Cities across the United States are relying more on criminalization policies—including laws targeting behaviors deemed disruptive to public order, such as sleeping or camping in public spaces—to remove visible homelessness. How the enforcement of these policies impacts the health of unhoused people is unclear. The present study leverages monthly survey data from a prospective cohort of unhoused individuals in Los Angeles County (n = 731) to examine the longitudinal associations of experiences with police encounters and homeless sweeps on physical and psychosocial health. We estimated multilevel mixed-effects models using repeated monthly observations nested within individuals that adjusted for sociodemographic, housing, and health-related covariates. Police encounters and sweep experiences were associated with poorer self-rated physical health (police: β = 0.12, 95 %CI = [0.06,0.18]; sweeps: β = 0.10, 95 %CI = [0.03,0.16]) and greater psychological distress (police: β = 0.32, 95 %CI = [0.08,0.56]; sweeps: β = 0.35, 95 %CI = [0.08, 0.61] in the same month. Police encounters were also associated with same-month increases in feelings of loneliness (β = 0.07, 95 %CI = [0.02,0.13]). These effects were partly mediated by experiences of displacement, accounting for 22–34 % of the total effects, suggesting that enforcement-related displacement contributes to adverse health likely through disruptions to individuals’ physical and social environments. Greater cumulative exposure to police encounters and to sweeps was associated with poorer physical and psychosocial health over time. As federal courts continue to evaluate the legality of criminalization policies, this study provides empirical evidence of their measurable health harms towards unhoused individuals, offering a basis for local authorities to consider alternatives to criminalization.
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