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Brief expansions in social services (e.g., SNAP, unemployment insurance) during the COVID-19 pandemic, while notable, failed to erase persistent inequities. Eligibility criteria excluded some of the most vulnerable, such as people who were unhoused or precariously housed, poor, or food insecure. Low-barrier programs, including street and mobile outreach centers, are an effective way to engage these individuals. Urban Aid (a pseudonym) is one such organization--a private nonprofit that conducts outreach throughout the NYC metropolitan area and provides care coordination and other resources, including food, clothing, and hygiene kits. In collaboration with Urban Aid, this study aimed to answer the following research questions: 1) what services do mobile outreach center guests frequent; 2) what services are, according to guests, most needed; and 3) how could services be better adapted to COVID-like conditions?
Methods:
Sampling occurred in two stages. First, between January and June 2021, trained Urban Aid volunteers and staff systematically sampled 140 guests in line at four mobile outreach sites in Manhattan and two in Northern NJ. Then, a convenience sample was constructed from 30 of the 140 guests who consented to further research. Urban Aid staff and interns contacted them between March and September 2021 and performed semi-structured interviews. Eligible guests were 18 or older, spoke English, and consented to audio recording. Twelve guests resided in an apartment or room, four resided in shelters, four resided with friends or family, three resided in hotels, two were unsheltered, and residences were not obtained from five guests. Interviews were transcribed verbatim and a trained Urban Aid staff member, a consulting professor with qualitative research expertise, and a social work graduate student conducted a thematic analysis (Braun & Clarke, 2006).
Results:
Analyses uncovered the following themes. Guests saw “identification documents as a Catch-22”: they needed identification documents to qualify for services but required assistance to secure identifying documents. Guests also reported frustrations with navigating service eligibility criteria—namely “demonstrating their deservingness” for services. That said, several guests underscored the importance of “proximity to a social service hub” in (NYC), with some relocating from NYC’s suburbs and outer boroughs to Manhattan. “Safety,” both in the context of needing to “sleep with one eye open” while unsheltered and in relation to “vaccine hesitancy and risk calculations” were also themes. Guests disclosed that, with access to low-barrier mobile outreach services they were able to better engage with “activities of daily living,” leading some to focus on “a desire to help others.”
Conclusions and Implications:
Our findings echoed findings from similar studies, such as the double-bind of obtaining identifying documents (Wusinich et al., 2019), the physical and psychological perils of sleeping rough (Ellsworth, 2019; Kushel et al., 2003; Thomas et al., 2012), and pressures to demonstrate eligibility for social services (Cook & Hole, 2020; Kissane, 2012). Urban geographies were also salient, with guests migrating into NYC's urban core in pursuit of robust social services. Moreover, our findings suggest that mobile outreach services and peer supports may help to mitigate social service inequities.