12 Simon Communities of Ireland 2.5 Homelessness among older people Pillinger (2008)14 identified three age related pathways into homelessness; youth, adult and later life. People who become homeless can enter and re-enter at any of these different stages, depending on the extent to which their various personal, housing and social support needs are not been adequately met. These include personal supports in meeting everyday health and care needs for example, older people and people with physical or learning disabilities are likely to have support needs; that are enduring and/or permanent.” (Edgar et al. 199915). Generally speaking, it has been found that anyone over 50 who has had a prolonged experience/s of homelessness is vulnerable to many of the physical health problems associated with older age. Life expectancy There is currently no definitive information on the average life expectancy of a person who is homeless in an Irish context. What is clear from a variety of studies is that people who are homeless in Ireland (are no different to other locations) have a higher risk of illness and have earlier mortality rates than the general population16. International research has found the most glaring discrepancies in mortality ratios between younger and middle-aged groups from 18 to 34 years and from 35 to 54 years of age. While older people who are homeless also have a greater risk of dying than their housed counterparts, the standard mortality ratios, while higher, are not as dramatically high as for the younger age groups. International literature estimates that people who are homeless and rough sleeping have mortality rates which are 3.5-4 times greater than the general population17. A study of women using a homeless shelter in Toronto18 concluded that “Homeless women 18-44 years of age were 10 times more likely to die than women in the general population of Toronto”. It noted that the mortality rates for older women (over 45 years) were lower than that for older men who were homeless suggesting that older women who are homeless retain their usual female survival advantage over their male counterparts. Another Canadian study19 found that (using data from the 1991-2001 Canadian census, to track 15,000 homeless and marginally housed people across Canada for 11 years)‘Homeless and marginally housed people had much higher mortality and shorter life expectancy than could be expected on the basis of low income alone. The study found that the probability of survival to age 75 was 32% for men and 60% for women compared to 51% and 72% among men and women in the lowest income group in the general population. The study’s authors attributed a large part of this premature mortality to alcohol and smoking- related diseases and to violence and injuries, much of which might have been related to problematic alcohol and/or drug use. 2.6 National policy responses to homelessness The Way Home is the National Strategy to address Adult Homelessness in Ireland (2008 – 2013). It has three core objectives: – eliminating long-term occupation of emergency homeless facilities; – eliminating the need to sleep rough and – preventing the occurrence of homelessness as far as possible. 14 Downey, Daithi (ed.) (2008) Perspectives on Irish Homelessness: Past, Present and Future. The Homeless Agency, Dublin. 15. Pp. 66 16 O’Connell , James J. (2005) Premature Mortality in Homeless Populations: A Review of the Literature. National Health Care for the Homeless Council, Inc., Nashville: 17 Hwang, S. et, al. (2009) Mortality rates among residents of shelters, rooming houses and hotels in Canada: 11 year follow up study, BMJ 2009;339:b4036 doi:10.1136/bmj.b4036 18 Cheung, Angela, M. & Stephen W. Hwang Risk of death among homeless women: a cohort study and review of the literature in Canadian Medical Association Journal, April 13, 2004: 170 (8) Pp. 1243-1247. 19 Anon (2009) Study reveals high death rates and short life expectancy among the homeless and marginally housed. http://esciencenews.com/articles/2009/10/26/study.reveals.high.death.rates.and.short.life.expectancy.among.homeless.& marginally.housed
Homelessness, Ageing and Dying
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