The latest data compiled by the National Statistics Institute show that the number of homeless people has grown by 25% in Spain in the last ten years. This social problem has gone from affecting 22,900 people in 2012 to more than 28,500 people in 2022. The average age of people in this situation in Spain is 42.7 years.
The outlook does not look much better in Europe. The European Parliament highlights the precarious living situation of more than 700,000 people who face homelessness every day (and every night) across Europe. This increase, they say, has been 70% in just a decade.
Beyond the basic need for accommodation, housing is key to the development of the life project. It is not in vain that we speak of a fundamental human right.
Not having a home places people in a situation of homelessness that increases inequalities in access to basic citizenship rights. Among them, the right to health.
How do you come to live without a home?
Many factors can lead us to a situation of homelessness. Sometimes they are individual or relational, such as a divorce, grieving the death of a loved one, mental illness, domestic violence, or substance abuse. Structural factors are also involved, such as the difficulty in accessing affordable housing, unemployment (or precarious employment) and discrimination.
In addition, the European Federation of National Organizations working with the Homeless (FEANTSA) stresses that behind homelessness there may be institutional factors such as a lack of coordination between services or an inadequately structured social aid system.
Homeless people live almost two decades less
Homeless people see their average life expectancy reduced by about 17.5 years compared to the rest of the population. It has also been seen that they present between 2 and 50 times more physical health problems, in addition to the fact that the living conditions of this group give rise to multiple diseases or make existing ones chronic. Mental illness, addictions and communicable infectious diseases proliferate especially in this group.
The main problem detected is that the majority of homeless people do not have access to primary health care services, do not have a family doctor, and are normally attended to through emergency services when they reach a serious or extreme situation. The direct consequence is an average age of death has been calculated at 52 years for women and 56 for men. An Irish study based on homeless people in Dublin lowered it even further: 36 years for women and 44 for men.
The seriousness of the matter is that there are investigations that suggest that around one in three deaths of homeless people was due to causes susceptible to timely and effective health care.
Specifically, cancer is the second most common cause of death among the homeless population. Cancer mortality is twice as high among the homeless as compared to the general adult population in high-income countries. Not only due to lack of treatment, but also because these individuals normally do not have access to prevention or early detection, which is essential to increase the chances of survival, reduce morbidity and make therapy cheaper. In addition, they are people more exposed to chronic stress and a poor diet.
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The poorest live less and get sick more
So that cancer does not attack the homeless, it is essential to give them visibility in public systems. With this objective in mind, several Spanish, Greek, Austrian and British institutions have recently launched, together with FEANTSA, the Cancerless pilot project, financed with European funds.
Until the end of 2023 they will work with 1,500 homeless people in Madrid, London, Athens and Vienna trying to increase their skills so that they can make better and more informed decisions about their own health. This implies, among other things, launching workshops on healthy habits to prevent cancer and including all homeless people in screening programs such as mammograms, cervical screening or colonoscopies.
Combining health education and social support is the best way for homeless people not to be excluded from the process of early detection against cancer from prevention. To do this, the pilot activates a coordination figure between the social services system and the primary health care system called Health Navigator. This model implements actions to overcome health inequalities by working individually with those affected both in centers for the homeless and in health centers.
The final objective is none other than to achieve equity in health, that is, that people can develop their maximum health potential regardless of their social position or other circumstances determined by social factors.
