Lifetime, 5-year and past-year prevalence of homelessness in Europe: a cross-national survey in eight European nations

• Published in: BMJ open Vol. 9; no. 11; p. e033237
• Main Authors: Taylor, Owen, Loubiere, Sandrine, Tinland, Aurelie, Vargas-Moniz, Maria, Spinnewijn, Freek, Manning, Rachel, Gaboardi, Marta, Wolf, Judith R L M, Bokszczanin, Ana, Bernad, Roberto, Kallmen, Hakan, Toro, Paul, Ornelas, Jose, Auquier, Pascal
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.12.2019; BMJ Publishing Group
• Subjects: Age; Citizens; Education; Gender; Health risks; Health services; Homeless people; Life Sciences; Linear analysis; Medicin och hälsovetenskap; Medicine; Polls & surveys; Public Health; Response rates; Santé publique et épidémiologie; Secondary education; Sociodemographics; Software; Unemployment; Urban schools; Variables; United States > US; Europe; prevalence; homelessness; Europe; public health
• DOI: 10.1136/bmjopen-2019-033237
• ISSN: 2044-6055

ObjectivesTo examine the lifetime, 5-year and past-year prevalence of homelessness among European citizens in eight European nations.DesignA nationally representative telephone survey using trained bilingual interviewers and computer-assisted telephone interview software.SettingThe study was conducted in France, Ireland, Italy, the Netherlands, Poland, Portugal, Spain and Sweden.ParticipantsEuropean adult citizens, selected from opt-in panels from March to December 2017. Total desired sample size was 5600, with 700 per country. Expected response rates of approximately 30% led to initial sample sizes of 2500 per country.Main outcome measuresHistory of homelessness was assessed for lifetime, past 5 years and past year. Sociodemographic data were collected to assess correlates of homelessness prevalence using generalised linear models for clustered and weighted samples.ResultsResponse rates ranged from 30.4% to 33.5% (n=5631). Homelessness prevalence was 4.96% for lifetime (95% CI 4.39% to 5.59%), 1.92% in the past 5 years (95% CI 1.57% to 2.33%) and 0.71% for the past year (95% CI 0.51% to 0.98%) and varied significantly between countries (pairwise comparison difference test, p<0.0001). Time spent homeless ranged between less than a week (21%) and more than a year (18%), with high contrasts between countries (p<0.0001). Male gender, age 45–54, lower secondary education, single status, unemployment and an urban environment were all independently strongly associated with lifetime homelessness (all OR >1.5).ConclusionsThe prevalence of homelessness among the surveyed nations is significantly higher than might be expected from point-in-time and homeless service use statistics. There was substantial variation in estimated prevalence across the eight nations. Coupled with the well-established health impacts of homelessness, medical professionals need to be aware of the increased health risks of those with experience of homelessness. These findings support policies aiming to improve health services for people exposed to homelessness.