Who are the homeless and what kind of problems do they have? A review of the literature
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Department of Family Medicine and Infectious Diseases, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland
Academy of Applied Medical and Social Sciences, Polska
These authors had equal contribution to this work
Submission date: 2023-10-16
Final revision date: 2023-11-20
Acceptance date: 2023-11-20
Online publication date: 2023-12-30
Corresponding author
Jerzy Romaszko   

University of Warmia and Mazury in Olsztyn, Warszawska 30, 10-082 Olsztyn, Poland. Tel.: +4889 524 61 65, +48 602 879 061.
Acta Elbingensia 2023;50(1):69-76
The publications about homeless persons and homelessness are very popular among scientists. Entering the keyword ‘homeless’ returns about 17 thousand hits in the PubMed search engine. What is so interesting about homelessness that so many researchers devote their time and resources to this topic?

Our paper is an attempt to answer the question about that, and partially about the genesis of homelessness.

Material and methods:
The PubMed and Scopus databases have been researched. We selected the articles related to the most common pathologies among the homeless.

Results and discussion:
The background of the phenomenon of homelessness is described in the context of the most commonly reported shared elements i.e. poverty, social exclusion, high mortality rates, male predominance, alcohol and drug dependence, intellectual deficits, depressive disorders and suicides. We described the differences resulting from geographical location and environmental factors. We are trying to elucidate the reasons for the discrepancies between individual investigators studying similar problems at different places and at different times.

Homeless people are not a different species. They are a derivate of societies on the margins of which these people live. They are therefore different in the geographical sense, but in a given area they change with time similarly to the local population.

