Most Americans probably already assume that the homeless do not experience the same overall good health enjoyed by most of the rest of society, but they probably don’t know just how bad it really is. Time for a reality check. It’s worse than you think and getting worse.
According to a new two-part Series on homelessness in high-income countries (“The hidden truth about the health of homeless people”) released on October 23, as many as 4 million people in Europe and 3.5 million people in the U.S. experience homelessness every year, and the health of the homeless is decreasing almost as fast as their population is increasing. On any given night, there are 600,000 homeless people in the U.S. and 400,000 in the UK, and their health – or, more accurately, their lack thereof – has an increasingly negative effect on society as a whole by the simple fact that homeless people use the most expensive acute health-care services, such as accident and emergency care, and require longer hospital stays.
“Homeless people are the sickest in our society. The evidence on disease rates is very concerning not only for drug and alcohol abuse but also for a range of infectious diseases, heart disease and other age-related chronic conditions, and mental health disorders. The evidence shows that homeless people are old decades before the rest of the population because of their poor health”*, according to Seena Fazel, lead author of the first paper of the series published in The Lancet. Frazel is also a Professor of Forensic Psychiatry at the University of Oxford in the UK.
Just a few of the health facts:
· Homeless people are two to five times more likely to die prematurely than the general population
· The rate of tuberculosis is at least 20 times higher in the homeless population than the general population.
· The rates of depression are up to seven times higher in the homeless population.
· The median age of a homeless person in the U.S. is now 50 years old which only exacerbates the potential of increasing medical issues.
· The rate of tobacco use by the homeless is 4 times that of the overall population.
The Series offers recommendations advocating changes to social policies and structural factors that result in homelessness. According to Dr. Stephen Hwang of St. Michael’s Hospital in Toronto, Canada, lead author of the second paper of the series, “It needs to be recognised that preventing homelessness, by creating more opportunities for housing, work, education, and health care during high risk periods, such as being discharged from institutional care, psychiatric hospital or prisons to the community, could effectively reduce homelessness and makes sound economic sense.”