By Mahdi E Diab / Op-Ed San Diego U-T / December 11, 2024
As a family physician treating San Diego’s homeless population, I witness firsthand how the city’s increased reliance on street sweeps is undermining our efforts to end homelessness while creating a costly public health crisis.
In recent days, I watched a patient break down in tears after losing the only photograph he had of his son during a sweep. Another patient ended up in the emergency room after police discarded his insulin and heart failure medications — medicines that cannot be replaced due to Medi-Cal’s monthly refill restrictions. While a third relapsed into addiction due to an arrest and the stress caused by losing all of their personal possessions. These are not isolated incidents but daily occurrences that illustrate how street sweeps actively harm our most vulnerable neighbors.
Through my work as founder and director of SoCal Street Medicine, I’ve seen how these sweeps create a devastating cascade of consequences. When police dispose of personal possessions, people lose more than just belongings — they lose critical medications, leading to dangerous health deterioration and preventable emergency room visits and hospitalizations. They lose government IDs and documents essential for accessing services, employment and housing. They lose phones that case managers need to contact them about housing opportunities.
The cruel irony is that these sweeps, intended to address homelessness, actually exacerbate it. Each time we displace people, we fragment the fragile support systems that are helping them move toward health and housing. Health care providers and case managers lose track of their clients, forcing them to restart the resource-intensive process of rebuilding trust and reestablishing care. Cities implementing public health approaches as opposed to the criminalization of homelessness have seen a reduction in emergency services, law enforcement and health care costs.
Consider the argument often used to justify sweeps, citing public health concerns, notably San Diego’s past hepatitis A outbreak. Although the city had a robust response to the outbreak, a lesson may have not been learned in the importance of prevention in public health, as the majority of encampments lack any trash receptacles, wash stations, or portable toilets nearby — simple, cost-effective solutions that would actually prevent future disease outbreak, while preserving human dignity.
Instead of investing in these proven public health measures, we’re spending resources on sweeps that create new health crises. As stated by the U.S. Department of Justice, “It is neither safe nor appropriate to put law enforcement on the front lines to resolve mental health, substance abuse, and housing crises when what people experiencing homelessness really need is housing and adequate services.”
Sweeps achieve only temporary clearing of one public space with an inevitable move to another; increasingly to more dangerous and inaccessible locations such as along freeways and the San Diego riverbed, further away from medical and social services needed to achieve health and housing.
The cycle costs the city millions of dollars a year in law enforcement, city workers, and health care costs, all the while creating public health disasters. When someone relapses into addiction after losing medication, when untreated mental illness leads to hospitalization, when chronic conditions spiral out of control due to sweeps — these preventable emergencies strain our health care system while causing needless suffering.
But the harm goes beyond dollars and data — it strikes at the core of human dignity. Imagine losing the last photo of a loved one, or the only memento you have from your childhood. For people who have already lost nearly everything, these possessions hold immense value. Each time a sweep destroys these personal items, it erodes another layer of their humanity.
San Diego needs a humane, evidence-based approach that prioritizes public health and housing solutions over punishment and displacement. Rather than investment in sweeps that displace people and interrupt services, we should invest in: basic sanitation infrastructure near encampments, increased access to health providers, case management, substance use counselors, housing navigators, and the continued development of affordable housing.
Only by treating our unhoused neighbors with dignity and ensuring continuity of care can we make meaningful progress toward ending homelessness. The current policy of increasing encampment sweeps and criminalizing homelessness isn’t just ineffective — it’s actively harmful to public health, fiscal responsibility, and exacerbating homelessness in San Diego.
Diab, M.D., is a family physician, founder and director of SoCal Street Medicine, a nonprofit providing health care to San Diego’s unhoused population. He lives in San Diego.
This is such a well-written piece and identifies exactly the concerns of on-the-ground housing advocates. Street sweep tactics are an incredible example of a shortsighted policy implemented to manage perceptions instead of delivering long-term outcomes.
I look forward with dread to the SDUT letters to the editor in response to this op-ed – I imagine folks will play the greatest hits, like “addiction is a choice,” “move somewhere you can afford,” “homeless people shouldn’t be anywhere near any of the goods or services that make up a society” and “the entirely unfeasible Sunbreak Ranch pseudo-proposal would have solved this problem AND I wouldn’t have to see them in my neighborhood.”
Well so far the comments haven’t said any of what you thought we would say. kate ?
You’re right Jeff they’re all just beating around the bush but saying exactly what Kate is saying they would say.
The homeless are here to stay, if you don’t like it, don’t blame them, blame the local government. Continuing to harass people down on their luck is a recipe for a massive disaster. Morphing this harassment into echos of the Holocaust by setting up internment camps and using the homeless as scapegoats and pawns for a political process is the name of the game, and people like me won’t have it.
Do those living on the street, still have a warning posted hours in advance announcing the date of an upcoming “sweep”? At the least they should get that. Then it’s on them if they leave their belongings there. Everything and every dollar that has been donated, for several years is not working. Someone with a viable plan needs to figure it out. The only two organizations I’ve heard of is Father Joe’s and McElroy’s Veteran Village that have been successful in working with the people. It’s too bad the homeless, create a health hazard in the trash and debri they create, live in, and leave behind as they migrate across the sidewalks, and into the traffic lanes. There is a fix, that is viable, and Larry Turner mayoral candidate talked about it endlessly. Maybe the voters should have paid attention and voted for him. BUT, they didn’t so it is what it is now.
