The challenge of providing medical care to homeless men

Abstract

The average age of death for a homeless man is 47 years, 30 years before the national average of 77.1 This is clear evidence of the impact of homelessness on a person’s wellbeing. It highlights the need within this population for the best possible medical care to try and address these health needs. Here we explore what homelessness means today and how it affects health, and reflect on the experience of our practice in providing medical care to a hostel for homeless men. Using this experience we formulate some general ideas on providing medical care to the homeless, and how this service could be improved. Homelessness in the UK is rising.2 Total numbers of homeless people are difficult to estimate due to the transient nature of the population. The legal definition of homelessness is used by local councils to decide whether they are obligated to provide assistance. A person is considered legally homeless if they have no home in the UK or anywhere else in the world or if they are being evicted or their property repossessed. A person can be considered legally homeless despite having accommodation if, for example, the home is too small for the person and their immediate family, if they are in temporary accommodation such as a hostel or refuge, if they don’t have permission to live where they are living, or if they can not afford to stay where they are.3 Multiple issues make the homeless population a unique community. Common health problems include drug dependence, alcohol use, mental health issues, and infectious diseases.4 Barriers to accessing health care include chaotic lifestyles due to substance abuse or mental health problems, difficulty registering with a practice, challenging behaviours, and previous experience of prejudice within health care. The White House Surgery in Sheffield …