Homeless In London Research Articles

The importance of stable housing in social capital development and utilisation: how homelessness undermines reciprocity, recognition, and autonomy

Social capital is recognised as an important resource for people experiencing poverty, yet conceptualisations of its relationship to homelessness are underdeveloped. Some studies show that social capital can protect against the risk of homelessness, whilst others show that reliance on social capital by people already experiencing homelessness rarely enables them to exit homelessness and can in fact render them vulnerable to exploitation and abuse. Building on these insights, we develop a framework for conceptualising the relationship between stable housing and social capital. Drawing on analysis of qualitative interviews with people experiencing homelessness in London, we demonstrate how, in the absence of stable housing, people experiencing homelessness lack key conditions that enable the accumulation and effective use of social capital. These include the ability to practice reciprocity, achieve recognition, and exercise autonomy in social relationships. We conclude that stable housing is a precondition for utilising social capital to ameliorate, rather than exacerbate, vulnerability, lending further evidence to support Housing First policies.

Developing a system response to health and homelessness: The important role of health leaders.

This article examines the role of health leaders in the early stages of a community response to address health and homelessness in London, Ontario. Specifically, we explore how leaders from large healthcare-providing organizations have influenced the dynamics of the entire community response. We argue that the high level of engagement from health leaders has been a key ingredient in the early successes of the new approach in London, in part because it validated the reframing of homelessness as a healthcare issue-importantly, changing perceptions about who shares the responsibility to address it.

Oral health of people experiencing homelessness in London: a mixed methods study

BackgroundThose experiencing homelessness have significant health and oral health needs and are at the extreme of health inequalities. The aim of the study was to conduct an oral health needs assessment for those experiencing homeless in London and impacts on their oral health-related quality of life.MethodsThe oral health needs assessment consisted of quantitative and qualitative methods. This included a survey questionnaire to assess perceived oral health needs, and oral health related quality of life. In addition, a focus group was conducted with 13 peer advocates.ResultsFindings from the focus group revealed numerous challenges for homeless populations to maintain good oral health and access to dental care including mental ill-health, stigma, costs, and chaotic lifestyles. A response rate of 79% (n = 315) was achieved for the questionnaire survey. Results showed high levels of unmet dental needs and risky health behaviours including 60% reporting being smokers, 39% consuming high amounts of sugar and 52.4% brushing their teeth less than twice a day. More than a third (32.1%) had experienced toothache. The majority of respondents 80% (n = 224) were very or fairly concerned about their dental health. There were significant associations between perceived oral health status and oral health-related quality of life.ConclusionThose experiencing homelessness in London were found to have high levels of unmet oral health needs, which significantly impacted on their oral health-related quality of life. Focusing on changing behaviours alone is insufficient and therefore addressing the structural determinants of homelessness is vital in improving oral and health outcomes of this vulnerable population.

Ambient Temperature and Emergency Hospital Admissions in People Experiencing Homelessness: London, United Kingdom, 2011-2019.

Objectives. To assess the impacts of ambient temperature on hospitalizations of people experiencing homelessness. Methods. We used daily time-series regression analysis employing distributed lag nonlinear models of 148 177 emergency inpatient admissions with "no fixed abode" and 20 804 admissions with a diagnosis of homelessness in London, United Kingdom, in 2011 through 2019. Results. There was a significantly increased risk of hospitalization associated with high temperature; at 25°C versus the minimum morbidity temperature (MMT), relative risks were 1.359 (95% confidence interval [CI] = 1.216, 1.580) and 1.351 (95% CI = 1.039, 1.757) for admissions with "no fixed abode" and admissions with a homelessness diagnosis, respectively. Between 14.5% and 18.9% of admissions were attributable to temperatures above the MMT. No significant associations were observed with cold. Conclusions. There is an elevated risk of hospitalization associated with even moderately high temperatures in individuals experiencing homelessness. Risks are larger than those reported in the general population. Public Health Implications. Greater emphasis should be placed on addressing homeless vulnerabilities during hot weather rather than cold. Activation thresholds for interventions such as the Severe Weather Emergency Protocol (SWEP) could be better aligned with health risks. Given elevated risks at even moderate temperatures, our findings support prioritization of prevention-oriented measures, rather than crisis response, to address homelessness. (Am J Public Health. 2023;113(9):981-984. https://doi.org/10.2105/AJPH.2023.307351).

