Healthcare and experiences of homelessness

This project aims to explore the healthcare interactions of homeless people, taking the case study of a single local authority in Wales.

Worsening health, both mental and physical, can be both a cause and consequence of homelessness, with a large body of literature drawing on both survey and administrative data documenting the health of homeless people. Rather than focus on the general health of homeless populations in Wales, we will attempt to enumerate the healthcare service usage of people during periods of homelessness, to quantify the impacts of homelessness on health services and to provide an impetus for intervention across government departments, including health.
Within the current knowledge base on the health of homeless people, there is a tendency to either focus on specific groups within the homeless population in isolation from others, such as rough sleepers, or to treat all homeless people as the same. The proposed study will, therefore, explore differences in healthcare needs amongst different experiences of homelessness. Specifically, our interest is in the prevalence of substance use and alcohol-related service interactions, given that drug and alcohol use can alter a person’s interactions with housing and support services, and how those services interact with the person. 

Key questions

  • Does healthcare service use, specifically attendance at A&E, increase during periods of homelessness?
  • What are the associated costs of healthcare service use by people during periods of homelessness? And do these costs differ between different homelessness groups?
  • Does the prevalence of substance misuse and alcohol related healthcare service interactions vary across homeless populations?

The data

The project will link Swansea Local Authority housing service data to a range of health data sources to identify interactions with healthcare services that are related to substance and alcohol use, and more broadly when enumerating healthcare services interactions. This project will also draw information from other health data sources, including General Practitioner data, emergency department data, inpatient admissions and substance misuse service data. 

Project leads

Dr Ian Thomas, Dr Peter Mackie, and Hannah Browne Gott, Cardiff University (ADR Wales).

This project is funded by ADR Wales via its core grant from the Economic & Social Research Council (ESRC) as an ADR UK partner.

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