如果我们意识到无家可归的真正代价,我们将在一夜之间解决它
图片由 Apollo22 

 暂停驱逐 (在澳大利亚,计划于2020年XNUMX月结束)。 国家 已可以选用 扩展 the moratorium, but when it ends that's likely to force even more into housing insecurity and outright homelessness.禁令,但是当它终止时,可能会进一步加剧住房的不安全感和无家可归的情况。 The moral and health arguments for housing people are clear, but many people are unaware of the financial cost we all bear for not fixing homelessness.住房人的道德和健康论点很明确,但是许多人不知道我们所有人为解决无家可归而付出的经济代价。

社会评论员Malcolm Gladwell写了一篇文章, 百万美元的默里,这是2006年《纽约客》的故事。这是两个内华达州警官一天中大部分时间都与无家可归的人打交道的故事,例如六英尺高的前海军陆战队员和长期酗酒的默里。 They regularly picked up Murray and drove him to hospital, drying-out clinics, the police lock-up and mental health facilities.他们定期接送默里,并将他送往医院,晾干诊所,警察拘留所和精神保健设施。

His bills were so legendary the policemen worked out, based on his health care alone, it would have been cheaper to house him in a hotel with his own private nurse.仅凭他的医疗保健,警察就制定了他的帐单,这真是传奇般的传奇,将他与自己的私人护士安置在旅馆中会便宜得多。 When not drunk, Murray was a charming, smart, talented chef.不醉时,穆雷(Murray)是一位迷人,聪明,有才华的厨师。 By the time he died of intestinal bleeding, they calculated the cost of Murray's homelessness over a decade was US$1 million.当他死于肠道出血时,他们计算出默里十年来无家可归的代价是一百万美元。

Those two Nevada policemen did something that is rarely done anywhere – they calculated (OK, roughly) the cost to the taxpayer of one man's homelessness.内华达州的那两名警察做了一件几乎在任何地方都做不到的事情–他们计算(大致上是)纳税人为一个人无家可归所付出的代价。 And, in doing so, they showed, as Gladwell pointed out:而且,正如Gladwell所指出的,他们这样做表明:

解决无家可归者问题所需要的金钱可能比忽略它所花费的金钱少。


内在自我订阅图形


没有人跟踪成本

在澳大利亚,尽管 政府的努力房子 people during the pandemic, we still see many on the footpath with their bags and begging signs.人们在大流行期间,仍然在行人路上看到许多人背着包和乞讨的迹象。 They are mostly the men.他们大多是男人。 Women女装 倾向于寻找其他方式 处理他们的无家可归者,例如沙发冲浪或与成年子女或大家庭在一起。

Beyond the human tragedy, what most passers-by fail to see is the cost of homelessness to us all.除了人类的悲剧,大多数路人没有看到的是无家可归给我们所有人带来的代价。 It includes the bills for police and ambulance call-outs, prison nights, visits to emergency departments, hospital stays and mental health and drying out clinics.它包括用于警察和救护车调遣,监狱之夜,拜访急诊室,住院和精神保健以及干clinic诊所的账单。

These expenses are rarely collated and tabulated to find the true cost of homelessness to the public.这些费用很少经过整理和制表,以找出公众无家可归的真正成本。 The costs are dispersed over so many government agencies and facilities that they are managed in a piecemeal way, as they always have been in Australia.成本分散在如此众多的政府机构和设施中,以至于像往常一样在澳大利亚进行零星管理。 The result is a hefty hit to the public purse.结果是对公共钱包的沉重打击。

安置无家可归者的经济理由很明确

To understand this further, we did a global scoping review of research since 2009 that examined the value of providing a secure, stable home for formerly homeless people and the wider taxpaying community.为了进一步理解这一点,我们对100年以来的研究进行了全球范围界定,以审查为以前无家可归的人和更广泛的纳税社区提供安全,稳定的房屋的价值。 In total, we examined XNUMX research papers and analysed outcomes across a range of domains including physical and mental health, emergency department use, substance use, well-being, community integration, mortality, criminal justice interaction, service use and cost-effectiveness.我们总共审查了XNUMX篇研究论文,并分析了各个领域的结果,包括身体和精神健康,急诊室使用,物质使用,福利,社区融合,死亡率,刑事司法互动,服务使用和成本效益。

