Policy report

Despite having a universal health system, not all Australians enjoy health equity. Physical and mental health outcomes in this country follow a social gradient, which means the higher up the social scale a person is, the better their health outcomes and overall life expectancy.

Research has shown that the people who have experienced long term rough sleeping have an average life expectancy of just 47 years compared to 77 years amongst other Australians. We need to close this 30-year life expectancy gap for people who sleep rough.

Understanding the causes of the disparity in health outcomes requires a holistic analysis of what contributes to good health. It is impossible to stay healthy if you don’t have a roof over your head or enough money to afford nutritious food. Together with other considerations like education and health literacy, employment opportunities, and cultural or language barriers, these factors are known as the social determinants of health.

Without addressing these social determinants, we can never achieve equitable health outcomes for all Australians. Not only should health equity be an aspiration for a country that cherishes the fair go but the pursuit of health equity is an economic necessity.

The most vulnerable and disadvantaged groups in our community are more likely to have complex, compounding health needs but they face the biggest barriers to accessing treatment. The result is preventable presentations to hospital, which are significantly more expensive and a drain on resources. People are dying on our streets or in social isolation in housing without adequate care, monitoring or review of the cause and frequency of deaths associated with homelessness and vulnerability in housing across Australia.

The relationship between healthcare and homelessness has created a reciprocating and multiplying cycle. Poor health conditions contribute to homelessness and homelessness further exacerbates ill health. Poor mental and physical health is both a cause and consequence of homelessness.

While there needs to be greater investment in housing and social support services, it is important that our health system is complemented by targeted health services for people experiencing homelessness to ensure that all Australians can live fulfilling and healthy lives.

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