They can live in a motel room, vehicle, tent, or caravan park. They can be on a friend’s couch or on the street.
They can be exposed to health hazards including excessive heat or cold, poor ventilation or mold, injury, overcrowding, vermin, violence or a combination of these – while trying to keep a job or get their children to school.
Here are some of the unique physical and mental health challenges of being homeless today.
Read more: We’ve identified who is most at risk of homelessness and where they are. We must act now, before it is too late
Housing is too expensive
Unaffordable housing is one main cause of homelessness in Australia. And having a job is no longer a guarantee for safe housing.
A recent report from Anglicare Australia described how difficult it will be to afford a private rental home in 2023, even if you work full time on minimum wage.
Families with children are homeless and also live in unsafe housing. Figures from the last census show around 19,400 children young people up to the age of 14 were homeless that night, either with their families or alone.
Read more: ‘I left with the kids and became homeless with them’: the nightmare of waiting lists for those fleeing domestic violence
For decades we have known that people’s health suffers when they become homeless. This includes ours own research homelessness among people visiting emergency rooms, showing the long-term consequences of unstable housing.
We found that even marginal housing (risk of homelessness) was enough to increase mortality rates. These people died on average six years earlier than people who were housed.
Steep housing costs, poor housing conditions, overcrowding and evictions make people vulnerable to illness, injury and victimization.
We know that overpopulation directly contributes to this poor physical healthsuch as infectious diseases and injuries.
Unstable housing contributes to unhealthy behavior, as substance use and malnutrition, which can increase over time. An unstable housing can also prevent access to healthcareincluding prescription drugs, which makes people do that delay seeking care.
Being homeless increases the likelihood of the victim of violent crimesthat threatens physical and psychological health in the short and long term.
Read more: Powerless, closed off and less able to afford healthy choices – how financial adversity is bad for our health
Understandably, the psychological well-being of adults who are homeless is worse than the general population.
Lack of routine and loss of a sense of home and community can lead to social isolation and the onset or recurrence of mental illness. Indeed, posttraumatic stress disorder, substance use disordersAnd suicidality (thinking about suicide or attempted suicide) are more common in people who are homeless.
Read more: How financial stress can affect your mental health and 5 things that can help
Consequences for children
When crammed into substandard spaces or places not intended for humans to live, a lack of space to cook, play or do school work can have consequences, especially for children.
For example, children who live in overcrowded houses have more chance poorer mental health and do less well in school.
Children’s long-term health can also be compromised if preventive healthcaresuch as vaccinations or dental visits, are missed.
Working while homeless brings additional challenges
Working while homeless is a unique challenge.
People who work and are homeless are allowed to do so hide their homelessness out of shame, fear of judgment and worry about losing their job.
Employees who sleep rough report special struggles. Getting enough sleep is difficult and even risky. Maintaining good hygiene and clean clothing is difficult. Transport to and from work can become difficult to afford.
Read more: Here’s what the lives of Big Issue sellers tell us about working and being homeless
It’s a human rights issue
Health and housing are fundamental human rights. And stable housing is a crucial health determinant.
But as recent evidence shows, even renting is priceless for some, despite working full time.
It is time we recognized the impact of structural issues on homelessness, including housing affordability and the labor market, rather than blaming individual risk factorssuch as substance use or psychological problems.
We also need to tailor support services for homeless people so that they are appropriate and affordable, but also close to family, friends and children’s schools.