A retrospective analysis of the health and social situation of homeless people in Berlin: study protocol

Abstract

Background Homelessness is often described as both a driver and a consequence of poor health, social exclusion and economic marginalisation. The present protocol provides a detailed description of the study Examining the health situation of homeless people in Berlin: a retrospective analysis of data from the health centre for the homeless of the Jenny De la Torre Foundation from 2006 to 2020 (GIG study). The primary objective of the GIG study is to describe and analyse the social and health situation of homeless people in Berlin. Methods A retrospective secondary data analysis of an anonymous full census of medical records for the years 2006 until 2020 from a health centre for homeless people will be carried out. The main outcome is the description and analysis of the social and health situation of homeless people in Berlin. Total and cross-sectional sample characteristics will be presented in a descriptive analysis using Chi-Square Test, Mann-Whitney-U-Test or independent t-Test as appropriate to test (sub) group differences. Further, outcomes will be analysed using finite mixture modelling in order to distinguish different types of social and health conditions. Latent variable regressions will be applied in order to identify sociodemographic and disease-related factors associated with decreasing health conditions. Discussion Given the high number of homeless individuals in Germany, it is of great importance to examine their social and health situation in order to gain a better understanding of challenges and needs of homeless people and work on new approaches and solutions to effectively address these. Trail registration The study was prospectively registered with the German Clinical Trials Register (trial registration number: DRKS00021172). Registered 26 June 2020.

Chronic diseases and multi-morbidity in persons experiencing homelessness: results from a cross-sectional study conducted at three humanitarian clinics in Germany in 2020

“…Homelessness is a complex and dynamic state, driven by the interactions between structural factors; such as the unavailability of affordable housing, employment opportunities for low-skilled workers and income support; and individual factors, such as poverty, mental illness, substance abuse, social isolation, sexual assault and domestic violence [ 1 , 2 ]. According to the German Federal Working Group on Homelessness ( Bundesarbeitsgemeinschaft Wohnungslosenhilfe ; BAG W), in 2018, 678,000 persons experienced homelessness in Germany, approximately 41,000 of whom slept without shelter, on the streets [ 3 , 4 ]. Estimates show that Germany witnessed a 64.8% increase in homelessness between 2006 and 2016, mirroring the rise in most European countries in the last decade [ 5 ], and representing a growing social and public health challenge [ 4 ].…”

“…According to the German Federal Working Group on Homelessness ( Bundesarbeitsgemeinschaft Wohnungslosenhilfe ; BAG W), in 2018, 678,000 persons experienced homelessness in Germany, approximately 41,000 of whom slept without shelter, on the streets [ 3 , 4 ]. Estimates show that Germany witnessed a 64.8% increase in homelessness between 2006 and 2016, mirroring the rise in most European countries in the last decade [ 5 ], and representing a growing social and public health challenge [ 4 ].…”

“…Due to a lack of harmonized data across Europe, assessing the extent of homelessness and identifying and addressing the needs of PEH represent a major challenge [ 4 , 29 ]. In 2005, the European Typology of Homelessness and Housing Exclusion (ETHOS) was developed by the European Federation of National Organisations working with the Homeless (FEANTSA) and the European Observatory on Homelessness, to provide a common framework to define and classify homelessness [ 30 ].…”

“…In 2005, the European Typology of Homelessness and Housing Exclusion (ETHOS) was developed by the European Federation of National Organisations working with the Homeless (FEANTSA) and the European Observatory on Homelessness, to provide a common framework to define and classify homelessness [ 30 ]. While it was recommended as the official definition of homelessness in the European Union (EU) [ 30 ], ongoing inconsistencies in definition and in data collection methodologies remain [ 4 ]. Additionally, most European research on PEH is skewed towards persons sleeping rough or living in emergency shelters, excluding persons experiencing housing exclusion, such as those provisionally accommodated within institutions, with friends or family, or living in precarious housing [ 31 ].…”

“…Homelessness is both a cause and a consequence of poor health [4], and persons experiencing homelessness (PEH) face mortality risks three to six times the general population [6][7][8]. Mental illness [9], alcohol and drug dependency [10], infectious diseases [11], and poor oral and dental health [12] are highly prevalent in this population.…”