Homelessness is a complex social problem that has proven difficult to solve in Los Angeles County, partly due to the lack of timely data that can be used for evidence-based policy development and evaluation. The year 2022 has seen the emergence of camping enforcement laws that are not based on evidence of unhoused people’s needs and preferences and lack mechanisms to track housing trajectories.

The Periodic Assessment of Trajectories of Housing, Homelessness, and Health Study (PATHS) attempts to fill this evidence gap by creating a representative, longitudinal cohort of unsheltered people experiencing homelessness (PEH) using mobile phone technology. The PATHS web-based survey platform was designed and piloted to address key challenges in surveying PEH, using a brief and highly focused questionnaire, trauma-informed design, and an innovative electronic gift card incentive delivery system. In this initial report, authors report results for the 298 PEH who completed the baseline and Month 1 PATHS survey between December 2021 and July 2022.

This study uses 2020 California Health Interview Survey (CHIS) data.

Findings: Some key findings include:

• The PATHS sample looks similar to the LA Homeless Count Demographic Survey sample in most sociodemographic characteristics, with slight underrepresentation of male, Hispanic/Latino, and older respondents. The PATHS sample has identical levels of substance using PEH as the homeless count survey.
• The PATHS sample has substantially worse health indicators than the general population, with 5 times higher level of food insecurity, 3 times higher rate of general poor health, and 2 times higher rate of anxiety and depression.
• About one third of PATHS respondents reported that they are currently on a waiting list for housing, with nearly half having received an offer at some time. Yet another third reported no engagement with outreach.
• 90% of PATHS respondents reported that they would be interested in some kind of interim or permanent housing solution, but only 2% said they would be interested in a group shelter.
• PATHS respondents reported an extraordinarily high level of exposure to law enforcement, both previously and presently: 55% of respondents had a lifetime history of incarceration and 19% of respondents had interactions with the police in the past 30 days, including 22% of those who were unsheltered.

The PATHS survey offers a relatively low-cost and rigorous approach to collecting timely data. In 2023, PATHS will produce new reports and a data dashboard, increase sample size, and develop new survey modules that can be used for planning and evaluation in the shifting policy environment of homelessness in Los Angeles County.