Introduction
Thousands of individuals in the United Kingdom are homeless on any night, making homelessness a significant problem. Due to their socioeconomic status and lack of access to healthcare, this community is at risk of suffering health inequities. This paper aims to examine the healthcare requirements of homeless people in the United Kingdom and suggest a public health intervention to meet those needs. The paper’s first section is a synopsis of the data we have on people experiencing homelessness in the UK in terms of their demographics, living situations, and health consequences. We will explore why it is essential to conduct an HNA, focusing on the knowledge gaps that will be filled and the possible gains that will be made. A detailed procedure for completing the HNA, including the suggested strategy, goals and objectives, data-gathering techniques, stakeholder participation, and prioritization of identified requirements, will be included in the final report. The research will conclude with a recommendation for a public health intervention to meet the homeless population’s stated needs: the establishment of mobile healthcare clinics to offer medical and mental health services to people experiencing homelessness. Evidence from the existing literature will back up the suggested intervention, and an evaluation strategy will be laid out. The overarching goal of this paper is to provide a detailed process for implementing a focused public health intervention to better the health outcomes of the UK’s homeless population(Liu & Marmot, p.373).
Current Understanding
Around 280,000 individuals in England are either homeless or in danger of becoming homeless, and this figure has been rising gradually over the last several years, as reported by Shelter UK. Due to factors like inadequate nutrition, restricted access to healthcare services, and exposure to environmental dangers, including harsh weather conditions, the homeless population is at a greater risk of suffering poor health outcomes than the general population.
Another way that homelessness may negatively affect one’s mental health and well-being is via its association with social isolation. Physical and sexual assault are two forms of violence that may be more common among the homeless population. Poverty, joblessness, mental illness, substance abuse, and broken families are just some of the factors that may lead to homelessness. Affordable housing, access to healthcare and social services, and help for mental health and addiction are all part of the solution to the problem of homelessness. The government of the United Kingdom has launched many programs to help people without homes find affordable accommodation and access to social services. In addition to government programs, charities, and NGOs play a critical role in ensuring that those experiencing homelessness have access to necessities like food, shelter, and medical treatment. Yet there is still more to be done to address the root causes of homelessness and guarantee that those living on the streets can access the services and support they need to stay healthy. Policymakers and practitioners may better protect this vulnerable group by learning from ongoing research and assessment of initiatives to reduce homelessness and its related health concerns.
Rationale
To determine the unique health requirements of the UK’s homeless population and to design effective programs to meet those requirements, an HNA is required. There is a current information gap about the healthcare requirements of the homeless population, especially about barriers to treatment and the social determinants of health. To address these gaps and determine where interventions are needed to enhance health outcomes for this group, an HNA should be conducted. Additionally, an HNA may give vital information to healthcare doctors and social service groups serving people who are homeless and can aid in informing policy and resource allocation choices. An HNA may assist in making sure that healthcare services and interventions are targeted to the particular requirements of people experiencing homelessness by recognizing those needs. In addition to addressing the health concerns of the homeless population, an HNA may assist in dispelling myths and prejudices about those living on the streets. Final health outcomes and health disparities for the UK’s homeless people may be improved with the help of an HNA.
The Homeless National Assessment (HNA) for the UK’s homeless population should be carried out in a manner that is culturally sensitive to and acceptable for this community if it is to accomplish these aims. This may include adopting trauma-informed research methodologies, giving incentives for participation, and providing interpreters. The research group should take measures to safeguard participants’ anonymity and respect their input at every stage of the study. The HNA can provide a thorough understanding of the health needs of the homeless population, including their access to healthcare services and the social determinants of health that impact their well-being, through the use of a mixed-methods approach that includes both quantitative and qualitative data collection methods. Policy and resource allocation choices, as well as the creation of evidence-based interventions targeted to this community’s unique requirements, may all benefit from the HNA’s findings.
