Source:
This policy brief was developed by: Molly Creighton and Elly Schoen
January 20, 2020
Background
Los Angeles County has a larger American Indian/Alaska Native (AIAN) population than any other county in the United States (165,5131). The county also sits on the traditional homeland of three AIAN tribes: Fernandeno Tataviam, Tongva, and Chumash2. However, the AIAN community is often underrepresented in sample data.
Further, identity is often misclassified. For example, the 2019 Greater Los Angeles Homeless Count found that approximately 1,800 people experiencing homelessness identify as AIAN (of both Hispanic and Non-Hispanic origin) – meaning that just over 1% of AIAN people in the county are experiencing homelessness. However, in the Healthy LA Natives study3, a 2016 survey of AIAN people in Los Angeles County, 14% of respondents reported experiencing homelessness. While the two data sources have different sample sizes and methodologies, the discrepancy in results warrants an examination of the underrepresentation of the AIAN population across sources for data available in Los Angeles County. Historical underrepresentation and misclassification are problematic in that it ignores the unique challenges of this population and may divert resources and services that are required to address the specific needs of the population. This brief builds off of Los Angeles County’s Community Forum on Native
American Homelessness report and analyzes data specific to the AIAN population experiencing homelessness.
Methods
This subpopulation analysis uses data on adults ages 25 and older from the 2019 Greater Los Angeles Homeless Count conducted by the Los Angeles Homeless Service Authority (LAHSA). The 2019 Homeless Count includes data obtained from:
- Unsheltered: A demographic survey of unsheltered adults (25 and older) conducted from December 2018 to March 2019.4 Of the 3,391 surveys conducted, 100 were of people who identify as AIAN. Unsheltered adults in family households accounted for 3% (n=3) of AIAN surveys while unsheltered individual adults accounted for 97% (N=97).
- Sheltered: Administrative data from an extract of the Homeless Management Information System (HMIS) from December 2018 including people in emergency shelters, transitional housing and safe havens. Of the 10,921 total records, 111 were for those who identify as AIAN. In the AIAN sheltered population, 12 adults were in family households (N=12), while 99 were individual adults (N=99).
All data includes information on people experiencing homelessness within the Los Angeles Continuum of Care (LACoC)5 and is used to present a descriptive summary of AIAN individuals experiencing sheltered and unsheltered homelessness in 2019. The analysis uses a definition of AIAN that includes people who identify as AIAN and Hispanic as well as those who identify as AIAN and Non-Hispanic. This analysis could not obtain a
subset of those who identify as “AIAN alone or in combination with other races.”
Findings
Demographics
According to the 2019 Homeless Count data, 91% of AIAN adults were unsheltered (1,692 people). Nearly 30% of all unsheltered AIAN families and individuals are located in Service Planning Area (SPA) 4, which encompasses communities including Boyle Heights, DTLA, Mid-City, and Westlake. SPA 6, which serves the communities of Athens, Compton, Crenshaw, and Watts, as well as other neighboring communities, has the second highest native population (19%). Figure 1 below shows the percentage of AIAN adults by SPA.
Seventy percent of AIAN unsheltered people identified as male, while just over 1% identify as transgender. The sheltered AIAN population, 99 people in total, was slightly more evenly distributed across gender (57% male, 41% female). Of the sheltered adults who identified as AIAN, 51% also identified as Hispanic, compared to 36% of unsheltered adults. Differences in how data is collected (i.e. administrative data forms for sheltered people vs. self-reporting on surveys for unsheltered people) could explain some of this discrepancy between ethnic identification for these two populations.
The 2019 demographic survey of unsheltered adults collected data on sexual orientation and found that of the unsheltered AIAN population, 13% identified as LGBT (11% bisexual; 2% gay or lesbian), compared to just 7% of the total unsheltered population in the LA CoC. This number may be even larger, as sexual orientation in the LGBT minority community is often underreported to healthcare and service providers6.
Veterans were also overrepresented among unsheltered AIAN adults experiencing homelessness at approximately 11% of the population compared to 7% of all unsheltered adults. Veterans experiencing unsheltered homelessness present a unique set of challenges due to higher rates of chronic physical illness/disability and mental health diagnoses7. 40% of AIAN unsheltered veterans reported having a mental illness; however, service gaps for this population exist even given the additional resources offered through the Veterans Administration (VA). No AIAN unsheltered veterans reported receiving any form of Veteran’s Disability (compared to 8% of all unsheltered Veterans). 17% of AIAN Veteran respondents reported receiving Veteran’s medical benefits compared to approximately 11% of all unsheltered Veterans.
