Food and Drinking Water Insecurity among Unsheltered Homeless People in Fresno, California. I. A Quantitative, Cross-Sectional Study

Rates of food and water insecurity are high among homeless people in California but no information is available regarding rates specific to homeless people in Fresno. We interviewed 472 unsheltered homeless people about food and water insecurity using a questionnaire and an audio recorder. Data were analyzed using Excel and the Pearson chi-square test of independence. Of the 472 people studied, 69.9% experienced food insecurity, which was significantly associated with mental disease and drug usage; 56.1% experienced water insecurity, which was strongly associated with number of nights slept at the same spot. Age, sex, ethnic group, and duration of homelessness were not significantly associated with food insecurity. The strong associations between food insecurity and mental illness and drug usage corroborate findings from other studies of unsheltered people. The similarities in food and water insecurity rates between people of different sexes, ages, ethnicities, and duration of homelessness indicate the levelling effect of street life on resource accessibility. We recommend increased provision of low-cost shelters, mobile food distribution services, and public drinking fountains; easier access to health and substance use treatment services; and implementation of less punitive ordinances.