This year, International Women’s Day emphasises the role of collaboration and support in achieving gender equality. New findings from the Unhealthy State of Homelessness show that women face different challenges to men in accessing the health care that they need, and calls on health and care services to work in collaboration both with each other and with homelessness services to help women better access the support they need to address their health care needs, and recover from homelessness.
We know that women experience homelessness differently to men, that these women face extremely poor health outcomes, and that at 43, the average age of death for a woman experiencing homelessness is lower than for a man experiencing homelessness (45) – and much lower than for women in the general population. At Homeless Link we have been exploring our Unhealthy State of Homelessness data to see what more this unique dataset tells us about the specific health needs of women experiencing homelessness, and what that tells us about what needs to change to improve the health of some of the most marginalised women in our society.
Our findings show that even before we consider health outcomes, women experiencing homelessness are more likely to have faced adverse life events or have lived experiences that we know risk exposure to increased trauma. This includes 54% of women having experienced domestic abuse, compared to 16% of men, 16% having been in the care system as a child, compared to 12% of men, and 17% of women having spent time sex working. We know that these experiences can have a devastating impact on people’s physical and mental health, and that this is only compounded by the ongoing trauma that comes from homelessness.
82% of women experiencing homelessness have a diagnosed mental health condition
Although high rates of poor mental health are common across everyone experiencing homelessness our data shows that mental health is a particular factor in women experiencing homelessness. We found that 82% of women have a diagnosed mental health condition, compared with 75% of men, and that nearly three-quarters of these women were already struggling with their mental health and had received a mental health diagnosis before they become homeless. This indicates huge missed opportunities in preventing homelessness amongst these women: they are already known, and accessing services, but their support needs are falling through a gap that is resulting in them being pushed out of their homes and into the devastating trauma of homelessness.
On the physical heath side our findings show that while women reported fewer diagnosed physical health conditions (a difference of 5 percentage points compared to men), but conversely they were more likely to report that they were actively symptomatic. Adding to this we also found that women reported higher obstacles to accessing care for their physical health when compared to men.
These are shocking findings, showing a population of women who are facing systematic barriers to accessing necessary health care support
Despite almost all women being registered with a GP or specialist healthcare provider, a quarter of women told us that they had needed to see their GP in the last 12 months but had not been able to (compared to 17% of men). Further to this, when we asked people about the support they were accessing for their physical health 58% of women told us that they needed more support for their physical health than they were currently receiving (compared to 49% of men). Not surprisingly, we see this showing up in women’s use of emergency and unplanned healthcare services. Women are also more likely than men to have used A&E in the past 12 months (56% of women, 51% of men), and to have been admitted to hospital (42% of women, 37% of men). The primary reason driving both A&E presentations and hospital admittances is physical health.
These are shocking findings, showing a population of women who are facing systematic barriers to accessing necessary health care support resulting in reliance on emergency support. Instead of collaboration and support, this implies a pattern of exclusion and inaccessibility of mainstream healthcare provision.
But there is reason for some cautious optimism towards tackling these issues. Homeless Link welcomed the inclusion in the Government’s Plan to End Homelessness of clear targets around ensuring that people do not leave institutions, including hospitals, into homelessness. We also welcome the acknowledgement of homelessness as a driver of health inequalities within the NHS 10 year plan, and the opportunity presented by the Neighbourhood Health Services. But as these new findings show, for these changes to help all people experiencing homelessness, we must ensure that a gendered lens is applied, otherwise we continue to risk further marginalizing women experiencing homelessness and pushing them away from accessing the health and care services that they urgently need.
On this International Women’s Day we should use these shocking findings of inequality and exclusion to galvanise the collaboration, partnership and support we know is possible to help improve access to healthcare for every woman and particularly for those experiencing homelessness.