Not declared.
Not declared.
Liu M, Hwang SW. Health care for homeless people. Nat Rev Dis Primers. 2021;7(1):5.
Gutwinski S, Schreiter S, Deutscher K, Fazel S. The prevalence of mental disorders among homeless people in high-income countries: An updated systematic review and meta-regression analysis. PLoS Med. 2021;18(8):e1003750.
Ayano G, Belete A, Duko B, Tsegay L, Dachew BA. Systematic review and meta-analysis of the prevalence of depressive symptoms, dysthymia and major depressive disorders among homeless people. BMJ Open. 2021;11(2):e040061.
Medlow S, Klineberg E, Steinbeck K. The health diagnoses of homeless adolescents: a systematic review of the literature. J Adolesc. 2014;37(5):531–542.
Beijer U, Wolf A, Fazel S. Prevalence of tuberculosis, hepatitis C virus, and HIV in homeless people: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12(11):859–870.
Swahn MH, Braunstein S, Kasirye R. Demographic and psychosocial characteristics of mobile phone ownership and usage among youth living in the slums of Kampala, Uganda. West J Emerg Med. 2014;15(5):600–603.
Humphry J. Looking for Wi-Fi: youth homelessness and mobile connectivity in the city. Inf Commun Soc. 2021;24(7):1009–1023.
Harpin S, Davis J, Low H, Gilroy C. Mobile phone and social media use of homeless youth in Denver, Colorado. J Community Health Nurs. 2016;33(2):90–97.
Jennings L, Lee N, Shore D, et al. U.S. minority homeless youth’s access to and use of mobile phones: Implications for mHealth intervention design. J Health Commun. 2016;21(7):725–733.
Heaslip V, Richer S, Simkhada B, Dogan H, Green S. Use of technology to promote health and wellbeing of people who are homeless: a systematic review. Int J Environ Res Public Health. 2021;18(13):6845.
Amore K, Baker M, Howden-Chapman P. The ETHOS definition and classification of homelessness: an analysis. Eur J Homelessness. 2011;5(2):19–37.
FEANTSA. Report: 8th Overview of Housing Exclusion in Europe 2023. 2023. Accessed: 2023-12-18.
FEANTSA. Extent and Profile of Homelessness in European Member States. European Observatory on Homelessness. A Statistical Update. 2014. Accessed: 2023-12-18.
Solari CD, Cortes A, Henry M, et al. The 2013 Annual Homeless Assessment Report (AHAR) to Congress. 2014. Accessed: 2023-12-18.
Nilsson SF, Nordentoft M, Hjorthøj C. Individual-level predictors for becoming homeless and exiting homelessness: a systematic review and meta-analysis. J Urban Health. 2019;96(5):741–750.
Thomsen RL, Balslov KD, Benjaminsen SE, Petersen P. Homeless persons residing in shelters in the county of Funen I. Psychosocial characteristics and need of treatment [in Danish]. Ugeskr Laeger. 2000;162(9):1205–1210.
Yoon C, Ju YS, Kim CY. Disparities in health care utilization among urban homeless in South Korea: a cross-sectional study. J Prev Med Public Health. 2011;44(6):267–274.
Fichter MM, Quadflieg N. Prevalence of mental illness in homeless men in Munich, Germany: results from a representative sample. Acta Psychiatr Scand. 2001;103(2):94–104.
Rhoades H, Wenzel SL, Golinelli D, et al. The social context of homeless men’s substance use. Drug Alcohol Depend. 2011;118(2–3):320–325.
Toro PA, Hobden KL, Wyszacki Durham K, Oko-Riebau M, Bokszczanin A. Comparing the characteristics of homeless adults in Poland and the United States. Am J Community Psychol. 2014;53(1–2):134–145.
Israel N, Toro PA, Ouellette N. Changes in the composition of the homeless population: 1992–2002. Am J Community Psychol. 2010;46(1–2):49–59.
Lee BA, Greif MJ. Homelessness and hunger. J Health Soc Behav. 2008;49(1):3–19.
Romaszko J, Kuchta R, Opalach C, et al. Socioeconomic characteristics, health risk factors and alcohol consumption among the homeless in north-eastern part of Poland. Cent Eur J Public Health. 2017;25(1):29–34.
Fazel S, Khosla V, Doll H, Geddes J. The prevalence of mental disorders among the homeless in western countries: systematic review and meta-regression analysis. PLoS Med. 2008;5(12):e225.
Morikawa S, Uehara R, Okuda K, Shimizu H, Nakamura Y. Prevalence of psychiatric disorders among homeless people in one area of Tokyo [in Japanese]. Nihon Koshu Eisei Zasshi. 2011;58(5):331–339.
McVicar D, Moschion J, van Ours JC. From substance use to homelessness or vice versa? Soc Sci Med. 2015;136–137:89–98.
Gutiérrez-Lobos K, Scherer M, Anderer P, Katschnig H. The influence of age on the female/male ratio of treated incidence rates in depression. BMC Psychiatry. 2002;2:3.
Ayano G, Tesfaw G, Shumet S. The prevalence of schizophrenia and other psychotic disorders among homeless people: a systematic review and meta-analysis. BMC Psychiatry. 2019;19(1):370.
Elvevåg B, Goldberg TE. Cognitive impairment in schizophrenia is the core of the disorder. Crit Rev Neurobiol. 2000;14(1):1–21.
Waclawik K, Jones AA, Barbic SP, et al. Cognitive impairment in marginally housed youth: Prevalence and risk factors. Front Public Health. 2019;7:270.
Nishio A, Yamamoto M, Ueki H, et al. Prevalence of mental illness, intellectual disability, and developmental disability among homeless people in Nagoya, Japan: A case series study. Psychiatry Clin Neurosci. 2015;69(9):534–542.
Tripathi A, Nischal A, Dalal PK, et al. Sociodemographic and clinical profile of homeless mentally ill inpatients in a north Indian medical university. Asian J Psychiatr. 2013;6(5):404–409.
Oakes PM, Davies RC. Intellectual disability in homeless adults: a prevalence study. J Intellect Disabil. 2008;12(4):325–334.
Bremner AJ, Duke PJ, Nelson HE, Pantelis C, Barnes TR. Cognitive function and duration of rooflessness in entrants to a hostel for homeless men. Br J Psychiatry. 1996;169(4):434–439.