A participatory evaluation of legal support in the context of health-focused peer advocacy with people who are homeless in London, UK.

Legal problems can be cause and consequence of ill-health and homelessness, necessitating efforts to integrate responses to these challenges. How to respond to legal issues within the context of health services for people who are homeless is though unclear. Groundswell piloted providing legal support to peer advocates (who have current or past experience of homelessness) and clients currently homeless in addition to their health-focused work. A participatory action-research design evaluated the emerging programme. Groundswell staff, both researchers and those involved in service delivery, co-led the research alongside an external researcher. Qualitative methods were used to understand the experiences of legal support. We interviewed peer advocates and volunteers (n=8), Groundswell clients (n=3) and sector stakeholders (n=3). Interviews were linked to regular reflective recorded meetings (n=7) where Groundswell staff and researchers discussed the programme and the evaluation. Data were analysed thematically. The findings focus on three themes. First, peer advocates' and clients' legal needs involve an experience of being overwhelmed by system complexity. Second, the legal support to peer advocates aided in brokering and signposting to other legal support, in the context of a supportive organisational culture. Third, support to clients can be effective, although the complexity of legal need undermines potential for sustainable responses. In conclusion, legal support for peer advocates should be developed by Groundswell and considered by other similar agencies. Legal support to people who are currently street homeless requires significant resources and so health-focused third-sector organisations maybe unable to offer effective support. Other modes of integration should be pursued. Findings also have implications for how the third sector relates to the government agencies implicated in the legal challenges facing people who are homeless.

Why were COVID-19 infections lower than expected amongst people who are homeless in London, UK in 2020? Exploring community perspectives and the multiple pathways of health inequalities in pandemics

High rates of COVID-19 infections and deaths amongst people who are homeless in London, UK were feared. Rates however stayed much lower than expected throughout 2020; an experience that compares to other settings globally. This study sought a community level perspective to explore this rate of infections, and through this explore relationships between COVID-19 and existing health inequalities. Analyses are reported from ongoing qualitative studies on COVID-19 and homeless health service evaluation in London, UK. Repeated in-depth telephone interviews were implemented with people experiencing homelessness in London (n=17; 32 interviews in total) as well as street outreach workers, nurses and hostel staff (n=10) from September 2020 to early 2021. Thematic analysis generated three themes to explore peoples’ experiences of, and perspectives on, low infections: people experiencing homelessness following, creating and breaking social distancing and hygiene measures; social distancing in the form of social exclusion as a long-running feature of life; and a narrative of ‘street immunity’ resulting from harsh living conditions. Further study is needed to understand how these factors combine to prevent COVID-19 and how they relate to different experiences of homelessness. This community perspective can ensure that emerging narratives of COVID-19 prevention success don’t ignore longer running causes of homelessness and reinforce stigmatising notions of people who are homeless as lacking agency. Our findings aid theorisation of how health inequalities shape pandemic progression: severe exclusion may substantially delay epidemics in some communities, although with considerable other non-COVID-19 impacts.

Peer advocacy and access to healthcare for people who are homeless in London, UK: a mixed method impact, economic and process evaluation protocol

IntroductionPeople who are homeless experience higher morbidity and mortality than the general population. These outcomes are exacerbated by inequitable access to healthcare. Emerging evidence suggests a role for peer advocates—that...

Dental public health in action: foundation dentists' delivery of an oral health promotion outreach project for people experiencing homelessness in London.

Dental public health in action: foundation dentists' delivery of an oral health promotion outreach project for people experiencing homelessness in London.Within a decade, the UK has seen a dramatic increase in homelessness. This is defined as being without an available home that could reasonably be occupied. The increase has been driven by increasing poverty, welfare reform, cuts to public services and lack of affordable housing (Bramley et al., 2015; Fitzpatrick et al., 2013; Fitzpatrick et al., 2018). Rough sleeping in England alone has increased by 2,909 people or 165% since 2010 (Ministry of Housing, Communities and Local Government, 2018). This increase has been particularly visible in London (National Audit Office, 2018), where approximately a quarter of the country's rough sleepers reside (Ministry of Housing, Communities and Local Government, 2018).

