Homeless people in England are 60 times more likely to visit A&E in a year than the general population, according to a study that reveals the extent of health problems among those who sleep rough or are stuck in temporary accommodation.

The research also shows that the proportion of homeless people with more than one health problem is far greater than would be expected given their average age of 38. The figure of about one in five is on a par with people in their 60s in the general population.

“The magnitude of the problem has been demonstrated by this study,” said Dr Vibhu Paudyal, a senior lecturer in clinical pharmacy at the University of Birmingham and co-author of the research, who added that the figures might even underestimate the scale of health problems among homeless people.

He said that although recent policies in the UK had resulted in some healthcare services being specifically targeted towards homeless people, more needed to be done.

Among the difficulties facing homeless people, Paudyal said some were being turned away by GP surgeries that wrongly insist patients must have proof of address, while others have faced stigma.

“We need to strengthen the access, use and outcomes of mainstream services,” said Paudyal, adding that the focus should be on prevention of health problems and that help for multiple conditions should be available in one place.

Recent reports suggest there are at least 320,000 homeless people in Britain, and that numbers are rising.

Writing in the British Journal of General Practice, Paudyal and his colleagues report how they analysed health data from more than 900 homeless patients at a specialist healthcare centre in the West Midlands, which provides access to a range of health services.

Almost 90% of these patients were male and more than half smoked, while ages ranged from 17 to 81.

The results showed homeless people were more likely to have a range of medical conditions than the general population.

While only 0.9% of the general population are on the register for severe mental health problems, the proportion was more than seven times higher for homeless people, at 6.5%.

Just over 13% of homeless men have a substance dependence, compared with 4.3% of men in the general population. For women the figures were 16.5% and 1.9% respectively. In addition, more than a fifth of homeless people have an alcohol dependence, compared with 1.4% of the general population. Almost a third had visited A&E at least once in the past year, compared with 0.5% of the general population.

Hepatitis C was also more prevalent among homeless people – at 6.3%, compared with 0.7% for the general population. Paudyal described the rate among homeless people as alarming. “Hep C requires a very prolonged treatment, very expensive,” he said, adding that the figures suggested early prevention and intervention work needed to be improved.

Even for diseases with similar prevalence in homeless people compared with the general population, the former might face a greater struggle to live with them, he said.

However, the study has limitations including the fact it uses data from only one healthcare centre, meaning it might not be representative of the wider homeless community, and not all homeless people have contact with healthcare services. The prevalence of problems might also differ around the country.

Dominic Williamson, the director of policy and strategy at the homeless charity St Mungo’s, said the findings were concerning but not surprising, with previous research showing homeless people in England die 40 years earlier than the general population.

“Despite this, our recent research revealed a £1bn a year drop in funding for specialist homelessness services over the last 10 years,” he said, adding that services also appeared to have become harder for homeless people to access.

He said the NHS long-term plan was welcome but must deliver for homeless people: “This must mean investing in specialist services for homeless people with the most complex needs including vital support to improve their health, including mental health and substance use problems, along with a home for good.”

Source: The Guardian