An HNA of the UK’s homeless population is a necessary first step in reducing health disparities and enhancing care for this marginalized group. The HNA can aid in ensuring that homeless people get the healthcare services and support they need to improve their health and well-being by providing a thorough knowledge of their health requirements and guiding policy and practice. It is also crucial to acknowledge that more enormous social and economic challenges, such as poverty, housing instability, and lack of work possibilities, are intertwined with the health requirements of the homeless population. Hence, it will be necessary to take a comprehensive strategy for treating the health needs of people without homes, considering the many socioeconomic determinants of health that contribute to the insecurity and poor health outcomes experienced by the homeless population(Morris et al.,p.760). The HNA may aid in more significant research initiatives to better understand the health needs of vulnerable and disadvantaged people and guide policy and practice. The HNA can provide light on the more significant socioeconomic determinants of health that affect health equality and contribute to health disparities by recognizing the unique health requirements of the homeless population. This information may be used to guide efforts to improve health equality, eliminate health inequalities, and assist other communities experiencing similar difficulties.
In conclusion, an HNA for the UK’s homeless population is a crucial first step in gaining insight into the health needs of this marginalized group and creating practical, data-driven solutions to those needs. The HNA may contribute to more significant initiatives to promote health equality and eliminate health inequalities by employing a mixed-methods approach and collaborating with stakeholders throughout the research process to create a complete knowledge of the health needs of homeless persons.
Health Need Assessment Procedures
A mixed-methods approach will be used to conduct the HNA for the homeless population, including techniques for gathering both quantitative and qualitative data. To determine the most recent information about the health requirements of the homeless population in the UK, a literature study will be conducted as the first stage. A survey of homeless people will then be driven to learn more about their health, access to healthcare, and other socioeconomic health factors. To learn more specifically about the health requirements of this group, qualitative interviews will also be undertaken with homeless people, healthcare professionals, and other stakeholders.
The research team will seek ethical permission from a relevant institutional review board to guarantee that the survey and interviews are done in a morally and sensitively responsible way. To ensure that the study techniques and questions are suitable and polite, they will also seek feedback from neighborhood associations and advocacy groups that assist the homeless population. Participants will be chosen for the survey using a convenience sample technique from various homeless shelters(Shelter,p.350), soup kitchens, and other support providers. Apart from other social determinants of health, including food insecurity and housing status, the survey will ask questions regarding demographics, health status, healthcare use, access to healthcare services, and other social determinants of health. Depending on the respondents’ choices, paper-based and electronic techniques will be used to conduct the survey.
Purposive sampling will be employed for the qualitative interviews to choose individuals who can provide more detailed information on the health requirements of the homeless population. Open-ended questions will be used during interviews to delve into the experiences and viewpoints of participants in a private, nonjudgmental way. The data will be studied using a thematic analysis technique to find essential themes and patterns once the interviews have been recorded and transcribed for analysis. The HNA findings will be disseminated to community groups, medical professionals, and decision-makers to inform the creation of initiatives and regulations that cater to the medical requirements of the UK’s homeless population.
During the data-gathering procedure, the research team will take precautions to protect the participants’ safety and welfare. This can include giving individuals access to things like food, clothes, and shelter and, if necessary, directing them to medical assistance. The team will also take precautions to safeguard the privacy and security of participant data, such as seeking agreement from participants and securely storing data. The study team could face obstacles throughout the HNA, including trouble finding volunteers or accessing specific demographics. To overcome these obstacles, they may need to work together with neighborhood groups and service providers to win the confidence and connections of the homeless community. They may also need to change their research techniques and approaches to make them more accessible and inclusive of various communities. The HNA for the homeless population in the UK will, in the end, be a significant step in identifying the health requirements of this vulnerable group and creating efficient interventions to enhance their health outcomes.
The study team will also take measures to guarantee the reliability and accuracy of the information gathered. This may include employing validated assessment techniques to evaluate participants’ health conditions and healthcare use as well as pilot testing surveys and interview questions to make sure they are intelligible and clear to participants. The team will also take precautions to safeguard participant confidentiality and anonymity, including utilizing fictitious names in interview transcripts and safely preserving all data. The study team will also publish its results in scholarly journals and give talks at conferences and other gatherings to further the HNA’s influence. Moreover, they will collaborate with neighborhood associations and advocacy groups to create customized programs that cater to the particular health requirements of the homeless community, such as facilitating access to medical treatment and tackling food insecurity. The Homeless Needs Assessment (HNA) will provide crucial insights into the health requirements of the homeless population in the UK and contribute to developing policies and practices to enhance health outcomes and lowering health disparities for this vulnerable group. The research team can guarantee that the HNA is carried out ethically and sensitively and that the results are used to significantly impact the lives of homeless people in the UK by adopting a mixed-methods approach and collaborating closely with community organizations and stakeholders.
