Water, Sanitation, and Hygiene (WaSH) insecurity in unhoused communities of Los Angeles, California.

Autor: Avelar Portillo LJ; Herbert Wertheim School of Public Health and Human Longevity Science, University of California (UCSD), 9500 Gilman Drive, La Jolla, CA, 92093, USA. lavelarportillo@health.ucsd.edu.; Benioff Homelessness and Housing Initiative, School of Medicine, University of California San Francisco, 2789 25th Street, San Francisco, CA, 94110, USA. lavelarportillo@health.ucsd.edu., Kayser GL; Herbert Wertheim School of Public Health and Human Longevity Science, University of California (UCSD), 9500 Gilman Drive, La Jolla, CA, 92093, USA., Ko C; Spatial Sciences Institute, University of Southern California (USC), 3616 Trousdale Parkway, Los Angeles, CA, 90089, USA., Vasquez A; Spatial Sciences Institute, University of Southern California (USC), 3616 Trousdale Parkway, Los Angeles, CA, 90089, USA., Gonzalez J; Spatial Sciences Institute, University of Southern California (USC), 3616 Trousdale Parkway, Los Angeles, CA, 90089, USA., Avelar DJ; Spatial Sciences Institute, University of Southern California (USC), 3616 Trousdale Parkway, Los Angeles, CA, 90089, USA., Alvarenga N; Spatial Sciences Institute, University of Southern California (USC), 3616 Trousdale Parkway, Los Angeles, CA, 90089, USA., Franklin M; Department of Statistical Sciences, University of Toronto, 700 University Ave., Toronto, ON, Canada., Chiang YY; Department of Computer Science and Engineering, University of Minnesota, 200 Union St. SE, Minneapolis, MN, 55455, USA.
Jazyk: angličtina
Zdroj: International journal for equity in health [Int J Equity Health] 2023 Jun 01; Vol. 22 (1), pp. 108. Date of Electronic Publication: 2023 Jun 01.
DOI: 10.1186/s12939-023-01920-8
Abstrakt: Background: Access to water and sanitation is a basic human right; however, in many parts of the world, communities experience water, sanitation, and hygiene (WaSH) insecurity. While WaSH insecurity is prevalent in many low and middle-income countries, it is also a problem in high-income countries, like the United States, as is evident in vulnerable populations, including people experiencing homelessness. Limited knowledge exists about the coping strategies unhoused people use to access WaSH services. This study, therefore, examines WaSH access among unhoused communities in Los Angeles, California, a city with the second-highest count of unhoused people across the nation.
Methods: We conducted a cross-sectional study using a snowball sampling technique with 263 unhoused people living in Skid Row, Los Angeles. We calculated frequencies and used multivariable models to describe (1) how unhoused communities cope and gain access to WaSH services in different places, and (2) what individual-level factors contribute to unhoused people's ability to access WaSH services.
Results: Our findings reveal that access to WaSH services for unhoused communities in Los Angeles is most difficult at night. Reduced access to overnight sanitation resulted in 19% of the sample population using buckets inside their tents and 28% openly defecating in public spaces. Bottled water and public taps are the primary drinking water source, but 6% of the sample reported obtaining water from fire hydrants, and 50% of the population stores water for night use. Unhoused people also had limited access to water and soap for hand hygiene throughout the day, with 17% of the sample relying on hand sanitizer to clean their hands. Shower and laundry access were among the most limited services available, and reduced people's ability to maintain body hygiene practices and limited employment opportunities. Our regression models suggest that WaSH access is not homogenous among the unhoused. Community differences exist; the odds of having difficulty accessing sanitation services is two times greater for those living outside of Skid Row (Adj OR: 2.52; 95% CI: 1.08-6.37) and three times greater for people who have been unhoused for more than six years compared to people who have been unhoused for less than a year (Adj OR: 3.26; 95% CI: 1.36-8.07).
Conclusion: Overall, this study suggests a need for more permanent, 24-h access to WaSH services for unhoused communities living in Skid Row, including toilets, drinking water, water and soap for hand hygiene, showers, and laundry services.
(© 2023. The Author(s).)
Databáze: MEDLINE
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