The Politics of Housing as Healthcare: Intergovernmental Competition and Social Deviance

Abstract:
Homelessness is a public health problem. Chronic-homelessness perpetuates poor health outcomes, while adverse health outcomes contribute to chronic-homelessness. In 2015, the Obama Administration mandated evidence-based, non-punitive homelessness policy approaches. However, municipal policies vary widely, ranging from providing healthcare and housing services to criminalizing homelessness. Criminalization policies perpetuate homelessness and incur high costs. Housing and healthcare is most effective and reduces costs compared to
criminalization. Why do municipalities approach chronic-homelessness so differently, despite federal action and programmatic costs? This dissertation applies a mixed-methods explanatory sequential design to understand municipal characteristics associated with disparate policy outcomes and explain the effects of intergovernmental relations and social constructions of the homeless on municipal policy decision-making.