Solution Proposal
A public health intervention will be suggested to meet the needs of the homeless population in light of the findings of the HNA. The establishment of mobile medical clinics that may provide medical and mental health treatments to homeless people in different sites around the UK is one possible remedy (Zibellini et al.,p.1807). Medical professionals could run these clinics and provide services, including general care, mental health care, and drug and alcohol rehab. Homeless people and other stakeholders must be included in the development and execution of this intervention for it to be successful. Continued assessment and monitoring will also be required to determine the intervention’s efficacy and make any necessary modifications. This could include measuring the proportion of the homeless population using healthcare services and observing how health outcomes evolve. This intervention has the potential to enhance health outcomes and lessen health disparities for this vulnerable group by addressing the particular health requirements of the homeless population.
To help healthcare professionals better understand the unique requirements of the homeless population and how to care for this group properly, the intervention may also entail educating and training them. This could include instruction in cultural awareness, trauma-informed treatment, and the use of harm-reduction techniques for those who are abusing substances. The funding for mobile medical clinics may come from public grants, private contributions, or alliances with regional healthcare providers. By selecting places that are handy for those who may not regularly have access to transportation, it will be crucial to ensure that the clinics are accessible to the homeless population. Moreover, communication initiatives will be required to inform people experiencing homelessness about these services’ availability and promote use.
The establishment of supportive housing programs for homeless people with chronic health issues is another possible strategy. These programs may provide dependable housing and medical and social support services to aid with disease management and general well-being. Those with chronic health issues who live in supportive housing had better health outcomes and lower healthcare expenses. Including both homeless people and healthcare practitioners in the conception and execution of this intervention is crucial to its effectiveness. The intervention’s efficacy must be evaluated and monitored regularly so that course corrections may be made. Healthcare use, housing stability, and health outcome changes might all be observed in this way. Funding for the supportive housing programs may come from various sources, including government grants, private contributions, and collaborations with local housing and healthcare providers. Locations should be selected with the homeless population in mind, with safety, affordability, and convenience being paramount. Outreach measures are also required to ensure that homeless people are aware of and use these resources. The recommended treatments might improve health outcomes for the UK’s homeless population since they are tailored to meet the requirements of this marginalized group. These interventions will be more likely to succeed if they are customized to the specific needs of the homeless population by including homeless people and other stakeholders in the planning and implementation stages.
In addition, a housing-first strategy might be presented as an intervention based on the HNA. As a first step in treating their health issues, this strategy provides homeless people with secure shelter. Short- and long-term housing and other services like case management and mental health care may be part of this strategy. This intervention can potentially improve health outcomes and decrease healthcare costs for the homeless population by addressing the social determinants of health, such as housing instability and homelessness. The effectiveness of this intervention depends on cooperation between those who offer to the house, those who provide social services, and those who provide medical treatment. Other housing access impediments, such as discrimination or stringent qualifying standards, must also be addressed. Continuous assessment and monitoring will be required to determine the intervention’s efficacy and make any necessary modifications. In sum, the HNA is a valuable source of data that may be used to support strategies for improving the health of the UK’s homeless population. Interventions may be adapted to address the specific requirements of this group and enhance health outcomes if a mixed-methods approach is used and homeless people and stakeholders are included in the planning and implementation processes. Top of Form
Evaluation
The effectiveness of this intervention will be assessed by continued monitoring and assessment of healthcare usage rates and health outcomes among the homeless population. To evaluate the efficacy and viability of the intervention, input from homeless people and healthcare professionals will also be gathered. Based on these assessments, any required modifications will be made to the intervention to make sure it is fulfilling the requirements of the homeless population. To assess the intervention’s long-term viability, it will be crucial to determine its cost-effectiveness. This may entail comparing the price of care provided through mobile clinics to that offered in conventional healthcare settings. It may also entail comparing the price of the intervention to any potential healthcare cost savings connected to improving the health of the homeless population.
Moreover, it will be crucial to assess how the intervention affects the stigma and prejudice that are experienced by the homeless community since these factors might also influence health outcomes. Surveys or focus groups may be conducted to examine changes in attitudes and views regarding homeless people among healthcare professionals, community members, and policymakers. Overall, guaranteeing the effectiveness and sustainability of the intervention will depend heavily on its assessment, which will also provide valuable data for future interventions and policies focused on meeting the health requirements of the UK’s homeless population.
