People who are homeless or families who live in emergency shelters, transitional housing, or other places not meant for human occupancy lack a secure, comfortable place to call home at night. A major socioeconomic problem, homelessness has repercussions for both individuals and society at large. About 8329 people rough sleep in London with a decrease of 2689 from the year 2020-2021 numbering 11018 (Statista.com, 2023). The importance of the issue lies in different ways which include humanity, health outcomes, economic cost, social cohesion and the housing crisis. This assignment provides a brief overview of the impact of homelessness on health inequality in the UK.
Figure 1: Number of people reported to be sleeping rough in London from 2010/11 to 2021/22
Discussion on the Topic
Risk behaviour:
People who have been homeless are more likely than the general population to have poor physical and mental health. The primary causes and effects of homelessness are poor physical and mental health. Homeless individuals have a higher risk of engaging in risky behaviour which has significant help consequences.
Substance abuse and addiction:
An individual having no home are more likely to engage in drugs and alcohol than the general population, and this lead to an increased number of addicted people and other health problem. Substance abuse can also describe as a significant risk factor of risk behaviour which include several health hazards for homeless people (Fitzpatrick, Mackie and Wood, 2021). Drug and alcohol abuse, according to two-thirds of those who are homeless, is the primary cause of their situation (Crisis.org.uk, 2023). Those who are using drugs are 7% more likely to be homeless than others (Crisis.org.uk, 2023). This type of behaviour is related to unprotected sex, which can lead to the transmission of sexually transmitted infections or STIs and other health-related issues. That signifies their vulnerability to health risks.
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Homeless individuals often engage in a range of dangerous behaviours related to violence and exploitation. These homeless individuals are sometimes forced to engage in criminal activities such as theft or sex work to survive. These activities can lead to physical and mental harm along with legal consequences among them in the long run.
Exposure to violence:
Homeless people are more prone to experience violence than the general public. This violence and activities include physical assault, sexual assault and domestic violence. The trauma related to this violence stays with them for a long time which can have long-lasting effects on their physical and mental health.
These risk behaviours related to homeless people in the United Kingdom can be compounded by a lack of access to health care and social services faced by them. Substance abuse and addiction can have significant health problems and cycles of addiction if they are not treated properly (Alradhawi et al. 2020). The risk of contracting STIs and other health issues while engaging in risky behaviour can lead to severe mental health problems like PTSD or post-traumatic stress disorder.
The impact of homelessness on health inequality in the United Kingdom can be significant. After addressing the risk behaviour it is necessary to have a multifaceted approach which includes providing access to health care, addiction treatment and social service to the homeless people (Nice.org.uk, 2021). Poor mental and Physical health needs to be treated in order to improve the quality of life of homeless people.
Physical health:
Homeless people are more susceptible to health issues and drug and alcohol abuse, because of the extreme stress that comes with being homeless. 78% of homeless people have some sort of Physical health condition whereas only 37% of the general population have issues related to Physical health (Homeless.org.uk, 2023). Homeless people have twice the chance to report Physical health issues than the general population. Their conditions include old age including a mortality age of 45 years.
Mental health:
Homelessness in any form is stressful and it significantly impacts the mental health of individuals. This some serious mental health issues including “schizophrenia, bipolar and post-traumatic stress disorder or PTSD”. Among the homeless people, 44% of them have mental health issues in comparison to the general population who have 23% mental health-related issues (Homeless.org.uk, 2023). It implies that homeless people are more susceptible to mental health problems.
Social Isolation and Stigma
Stigma and isolation are other impacts of homelessness in the UK. This stigmatization refers to a negative attitude and beliefs towards homeless individuals and often they are viewed as responsible, lazy and deserving of the situation. They are often isolated which leads to poor mental and physical health.
Access to services and health:
There are several barriers to accessing healthcare for homeless individuals. Lack of preventive care, lack of sincerity and neglecting treatment along with problems in the health care system.
Addressing Health Outcomes and Inequality
Over 120,000 homeless individuals experience different forms of disadvantage. Two-thirds of them experience severe and multiple substance misuse and offending behaviour than the general population (Crisis.org.uk, 2023). Access to healthcare among different demographic groups like women, minorities and LGBTQ+ individuals has additional warriors due to stigma and discrimination.
Recommendation On Actions To Be Taken To Address Health Inequality And Mitigate Existing Health Issues
Several policies are to be implemented to treat and provide accessible healthcare to the homeless. Social discrimination of health needs to be addressed and treatment for mental health and substance abuse needs to be provided to unprivileged people. A rise in the funding for homeless services needed to be reviewed and promoting community involvement to reduce stigmatisation and promote social inclusion for homeless individuals are needed. Interventions addressing these issues can help to improve the health and well-being of homeless individuals and reduce health inequality.
