The European Journal of Public Health Advance Access originally published online on June 25, 2008
The European Journal of Public Health 2008 18(5):448-453; doi:10.1093/eurpub/ckn038
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Social factors and health |
Health of the homeless in Dublin: has anything changed in the context of Ireland's economic boom?
Austin O’Carroll1 and Fiona O’Reilly1,2
1 Mountjoy Street Practice, 53 Mountjoy Street, Dublin 7
2 Division of Population Health Sciences, Department of Family Medicine and General Practice, Royal College of Surgeons in Ireland, Ireland
Correspondence: Austin O’Carroll, Mountjoy Street Practice, 53 Mountjoy St, Dublin 7, tel: 0035318303325, fax: 0035318828152, e-mail: aocarroll{at}rcsi.ie
Received June 28, 2007 , accepted April 22, 2008
Background: In the context of the Irish economic boom we assessed the health, service utilisation and risk behaviour of homeless people in north Dublin city and compared findings with a 1997 study. Methods: A census of homeless adults in north Dublin city was conducted in 2005 using an adapted interviewer-administered questionnaire from the 1997 study. Results: A total of 363 (70%) of the target population participated. Compared to 1997 the population was younger (81% versus 70% under 45 years, P < 0.01) with a higher proportion of women (39% versus 29%, P < 0.05) and long-term homeless (66% versus 44%, P < 0.001). Drug misuse superseded alcohol as the main addiction with a doubling of the proportion reporting past or current drug use (64% versus 32%, P < 0.001). The prevalence of comparable physical chronic conditions was largely unchanged while depression (51% versus 35%, P < 0.01) and anxiety (42% versus 32%, P < 0.05) had increased. There were high rates of blood-borne infections, such as HIV (6%), hepatitis B (5%) and hepatitis C (36%) in 2005 and dental problems (53%) all of which can be associated with drug use. Access to free healthcare had not increased. Similar proportions reported not having medical cards (40% versus 45% NS). Homeless people continued to have higher usage of secondary care services than the general population. Conclusions: This study shows a changing disease profile among the homeless population consistent with a growing drug using population. It confirms that the homeless population in Dublin in terms of health remain excluded from the benefits of an economic boom despite a government policy aimed at redressing social inclusion.
Keywords: health services N02.421, homeless persons M01.325, illicit drugs D26.87, economics 101.261