This website is now part of Public Health Scotland. Publications released after 16 March 2020 are now published on the Public Health Scotland website.
Improving health
Previously NHS Health Scotland

Homelessness is both a cause and a result of social inequality, health inequality and poverty. You will find information below on

  • the Scottish Government’s Health and Homelessness Standards
  • the Scottish Public Health Network’s report ‘Restoring the public health response to homelessness in Scotland’
  • the report and presentations from the 2016 National Health and Homelessness Group conference.
  • Early childhood trauma is often at the root of homelessness.
  • 1,643 people slept rough the night before applying for assistance in 2018-2019.
  • 29,894 people were assessed as homeless or threatened with homelessness in 2018-2019.
  • Common health issues for homeless people include mental ill health, alcohol abuse, drug use and violence.
  • Homeless people have a much higher risk of death from a range of causes than the general population.
  • Having a 'home' and a secure, nurturing environment is essential to the wellbeing of individuals, families and children.

You can read more data about homelessness on the Scottish Government website (external website)

Homelessness and health inequalities

Homelessness is often a ‘late marker’ of severe and complex disadvantage which can be identified across the life course of individuals. Multiple exclusion homelessness (MEH) is an extreme form of social exclusion and inequality. It is the visible result of complex issues including

  • homelessness
  • street culture activities
  • mental health problems
  • drug and/or alcohol dependencies
  • experience of institutions such as prison, hospital or the care system.

Homeless people experience poorer physical and mental health than the general population.

  • Homeless children have higher rates of health problems and their development can be damaged.
  • Homeless people have a much higher risk of death from a range of causes than the general population.
  • Common health issues for homeless people include mental ill health, alcohol abuse, drug use and violence.
  • The average age of death for a homeless male is 47 compared to 77 in the general population and for women is 43 compared to 81.

A health audit of over 2,500 homeless people in England in 2014 found much higher prevalence of physical and mental health issues in the homeless population compared to the general population. The audit found that

  • 45% of homeless people have diagnosed mental health problems compared to 25% of the general population
  • 41% of homeless people have long term physical health problems compared to 28% of the general population.

Our inequality briefing on health and homelessness has further information about the impact that homelessness can have on health and wellbeing and the actions being taken to address this.

National and local action

Action to prevent and address homelessness takes place nationally and locally through

  • five regional local authority Housing Options Hubs, which cover all local authorities and focus on homelessness prevention
  • the Health and Homelessness Steering Group, which assists NHS boards in implementing the Health and Homelessness Standards (see below)
  • Community Planning Partnerships, Health Boards and Integrated Joint Boards ensuring services are planned for, designed and delivered in ways that meet the needs of homeless people
  • the Homelessness Prevention and Strategy Group, a joint Scottish Government and Convention of Scottish Local Authorities (COSLA) group which works to embed prevention of homelessness activity across Scotland.

A strategy to address homelessness as a significant health inequality will require action across all causes of health inequalities including

  • fundamental causes
  • individual experiences
  • environmental influences.

Action at the individual level may include the provision of

  • equitable access to services
  • income maximisation services
  • specific out-reach arrangements
  • training and support for young people.

Health and Homelessness Standards

The Scottish Government introduced Health and Homelessness Standards for NHS Boards in 2005 which remain central to efforts to improve the health of homeless people.

Recent policy reports

The Scottish Public Health Network (ScotPHN) report ‘Restoring the public health response to homelessness in Scotland’ identified actions including

  • the inclusion of homelessness prevention and mitigation actions within new or existing health inequalities strategies
  • considering how NHS Boards support the role of housing and homelessness services within Community Planning and Health and Social Care Partnerships
  • making the health needs of homeless people, children and families part of Health and Social Care Partnership strategic commissioning and locality planning
  • establishing a Scottish branch of the Faculty for Homeless and Inclusion Health (external website) to support practitioners involved in health care for homeless people and other excluded groups.

The Commission on Housing and Wellbeing’s report ‘A blueprint for Scotland’s future’ (external website) highlights the crucial role that housing plays as a foundation for wellbeing across the life course. The report includes 47 recommendations, all of which are intended to strengthen the link between housing and wellbeing.

National Health and Homelessness Group

We facilitate the National Health and Homelessness Group which

  • identifies new opportunities for the prevention of homelessness
  • oversees the implementation of the recommendations of the ScotPHN report.

The group hosted the fourth national conference in March 2019 which brought key stakeholders together to discuss recent research and current practice. The presentations are now available online. The presentations are now available online.

You can contact us for more information about our work on homelessness.