Treating ill health might not be enough to help homeless people get off the streets

October 23, 2014, St. Michael's Hospital

Health care providers should recognize that any effective strategy to address homelessness needs to include both interventions to improve the health of homeless individuals as well as larger-scale policy changes, according to a paper published today.

"It is essential to recognize that homelessness is equally the result of structural factors within a society, such as systematic inequities in educational and employment opportunities, a shortage of affordable housing, and social policies that are targeted against marginalized populations," said Dr. Stephen Hwang of St. Michael's Hospital.

Dr. Hwang's paper was published today in The Lancet, half of a two-part series on homelessness in . Dr. Hwang, a general internal medicine physician and a researcher at the hospital's Centre for Research on Inner City Health, is one of the world's leading experts on health and homelessness. He also holds the hospital's Chair in Homelessness, Housing and Health, which is believed to be the first hospital-based chair in homelessness in the world.

As many as 3.5 million Americans and 200,000 Canadians experience homelessness every year, and the numbers are rising. Homeless people "are the sickest in our society," but just treating ill health might not be enough to help get people off the streets, according to the author of the first Lancet paper, Seena Fazel, professor of forensic psychiatry at the University of Oxford.

The series highlights that being homeless is not only bad for a person's physical and mental health but also has dramatic effects on life expectancy. Previous studies by Dr. Hwang and others have found that homeless people use the most expensive acute , such as accident and emergency care, and need longer hospital stays than people with homes.

The Lancet series says that while government targets to improve the health of should be introduced (e.g. for the identification and management of infectious diseases, mental illness and diseases of old age), should also advocate for changes to the and structural factors that result in homelessness, including the lack of and employment opportunities for low-skilled workers.

The papers note there are some programs in high-income countries bridging the gap between homelessness and health services, such as the Housing First programs that provide housing and support services for with severe mental illness or substance abuse problems. Dr. Hwang is the principal investigator in Toronto for the At Home/Chez Soi project evaluating Housing First in Canada.

Medical respite programmes for patients leaving hospital reduce the risk of readmission and the number of days spent in hospital.

St. Michael's also has two interventions aimed at helping people with unmet, complex health care needs access health resources in the community: CATCH-Homeless and CATCH-ED, specifically for people who use Emergency Departments five or more times a year, at least one of those times for a mental health and-or addiction problem. CATCH case managers work with family physicians, psychiatrists and other service providers to support patients' access to such things as medical care and and addiction services

However, these examples are not the norm and much more needs to be done, said Dr. Hwang.

"It needs to be recognised that preventing homelessness, by creating more opportunities for housing, work, education, and during high risk periods, such as being discharged from institutional care, psychiatric hospital or prisons to the community, could effectively reduce homelessness and makes sound economic sense."

Explore further: Mental illness linked to extreme risk of homelessness

Related Stories

Mental illness linked to extreme risk of homelessness

October 8, 2014
University of Adelaide researchers say the greatest level of accommodation assistance should be directed to those most likely to need it, with Australians suffering from psychiatric and intellectual disabilities found to ...

Study examines discrimination among homeless adults in Toronto with mental illness

September 8, 2014
Vulnerable populations in ethnically diverse Toronto reported more discrimination by health care workers based on their housing status, mental health or substance abuse issues than race, a new study has found.

Small group of homeless people are extremely high users of ERs

October 22, 2013
Although homeless people account for a small proportion of Emergency Department visits, a small group of them are extremely high users and have multiple complex health care needs, new research has found.

Study: 85 percent of homeless people have chronic health conditions

August 24, 2011
More than eight out of 10 homeless people surveyed by researchers at St. Michael's Hospital and elsewhere have at least one chronic health condition and more than half have a mental health problem.

Study finds almost half of homeless men had traumatic brain injury in their life

April 25, 2014
Almost half of all homeless men who took part in a study by St. Michael's Hospital had suffered at least one traumatic brain injury in their life and 87 per cent of those injuries occurred before the men lost their homes.

New book examines homelessness issues in Canada

May 29, 2014
Ryan McNeil, a Simon Fraser University postdoctoral researcher, hopes health care providers and policy makers dig deep into a new book he has co-authored to improve health care for Canada's approximately 200,000 homeless ...

Recommended for you

Engineered enzyme eliminates nicotine addiction in preclinical tests

October 17, 2018
Oct. 17, 2018—Scientists at Scripps Research have successfully tested a potential new smoking-cessation treatment in rodents.

Self-lubricating latex could boost condom use: study

October 17, 2018
A perpetually unctuous, self-lubricating latex developed by a team of scientists in Boston could boost the use of condoms, they reported Wednesday in the journal Royal Society Open Science.

How healthy will we be in 2040?

October 17, 2018
A new scientific study of forecasts and alternative scenarios for life expectancy and major causes of death in 2040 shows all countries are likely to experience at least a slight increase in lifespans. In contrast, one scenario ...

Study finds evidence of intergenerational transmission of trauma among ex-POWs from the Civil War

October 16, 2018
A trio of researchers affiliated with the National Bureau of Economic Research has found evidence that suggests men who were traumatized while POWs during the U.S. Civil War transmitted that trauma to their offspring—many ...

Father's nicotine use can cause cognitive problems in children and grandchildren

October 16, 2018
A father's exposure to nicotine may cause cognitive deficits in his children and even grandchildren, according to a study in mice publishing on October 16 in the open-access journal PLOS Biology by Pradeep Bhide of Florida ...

Many supplements contain unapproved, dangerous ingredients: study

October 13, 2018
(HealthDay)—U.S. health officials have issued more than 700 warnings during the last decade about the sale of dietary supplements that contain unapproved and potentially dangerous drug ingredients, new research reveals.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.