Unhealthy State of Homelessness 2025: Findings from the Homeless Health Needs Audit

It is now well established that people experiencing homelessness face worse health and health outcomes than the general population.

The Unhealthy State of Homelessness 2025 presents new findings from Homeless Health Needs Audits (HHNA) undertaken between 2022 and 2025. This edition presents a fourth wave of data alongside three previous waves (spanning 2012-2021). This data, drawn from local HHNAs, still provides the only national dataset of its kind on this topic.

The data presented makes clear that the health of people experiencing homelessness has worsened, in particular physical health; and that many people are left to self-medicate for their mental health in the face of inadequate support. The findings highlight the vital role of health services in preventing homelessness, with a clear identified pattern of people experiencing ill health before becoming homeless.

Homelessness is a health issue: it is both caused by poor health and a cause of poor health. The findings from this report highlight the deep health inequalities faced by people experiencing homelessness, and the challenges faced in accessing appropriate, and enough, support.

As national government reinforces its commitment to an NHS that works better for everyone and a cross-departmental homelessness strategy, we must see more invested by local and national government to recognise and address homelessness as a health issue, and commit to the shared accountability needed to take seriously, and reduce, the stark and unacceptable health inequalities caused by homelessness.

Key findings 

Physical Health 

• In wave 4, 81% (587) of respondents reported having at least one physical health condition. This figure marks a continuing decline in the physical health of people experiencing homelessness, with an increase of 8 percentage points in those reporting physical health conditions since wave 1 (wave 1: 73%; wave 2: 76; wave 4: 78%).
• The most common diagnosed physical health condition was asthma (21% (142)), followed by chronic breathing problems including bronchitis, and emphysema, obstructive airways disease (19% (132)).
• ‘Dental/ teeth problems’ are now the most commonly reported physical health condition, affecting 48% (339) of respondents, and representing a 12 percentage point increase from wave 3 (36% (187)).

Mental Health

• The number of people reporting a diagnosed mental health condition soared between wave 1 (45%) and wave 3 (82%). Wave 4 shows a stabilisation and a slight reduction, with 77% (560) of respondents reporting at least one mental health condition.
• The most commonly reported mental health conditions remain consistent between waves 3 and 4:  depression and anxiety disorder are most prevalent, whilst dual diagnosis, PTSD, and personality disorders have seen the largest increases.
• Almost half (49% (344)) of respondents reported self-medicating with drugs or alcohol to help them cope with their mental health. This is an increase from wave 3 (45% (211)).

Drug and alcohol use 

• In wave 4, almost three quarters of respondents (72%, (510)) reported using drugs in the last 12 months.
• 49% (131) of respondents were at high risk of exceeding the Chief Medical Officer’s (CMO) low-risk drinking guidelines.

Use of healthcare services

• In wave 4, the majority of respondents were registered with a GP (89%, 626)). A further 28% (149) of respondents were registered with a specialist homeless healthcare provider.
• Dental registration levels are much lower than GP registrations, with only 37% (247) of respondents reporting they were registered with a dentist in wave 4, compared to 53% (246) in wave 3.
• Just over half of respondents (52%, (350)) had used A&E services at least once in the past year, a slight increase from wave 4 (48%, (202)). This indicates that people experiencing homelessness use A&E four times more often than the general population.
• 38% (254) of respondents had been admitted to hospital in the 12 months prior to taking part in a HHNA.
• The number of people being discharged onto the streets stands at the highest rate since data collection began. Nearly a third (32%, (77)) of respondents were discharged onto the streets, and a further 18% (44) were discharged into accommodation that was not suitable for their needs.

Is more help needed?

• Just over half of respondents who were currently experiencing symptoms for a physical health condition (54% (304)) were accessing support or treatment. 49% (276) of those with a physical health condition reported needing more help than they were currently receiving.
• 61% (321) of respondents experiencing symptoms of a mental health condition were receiving support or treatment. Of these, 32% (170) felt their needs were met, 29% (151) needed more help, and 21% (110) received no support despite needing it.
• 71% (163) of respondents who had or were recovering from a drug problem received support or treatment, yet 46% reported wanted more help.
• 64% (107) of respondents who had or were recovering from an alcohol problem received support or treatment, yet 49% wanted more help.

Wellbeing, prevention and health resilience 

• Vaccination rates were low: in wave 4, just 7% (46) of respondents were fully vaccinated against Hepatitis B, and 25% (129) had received a flu vaccination in the last year, up from 18% in wave 3.
• Women experiencing homelessness were far less likely than the general population to access cervical or breast cancer screening. Only 38% of eligible respondents had received a cervical smear, and 29% a breast screening, compared to 69% and 70% in the general population respectively.
• Smoking remains prevalent: 77% (551) of respondents reported smoking cigarettes, e-cigarettes, cigars or a pipe.
• Food access is limited. 36% (239) of respondents reported eating only one meal per day, 40% (268) ate two meals, and just 20% (137) ate three or more meals per day.