Health behaviours and mental and physical health status in older adults with a history of homelessness: a cross-sectional population-based study in England

Abstract

ObjectivesThis study compared (1) levels of engagement in lifestyle risk behaviours and (2) mental and physical health status in individuals who have previously been homeless to those of individuals who have not.DesignCross-sectional.ParticipantsData were from participants (n=6931) of the English Longitudinal Study of Ageing.MeasuresParticipants reported whether they had ever been homeless. We used regression models to analyse associations between homelessness and (1) cigarette smoking, daily alcohol consumption and physical inactivity, adjusting for sociodemographic covariates (age, sex, ethnicity, highest level of education, marital status and household non-pension wealth) and (2) self-rated health, limiting long-standing illness, depressive symptoms, life satisfaction, quality of life and loneliness, adjusting for sociodemographics and health behaviours.Results104 participants (1.5%) reported having been homeless. Individuals who had been homeless were significantly more likely to be physically inactive (OR 1.62, 95% CI 1.44 to 2.52), report fair/bad/very bad self-rated health (OR 1.75, 95% CI 1.07 to 2.86), have a limiting long-standing illness (OR 2.66, 95% CI 1.65 to 4.30) and be depressed (OR 3.06, 95% CI 1.85 to 5.05) and scored lower on measures of life satisfaction (17.34 vs 19.96, p<0.001) and quality of life (39.02 vs 41.21, p=0.013). Rates of smoking (20.2% vs 15.4%, p=0.436), daily drinking (27.6% vs 22.8%, p=0.385) and loneliness (27.1% vs 21.0%, p=0.080) were also elevated.ConclusionsThose who were once homeless have poorer mental and physical health outcomes and are more likely to be physically inactive. Interventions to improve their health and quality of life are required.

Social isolation and loneliness among people living with experience of homelessness: A scoping review

“…[9][10][11] People with experiences of being unhoused have self-reported higher odds of poor mental and physical health and loneliness than their housed counterparts. 12 Moreover, people with experiences of being unhoused have lower life expectancy and experience impairments associated with aging earlier than people without experiences of being unhoused. [13][14][15] These factors make individuals more vulnerable to social and economic abuse, which may affect the ability to build meaningful social connections.…”

Primary care embedded within permanent supportive housing for people who use substances: A qualitative study examining healthcare access in Vancouver, Canada

“…It is well documented that structurally vulnerable people who use drugs and alcohol (PWUD/A) face significant barriers in achieving stable housing due to a myriad of factors, such as stigma, poverty, isolation, intergenerational trauma, recent incarceration and restrictive housing policies (Krüsi et al, 2010; Menzies, 2006; Rowlands Snyder et al, 2021; To et al, 2016). In turn, people who are marginally housed endure significantly poorer health outcomes, utilise greater emergency care resources and experience higher overall mortality rates (Aldridge et al, 2018; Fleury et al, 2021; Hwang, 2000; Hwang et al, 2009; Smith et al, 2019; Turnbull et al, 2007). Despite the higher incidence of illness and emergency service utilisation amongst people who are marginally housed, access to primary care services remains suboptimal (Kendall et al, 2020) and there is a continual need for novel approaches to improve healthcare access.…”

Differences in health status, health behaviour and healthcare utilisation between Immigrant and native homeless people in Spain: An exploratory study

“…Overall, studies report that homeless people experience worse physical and mental health outcomes compared to the general population, including those from the most deprived areas (Henwood et al, 2013;Lebrun-Harris et al, 2013;Schanzer et al, 2007;Sun et al, 2012). This may be related to higher prevalence of undesirable health behaviour that is associated with adverse health outcomes, as homeless people report more illicit drug use, tobacco smoking, alcohol consumption, poorer nutrition and low levels of physical activity, as well as limited access to healthcare services (Fazel et al, 2008;Garner & Ratschen, 2013;Smith et al, 2019;Torchalla et al, 2011).…”