Young and homeless

Young and homeless

Managing poverty, managing dissent: homeless politics and collective action in London

This paper explores the relationship between strategies to manage poverty and the mobilisation of collective action. Focusing on the period 1979–93, the paper describes how the British Conservative government employed a combination of supportive and punitive interventions to manage homelessness in London. In the process, the paper finds, the government also effectively managed the mobilisation of collective dissent by containing the disruptive effects of visible homelessness while channelling opposition into conventional routes of political power. The paper integrates recent research on poverty management with insights from social movement theory, and explores the implications of these findings for contemporary homeless politics.

Homo Sovieticus Revisited – Anti‐Institutionalism, Alcohol and Resistance Among Polish Homeless Men in London

AbstractThis article looks at the issue of the dramatic rise of street homelessness in London among Polish migrants from the perspective of social anthropology looking at the relationship between structural constraints faced by Polish migrants and their own perception of the social world, their meaning‐making practices, norms and values, behavioral patterns. As I will show, focusing just on structural and economic determinants not only offers a simplistic and one‐dimensional picture but it also fails to give an explanation and predict what happens if these constraints and exclusionary policies are removed and homeless migrants gain the same set of social rights as the rest of British and EU citizens (which in theory will happen in May 2011). An anthropological approach to the functions, roles and cultural meanings of homelessness, group bonds, masculinities, alcohol consumption, perception of the state and dominant society as voiced by homeless migrants I ’hanged around’ with, reveals that structurally rejected people with particular backgrounds reconstruct communities and form strong ties despite (or because of) a hostile, exclusionary and hegemonic social environment of the neoliberal order. Two conclusions are drawn from this analysis, empirical and theoretical: first, taking both structural and cultural factors into account, the levels of homeless among that group is going to rise, at least in London; second, the set of cultural forms of behavior and social practices described in academic literature as the homo sovieticus syndrome (Wedel 1986, Sztompka 2000, Morawska 1998) proves not only valuable and resourceful in highly individualized, neoliberal and capitalistic society but may in fact be reinforced in new conditions being a productive – socially and culturally ‐ counter‐reaction to the neoliberal order of social life in the global city.

Comparing Men's and Women's Experiences of Multiple Exclusion Homelessness

This article explores gender as a variable in multiple exclusion homelessness in England. Much past research has taken insufficient account of the gender of homeless people, especially the predominance of men in the single homeless population and of women heading homeless households with dependent children. Drawing on qualitative data generated in a study of multiple exclusion homelessness in London and Nottingham, the article considers three ways in which gender may act as a homelessness variable: in people's susceptibility to homelessness, in their experiences of homelessness and in their encounters with accommodation services. By comparing the accounts of homeless men and women with complex support needs with evidence from staff working for support agencies, the overall aim of the article is to offer a critical examination of the gendered assumptions of homelessness policy and practice.

FC01-02 - Homelessness and experiences of psychological trauma in the western world: A research review and a qualitative study

Over the last forty years, and particularly within the last decade, homelessness is recognised as a multifaceted problem. Homelessness is associated with poverty, because the ability to access employment is limited by the lack of a stable address. Secondly, homeless people often experience severe difficulties with housing related services, health services and education. These problems are often sustained or exacerbated by, e.g., poor physical and mental health and the need to support alcohol or drug dependencies. What role does traumatic events, in particular childhood trauma and abuse, have in the lives of the homeless? The negative effects of psychological trauma on psychosocial functioning and wellbeing in the general population are well documented; a quick review of the research on homelessness and trauma suggested that more work is needed.The objectives of this paper are to review research on homelessness and experiences of psychological trauma and evidence from a sample of single homeless adults.The aim of this paper is two-fold: to provide a systematic review of studies on the relationship between childhood trauma and homelessness and to present findings from a qualitative study of adult people who are homeless in London and Nottingham, UK.The systematic review examines research published in the Western world, 1990 - July 2010. The qualitative study collected data through semi-structured interviews with 103 single people, aged 18–69 years.A summary of the results from the review and qualitative study and guidance for further research on the relationships between traumatic experiences and homelessness will be provided.

