Next Article in Journal
WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Annoyance
Next Article in Special Issue
Food (In)Security in Rapidly Urbanising, Low-Income Contexts
Previous Article in Journal
Prevalence and Determinants of Gestational Diabetes Mellitus: A Cross-Sectional Study in China
Previous Article in Special Issue
Social Determinants of Health, Disaster Vulnerability, Severe and Morbid Obesity in Adults: Triple Jeopardy?
Open AccessArticle

Tackling Health Disparities for People Who Are Homeless? Start with Social Determinants

Royal Perth Hospital, Perth, WA 6000, Australia
School of Population and Global Health and Centre for Social Impact, The University of Western Australia, Crawley, WA 6009, Australia
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2017, 14(12), 1535;
Received: 13 October 2017 / Revised: 29 November 2017 / Accepted: 4 December 2017 / Published: 8 December 2017
(This article belongs to the Special Issue Social Determinants of Health Inequities and Prevention)
Background: Homelessness is associated with enormous health inequalities, including shorter life expectancy, higher morbidity and greater usage of acute hospital services. Viewed through the lens of social determinants, homelessness is a key driver of poor health, but homelessness itself results from accumulated adverse social and economic conditions. Indeed, in people who are homeless, the social determinants of homelessness and health inequities are often intertwined, and long term homelessness further exacerbates poor health. Aggregated health service data can mask this, and case histories thus provide important insights. Methods: This paper presents three case histories of homeless patients seen at an inner city public hospital in Perth, Western Australia. The case histories draw on several data sources: hospital data, information collected from rough sleepers and clinical observations. Estimates of the cost to the health system of the observed hospital usage by the three patients are included. Findings: The case histories illustrate the interplay of social determinants of health in homelessness that help explain the high level of hospital usage by rough sleepers. The cumulative healthcare costs for the three individuals over a 33 months period were substantial. Hospital attendance plummeted even in the short term when housing needs were addressed. Conclusions: Treating homelessness as a combined health and social issue is critical to improving the abysmal health outcomes of people experiencing homelessness. In addition, the enormous economic costs of hospital care for people who are homeless can be reduced when housing and other social determinants are taken into account. View Full-Text
Keywords: homeless; social determinants of health; health inequalities; health sector homeless; social determinants of health; health inequalities; health sector
MDPI and ACS Style

Stafford, A.; Wood, L. Tackling Health Disparities for People Who Are Homeless? Start with Social Determinants. Int. J. Environ. Res. Public Health 2017, 14, 1535.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

Back to TopTop