INTRODUCTION
Everyone is unique, as is their living situation. Homelessness goes beyond what you may typically think of; someone rough sleeping, for example. Not everyone without stable housing sleeps rough.
People experiencing homelessness, travelling communities, and asylum seekers are among the most vulnerable in society and often face serious health inequalities. They experience higher rates of both short and long-term illness than the general population yet are less likely to access healthcare in the early stages of illness.
CAUSES AND TYPES OF HOMELESSNESS
Hidden homelessness refers to people who are without a fixed address however they are not included in official statistics because they are staying in temporary, unstable, or unsuitable living arrangements. This could include those who are:
- Sofa surfing (staying with friends or family temporarily)
- Living in hostels
- Living in temporary accommodation
- Living in squats
People may experience homelessness for many reasons, often a combination of challenges such as relationship breakdown, financial problems, abuse, mental health issues, addiction, or leaving institutional care.
Local authorities prioritise housing for those with the greatest need, such as families with children, those who are pregnant, or adults deemed vulnerable. Others may rely on voluntary sector support.
INCREASED HEALTH & EYE CARE NEEDS
People experiencing homelessness have higher rates of eye problems than the general population, including uncorrected vision, cataracts, glaucoma, and binocular vision issues.
Risk factors such as poor nutrition, trauma, smoking, substance use, and untreated medical conditions increase the likelihood of sight loss.
BARRIERS TO ACCESSING EYE CARE
- Competing Priorities: More pressing immediate concerns such as finding food, shelter, and safety likely to take priority over eye care
- Awareness: Some may not know the importance of regular eye exams or recognise symptoms of eye and other health issues
- Financial: Costs of eye care and glasses can be a barrier, especially for those not receiving benefits that cover NHS sight tests or spectacles
- Past experiences: Fear, anxiety, or previous negative experiences with healthcare can reduce trust
- Stigma & Prejudice: Fear of being judged or feeling out of place in medical or professional environments
- Transportation: Lack of reliable transport can make attending appointments difficult
This means they are more likely to seek care only in emergencies or for advanced conditions, increasing the risk of serious health problems and preventable sight loss.
MAKING EYE CARE INCLUSIVE
Access to eye care is more than just vision, it supports overall health, independence, and quality of life.
Vision Care believe everyone deserves the right to sight. Our clinics provide welcoming, accessible eye care. Learn more about how we work closely with communities to ensure people feel safe, supported, and empowered to prioritise their eye health under ‘WHAT WE DO’
Click here to watch a short video to find out about the work Vision Care carries out and its impact on many vulnerable lives.
Further reading:
1. Physical diseases among homeless people: gender differences and comparisons with the general population. National Centre for Biotechnology Information 2009
2. Hidden Needs – Identifying Key Vulnerable Groups in Data Collections: Vulnerable Migrants, Gipsies and Travellers, Homeless People and Sex Workers. Peter J Aspinall, Centre for Health Services Studies, University of Kent 2014 Inclusion Health
3. Promoting the health of homeless people. Setting a research agenda. Health Education Authority 1999
4. Homelessness kills: An analysis of the mortality of homeless people in early twenty-first century England. Crisis 2012
5. Longevity science advisory panel. Life expectancy: Past and future variations by gender in England & Wales. LAP paper 2. Longevity Panel 2012
6. Home is where the heart is. Homelessness and rebuilding relationships. St Mungo’s and Relate 2007
7. Homelessness Code of Guidance for Local Authorities – Department of Health Department for Communities and Local Government 2006
8. Department for communities and local government. Statutory Homelessness: January to March 2013 and 2012/13, England. Department for Communities and Local Government 2013
9. Rough Sleeping Statistics England – Autumn 2013 Official Statistics. Department for Communities and Local Government 2014
10. Street to home bulletin 2012/13. Combined Homelessness and Information Network (CHAIN) 2013
11. Gelberg L, Andersen RM, Leake BD. (2000) Healthcare Access and Utilization. The Behavioral Model for Vulnerable Populations: Application to Medical Care Use and Outcomes for Homeless People Health Service Research 34, 1273-1302. National Centre for Biotechnology Information 2000
12. Shahid K, Kolomeyer AM, Nayak NV, Salameh N, Pelaez G, Khouri AS, Eck TT, Szirth B. (2012) Ocular telehealth screenings in an urban community. Telemed J E Health. 18:95-100. National Centre for Biotechnology Information 2012
13. LSE Manheim Centre for Criminology Living in Fear: Violence and Victimisation in the Lives of Single Homeless People Crisis 2004
14. Tobacco Use and Homelessness National Coalition for the Homeless 2009
15. International Classification of Diseases (ICD) World Health Organisation 2010
16. General Ophthalmic Services Contract Association of Optometrists 2008
17. Welfare Benefits and Tax Credits Handbook Child Poverty Action Group 2014