Food, health
and
homelessness
Alison McKay
alimckay@ekit.com
Homelessness in Hampshire
 Climate
of increasing homelessness across UK
and in Hampshire.
 Lacking
accurate definitions and counts
 statutory
vs single homeless/rough
sleepers/hidden homeless
 Vulnerable
and marginalised group
Maslow’s Hierarchy of Needs
What is Public Health Nutrition (PHN)
The promotion of good health through the
primary prevention of diet-related illness in
the population






What people eat
Nutritional needs through the lifespan
Dietary recommendations
Nutritional surveillance
Achieving change
Food supply, food safety and policy
Is PHN relevant for the homeless?
Food related homeless services
 Homeless

services:
Types:
 Day
centres, hostels and supported accommodation
 Churches and voluntary groups
 Food
provision:
 Food
or cooking facilities
 Resources are limited – financial, human
 Often depend on donations of food and/or money
 Examples


of good practice;
Edinburgh Cyrenian’s
St Mungo’s
Why is food important for homeless
people?
A
nutritious and healthy diet is important:

In restoring and safeguarding health

In improving quality of life

In helping people make a
sustainable recovery from
homelessness.
Short term consequences of a
poor diet
 Low
energy, tiredness
 Irritability and lack of concentration
 Increased susceptibility to infection
Poor diet and longer term health
 Often
a tri-morbidity of:
 physical
illness,
 mental health problems
 substance abuse
 Common
health problems:
 Dental
caries and gum disease
 Liver disease
 Exacerbation of pre-existing health conditions
 Increased risk of premature mortality
 Role
of diet and lifestyle ???
Food and health project
 Aim:

To understand the eating habits and food acquisition
practices of the users of Southampton's homeless services
 Key


4




Interviews with service providers
Service users’ survey
homeless services in Southampton:
1 Day centre
1 Hostel with full board
1 Hostel with self catering facilities
1 Supported accommodation project
79

activities:
single homeless participants
Those who agreed to participate out of 111 individuals
approached
Homeless peoples’ food patterns
 63%
of participants ate at least 2 meals daily
 14%
ate only one small meal daily
2
individuals ate no regular meals
Rough sleepers and those
not engaged with
homeless services most at
risk of poor nutrition.
Where do homeless people eat?
Food sources 4-7 days weekly
n =79
Hostels were a regular food source for nearly half of
the survey participants.
Participants (%)
Alternative
food
sources
50
45
40
35
30
25
20
15
10
5
0
Begging Begging Stealing Raiding Selling Other
for
for food food
bins property
money
Prefer
not to
say
Begging for money for food, stealing, raiding bins
and selling property were commonly used
Barriers to homeless people eating
well
 Service




Food availability
Variety of food
Cost
Nutritional quality
 Service




provider:
user:
Lack of nutritional knowledge and skills
Addictive behaviours of clients
Poor physical and/or mental health
Lack of interest
Factors influencing food related health and wellbeing
What next for food and health?
 Food,
nutrition and homelessness policy
 Multi-sector approach
 Using food as centre of community and
skills building
 Cooking,
 Local

shopping, budgeting skills
needs assessments
Screening for nutritional needs
Summary
 Good
food and nutrition are vital for health
 Homeless people have worse health
outcomes than the general population
 Little
guidance or financial help for foodrelated homeless services

There are numerous barriers to eating well
To improve nutritional health and wellbeing a
multi-sector, practical and educational
approach is needed.
References
1.
2.
3.
4.
5.
6.
7.
8.
Fitzpatrick S Pawson H Bramley G Wilcox S. The Homelessness Monitor:
Great Britain 2012. London: Heriot Watt University, University of York Crisis,
2012.
Maslow A. Motivation and Personality. New York: Harper; 1954.
Department of Health. The Eatwell Plate Resources. DoH. London: TSO;
2011.
Saeland M Haugen M Eriksen F Wandel M Smehaugen A Bohmer T and
Oshauger A. High sugar consumption and poor nutrient intake among
drug addicts in Oslo, Norway. Br J Nutr. 2011;105:618-24.
Royal College of Physicians of the United Kingdom. Food poverty and
health: Briefing statement. London: Faculty of Public Health, 2005.
St Mungo's. Homelessness: It makes you sick. London: St Mungo's,
2008Homeless Link. The Health and Wellbeing of People who are Homeless.
London: Homeless Link, 2010.
Homeless Link. The Health and Wellbeing of People who are Homeless.
London: Homeless Link, 2010.
Crisis. Homelessness: A silent killer - a research briefing on mortality amongst
homeless people. London: University of Sheffield, 2011.
Thank-you!
alimckay@ekit.com