Homelessness: a barometer of social justice

Abstract

The number of people experiencing homelessness in the UK has dramatically increased since 2010. In the autumn of 2018, 4677 people in England were estimated to be sleeping rough, a worrying increase from 1768 in 2010.  Rough sleeping is at the extreme and visible end of homelessness, and estimates of the total number of people affected by the UK’s housing crisis highlight an even larger problem. Data from 2019 suggest that around 250 000 households and 400 000 people are currently homeless or at risk of homelessness. Homelessness can have fatal consequences.

A study has highlighted  the importance of chronic and potentially preventable diseases, such as coronary heart disease, respiratory disease, and cancer. Crucially, after adjusting for age and sex, nearly one in three of the deaths among people who were homeless in our study were due to causes that are amenable to timely health care. Collectively, this evidence demonstrates a public health emergency that we already know how to tackle—but have failed to do so. Most people experiencing homelessness had been admitted to hospital in acute health crisis.  Their health needs represent a system failure to intervene early and prevent serious harms. Evidence from England, corroborated internationally, highlights multiple missed opportunities for timely intervention.