It doesn’t matter Pat. It’s unacceptable to ask people to move when there is no place to go. Endlessly sweeping the problem under the rug is not a solution. You are further damaging the lives of the people on the street through this abuse.
The homeless do not create a health hazard. Many homeless find trash cans and bathrooms. The ones that don’t are mentally ill. Stop labeling homeless as dirty, there’s a difference between people who can’t pay the rent and people who defecate on the sidewalk. The visible homeless, the ones in the intersection, need to be rehabilitated in a mental institution or arrested when they commit crimes. The homeless who are littering need to be ticketed, arrested, imprisoned, treated. Indiscriminately harassing people who live in tents or vans and leave enough room to walk is not a solution. Frankly I’m tired of it to the point I consider violently resisting and I would be right for it.
You need to leave us alone. I live in a vehicle, I park it on the side of the road, I dispose of my trash in public trash cans and I use public bathrooms, despite the lack of available ones, which is another cause of your accusations.
Stop acting like we’re dirty, stop blaming us when wages remain stagnant and rental conglomerates are using A.I. algorithms to squeeze every last penny from our already fragile financial states due to inexplicably low wages in the most expensive place in the United States.
Stop expecting people who were born here, grew up here, to just up and move to Alabama because it’s not going to happen. The wealthy gentrifiers have no right to claim these lands as their own simply because of their ill begotten purchasing power. I will defend this to the death. The moment you people decide to send the Gestapo around to put us in camps is the moment I go from a peaceful man to the criminal you always claimed I was.
2 Big falsehoods/narratives in this opinion piece.
1) The POLICE don’t do the sweeps, the city workers do, mandated by the Mayor Todd Gloria. The police are security for the workers.
2) They are all given a notice 1-2 days prior of the sweeps, notifying homeless that there stuff will be discarded. So if a person leaves their belongings, meds and go on a binder and their stuff is discarded, well. Homeless are not dumb, they know exactly what or when the sweeps are coming.
If we keep enabling and victimizing those who don’t want shelter and let them leave their belongings wherever, when their are places to keep them safe during the day.
There aren’t places to keep them safe during the day Jeff. shelters kick people out as early as 6am. You need to get with reality and stop treating people like this homeless or otherwise or else pretty soon the educated and strong among us will revolt and you will be the one who is unsafe. Stop harassing the homeless, help or get lost. Arrest the criminals among us, the litterers, the thieves, the addicts – by all means arrest and treat them, but continue to harass those of us who just can’t pay the rent and you can expect violence. There are more of us every day.
The 13th Amendment can turn anyone who breaks any law into a literal slave, including a ‘criminalized’ homeless population…and migrants. Which guess might be the point as Trump’s election win caused an immediate rise on private, for-profit prison stocks.
Jasmine Crockett Claps Back at Nancy Mace During Tense Hearing
Migrants and homeless destined for work camps?
https://www.youtube.com/watch?v=QjNzsWwlQX8
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High Housing Costs Force Many Employed People into Homelessness
https://www.youtube.com/watch?v=aL4NnMW4PqA
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Private Equity’s Ruthless Takeover Of The Last Affordable Housing In America
https://www.youtube.com/watch?v=wkH1dpr-p_4
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Sweeps Don’t Solve Homelessness
https://www.counterpunch.org/2024/12/20/sweeps-dont-solve-homelessness/
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It’s going to get worse you know?
sealintheSelkirks
The 13th Amendment can turn anyone who breaks any law into a literal slave, including a ‘criminalized’ homeless population…and migrants. Which guess might be the point as Trump’s election win caused an immediate rise on private, for-profit prison stocks.
Jasmine Crockett Claps Back at Nancy Mace During Tense Hearing
Migrants and homeless destined for work camps?
https://www.youtube.com/watch?v=QjNzsWwlQX8
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Alabama Is Generating Billions by Trapping People in Prison
https://www.youtube.com/watch?v=QDzL_2EP0mU
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‘Shame’: Homeless Woman Was in Labor and Needed Care, But Was Given Ticket Instead
One advocate called out “the politicians who paved the way for this tragedy.”
https://www.commondreams.org/news/pregnant-and-homeless
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Merry Christmas and Happy Holidays to all…um, well, maybe not…
sealintheSelkirks
The latest homeless number is 18% increase in 2024 which in all honesty is probably quite a bit lower than the reality:
Half a Trillion Reasons for Shame
https://www.counterpunch.org/2025/01/01/half-a-trillion-reasons-for-shame/
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What I Learned Reporting in Cities That Take Belongings From Homeless People
Some cities take people’s belongings — ignoring their own policies and court orders — and then fail to store them. Our reporting shows there are more effective and compassionate ways to deal with homeless encampments.
https://www.propublica.org/article/homeless-encampments-essay
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If that illegal immigrant from South Africa that keeps ripping off the US with all his contracts gets his way with this DOGE crap, there will be a huge number of senior citizens being added to the roles of homeless by the end of this year. But then we should expect to be considered expendable in the billionaires Gilded Age II, aren’t we? We were last time…
sealintheSelkirks