Health, health promotion, and homelessness

Journal of Community Health Nursing, 2013

Health Education Research, 2012

Homeless people are susceptible to a range of health problems, yet in terms of health promotion, tend to be a hard-to-reach, marginalized group. Robust evidence regarding the ability to engage with this population via effective health promotion programmes is essential if policy and practice are to be informed to improve the health of homeless people. A structured review was conducted with the aim of examining what is known about community-based health promotion for homeless people. Six databases were searched and 8435 records screened. Thirteen studies met the inclusion criteria. A mixed-methods 'combined separate synthesis' approach was used to accommodate both quantitative and qualitative evidence within one review. Three themes emerged: (i) incorporating homelessness, (ii) health improving and (iii) health engaging. The review has implications for health promotion design, with evidence suggesting that as part of a tailored approach, homeless people must be actively involved in intervention development, ensuring that appropriate, acceptable and potentially effective individual elements are incorporated into community-based interventions.

The European Journal of Public Health, 1997

Housing has long been identified as a prerequisite for good health. In Britain not all members of the population have access to housing. The homeless population may be divided into those who are officially accepted as homeless and the unofficial homeless population. The official homeless population is dominated by families with children whilst the unofficial homeless population includes a range of circumstances from those living in squats to those literally living on the streets. In Britain the number of official homeless tripled between 1978 and 1992 and is currently 143,500 households (approximately 330,500 people). It is estimated that there are a further 6,000 people living on the streets and 50,000 in hostels giving a total estimated homeless population of 386,050. Demographic data indicate that there are important differences in the composition of the official and unofficial homeless populations. The official homeless group consists almost exclusively of young families, usually headed by a lone female. The unofficial homeless group is predominantly male and older. The official homeless population report higher prevalences of chronic health problems and general psychiatric problems than the general population whilst the unofficial group are characterized by elevated rates of psychiatric disturbance and alcohol consumption. These data indicate that homeless people are not a homogeneous social group but present a variety of different health needs which require the provision of appropriate services.

Health Promotion …, 2004

Journal of Urban Health: Bulletin of the New York Academy of Medicine, 2002

The experience of homelessness is considered one of the most important social determinants of health. When people are forced to live without stable shelter, they are exposed to a number of risk factors for poor health and well-being, including harsh living environments, violence and unsafe conditions, drugs and alcohol, reduced access to health care, and existing or new physical and behavioral health issues. The daily struggles of being homeless-safety, food, shelter, clothing-limits or prevents individuals' capacity to focus on their physical and behavioral health care needs. This paper reviews the current state of homelessness in Colorado, explores the connection between homelessness and health, and identifies promising strategies that Colorado communities are using or may use to end homelessness, improve the health of their communities, and promote health equity. It is important to recognize the cyclical nature of homelessness. In examining the relationship between homelessness and health, some health problems may cause or contribute to homelessness, while other health problems are a consequence of homelessness. In either case, homelessness often complicates existing health problems. This paper primarily focuses on how health problems result from homelessness and how homelessness may exacerbate health issues specific to mental health, Substance Use Disorder (SUD), chronic disease, and violence. What is Homelessness? The U.S. Department of Housing and Urban Development (HUD), guided by the McKinney-Vento Act and the Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act 1 , provides a definition for homelessness that includes four broad categories: 1. "People who are living in a place not meant for human habitation, in emergency shelter, in transitional housing, or are exiting an institution where they temporarily resided. 2. People who are losing their primary nighttime residence, which may include a motel or hotel or a doubled-up situation, within 14 days and lack resources or support networks to remain in housing. 3. Families with children or unaccompanied youth who are unstably housed and likely to continue in that state. 2 4. People who are fleeing or attempting to flee domestic violence, have no other residence, and lack the resources or support networks to obtain other permanent housing." 3 Researchers also define the extent or severity of homelessness using chronic homelessness, intermittent homelessness, and crisis or transitional homelessness. The causes of homelessness are complex and include factors that cross the social-ecological model and require an examination of interaction between the individual, relational, community, and societal levels. These include: 1 The HEARTH Act updates the McKinney-Vento Act by including people at imminent risk of becoming homeless and by providing a formal definition of chronic homelessness. 2 This is a new category of homelessness, and it applies to families with children or unaccompanied youth who have not had a lease or ownership interest in a housing unit in the last 60 or more days, have had two or more moves in the last 60 days, and who are likely to continue to be unstably housed because of disability or multiple barriers to employment.

SpringerBriefs in Public Health, 2021

This book contributes to the field of social research in health by providing new insights into the lived experiences of homeless young people (HYP) in Pakistan. Broadly speaking, using the theory of capital and social practice has helped to identify and explain social processes shaping HYP's pathways to homelessness, their journey on the streets, trajectories into sex work, and sexual choices, decisions, and practices, which may increase their risk of HIV and other sexually transmitted infections (STIs). This final chapter is composed of four main sections. The first section highlights the key contributions of the study by synthesising the main findings and connecting them with existing literature on homelessness, sexual practice, and HIV. The second section discusses the limitations of this relatively small-scale study with some recommendations for researchers who may conduct future research into homelessness in Pakistan. The third section outlines the study's implications for policy and practice. Drawing on the five action areas of the Ottawa Charter for Health Promotion, it invites government and civil society organisations to take coordinated actions to address homelessness and HIV in Pakistan (WHO, 1986). The fourth section discusses implications for future research, which I propose should include further efforts to estimate the magnitude of homelessness and HIV prevalence among the homeless population in Pakistan and explore the relationship between heteronormativity, patriarchy, and homelessness. The chapter ends with a reminder that appropriate actions by the government and community-based organisations (CBOs) can help HYP in their efforts to contribute to the socioeconomic development of Pakistan.

International Journal of Environmental Research and Public Health, 2022

Homelessness is a complex global public health challenge [...]

Medical Education, 2013

Gender Issues, 2008