Homelessness Flashcards
Legal definition of homelessness
- Homelessness is that a household has no home in the UK or anywhere else in the world available and reasonable to occupy.
- Not just people who are sleeping rough
When is a person legally defined as homeless?
- they have no accommodation available in the UK or abroad
- they have no legal right to occupy the accommodation
- they have a split household and accommodation is not available for whole household
- it is unreasonable to continue to occupy accommodation
- they are at risk violence from any person
- they are unable to secure entry to their accommodation
- they live in a moveable structure but have no place to put it
Definitions of Rough Sleeping
- People sleeping, about to bed down (sitting on/in or standing next to their bedding) or actually bedded down in the open air (such as on the street, in tents, doorways, parks, bus shelters or encampments).
- People in buildings or other places not designed for habitation (such as stairwells, barns, sheds, car parks, cars, derelict boats, stations, or “bashes” which are makeshift shelters often comprised of cardboard boxes).
What does sleeping rough not include?
- people in hostels or shelters
- people in campsites or other sites used for recreational purposes or organised protest
- squatters
- travellers
Structural factors causing homelessness/rough sleeping?
Poverty
Inequality
Housing supply & affordability
Unemployment or insecure employment
Access to social security
Individual factors causing homelessness/rough sleeping?
Poor physical health
Mental health problems
Experience of violence, abuse & neglect
Drug & alcohol problems
Relationship breakdown
Experience of care or prison
Bereavement
Refugees
Risks to homeless health
Poor living conditions
Inadequate nutrition
Poor hygiene
Substance misuse
Stress
Trauma & accidents
Poor access to health services
What is chronic homelessness?
Characterised by mental and physical ill health and substance misuse.
Physical health needs of homeless in London
- Poorer health outcomes
- High prevalence of CVD, respiratory disease and chronic infections
- Large surge in hospitalisations during influenza seasons – i.e.
increased vulnerabilities to viral respiratory infections
Comparison of homeless oral health with general population
- homeless people tend to have more missing and decayed teeth but fewer treated or filled teeth.
- oral hygiene and the maintenance of oral health can be a low priority for people who are homeless.
- a greater prevalence of dental pain and higher levels of gum disease among homeless populations.
- People experiencing homelessness often have a less nutritious diet, characterised by frequent consumption of sugary foods and drinks
What is the access to health services like for homeless people?
- Homeless people are less likely to visit the dentist
- They may experience difficulty in accessing dental services
- May only visit the dentist in pain
Barriers to improving oral health/health services for homeless people?
Difficulties in maintaining daily oral hygiene
Neglect due to substance mis-use
Low oral health expectations
Attitudes of dental teams
Lack of mobile phone, limited access to the internet, travel issues, and assumptions that a fixed address is needed to access services.
Facilitators of access to health services for homeless people?
Homeless person ready to ‘move on’ out of homelessness
Reducing or ending substance mis-use
Concerns about appearance of teeth
Need for oral health information
Taking first step to resume regular dental attendance
London response to homelessness during the pandemic
- Rapidly forging governance structures and relationships to underpin delivery of an integrated health, care and housing response at pan-London, ICS/sub-regional and local boroughs levels.
- Partnership working with City Hall, London’s councils, voluntary organisations, PHE, Healthy London Partnership and the NHS on COVID-19 ensured rough sleepers were being protected during the pandemic.
- Implementing the Mayor’s ‘In For Good’ principle - providing an offer of support to everyone in the hotels so that no-one needs to return to rough sleeping when they leave and winding down some of the hotels. This rapid and comprehensive response has kept the rates of COVID-19 infection among London’s rough sleepers far below that seen in other world cities.
Oral health promotion
Housing and ongoing support
Collaboration between health, housing and social care
To support consistent evidence informed oral health information - training of front line staff on dental health)
Integrating oral health within general health
Reduce the intake of sugary food and drinks
-Increase the availability of fluorides
-VBA on tobacco and alcohol
To signpost to local NHS dental services
Prevention and outreach
