Health characteristics of people experiencing homelessness based on a mixed-methods study

Abstract

INTRODUCTION: Overall health is significantly influenced by both the individual's history and current living conditions, such as financial, mental, physical, lifestyle, physical activity, nutrition, temperature, etc. These factors often have a very adverse impact on the lives of people experiencing homelessness, purely by chance: many of those experiencing homelessness suffer from a serious illness before they are on the streets, which can be a precursor to homelessness. When one falls into homelessness, one accumulates many new illnesses, so homeless people are characterised by multimorbidity, i.e. they can often have several serious illnesses at the same time.

METHODOLOGY: In 2024, I conducted a major piece of research for my Master's thesis, focusing on the health and healthcare of homeless people. In this paper, I detail the findings on health status. The definition of homelessness was based on the definition used in the Act III of 1993 on Social Administration and Social Benefits, and the statistical data collection was based on those who were registered as 'homeless' by the health insurance and contacted health care providers between 2015–2021. The research used a so-called mixed methodology, consisting of qualitative (interviews, literature analysis) and quantitative data collection and analysis (statistical data retrieved from NEAK between 2015-21).

RESULTS: The research confirmed the literature sources that homeless people are characterised by multimorbidity. The study showed, based on a Kaplan-Meier curve, that homeless people are more likely to die earlier compared to a control group matched by sex and age. It also revealed that a quarter of homeless people suffer from some form of psychiatric illness and that many of the illnesses that homeless people suffer from can be explained by their neglected lifestyle.

CONCLUSIONS: My research has highlighted the fact that the health of homeless people can be linked to their neglected lifestyles and their past lives. Their serious illnesses are often linked to poor eating habits, alcohol consumption, physical inactivity, and the conditions on the streets or in institutions, the negative experiences in their past, addictions, weakened immune systems and other major psychiatric conditions.