Homelessness is a major public health issue

By on 19/11/2014 in Blog, Cllr Cotton

Cllr John Cotton

Cllr John Cotton

As he prepares to join the St Basils Big Sleepout, Cabinet Member for Health and Wellbeing, Cllr John Cotton, highlights homelessness as a major public health issue in Birmingham.

If asked to name the biggest public health issues facing Birmingham, most people would correctly identify obesity, smoking, substance misuse and even sexual health.

I suspect fewer people would identify homelessness as a big issue but the following depressing statistics underline why we’ve made it a public health priority in Birmingham.

The average age of death for a homeless person is just 47 years old – that’s lower even than the average life expectancy in war-torn Central African Republic. Shockingly, the figure is even lower for homeless women at just 43. That compares to 77 for the general population.

The Homeless Link report ‘The Unhealthy State of Homelessness‘ in July this year reported that:

  • 73 per cent of homeless people report a significant physical health problem.
  • 80 per cent of homeless people report a mental health issue.
  • 35 per cent of homeless people attended A&E in the past six months
  • Not surprisingly, drug and alcohol abuse are particularly common causes of death accounting for just over a third of all deaths.
  • Homeless people are over nine times more likely to commit suicide than the general population.
  • Disease causes the vast majority of deaths among the general population. But for the homeless population there are higher instances of suicide and death as a result of traffic accidents. Infections and falls are also more common.
  • Drugs and alcohol are major causes of death among homeless people.

You could almost say that homelessness represents a ‘perfect storm’ of many of the public health issues facing our city.

Now there is a misconception that homeless people are less concerned about their health and wellbeing. But the take up of dental and other services offered at Digbeth-based SIFA Fireside would suggest otherwise. Homeless people do care about their health – they just have many added competing worries.

To me, how we respond to the challenges outlined above is one of the big public health issues facing local government in 2014.

Birmingham Public Health has developed a homeless health needs audit, which asks homeless people about their health, lifestyle and use of healthcare services in Birmingham. The data will be used to better plan and provide healthcare services for homeless people across the city.

Particular emphasis here will be given to:

  • GP registrations
  • Community mental health assessments
  • Barrier-free access to wider support services

Engagement with homeless service providers in Birmingham has been very positive and the following sites have proactively supported the audit:

I’m very passionate about this issue. I believe one of my major roles as a cabinet member is to protect the most vulnerable people in our society.

One of my clear commitments since taking on this post at the end of May has been to work toward the absolute minimum use of bed and breakfasts and we are making significant progress.

Aside from the depressing statistics I’ve already outlined, there is clear evidence that if physical, mental health, substance misuse and housing agencies work together in a coordinated way to support an individual’s multiple problems; better health outcomes can be achieved.

Not only that, but we can also save money in the long term.

So working to help improve health outcomes for homeless people is morally the right thing to do and it also makes financial sense.

To that end, I am pleased that in Birmingham we are signing up to the St Mungo’s Broadway charter for homeless health – A Future Now and I will be taking this to our next Health and Wellbeing Board to formally sign-up. We’re already undertaking many of the actions outlined in this excellent report and we’re committed improving the health of Birmingham’s homeless.

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