Homelessness Harms Health
According to last week’s editorial in the esteemed British Medical Journal, the number of people officially recorded as sleeping on the streets of England rose from 1768 in 2010 to 4751 in autumn 2017. Charities estimate the true figure to be more than double this.
The most common reason, the BMJ says, is falling into arrears with housing payments. Living in damp, cold, or overcrowded housing leads to greater physical risks to health, and strains on mental health occur though insecurity and personal debt. Associated health effects include respiratory conditions, depression, anxiety, unintentional injury, excess winter mortality, and skin irritation. At the extreme end, when last calculated (for 2001-09) single homeless people had an average age at death of 47 years, compared with 77 years for the general population.
The recent rise in homelessness has its roots in welfare reform and the housing market. It is almost entirely accounted for by an increase in families losing their privately rented housing. Between 2010 and 2016 the number of households accepted as homeless by English local authorities rose by 16,780, from 42,390 to 59,260; the number becoming homeless because of losing a private sector tenancy tripled from 6,150 to 18,750.
Despite having greater health needs, homeless people face barriers to accessing primary healthcare, leading to a higher rate of attendance at emergency departments. This has prompted the development of some specialist primary healthcare services for homeless people, such as Oxford’s Luther Street Medical Centre.
What is needed is a comprehensive strategy that improves support services for vulnerable people, an increased supply of affordable housing, more security of tenancies, adequate cash benefits to cover the rising cost of housing, and more efficient use of our existing housing stock.