Conclusion
Homelessness problems not only cause implications for not only individuals but for the whole society and the economy of a country. Homeless people are more prone to risky behaviour, substance abuse, violence and social isolation. These behaviours can lead to poor mental and physical health because they are susceptible to health issues including drug and alcohol abuse. Social stigma and isolation towards them are some of the impacts that lead to creating a significant barrier for them to access healthcare that results in health inequality. Thus, it is important to apply a multifaced approach to address the problem of homelessness and healthcare inequality among them.
Assignment 2
Critically analyse a national-level public health strategy from the UK
Introduction
A National-level Public Health strategy or Public Health intervention is a method that seeks to increase access to health care for the general and unprivileged people including the homeless. National-level public health strategies play a crucial role in defining a nation's goals, policies, and practices for assuring the population's health. The United Kingdom also established their National level public health strategies in order to maintain the health of its population. In accordance with the present state of public health policy and practice, this study will critically assess the UK's national public health strategy and its theoretical foundation. A national-level Public Health strategy for the UK is a comprehensive and coordinated approach to promote and protect the health of people without considering their class and status of people. This has the ultimate goal of improving health outcomes while reducing health inequalities for all people. The chosen public health strategy for this essay is the Public Health England Strategy 2020 to 2025 (Gov.uk, 2019). This public health strategy involves addressing avoid a range of health discrimination like social, economic and environmental factors as well as individual behaviour and lifestyles to promote equality in the health care system. In order to analyse the Public Health strategy of the United Kingdom latest data and trends along with effective interventions are important.
Critically Analysing A National Level The Phe Or Public Health England Strategy 2020 To 2025 From The Uk Based On Theoretical Understanding
Homelessness in the United Kingdom is a significant problem. Law on homelessness in the UK set out the job of councils who are legally required to help homeless people. The laws were similar for every government but they became inclusively different after each government brought their new changes. The majority of homeless people who contact the Scottish Council for assistance must be housed. Councils in Wales and England must stop people from becoming homeless in the first place. These changes have significantly improved the homelessness problem but the government needs to do more in order to mitigate the inequalities toward the homeless in healthcare and society. According to research, there are about 271,000 homeless persons in England, including nearly 125,000 kids (England.shelter.org.uk, 2023). It is essential to address this issue with a thorough, coordinated and comprehensive approach to prioritising the well-being and dignity of all the people in the society. Among the total number of homeless people, 63% of them say that temporary accommodation for them harms their physical and mental health (England.shelter.org.uk, 2023). Half of the people or 51% of the head experience a negative impact on their Physical health and 39% of respondents claim that having temporary housing has made it more difficult for them to get to medical appointments (England.shelter.org.uk, 2023). Homelessness in London is worst among other areas in England where one in every 58 people is homeless (England.shelter.org.uk, 2023). This homelessness problem creates significant inequality in accessing healthcare for the people having no home and is stigmatised due to their condition. Also, it creates inequality while providing healthcare to them.
The law related to homelessness in England has changed throughout the decades as a result of successful campaigning via Crisis and different homelessness organisations. Homeless people of England have been able to get help if their local council considered them a priority. The people getting help were mostly families with children and individuals without children have been turned back by the council. In the year 2017, a new law passes by the Parliament homelessness reduction act considering three facts (Crisis.org.uk, 2023). The council must work to prevent people from becoming homeless in the past and must continue to house families with children in order to assist those who are homeless. Homeless people can now receive assistance from the local council. The council started delivering their work in April 2018. They work closely with the government in order to help the homeless people and also to develop the new law into practice. They implemented a campaign like the No One Turned Away campaign. In Scotland, it appears that in 2012 there was no distinction between homeless people who were prioritized and those who were not (Crisis.org.uk, 2023). This provides Scotland's homeless population with the best chances of escaping homelessness anywhere in the world. This implies that homeless persons can seek medical attention from their local council, and the council is required to offer the person a place to stay temporarily. This is if their homelessness is not their fault or not a or not result of anti-social behaviour or deliberate act of not paying the rent. Like Scotland, the Welsh Government introduced a new law on homelessness in the year 2014 (Crisis.org.uk, 2023). This law prevented people from becoming homeless beforehand by helping more people. The United Kingdom applies different strategies in order to keep people safe including the homeless. The PHE strategy 2020 to 2025 is established to outline the priority and focus of the government for the next 5 years to both protect people and health them live longer in good health.
The Government of the United Kingdom established the PHE strategy in 2020 with the help of the PHE organisation. In order to safeguard and enhance people's health and well-being by lowering health inequalities, the Department of Health and Social Care formed Public Health England or PHE as an executive agency in 2013 (Instituteforgovernment.org.uk, 2020). This is regarded as a national public health policy to enhance and safeguard the general public's health. For the upcoming five years, 2020-2025, this plan establishes the direction and function of the PHE organization (Instituteforgovernment.org.uk, 2020). As a result, all of PHE's departments and its numerous partners from the public health system worked together to establish the strategy. The key goals of this plan are to maintain public safety, prevent ill health, make significant progress toward closing the health gap, and promote a robust economy (Lockyer and Spiro, 2019). There are several opportunities for the strategy to improve the inequality in healthcare to prevent unwanted circumstances of homeless people being discriminated against due to their condition. The realisation of potential new technologies, optimising behavioural science, making the economy strong to prevent inequality, harnessing the progress in healthcare and research and supporting system pattern while creating a healthy community which provide proper Healthcare service without judging people's status.
