Health of individuals with lived experience of homelessness in Wales, during the COVID-19 pandemic

• All Wales/National

Background

• Homelessness covers a spectrum of poor housing arrangements ranging from insecure (or precarious) housing, to living in temporary accommodation, through to street homelessness (rough sleeping).
• Our understanding of the health needs amongst homeless populations is largely informed by research studies on the more visible street homelessness. Findings highlight poor mental health, physical illness, substance dependencies, reduced life expectancy, and excess preventable morbidities amongst this vulnerable population. This is reflected in a disproportionately higher need for healthcare services, often alongside barriers to accessing care.
• Street homelessness only represents a small proportion of homelessness experiences and health needs, captured at one point in time, and does not reflect the fact that homelessness may not be a fixed state across the life course of an individual. Previous studies are therefore likely to underestimate the impact of lived experience of homelessness on an individual’s health and wellbeing, and care needs.
• In our study, through the potential of linked patient-level routine health and care datasets in Wales, we have attempted to capture the full consequences of ‘lived experiences of homelessness’ on an individual’s health that extends beyond the actual homelessness event(s). The novel methodology developed in this study can be applied to better understand the impact of housing on health and vice versa, and to evaluate the health impact of approaches aiming to support those who are homeless or at risk of homelessness.