Tackling Health Inequalities Faced by People who are homeless

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Tackling Health Inequalities Faced by People who
are homeless

• FEANTSA
• Peer Review Budapest

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FEANTSA

•  La Féderation Européenne des Associations
  Nationales Travaillant avec les Sans-Abri 
  (FEANTSA)
• A Federation of over 100 organisations working
  with homeless people mostly umbrellas of
  service providers
• Core-funded by the European Commission
• In existence since 1989 started on the
  initiative of national organisations

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FEANTSAs contribution

• FEANTSAs contribution to this peer review draws
  on the experience and practices of its members
  across the EU, drawn from annual theme work in
  2006.
• Health Inequalities and Homelessness
• Barriers to Accessing Care
• Overcoming the barriers to access
• Reducing and eliminating health inequalities
  faced by people who are homeless

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Some Important Context

• Homelessness Arriving at a shared European
  understanding - The ETHOS Typology of
  homelessness and housing exclusion
• Insecurely / Inadequately housed
• Damp and cold, Overcrowding, Accidents and fire,
  Indoor air quality, hazardous substances, housing
  dissatisfaction and insecurity, lack of amenities
  and public transport.
• Roofless and Houseless
• Bad health and homelessness cause and effect
• Complex and Multiple needs

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Barriers to healthcare

• Problematic health situation is worsened by
  difficulties in accessing quality healthcare.
• Administrative and Financial barriers
• Complex administrative procedures
• Out of pocket payment German example
• Gap between homeless and hospital life
• shame and stigma, previous negative experiences,
  inflexible appointment procedures, certain
  services are inadequate (mental, detox),
  cultural/linguistic barriers
• Lack of knowledge about entitlements

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Some approaches to overcoming barriers to
accessing healthcare

• Alternative routes into care
• low-threshold and outreach health services - a
  vital gateway into the mainstream healthcare
  system flexible with multi-disciplinary focus
• Homeless services as mediator and partner
• Support homeless people to put administrative
  procedures in train and engage with healthcare
• Overcoming local residency requirement
• Use of hostel address creation of imaginary
  street where all homeless people are registered.
• Overcoming financial barriers
• Tailor public health insurance packages and do
  away with need for out-of-pocket payments.

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Reducing and eliminating health inequalities

• All EU countries have expressed their support for
  building equitable access to health, underpinned
  by principles of universality and solidarity.
• Underpinned by Human Rights Commitments EU
  Charter and ESC
• This requires adaptation of healthcare system and
  the safeguarding of the needs of vulnerable
  groups in all reforms and planned developments.

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Scope for European processes to reduce health
inequalities

• OMC to promote mutual learning around the issue.
  DG Sancos work around health inequalities to
  generate political will to prioritise and tackle
  this problem.
• Work to improve quality and financial
  sustainability should not be at the expense of
  equity of access guard vulnerable groups as
  part of reforms.
• Consideration of health inequalities in work to
  develop an internal market framework no
  jeopardisation of general interest aims.
• Use the expertise of civil society and bring it
  into the debate and policy processes.

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Further Resources from FEANTSA

• Annual theme 2006 European and national reports
  on access to health for people who are homeless
  http//www.feantsa.org/code/en/theme.asp?ID35
• Research Observatory Report on barriers to
  healthcare (shortly available http//www.feantsa.
  org/code/en/pg.asp?Page455
• FEANTSA magazine Winter 2006
• Contact dearbhal.murphy_at_feantsa.org