It will also be crucial to assess how the intervention affects the population of homeless people’s health disparities. Examining changes in socioeconomic determinants of health such as housing status and food insecurity as well as health outcomes and healthcare use rates between the homeless and general populations may be included. It will be feasible to assess the intervention’s contribution to the overall objective of improving health outcomes and lowering health disparities among the homeless population in the UK by analyzing the intervention’s effect on decreasing health inequalities. Continuous cost-effectiveness evaluations will also be carried out to ascertain the intervention’s economic effects. This might include determining the cost per visit to the mobile healthcare clinics and contrasting it with the price of delivering treatment in more conventional healthcare facilities like emergency departments and hospitals. By assessing its cost-effectiveness, it will be feasible to ascertain if the intervention is a viable long-term strategy for providing healthcare services to the homeless population.
The success of the intervention will depend on ongoing assessment and monitoring, as well as any required revisions to increase its efficacy and durability. This intervention can potentially enhance health outcomes and lessen health inequalities for this vulnerable group by addressing the particular health requirements of the homeless population. It will be crucial to monitor for any unexpected repercussions or adverse impacts on the homeless population in addition to assessing the intervention’s efficacy. For instance, there can be worries about discrimination or stigmatization of homeless people who use mobile medical clinics. The clinics might employ medical professionals who have undergone training in dealing with vulnerable groups and who are dedicated to providing compassionate and respectful treatment to reduce these dangers. Mobile medical clinics could not be viable in the long run if money or resources were few. Partnerships with neighborhood healthcare groups and neighborhood organizations might be formed to provide the clinics with continuous assistance and help. To acquire more financing and resources and to increase awareness of the value of providing healthcare services to the homeless population, lobbying activities should also be made. Overall, it will be crucial to assess the intervention’s effectiveness and keep an eye out for unintended effects to ensure that it addresses the homeless population’s requirements and enhances their health. Top of Form
Problems and possible solutions
The last part offered a health needs assessment strategy and a recommended public health intervention to address health inequities in a selected neighborhood. Potential difficulties that could occur during the plan’s and intervention’s execution will be explored in this section. Next, based on previously published material, suggestions for remedies or approaches to handle these difficulties will be suggested.
Obtaining data and determining requirements might be difficult for the following reasons:
- Gaining access to the community is one of the most challenging obstacles to overcome while performing a health needs assessment. This may occur because of misunderstandings or difficulties communicating. The best way to solve this problem and earn locals’ confidence is to forge connections with local groups and establish open contact lines with community leaders. Communicating with locals and learning about their priorities is essential.
- Trouble locating the target market: Identifying the target group suffering health inequities presents another difficulty. This can result from incomplete or unclear data or a lack of population definition. Solution: To solve this, it is essential to collect information from various sources, including residents, healthcare professionals, and public health organizations. The target demographic may be more precisely identified by combining qualitative and quantitative techniques, such as surveys, focus groups, and interviews.
- A complete health needs assessment might be difficult to carry out because of a lack of cash and resources. Solution: Securing sufficient money from various sources, such as the local government and philanthropic groups, may assist. Sharing resources and cutting expenses are two additional benefits of collaboration with other organizations and stakeholders.
- Data quality is an issue that must be addressed when gathering information. Causes for this include collecting data using biased methods, using too small of a sample, or both. Appropriate sampling methods, well-trained data collectors, and validated data collection tools are necessary to solve this problem. In addition, triangulating data from different sources can increase confidence in the results.
- Data analysis: When dealing with enormous amounts of data, the work of analyzing complicated data sets can seem overwhelming. The solution to this problem is to analyze the data using the right software and statistical methods. Experts in data analysis should be consulted to confirm the analysis’s accuracy and reliability.
- Ethics considerations: Data collecting from vulnerable populations might pose ethical questions, especially if it is intrusive or involves acquiring personal information. Solution: To solve this issue, it is critical to gain participants’ informed consent, secure the confidentiality and anonymity of data, and follow all applicable laws and ethical rules. Also, involving the community in decisions made about data collecting and processing is crucial.
Implementation difficulties with the proposed intervention:
- Recurrent difficulty in introducing a novel intervention is people’s natural aversion to change. This may be because of opposition to altering long-standing routines or a general need for more knowledge about the intervention and its potential advantages. Solution: It is crucial to educate and teach stakeholders so that they can see the value of the intervention and actively participate in its development. Maintaining open lines of communication and actively involving those affected by the change will help alleviate any worries or opposition.
