Public Health:

Public Health is defined as: The science and art of promoting and protecting health and well-being, preventing ill-health and prolonging life through the organised efforts of society.

It does this through its work in three main 'domains':

·     Health Protection - protecting people's health (for example from environmental or biological threats, such as food poisoning or radiation)

·     Health Improvement - improving people's health (for example by helping people quit smoking or improving their living conditions)

·     Healthcare Public Health - ensuring that our health services are the most effective, most efficient and equally accessible

Public health is about helping people to stay healthy and protecting them from threats to

their health.

HLHL support the public health agenda in the homeless population in the following ways:

Covid vaccination – We have been pleased to facilitate client vaccination and have worked tirelessly with statutory services to support a good uptake.

Flu vaccination – we have been able to purchase flu vaccines for the last 2 years and this has increased uptake by taking it out to wherever the individual is.

TB – we work in partnership with UCLH mobile Xray unit and the chest clinic at KGH alongside the public health directorate in LBR to identify individuals who may potentially have TB and support their referral, assessment and treatment. TB is beginning to increase again in London and individuals experiencing homelessness are at particular risk.  TB is curable in virtually all cases and can be effectively controlled provided cases are found early and patients can complete treatment.

Smoking cessation – Within the homeless community, there are very high levels of smoking. A study by The Health Development Agency (HDA) (2004) l "ixzz4OxhlXMny" reported that 90% of rough sleepers smoked. It also reported that they were more likely to smoke high-tar cigarettes, sourcing butts from the street and bins and would inhale more deeply.  Smoking then makes these individuals even more vulnerable to infections and respiratory disease as well as heart disease and cancer.  The HDA also reported that most of the homeless community will forfeit food in favour of cigarettes.  We offer 'brief intervention' at every opportunity. When a client is ready to quit smoking, we refer them to the local smoking cessation service for ongoing support.

Substance misuse – WDP provide the specialist drug and alcohol service in LBRedbridge and we work in close partnership with their team to support harm reduction.

Sexual health – According to the World Health organisation (WHO) definition, 2002

“Sexual health is a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.”263

Poor sexual health is a public health issue and in particular, if an individual doesn't have access to condoms and has a sexually transmitted infection, this leaves others at risk.

Within the homeless community, sexual health issues are often overlooked or not considered in terms of risk, with some becoming sex workers as a means to gain money for food, drugs, alcohol etc. and for many, simply to get a roof over their head each night.  This is not without risk, as we see a number of ladies, particularly, who have been beaten instead of being paid financially.  Equally some clients find themselves homeless because of their sexual preference and their family being intolerant of this choice. This then leads to isolation which in turn may lead to homelessness, substance misuse and criminal activity.

We partner with Positive East, HepC Trust and local NHS sexual health services to support improved sexual health and well-being.

As well as this we are able to support women to have their smear tests as per national guidelines and offer health promotion such breast self-examination and testicular self-examination leaflets.

Homeless health days – during 2022 regular health open days have been re-established in partnership with Public Health and all other service providers in LBR.  Around 60 service users have attended each time with good engagement with most services present.