Nashville Working to Prevent Homeless Street Deaths

by Shannon Moriarty

Published November 03, 2008 @ 12:12PM PT

Volunteers in Nashville have taken to the streets to survey over 8,000 homeless people. Their goal? To save lives.

According to advocates, homeless people suffering from renal disease, AIDs, liver disease, mental illness, or cold weather diseases have a 40 percent risk of dying on the streets within the next seven years if they do not receive housing or critical medical attention. 

So last week, during the early morning hours, volunteers scoured in parks, under bridges, and in make-shift tent cities for homeless people in order to assess their "vulnerability." The Tennessean provided an in-depth look at the process of counting and defining the health of the homeless: 

They were found in doorways and stairwells, on grated vents or bundled under plastic tarps to fight the cold, even though many of them should be in hospital beds. Many of their hungry bodies are sick, stricken with cancer, liver disease, kidney failure, AIDS and mental illness.

Volunteers gently shook each one awake, asked permission to interview them, and began asking questions that homeless advocates hope will end up saving lives.

Over three days last week, outreach teams surveyed 320 people sleeping on Nashville's streets and shelters about their medical histories and the time they've lived on the street. The goal is to put the city's most vulnerable ahead of the line when it comes to prioritizing housing. Results released Friday show that 134 were deemed to have one or more health problems that put them at the highest risk of dying, and in immediate need of housing.

The process of prioritizing homeless people for services based on health is called the Vulnerability Index, a process created by a New York-based nonprofit called Common Ground that has been replicated in major cities across the U.S. The process identifies those as "most vulnerable" (based on specific criteria) so they may receive top priority for housing vouchers. 

Steven, a Nashville homeless outreach worker who blogs at Stone Stoup Station, talks about how service providers hope the vulnerability index will not only save lives, but also resources:

Ultimately, we hope to begin a new phase in the care and assistance of Nashville's homeless population. By targeting those who most need the scarce resources, we believe we can save lives, minimize suffering, reduce costs to the city and the community, lower emergency responses for homelessness-related problems, and provide a return of dignity and self-worth to those who have been incorrectly labeled as lazy or malingering by ignorant critics.

It is a travesty that gravely ill people are forced to live on our streets. There is no question that these individuals should receive priority for housing and services. In cities with large homeless populations (like Nashville), the vulnerability index will no doubt save many lives.

However, it's been proven that living on the streets can make make even healthy individuals susceptible to sickness and violence. I just can't shake the sick feeling I get thinking about having to prioritize people for housing vouchers and services to meet simple, basic human needs. 

Ultimately, advocates argue, it's about helping people survive. Here's one story of a man whose life will no doubt improve because of Nashville's outreach this week:

Nelson Johnson, 43, has been homeless for more than 30 years, and has spent 12 of those years in Nashville, in and out of hotels and shelters, but mostly on the streets.

This week, he found temporary shelter at a campsite in Tent City.

As the sun rose early Thursday morning, Johnson fought through coughing fits to answer the survey questions volunteers asked him.

He said he has been diagnosed with AIDS and hepatitis C, and has been dealing with both since 1991.

"I stay pretty sick being out here," he said. "But I'm glad somebody's out here trying to help me."