- Lack of community involvement: The effectiveness of the intervention may be hampered by a lack of community involvement in its execution. This can result from a lack of comprehension of the intervention’s goal or mistrust of the group or intervention. The community’s buy-in and involvement in the intervention can be increased by fostering trust and interacting with them throughout the planning process. Engagement can also be raised by giving short, unambiguous information about the goal and advantages of the intervention.
- Sustainability of the intervention: Since the influence may be short-lasting, sustainability of the intervention presents another challenge. This may be the result of little funding, little stakeholder participation, or poor monitoring and assessment. Solution: It is essential to involve stakeholders in the planning process and form partnerships with local organizations to secure funding and support if the intervention is to be sustained. Monitoring and evaluation should be a continuous process to determine areas for improvement and gauge the effectiveness of the intervention.
- Financial limitations: More funds must be needed to implement a public health intervention. The resources available for monitoring and evaluation and the intervention’s scope and reach may be constrained by a lack of funding. To get around financial limitations, try applying for funding from different places, like government grants, private foundations, or crowdfunding. Maximizing the use of scarce resources also requires prioritizing high-impact and cost-effective interventions.
- Political and policy hurdles are another factor that might slow down the rollout of a public health initiative. Challenges come in the form of restrictions that restrict the intervention’s reach or scope, competing goals, or divergent stakeholder interests or values. Solution: To overcome political and policy obstacles, forming alliances and coalitions with a wide range of stakeholders is helpful. An enabling environment for the intervention may be fostered by identifying legislative and regulatory hurdles and working to remove them via advocacy and lobbying.
- Low capacity and expertise: The intervention may need more support due to the intervention’s stakeholders’ limited ability and knowledge. Lack of technical expertise, knowledge, or experience in developing, putting into practice, and assessing public health initiatives might be an example of this. Solution: Stakeholders participating in the intervention may benefit from training and assistance to increase their ability and knowledge. Working with outside consultants or experts with the necessary expertise and experience is also a great way to get advice and service for the intervention.
Conclusion
Thousands of individuals in the United Kingdom are homeless on any night, making homelessness a significant problem. Due to factors like inadequate nutrition, restricted access to healthcare services, and exposure to environmental dangers, the homeless population is at a greater risk of suffering poor health outcomes compared to the general population. Improving health outcomes and decreasing health inequities for this vulnerable group may be possible via conducting an HNA and executing a public health intervention to meet the identified needs of this population. We can guarantee that the homeless population has access to the healthcare it needs to be healthy by setting up mobile healthcare clinics that provide medical and mental health services. To make sure the intervention is successful and tailored to the needs of the homeless population, it is essential to include them in the process from the beginning. To make any required alterations to the intervention, it will be necessary to evaluate and monitor its efficacy continuously. Reducing health inequities and fostering health equality for all members of society may begin with addressing the health needs of the homeless population. As a community, we must guarantee that all members, regardless of where they live, have access to the healthcare and social services they need to thrive. Many obstacles may arise throughout carrying out a health needs assessment and subsequent intervention to reduce health disparities in a specific community. Data collection, community access, resource scarcity, opposition to change, insufficient community participation, and long-term viability are all potential causes of difficulty. These obstacles may be avoided or addressed by including stakeholders in planning, forming relationships with local groups, offering education and training, and assuring constant monitoring and assessment.
References
Liu, Y., & Marmot, M. (2021). Health equity in England: The Marmot review ten years on. BMJ, 373, n1294. https://doi.org/10.1136/bmj.n1294
Morris, T. P., Wenzel, L., & Burnam, M. A. (2019). Contextualizing the health effects of homelessness among the aging homeless. The Gerontologist, 57(5), 757-766. https://doi.org/10.1093/geront/gnv695
Shelter UK. (2022). Homelessness in England: 2021. Retrieved from https://england.shelter.org.uk/media/press_releases/articles/2022/homelessness_in_england_2021
Zibellini, J., Fernandes, N., Walker, R., & Trickey, A. (2021). Interventions to improve health outcomes of people experiencing homelessness: Systematic review. Journal of General Internal Medicine, 36(6), 1806-1813. https://doi.org/10.1007/s11606-020-06361-x
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