The well-being of the people of the UK by focusing on prevention, and reducing inequalities in Healthcare is underpinned by theories that help to improve the result of these approaches by critically evaluating the strategy of the government. The theory of planned behaviour says that behaviour can be influenced by the attitude of individuals, subjective norms and perceived behavioural controls (Guo et al. 2019). The PHE strategy tends to acknowledge the importance of attitude and social norms in shipping the healthcare system and aims to create a supportive culture towards people of different social classes. The plan includes measures to promote healthy social standards that may enhance the quality of life for homeless persons while decreasing smoking, drug and alcohol addiction, and increasing physical activity. According to the social cognitive theory, a person's behaviour can be impacted by their surroundings, themselves, and other people's behaviour (Lin et al. 2020). The social cognitive theory in PHE strategy is important while addressing the behaviour of people in a certain community whose behaviour is influenced by social norms and isolation from other communities like the homeless people. The PHE strategy incorporates initiatives to improve the environment and increase access to healthy food and health choices that can improve the eating and overall behaviour of people. The health belief model suggests that the behaviour change of people is influenced by individual beliefs about the perceived benefits and barriers while assessing Healthcare and another benefit. The PHE strategy recognises the importance of addressing the barriers and promoting the pursuit of benefits for healthy behaviour in order to promote the change in behaviour among the premise people having no home (Stansfield, South and Mapplethorpe, 2020). Homeless people often experience hardship while accessing Healthcare benefits for supporting their health condition. The strategy initiates improvements in accessing mental health support services to reduce the social stigma associated with seeking help for the cause. However, the strategy is not always fully implemented in every region. The root causes of homelessness thus needed to be identified thoroughly to provide benefits to the homeless people.
The PHE strategy for 2020-2025 is implemented with several health behavioural change theories which emphasize the importance of factors that shape the health behaviour of individuals. However, a critical analysis of the strategy that there or some limitations in the implementation of this strategy because the focus on individual behaviour may overlook the social behaviour and discrimination of people toward homeless individuals. The social discriminants of health like poverty, social inequality, stigmatization, risky behaviour and social isolation can result in poor health conditions (O’Donnell et al. 2022). Additionally, the strategy emphasizes influencing agenda, shaping policy and practices, delivering services along with building systems capable of providing required healthcare services. The PHE strategy has the vision to lower the rate of inquality, infant mortality, childhood obesity, smoking, and poor health of the vulnerable population who are prone to infectious diseases. The strategy tends to screen more than 21 million people for health conditions each year with more than 5 million tests carried out by the laboratory each year (Keys et al. 2021). The health strategy of the United Kingdom acknowledges the importance of collaboration and partnership in working that recognise that are single organisation or sector cannot address a complex issue facing Public healthcare alone.
There are some limitations of the strategy that the ambitious goals of the strategy may not be resourced adequately. Also, the covid-19 pandemic has posed a significant trade towards the implementation of this strategy in public health resources. This has generated significant concerns among the respective bodies because it distracted the efforts of implementation of the PHE strategy. Additionally, the risk of cutting the funds due to the economic situation of the United Kingdom impacted the implementation of the strategy fully. The ability of the local authorities and partners for delivering the intervention outlining the strategy has been impacted. Also, because of the pandemic and the focus being diverted towards the pandemic-stricken people as the UK is one of the most affected countries due to the pandemic (Shah et al. 2022). However, the strategy is a piece of comprehensive evidence and has importance towards recognising Public Health challenges. The problem of homelessness is also recognised by the strategy and with adequate resourcing and effective collaboration across the sectors the strategy can help millions of people to improve their health and well-being.
Conclusion
The public health strategy is a comprehensive framework that aims the health challenges faced by the United Kingdom population. The strategy underpins different theories and frameworks with different perspectives including the theory of “planned behaviour, social cognitive theory and the health belief model”, informing their approach to improving the health outcome in order to reduce health inequalities. It has been observed that the strategy have both positive and negative aspect emphasizing promoting healthy behaviour, social discrimination in health and focusing on improving health equality. The limitations of the strategy include intervention for certain health issues and the need for more attention to be paid while addressing underline social and economic factors like homelessness and its impact on individuals physically and mentally. These factors resulting poor health outcomes and significantly impact the total population and economy of the country. Overall, the PHE strategy provides a useful framework and guidance for public health policy and practices in the United Kingdom with a theoretical underpinning. However, evaluation and adaptation are necessary for ensuring the strategy is effectively addressing the healthcare problems. Also, it is important to monitor the health challenges that are faced by underprivileged people and proper implementation of healthcare services is necessary to effectively reduce health inequalities.
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