The overriding consensus among the 100 peer-reviewed studies and agency reports was that housing stability brought a raft of benefits to formerly homeless individuals.在XNUMX篇同行评审的研究和机构报告中,最普遍的共识是,住房稳定给以前无家可归的人带来了很多好处。 Reducing the cost of non-shelter services also saved the public money.减少非庇护服务的成本也节省了公共资金。

稳定的住房通常是通过 房屋优先模型。 The first priority is to find people a safe and permanent home, with no strings attached.首要任务是为人们找到一个安全,永久的住所,没有附带条件。 Wraparound support services are provided, which are critical in helping them adjust to a new life in a stable and permanent home.提供环绕式支持服务,这对于帮助他们适应稳定的永久居所中的新生活至关重要。

节省始于健康

The most researched measure was health.研究最多的措施是健康。 Almost all the research found positive changes when people moved into permanent, secure housing.当人们搬进永久,安全的住房时,几乎所有的研究都发现了积极的变化。 Almost one-third of the studies looked at the fall in use of hospital wards and emergency services once people were housed.几乎有三分之一的研究着眼于人们被安置后医院病房和急救服务使用率的下降。

作为一个 澳大利亚的研究 found, people sleeping rough are less likely to have their own GP.发现,睡眠粗糙的人不太可能拥有自己的家庭医生。 When symptoms become too severe to ignore they go to hospital emergency wards.当症状变得严重到无法忽视时,他们会去医院急诊室。 They are admitted to hospital more often and stay longer.他们被送往医院的频率更高,停留时间更长。

In the 12 months after the 44 clients in this Perth-based study were housed, emergency admissions were reduced by 57% and overnight stays by 53%.在基于珀斯的这项研究中安置了404,028位客户之后的XNUMX个月内,紧急入院人数减少了XNUMX%,过夜时间减少了XNUMX%。 The overall health-care saving was A$XNUMX.总体而言,医疗保健节省了XNUMX澳元。

收容后,人们对清醒服务和心理健康诊所的使用也下降了。 加拿大研究 looked at whether placement in a permanent home was a solution for those with a severe mental illness.考察了将永久性房屋安置对患有严重精神疾病的人是否可以解决。 With the right supports, the researchers found, these people were largely able to manage their own housing.研究人员发现,在正确的支持下,这些人基本上能够管理自己的住房。

They were able to sleep better.他们能够睡得更好。 They were more likely to take medications as prescribed.他们更有可能按处方服用药物。 Continuity of care for health problems was better and infection rates were lower.健康问题的护理连续性更好,感染率更低。 And they experienced less psychological distress, depression and anxiety.他们的心理困扰,抑郁和焦虑感也有所减轻。

刑事犯罪也大大减少

All 18 studies looking at criminality reported improvements once people had a stable home.一旦人们有了稳定的住所,所有关于犯罪的XNUMX项研究都报告了情况有所改善。 They had fewer nights in jail, arrests and rearrests, and encounters with police.他们在监狱,逮捕和重新逮捕以及与警察相遇的夜晚更少。

2013年的加利福尼亚人 根据一项研究, found once people were housed, with appropriate support services, police contacts fell by 99%.发现一旦有人被安置,并提供适当的支持服务,警方的联系下降了85%。 Health costs fell by XNUMX%.医疗费用下降了XNUMX%。

再两年 加拿大研究 毫不奇怪,五个城市中的2,000人发现公共骚扰罪的人数大幅下降,例如在公共场所睡觉,在公共场所小便和在公共浴室洗手。

All 19 studies measuring cost-effectiveness found housing people produced savings across a broad range of areas – including crisis accommodation, the justice system, sobering clinics and hospitals.所有XNUMX项衡量成本效益的研究都发现,住房居民在许多领域都产生了节余,包括危机处理,司法系统,清醒的诊所和医院。 Even after deducting the cost of housing, a即使扣除住房成本, 2011年澳大利亚研究 268位参与者在2,182个月后发现每人节省了$ 12。

我们的审查发现,政府可以采取系统的方法消除无家可归现象,这是一个明显的经济案例。 尽管该论点可能被视为对“万事金融化”的屈服,但大流行的黑暗经济云可能为政府决策者应对无家可归的灾难提供正确的掩护。谈话

作者简介

Vivienne Skinner,建筑环境学院工业/专业研究员, 悉尼科技大学 建筑环境学院高级研究员Phillippa Carnemolla 悉尼科技大学

本文重新发表 谈话 根据知识共享许可。 阅读 原创文章.

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