While economic factors such as unemployment and financial instability were the primary reasons cited for homelessness (43%), a large proportion of AIAN adults reported eviction or foreclosure (25%) or uninhabitable living conditions (14%) as a condition that led to their loss of housing (compared to just 8% and 5% of the general population respectively citing these reasons). Figure 3 below shows the top six reasons that unsheltered AIAN people reported as contributing to their homelessness compared to how often all unsheltered adults cited those same reasons.
Although the Los Angeles Metropolitan region has one of the largest AIAN populations in the country, 34% of unsheltered AIAN adults came from out of state prior to being homeless, compared to 19% of the general population experiencing homelessness. Similarly, 23% of AIAN adults were former foster youth, compared to 13% of the general homeless population. Foster care system involvement is correlated with housing instability and increased risk of homelessness in youth8.
Experience when Homeless
64% of unsheltered AIAN adults reported living on the street with no form of shelter while 23% reported living in tents or homeless encampments. Fewer AIAN adults (7%) reported living in a vehicle than the general population experiencing homelessness (12%).
AIAN were also classified as experiencing chronic homelessness9 at higher rates than the general population. Approximately 27% of sheltered AIAN adults were considered chronically homeless compared to 22% of all sheltered adults. Similarly, 50% of unsheltered AIAN adults were chronically homeless compared to 33% of all unsheltered adults.
Health Conditions & Access to Medical Care
Living on the streets presents a particular set of challenges for those with pre-existing medical diagnosis and disabilities. AIAN unsheltered adults reported higher rates of PSTD and severe depression than the general unsheltered population, while the prevalence of other types of physical and mental illness were roughly on par with the general population. Health conditions for AIAN unsheltered adults and all unsheltered adults are
shown in Figure 3 below. Additionally, AIAN sheltered and unsheltered adults reported higher rates of HIV/AIDS (4%) than the general population experiencing homelessness (2%).
In addition to experiencing certain health conditions at higher rates, AIAN people experiencing homelessness also report having slightly lower rates of medical insurance coverage. 17% of unsheltered AIAN adults reported receiving Medicaid compared to 22% of all unsheltered adults, while 76% of sheltered AIAN adults reported being covered compared to 78% of all sheltered adults.
1 2018 5-Year ACS Estimates Table B02010 (American Indian and Alaska Native Alone or in Combination With One or More Races)
2 As a result of Termination policies in the 1950s and 1960s which eliminated the protected status of many Native American trust lands in an effort to assimilate Native Americans into “mainstream” American society, none of these tribes are federally recognized nor have a land base.
This also forced thousands of Native Americans to lose Federal recognition, which may contribute to underrepresentation of the total population
today.
3 County of Los Angeles Public Health (2018). Healthy LA Natives Study. https://lanaic.lacounty.gov/wp-content/uploads/2019/03/Healthy-LANative-Infographic.pdf
4 For more information on survey methodology, see https://www.lahsa.org/documents?id=4016-hc2019-methodology-report
5 The LACoC coordinates housing and services funding for individuals and families experiencing homelessness and includes 85 separate cities throughout the County of Los Angeles, excluding Glendale, Pasadena, and Long Beach, which have their own CoCs. January 20, 2020
6 See Durso, L., Meyer, I. (2012). https://link.springer.com/article/10.1007/s13178-012-0105-2 and Institute of Medicine Committee on Lesbian,
Gay, Bisexual and Transgender Health Issues and Research Gaps and Opportunities. (2011). https://www.ncbi.nlm.nih.gov/books/NBK64802/
7 See United States Interagency Council on Homelessness. (2018). https://www.usich.gov/resources/uploads/asset_library/Homelessness_in_America._Focus_on_Veterans.pdf.
January 20, 2020
8 See LAHSA. (2018). https://www.lahsa.org/documents?id=2823-report-and-recommendations-of-the-ad-hoc-committee-on-black-peopleexperiencing-homelessness. January 20, 2020
9 Chronic homelessness describes people who have experienced homelessness for at least a year — or more than four times in the past three years
— while struggling with a disabling condition such as a serious mental illness, substance use disorder, or physical disability. January 20, 2020
.