoused communities and the institutions charged to serve them. These negative impacts lead to frequent, costly emergency room visits and hospitalizations. In sum, sweeps are a form of state violence that increase the burden on health care systems by directly creating suffering and sickness.

Mayor London Breed and The City of San Francisco must honor their verbal commitment to reducing state violence against Black and unhoused communities. This will not happen unless we permanently end street sweeps of all forms. The funds wasted by The City on street sweeps through SFPD and the DPW should be diverted towards sustainable social services and permanent supportive housing — and in the absence of permanent supportive housing, people must be allowed to remain stable on the streets or in sanctioned and serviced encampments, free of police and state harassment. In addition, The City should invest in non-police mental health crisis response programs such as Eugene’s Crisis Assistance Helping Out On The Streets or Sacramento’s Mental Health First.

San Francisco is at a crucial crossroads: Do we keep chasing a false utopian vision of a San Francisco absolved of the burden of witnessing the suffering on its streets — a San Francisco that exists only through continued systemic racist violence against our unhoused neighbors? Or instead, will we commit to a vision of a city that invests in Black lives and radically restructures our priorities to compassionately embrace and care for everyone in our community?

Diane Qi, Rani Mukherjee and Kamran Abri are medical students at UCSF and members of a research team that evaluated the health impacts of homeless sweeps. All opinions are their own.

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