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Better recording and sharing of data essential to meeting healthcare needs of those experiencing homelessness

Published: 7 October 2021

A new report published today by Public Health Wales’ Research and Evaluation Division highlights the need for healthcare services to record and share information on patients’ housing status, so that their healthcare needs can be better identified, understood and supported.

Availability of safe, secure, good quality housing is a key determinant of health, but an individual’s housing status is not routinely collected by health care services. 

Using a novel approach to bring together information on housing status across services, this report estimates there are over 15,000 individuals with lived experience of homelessness in Wales. This includes nearly 2,000 individuals who were recorded as being homelessness during the Coronavirus pandemic.  

Through data linkage, the team were able to create a more comprehensive picture of health amongst this population, despite housing status being inconsistently recorded across services.

Key findings are;   

  • Of the population with lived experience of homelessness, 69 per cent were male and 86 per cent were less than 55 years of age 
  • 13 per cent of individuals with lived experience of homelessness were managing two or more long-term health conditions in secondary care settings, compared to only 3 per cent in the population comparison group  
  • The top three long-term conditions managed in secondary healthcare settings for individuals with lived experience of homelessness are alcohol dependency, depression and drug dependency, regardless of their interaction with substance misuse services  
  • Health care use was higher amongst those experiencing homelessness during the pandemic, likely reflecting their increased health needs.  
  • Attendance in emergency services was 562 A&E attendances per 1000 population in those with lived experience of homelessness, compared to 83 in the general population comparison group during 2020 
  • 50 per cent of individuals experiencing current homelessness accessed at least one secondary healthcare service, compared to 20 per cent in the general population comparison group during the pandemic. 
  • While similar numbers tested positive for Coronavirus in both those experienced current homelessness during the pandemic and the general population comparison group, the homeless were more likely to be admitted to hospital and die with the virus. 

Jiao Song, Principle Statistician at Public Health Wales, said: “The study also highlights the inconsistency of recording housing status in health data. Amongst those identified as homeless in substance misuse services, 78 per cent had attended another National Health Service (NHS) facility within a month, but only 3 per cent had their housing status recorded in the other services despite homelessness impacting on effective treatment and care.  

“By bringing together these datasets we can provide valuable insights into the health of those currently homeless, and also those who have past experience of homelessness.  Demonstrating the longer term relationship between housing and health for some individuals.” 

Alisha Davies, Head of Research and Development at Public Health Wales, said:  

“A key strength of this study is the ability to identify the population with lived experience of homelessness across Wales using routine data. We can then apply that approach to better our understanding of the drivers of inequalities in health in this population and to evaluate the impact of policy and service approaches to identify and address health needs.”  

Ruth Power, CEO of Shelter Cymru, said: 

‘We welcome this report that evidences the significant additional health issues associated with homelessness and inadequate housing. The data reinforces our experience of providing housing advice to people across Wales - high quality, affordable housing is fundamental to good health and wellbeing.’