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The impact of homelessness on health - a guide for local authorities

Homelessness is bad for all our health, and wealth. Homelessness is a measure of our collective success, or otherwise, in reducing inequalities.

The information and ideas in this briefing aim to support local authorities in protecting and improving their population’s health and wellbeing, and reducing health inequalities, by tackling homelessness and its causes.

• homelessness is often the consequence of a combination and culmination of structural and individual factors: ill health can be a contributory factor
• homelessness, and the fear of becoming homeless, can also result in ill health or exacerbate existing health conditions
• people who are homeless report much poorer health than the general population
• homelessness in early life can impact on life chances and the longer a person experiences homelessness the more likely their health and wellbeing will be at risk
• homelessness is more likely amongst populations who also experience wider inequalities eg, care leavers and people with experience of the criminal justice system
• co-morbidity amongst the longer-term homeless population is not unusual; the average age of death of a homeless person is 47 (lower for women – 43), compared to 77 years amongst the general population
• people who experience homelessness can struggle to access quality health care and social care.

Homelessness has been rising since 2010. The scale and nature of homelessness is difficult to understand, and can be a complex problem to solve – housing alone is often not the only solution, particularly when people already have poor health or other needs that require additional support.

The Homelessness Reduction Act 2017 will widen access to assistance from local housing authorities to all households at risk of homelessness and require earlier action to prevent homelessness. This presents a real opportunity to reduce homelessness, particularly amongst populations who have previously been unable to access services. However, success is highly dependent on the availability of sufficient resources and genuinely affordable homes to rent, and collective willingness amongst local systems leaders to play their part in prevention.

To improve health outcomes and reduce health inequalities, local leaders in health and social care systems clearly have a role to play in preventing, reducing and ending homelessness: in systems leadership and in enabling holistic responses that have the voice of people who have experience of homelessness at their heart.