Food, health and homelessness Alison McKayalimckay@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 homelessVulnerable 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 dietLow energy, tiredness Irritability and lack of concentration Increased susceptibility to infection

Poor diet and longer term healthOften 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 projectAim:

To understand the eating habits and food acquisition practices of the users of Southampton's homeless services

Key activities: Interviews with service providers Service users’ survey

4 homeless services in Southampton: 1 Day centre 1 Hostel with full board 1 Hostel with self catering facilities 1 Supported accommodation project

79 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

daily14% ate only one small meal daily2 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

Hostels were a regular food source for nearly half of the survey participants.

n =79

Alternative food sources

Begging for money for food, stealing, raiding bins and selling property were commonly used

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Barriers to homeless people eating wellService provider:

Food availability Variety of food Cost Nutritional quality

Service 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 approachUsing food as centre of community and

skills building Cooking, shopping, budgeting skills

Local 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 food-

related homeless services There are numerous barriers to eating well

To improve nutritional health and wellbeing a multi-sector, practical and educational approach is needed.

References1. Fitzpatrick S Pawson H Bramley G Wilcox S. The Homelessness Monitor:

Great Britain 2012. London: Heriot Watt University, University of York Crisis, 2012.

2. Maslow A. Motivation and Personality. New York: Harper; 1954.3. Department of Health. The Eatwell Plate Resources. DoH. London: TSO;

2011.4. 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.

5. Royal College of Physicians of the United Kingdom. Food poverty and health: Briefing statement. London: Faculty of Public Health, 2005.

6. 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.

7. Homeless Link. The Health and Wellbeing of People who are Homeless. London: Homeless Link, 2010.

8. Crisis. Homelessness: A silent killer - a research briefing on mortality amongst homeless people. London: University of Sheffield, 2011.

Thank-you!

alimckay@ekit.com