Public Health Responses to Homelessness During COVID-19 in Ireland: Implications for Health Reform

Abstract

The intersection between health and homelessness is well documented and has been made more explicit since the onset of the coronavirus disease of 2019 (COVID-19). In the Global North, COVID-19 related public health responses targeting homeless populations have varied across countries, including greater national-level financial investment, temporarily housing those in congregate facilities in ‘self-contained’ accommodation, time-limited eviction moratoriums and dedicated health system interventions across homelessness and addiction services to enable social distancing and self-isolation. Yet questions remain about the immediate and longer-term outcomes of these newly implemented responses and whether they will be sustained. Such considerations are critical and timely in countries such as Ireland, where significant health reform is underway. In this paper, we use Ireland as a case study to explore whether and how public health responses to homelessness during COVID-19 hold important insights for the development of more effective health policy. Drawing on publicly available Irish data, we present a secondary analysis of COVID-19 infection rates amongst homelessness service users as well as trends in emergency accommodation usage between 2020 and 2021. Focusing specifically on public health measures implemented during the pandemic via the health and housing systems, respectively, we discuss how such interventions may have impacted on these homelessness figures in both intended and unexpected ways. We conclude by teasing out and unpacking relevant lessons for health reform.