Homelessness is among the most urgent crises facing the United States. In addition to tents or sleeping bags on urban sidewalks, many people experiencing homelessness exist outside of public view, along rivers and other waterways, and elsewhere “out in nature.” This paper explores reasons individuals live near waterways, specific health and human service needs of this population, and why these needs remain largely unmet. We conducted in-depth, semi-structured interviews with 84 individuals experiencing homelessness, 56 of whom were currently residing or had previously resided near the San Diego River or in nearby canyons, as well as seven key informant interviews with homelessness services and environmental conservation organizations. Our findings reveal that people live near urban waterways for several reasons, including the competing influences of systems designed to ameliorate the impacts of homelessness, such as criminal justice systems, public health systems, and the emergency shelter system.
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