Health and Homelessness: statistics and solutions

We wanted to share some information with you on the impact that homelessness can have on a person’s health.

What is homelessness?

“Homelessness is a measure of our collective success, or otherwise, in reducing inequalities.”

Narrow definitions of homelessness suggest that it means not having a home. Did you know, you can actually be homeless even if you have a roof over your head. According to Shelter, you count as homeless “if you are staying with friends or family, in temporary accommodation, e.g. hostel or B&B, squatting, at risk of violence or abuse in your home, living apart from your family because you don’t have a place to live together or living in poor conditions that affect your health.”

A guide for local authorities on the impact homelessness has on health was published by the Local Government Association (LGA) in September 2017, just a month ahead of World Homelessness Day, as part of an ongoing commitment to tackle homelessness in the UK through the lens of a multidisciplinary approach.

Who is homeless in the UK?

The LGA report highlights the range of people in the UK who have experienced homelessness or may be at risk of becoming homeless, including those in employment simply struggling to make ends meet.

The extent of the problem is not insignificant. Crisis reported that last year, 59,090 households were accepted as homeless in England, 28,247 applications were assessed as homeless in Scotland and 7,128 households were threatened with homelessness in Wales. That’s 94, 465 households altogether! Since a large proportion of homeless individuals do not even feature in the official statistics, we know this figure is only just scratching the surface.

Common scenarios leading up to homelessness are situations many of us have experienced at some point. Such instances include eviction or just being asked to leave by those we live with, a relationship breakdown, loss of employment, domestic violence, or a disaster such as a fire or flooding.

Homelessness does not discriminate! It could affect any one of us.

The LGA report highlights the devastating impact of the cost of housing being increasingly out of reach for working households, even where there is more than one earner.  “Homelessness experienced by young families with dependent children increased by 56 per cent between 2009/10 and 2015/16 (41,970 households), even though these households are likely to have two working-age adults.”

So, how does homelessness impact health?

Evidence collated in the LGA report informs us that the health of people experiencing homelessness is significantly worse in comparison with the general population.

“The average age of death of a homeless person is 47 (lower for women – 43), compared to 77 years amongst the general population.”

Rough sleepers are not only subject to the harshness of inclement weather when faced with the outdoors, but more than one in three rough sleepers have been deliberately hit or kicked or experienced some other form of violence whilst homeless.

Temporary shelter does not overcome the exposure to health risks either. Living in temporary accommodation puts children at greater risk of infection and accidents according to Shelter. The longer they are homeless, the more at risk they are. Children who have been in temporary accommodation for more than a year, are over three times more likely to demonstrate mental health problems such as anxiety and depression than non-homeless children (Shelter 2006).

Both mental and physical health outcomes are impacted by homelessness.

The LGA report references audit findings showing “41 per cent of homeless people reported a long term physical health problem and 45 per cent had a diagnosed mental health problem, compared with 28 per cent and 25 per cent, respectively, of the general UK population.”

Young people in particular are vulnerable and struggle with mental and physical health challenges, with research findings highlighting:

  • high levels of self-reported mental health problems, self-harm, drug and alcohol use
  • increased risk of exploitation, abuse and trafficking, and involvement in gang and/or criminal activity
  • higher risk of sexually transmitted infections (STIs) and unwanted pregnancies as a result of the pressures to exchange sex for food, shelter, drugs and money

People who experience homelessness can struggle to access quality health care and social care. In order to tackle the problem, we need more joined up services to work together.

Why we need to work together to do something about it?

Homelessness is complex issue and therefore requires a multidisciplinary approach to support some of the most vulnerable members of our community.

The Homelessness Reduction Act 2017 seeks to increase access to support for those at risk of homelessness and will require earlier action to prevent homelessness.

Prevention and cure will involve understanding the complex nature of the circumstances that lead to homelessness and the impact that it has on people. To this effect, service redesign will require collaboration between local leaders from environmental health and housing to public health and social care to identify opportunities to share learnings, integrate processes, deliver better care, reduce health inequalities and improve outcomes for anyone facing homelessness.

“The challenge for us all is not just to develop good practice but to champion and share it.”

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