U.S. cities preparing to host the FIFA World Cup have expanded homelessness initiatives. Dallas expanded a homelessness initiative with a budget of approximately $30 million. City officials in Dallas attribute reductions in unsheltered homelessness downtown to this expanded initiative.

Seattle has expanded its temporary housing options. Atlanta launched a $185 million effort earlier this year dedicated to permanently housing thousands of residents experiencing housing instability.

An emergency physician stated, "Yet I also take issue with the fact that the pressure to expand and incorporate public housing is being driven by a large international sporting event rather than a lasting commitment to structural health equity." The physician added, "I believe that safe housing is a human right and that cities should, at baseline, invest more in public housing."

The emergency physician also stated, "Hosting the World Cup is also expensive because host city agreements require municipalities to shoulder high costs, including public safety, transportation, sanitation, and emergency response infrastructure." The physician noted, "Local taxpayers will bear much of the financial burden of hosting-related infrastructure," while "All the while, FIFA retains revenue from merchandising, ticket sales, broadcasting rights, and sponsorships."

"Spokespeople for major cities hosting the World Cup frame their initiatives as housing-first approaches rather than sweeps targeted at relocation and the upheaval of encampments en masse," the emergency physician stated. Despite this, the physician said, "Advocates continue to report increased pressure on unhoused residents to leave the visible areas surrounding stadiums and downtown tourist districts in major host cities."

"Several individuals experiencing homelessness describe uncertainty about where they will be expected to move as the tournament progresses and tourist influxes intensify," the physician noted. The physician also said, "Stable housing improves medication adherence, facilitates treatment for chronic illness, and provides the scaffolding for people to seek preventive care rather than falling prey to avoidable hospitalizations or potentially dangerous exposures."

"Homelessness is associated with higher rates of chronic disease, untreated psychiatric illness, substance use disorders, and the exacerbation of preventable diseases," the physician stated. The physician added, "Those experiencing homelessness also rely disproportionately on emergency departments, often because this is the only part of the healthcare system that remains open to everyone without the barriers of insurance requirements or appointments."

Why It Matters

The initiatives in Dallas, Seattle, and Atlanta represent financial commitments to addressing homelessness in U.S. cities. These efforts are occurring as cities prepare to host a major international event, raising questions about the motivations behind such expansions. Concerns from advocates and individuals experiencing homelessness suggest an impact on vulnerable populations within these urban centers during the lead-up to and duration of the event.