Focus on the homeless

One of the consequences of being homeless is the effect it has on a person's health. New data from the Central Statistics Office shows that one in five homeless people consider they are not in good health – double the 9.6 per cent rate in the general population. The thematic analysis of Census 2016 results also revealed a disability rate among the homeless that was double that of the general population. And almost 12 per cent of homeless people aged over 15 were unable to work due to permanent sickness. On census night just over 6,900 people were either sleeping rough or were in accommodation designated for the homeless.

There is a high prevalence of the liver virus hepatitis C among homeless people in Dublin, authors of a soon to be published study told this newspaper. Of the 206 people who tested positive during the screening by Safetynet homeless services, 112 were new cases that had not been previously diagnosed. The research suggests a hepatitis C prevalence rate of 38 per cent among the capital’s homeless population. The average period of homelessness among those surveyed was 6.2 years; most were living in a hostel. Unsurprisingly those interviewed identified unstable accommodation as a barrier to attending specialist appointments and treatment for hepatitis C. Researchers noted that for the homeless “myriad health and social risk factors need to be addressed in conjunction with further care if we are to make any difference in hepatitis C prevalence”.

Health inequalities

This is a statement that could be applied to a range of health issues facing the homeless. These issues are an extension of the well-established health inequalities affecting those in lower socioeconomic groups: higher cancer mortality rates, a greater prevalence of heart disease and of infections, all of which contribute to premature death and poorer longevity. There is a need to shift resources for treating the homeless and the poor out of hospitals and into the community. And for longer-term prevention there must be greater recognition of the need to health-proof initiatives in transport, the built environment and education.