Health, health promotion, and homelessness

Abstract

Contemporary health promotion emphasises the concepts of lifestyle, risk, and preventive health behaviour alongside the broader societal concerns of the environment, public policy, and culture.1 The recent green paper Our Healthier Nation stresses a more coordinated approach to health promotion for people who are socially excluded, emphasising behavioural change through targeted interventions at the level of the community. 2There have been extensive reviews of homelessness and health, 3 4 along with calls for urgent action, 5-7 but little attention has been paid to the health promotion needs of homeless people, and there is no firm evidence base for practice. One challenge for health promotion is to develop and deliver appropriate initiatives to a heterogeneous population that is not always easy to categorise but has a wide range of needs. The healthcare priorities of a young man sleeping on the streets differ from those of a single mother in temporary accommodation. To be homeless means more than just the absence of secure accommodation. Homelessness has as much to do with social exclusion as with bricks and mortar, and demands a range of health promotion strategies.

Housing and Public Health

“…Studying the health effects of the lack of a home can serve to highlight the benefits of being housed, as well as providing evidence of the effects of being homeless. In a structural sense, the two are also linked in terms of the availability, distribution, allocation, and cost and affordability of housing: Homelessness is experienced by the individual but results from socioeconomic structural inequalities and housing policies (59).…”

Needs Assessment for Creating a Patient-Centered, Community-Engaged Health Program for Homeless Pregnant Women

“…This need for successful health promotion for the homeless also has been described in previous research. 21 Adequate nutrition can be difficult for lowincome mothers due to limited access and knowledge about healthy options. 3,5 Homeless women are less likely to eat balanced meals, take multivitamins, or breastfeed, all of which can lead to health complications for mothers and infants.…”

Using the Omaha System to Document the Wellness Needs of the Elderly

“…A healthy lifestyle is more influential than genetic factors in preventing the deterioration of older adults' health [3]. Populations with a lack of resources such as the homeless and elderly have made it difficult to implement and measure health promotion outcomes, but these are highly recommended [4].…”