Identify a policy that is not usually intended to be a health policy but that you think may have important health implications.
The criminalization of homelessness (through local laws against camping/ sleeping in public, panhandling, etc) has health implications, as individuals meet punishment for basic life sustaining behavior. As a result of some of these policies, individuals may be unable to access housing in a shelter after arrest for camping/ sleeping in public (do to "no return" clauses), making them even more vulnerable. According to a 2016 UC Berkeley report on California’s vagrancy laws, San Francisco now has 23 anti-homeless laws under its belt, the highest of any city in California.
Describe why an evaluation of that policy is informative (e.g., determining effects of the policy, or primarily a test of hypothesized mediators).
Determining the health effects of this policy is informative because of the well-documented issues of housing insecurity in the Bay Area. Studies will likely show that the goal of such initiatives (to improve the appearance of public spaces) is not being met with the laws as they are written.
Specify the outcomes and populations you think most affected or least affected by the policy.
The population of homeless individuals in a city is difficult to quantify, as these individuals may be in and out of housing (not a fixed population), may lack identification, etc, and may be less likely to be fixed in a certain place. The outcome of "tickets administered for homeless related crimes", however, would be an interesting one to study over time.
Propose a study design to evaluate the policy.
Study comparing two cities with different homeless criminalization policies, with the outcomes of number of tickets/ fines administered, volume of imprisonment for homelessness related crimes, and costs associated with implementation of the laws respectively.
· Describe biggest challenge to implementing and drawing inferences about the impact of the policy on health.
Several confounders could be at play including the systemic effects of racism (are certain individuals more vulnerable to police targeting, etc), availability of shelters/ low income housing in the community, etc.
Reference: "Six ways homeless people are criminalized everyday." Street Sheet: A Publication on the Coalition on Homelessness, 12/15/16. http://www.streetsheet.org/?p=2282