Considering Photographs Never Taken During Photo-production Projects

The visual medium is central to how most of us navigate daily life and come to know and interact with our social worlds. Recently, the role of visual dimensions of everyday life has surfaced in qualitative research in psychology. This paper explores some of the underlying processes foundational to participants' efforts to picture their worlds during photo-production projects. We draw on excerpts from a study of images of homelessness in London to exemplify various methodological issues surrounding the interpretation of photo-production materials. Emphasis is placed on the need to focus on photo-production because photographs taken never fully contain what is important to participants. Issues and events are often talked into the frame of photographs by participants. This process of presenting aspects of one's life extends to discussions of photographs not taken and reflections on processes of picturing everyday life. We argue that a consideration of photographs not taken is important if we are to maximise the utility of photo-production as a method and fully understand what it provides.

Not Miser Not Monk: Begging, Benefits and the Free Gift

This article considers the idea of the ‘free’ gift, in particular relation to begging and the receipt of social security benefit and in reference to ethnographic research with the homeless in London and the South East of England. The article draws attention to the potential for both ‘dole money’ and spare change to signify, socially, in ways which wound. This is to recognise the Maussian connotations and moral framing to contemporary exchanges which mark out people as poor, even where the intention might be to give freely.

Health and home for homeless people in transition.

In recent years, increasing focus has been placed on the relation between environmental qualities and the promotion of well-being. This paper explores this relationship from an environmental psychological approach that emphasizes the broader social and physical context and the central significance of individual goals. In particular, the qualities of home and their potential value in the promotion of well-being are discussed. This paper presents a review of recent literature, followed by an empirical study of homelessness in London. A sample of 531 adults was staying in squats, hotels, hostels, and on the streets. Each setting was examined in terms of qualities of home and a general level of well-being. The results suggest that this sample experienced low levels of well-being, typical of persons experiencing such upheaval. Furthermore, there may be a positive relation between levels of well-being and home-like qualities for some homeless settings. The paper concludes that a focus on qualities of home may contribute to a broader understanding of health and well-being that values individual experience and goals.

The Faces of Homelessness in London

The Faces of Homelessness in London

A. H. Halsey, Roger Jowell, Bridge Taylor (eds.), The Quality of Life in London, Dartmouth, Aldershot, 1995, iv + 159 pp., £35.00 hard; - Jeanne Moore, David Canter, Des Stockley, Madelaine Drake, The Faces of Homelessness in London, Dartmouth, Aldershot, 1995, vii + 339 pp., £30.00 hard.

A. H. Halsey, Roger Jowell, Bridge Taylor (eds.), The Quality of Life in London, Dartmouth, Aldershot, 1995, iv + 159 pp., £35.00 hard; - Jeanne Moore, David Canter, Des Stockley, Madelaine Drake, The Faces of Homelessness in London, Dartmouth, Aldershot, 1995, vii + 339 pp., £30.00 hard.

Tuberculosis among the homeless at a temporary shelter in London: report of a chest x ray screening programme.

To estimate the prevalence of active pulmonary tuberculosis in a homeless population in London and to assess whether those with suspected disease could be integrated into the existing health care system for further follow up and treatment. Voluntary screening programme based on a questionnaire survey and chest x ray. SETTING AND CASES: Screening programmes were set up over the Christmas period in 1992 and 1993 at a shelter for the homeless in London. An offer of screening was made to all individuals who visited the centre and an interviewer administered questionnaire was completed on those who volunteered for the screening. Chest x rays were carried out, developed, and read on site. Individuals with chest x rays features suggestive of tuberculosis or other medical problems were referred to a hospital of their choice. RESULTS AND OUTCOME: In 1992 nearly 1600 people visited the centre, of whom 372 volunteered for the screening and 342 were x rayed. Nineteen of the 342 (5.6%) had radiological features suggestive of active tuberculosis. In 1993 around 2000 homeless people visited the centre, of whom 270 volunteered for the screening and 253 were x rayed. Eleven (4.3%) had features consistent with active tuberculosis on the basis of the chest x rays and clinical examination by a chest physician. Overall, of 595 people x rayed in the two surveys, 30 (5%) had changes suggestive of active tuberculosis. Further investigations confirmed nine (1.5%) with active pulmonary disease and eight with no active tuberculosis. In 13, the diagnosis was not determined as four declined further investigation and nine did not attend their hospital appointment. Tuberculosis among the homeless remains a cause for concern. Follow up and treatment present unique difficulties. Services for the homeless need to include mechanisms for timely diagnosis and monitored treatment. Control programmes designed for the needs of the homeless are required.

Tuberculosis among the homeless in London

Tuberculosis among the homeless in London