Homelessness and self-rated health: evidence from a national survey of homeless people in Spain

Abstract

Background Internationally, acute homelessness is commonly associated with complex health and social care needs. While homelessness can be understood as an outcome of structural housing exclusion requiring housing led solutions, the health care issues faced by homeless people equally require attention. A substantive evidence base on the health needs of homeless people exists, but relatively little is known about what influences the self-rated health of homeless people. This article presents new evidence on whether drug use (alcohol consumption, ever having used drugs), health variables (visiting a hospital once in the last year, visiting the doctor in the last month, having a health card, sleeping difficulties, and having a disabling impairment) and sociodemographic characteristics are significantly associated with Self-Rated Health (SRH) among Spanish homeless people. Method The approach applies secondary analysis to cross-sectional data from a sample of 2437 homeless adults in Spain (83.8% were male). Multinomial logistic regression modelling was used to analyse the relationships between drug use, other health variables and SRH. Results Being male, an abstainer, having a health card and being in the youngest age groups were significant factors associated with perceived good health. On the other hand, ever having used drugs, having been a night in hospital, having gone to the doctor in the last month, having sleeping difficulties, having a disabling impairment and being in the older age group were all significant risk factors associated with perceived poor health. Conclusions These results help to improve understanding of the key factors that influence the SRH among homeless people. The findings can contribute to development and delivery of preventive policies, suggesting that interventions to reduce drug consumption and ensure access to a health card/health services, as well as enhancing services for older, female and disabled homeless people are all measures which could improve health and well-being for those who face homelessness. Effective housing interventions (e.g. Housing First or Permanent Supported Housing programmes) are equally important to underpin the effectiveness of measures to improve the self-rated health of homeless people.

Health status and health behaviour of the Hungarian homeless people

“…A larger self-reliant transitionally homeless group experiences living rough for shorter periods also exist with more favourable health indicators (1). Our data on the presence of chronic diseases support this type of distribution in the roo ess group, in addition with the concordance of a recent Spanish research, in which less than half of the examined population was heavy drinker (39).…”

Well-Being without a Roof: Examining Well-Being among Unhoused Individuals Using Mixed Methods and Propensity Score Matching

“…Similarly, our unhoused study sample also skewed to be mostly white (47.1%) and non-Hispanic (68.6%), but was evenly split between males and females. The existing research on the association between sex and well-being in unhoused individuals suggests that women may be a particularly vulnerable subgroup [ 31 ]. Unhoused women are less satisfied with their health and empowerment, have lower self-esteem, and experience more psychological distress than unhoused men [ 32 ].…”

“…Additionally, although findings are mixed as to the degree of vulnerability, the risks of homelessness associated with health and well-being may be greater for people of color than for white people, especially for women [ 33 ]. Age also plays a role in the experience of homelessness: older age among unhoused individuals has been associated with worse physical health and more limited social support [ 31 , 34 ]. Thus, the demographics of a homeless individual may influence their experience of homelessness and how they report their well-being.…”

“Life Starts for Me Again.” The Social Impact of Psychology on Programs for Homeless People: Solidarity Networks for the Effectiveness of Interventions

“…If one considers social impact to infer social improvements attained from the transference of the research results (Pulido et al, 2018), the social impact of psychology has served homeless people mostly by informing intervention programs related to preventing and responding to substance abuse (Davidson et al, 2013), healthcare (Salem and Ma-Pham, 2015;Fajardo-Bullón et al, 2019), sexual risks (Pedersen et al, 2018), or mental illnesses (Noël et al, 2016;Fond et al, 2019) -key problems that also psychology has studied and found to be connected to homelessness. Such strategies have often been centered on tackling the challenges that homeless people face, such as those mentioned above.…”