Homelessness is a complex issue and can be caused by structural factors such as insufficient or inadequate social and health systems, unaffordable housing and/or individual factors, such as health problems, poverty or mental disorders. More than 700,000 homeless people are currently living in Europe and the trend is expected to increase over the coming years. In the Basque Country there are around 2,800 people living in severe residential exclusion. In the light of these data, a key issue is the development of new research to better understand the situation of this group.

“This work set out to analyse certain variables that may influence how homeless people and people living on the street perceive their health situation: personal variables, such as gender or the length of time a person has been in a situation of serious residential exclusion; interpersonal variables, such as contact with family members or whether they spend the day alone or accompanied by someone; and finally, the influence of social services (day centres, health centres, etc.) on their perception of health," said Igor Esnaola-Echaniz, researcher in the UPV/EHU's Department of Developmental and Educational Psychology.

To do this, "we used the data provided by the Social Information and Research Service (SIIS) in the IV Study on the situation of people in a situation of serious residential exclusion in the Autonomous Community of the Basque Country in 2018. The Basque Country is one of the communities most committed to homelessness in Spain, and has been conducting studies every two years since 2012. The fieldwork consisted of two actions: firstly, the night count, and secondly, the interviews conducted in the various day centres", indicated the UPV/EHU researcher.

"The results of this research show that sex is not significantly related to the health of this group. However, the length of time spent on the streets has shown to exert a considerable influence; in other words, the longer a person has been homeless, the worse the perception of their health is. Long-term homelessness is strongly associated with a poor perception of health," said Igor Esnaola.

 “The second objective of this work," as the UPV/EHU researcher pointed out, "was to analyse the influence of certain interpersonal relationships (family, friends, etc.). The effects of this variable tally with what was expected a priori. Having even occasional contact with one's family when one is homeless is assumed to help one perceive one's health in a more positive way. People who always spend the day alone are also expected to have a worse perception of their health than if they are accompanied”.

“The results also show that the use of health centres and mental health services is associated with a poor perception of health. In other words, if homeless people use both centres, it means that their health is not as good as they would like it to be," he added. Finally, "the use of day centres has a positive influence on the perception held by these people about their health. In other words, a better perception of health is held by the individuals who use day centres, where they have the opportunity to socialise, get to know people they can talk to, or with whom they can amuse themselves", said the author of the study.

“This work highlights the importance of developing interpersonal relationships and using day centres to improve the health of homeless people. Evidence shows that instilling or encouraging social relationships, trying to rebuild family relationships or the possibility of having social contact improves the health perception of homeless people. So perhaps rather than focusing on providing food, hygiene or a bed, initiatives that contribute towards the health of the homeless population should also focus on prevention initiatives related to the factors that contribute towards the health of the homeless population, such as the possibility of engaging in social relations and rebuilding family relationships," stressed Igor Esnaola.