No fixed abode: Homeless struggle to access doctors and die younger, study finds

Dr Sandrine Charvin-Fabre said it was harder for homeless in the regions, calling for more flexible and proactive health care services. Photo / NZME

Research has found that people with no fixed abode in Hawke's Bay are more likely to be disconnected from health care services and die younger.

But those working with these homeless say they're doing the mahi to change that.

Dr Sandrine Charvin-Fabre moved to New Zealand five years ago, having worked with the homeless in Paris through her medical career in her home country of France.

Analysing coroners' reports as part of a University of Waikato study last year, she found health inequalities that affect the homeless population worldwide contribute disproportionately to a dramatic premature mortality rate compared to the housed population.

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Charvin-Fabre found the life expectancy was "dramatically less".

Although the mortality rate varies between studies, homeless people typically die 15 to 30 years younger than their housed counterparts.

She said this was due to difficulty accessing health care services, adding that many were completely isolated", with no support from social workers.

"In their everyday life, they face considerable challenges to access health care.

"There are lots of people not enrolled with a GP or who have not engaged with a GP for many years.

"There is a complete disconnection between the health system and street people."

Dr Sandrine Charvin-Fabre of the University of Waikato, found in a study last year that homeless people were more likely to die younger due to a disconnect from health services. Photo / Supplied

She said financial and bureaucratic constraints contributed to this, adding it was harder for those in the regions.

"They need an address or phone just to receive an appointment."

There was a lot of "judgement" and "attitude" which prevented them from accessing certain services, she said.

"There's lots of paperwork that makes it hard for them.

"Homeless people can't just go to the GP and within minutes things are fixed. We need to think about how we provide care in a more flexible manner."

She said having more flexible and proactive health services, such as holding special clinics or allowing walk-in appointments, would help close the gap.

Reducing bureaucratic constraints like having to provide ID would also help.

It came down to engaging the community more meaningfully and building trust, she said.

"It would be great to have a more inclusive health system.

"A little bit of awareness will help."

Shirley Lammas, general manager at the Whatever It Takes Trust, noted that they had started to provide 'Hassle-Free Clinics' for the homeless, a good example of how the barriers to healthcare can be reduced.

The service runs weekly, alternating between sites in Hastings and Napier.

"It can be difficult to access health care services even when you are healthy and well and have a fixed abode," she said.

The trust provides a range of community support services, particularly focused on mental health and addiction issues.

Lammas said the barriers largely related to trust, though there were also practical issues like poor hygiene which made it less comfortable to sit in waiting rooms.

She emphasised it was a "complex" issue and there were a number of factors relating to a broad spectrum of homelessness.