Gonzalez EA, Dieter JN, Natale RA, Tanner SL. Neuropsychological evaluation of higher functioning homeless persons: A comparison of an abbreviated test battery to the mini-mental state exam. J Nerv Ment Dis. 2001;189(3):176–181.
Romaszko J, Cymes I, Dragańska E, Kuchta R, Glińska-Lewczuk K. Mortality among the homeless: Causes and meteorological relationships. PloS One. 2017;12(12):e0189938.
Nusselder WJ, Slockers MT, Krol L, Slockers CT, Looman CW, van Beeck EF. Mortality and life expectancy in homeless men and women in Rotterdam: 2001–2010. PLoS One. 2013;8(10):e73979.
Wincup E, Buckland G, Bayliss R. Youth homelessness and substance use: Report to the drugs and alcohol research unit. 2003. Accessed: 2023-12-18.
Baggett TP, Rigotti NA. Cigarette smoking and advice to quit in a national sample of homeless adults. Am J Prev Med. 2010;39(2):164–172.
Chen Q, Wan M, Ban C, Gao Y. Retrospective assessment of the prevalence of cardiovascular risk factors among homeless individuals with schizophrenia in Shanghai. Shanghai Arch Psychiatry. 2014;26(3):149–156.
Lee TC, Hanlon JG, Ben-David J, et al. Risk factors for cardiovascular disease in homeless adults. Circulation. 2005;111(20):2629–2635.
Kaldmäe M, Zilmer M, Viigimaa M, et al. Cardiovascular disease risk factors in homeless people. Ups J Med Sci. 2011;116(3):200–207.
Buciński A, Romaszko J, Kaliszan R, et al. Can homelessness be treated as a defined risk factor for cardiovascular diseases? [in Polish]. Zdrowie Publ. 2007;3(117):324–329.
Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: A 26-year follow-up of participants in the Framingham Heart Study. Circulation. 1983;67(5):968–977.
Maness SB, Reitzel LR, Hernandez DC, et al. Modifiable risk factors and readiness to change among homeless adults. Am J Health Behav. 2019;43(2):373–379.
Wang Y, Beydoun MA, Min J, Xue H, Kaminsky LA, Cheskin LJ. Has the prevalence of overweight, obesity and central obesity levelled off in the United States? Trends, patterns, disparities, and future projections for the obesity epidemic. Int J Epidemiol. 2020;49(3):810–823.
Langnase K, Muller MJ. Nutrition and health in an adult urban homeless population in Germany. Public Health Nutr. 2001;4(3):805–811.
Arnaud A, Fagot-Campagna A, Reach G, Basin C, Laporte A. Prevalence and characteristics of diabetes among homeless people attending shelters in Paris, France, 2006. Eur J Public Health. 2010;20(5):601–603.
Scott J, Gavin J, Egan AM, et al. The prevalence of diabetes, pre-diabetes and the metabolic syndrome in an Irish regional homeless population. QJM. 2013;106(6):547–553.
Nishio A, Horita R, Sado T, et al. Relationship between non-communicable diseases and background characteristics among homeless people in Nagoya City, Japan. Plos One. 2019;14(7):e0219049.
Chen C-L, Chen M, Liu C-K. The effects of obesity-related anthropometric factors on cardiovascular risks of homeless adults in Taiwan. Int J Environ Res Public Health. 2020;17(18):6833.
Romaszko J, Buciński A, Kuchta R, Bednarski K, Zakrzewska M. The incidence of pulmonary tuberculosis among the homeless in north-eastern Poland. Cent Eur J Med. 2013;8(2):283–285.
Mitruka K, Winston CA, Navin TR. Predictors of failure in timely tuberculosis treatment completion, United States. Int J Tuberc Lung Dis. 2012;16(8):1075–1082.
Curtis AB, Ridzon R, Novick LF, et al. Analysis of Mycobacterium tuberculosis transmission patterns in a homeless shelter outbreak. Int J Tuberc Lung Dis. 2000;4(4):308–313.
Hwang SW, Kiss A, Ho MM, Leung CS, Gundlapalli AV. Infectious disease exposures and contact tracing in homeless shelters. J Health Care Poor Underserved. 2008;19(4):1163–1167.
van Hest NA, Aldridge RW, de Vries G, et al. Tuberculosis control in big cities and urban risk groups in the European Union: a consensus statement. Euro Surveill. 2014;19(9):20728.
Hessol NA, Eng M, Vu A, Pipkin S, Hsu LC, Scheer S. A longitudinal study assessing differences in causes of death among housed and homeless people diagnosed with HIV in San Francisco. BMC Public Health. 2019;19(1):1–12.
Hwang SW. Mortality among men using homeless shelters in Toronto, Ontario. JAMA. 2000;283(16):2152–2157.
Ochal M, Kuchta R, Tokarczyk-Malesa K, Romaszko M, Skutecki R. A COVID-19 micro-epidemic in the shelter for the homeless in Olsztyn. Pol Ann Med. 2021;28(2):194–198.
Ogbonna O, Bull F, Spinks B, Williams D, Lewis R, Edwards A. The impact of being homeless on the clinical outcomes of COVID-19: Systematic review. Int J Public Health. 2023;68:1605893.
Topolovec-Vranic J, Ennis N, Howatt M, et al. Traumatic brain injury among men in an urban homeless shelter: observational study of rates and mechanisms of injury. CMAJ Open. 2014;2(2):E69–E76.
McLeod R, Stockwell T, Stevens M, Phillips M. The relationship between alcohol consumption patterns and injury. Addiction. 1999;94(11):1719–1734.
de Labry LO, Glynn RJ, Levenson MR, Hermos JA, LoCastro JS, Vokonas PS. Alcohol consumption and mortality in an American male population: recovering the U-shaped curve – findings from the normative Aging Study. J Stud Alcohol. 1992;53(1):25–32.
Centers for Disease Control and Prevention. Hypothermia-related deaths-United States, 1999–2002 and 2005. MMWR Morb Mortal Wkly Rep. 2006;55(10):282–284.
Harlan SL, Declet-Barreto JH, Stefanov WL, Petitti DB. Neighborhood effects on heat deaths: social and environmental predictors of vulnerability in Maricopa County, Arizona. Environ Health Perspect. 2013;121(2):197–204.
Feodor Nilsson S, Hjorthoj CR, Erlangsen A, Nordentoft M. Suicide and unintentional injury mortality among homeless people: a Danish nationwide register-based cohort study. Eur J Public Health. 2014;24(1):50–56.
Hor K, Taylor M. Suicide and schizophrenia: a systematic review of rates and risk factors. J Psychopharmacol. 2010;24(4 Suppl):81–90.
Galaif ER, Sussman S, Newcomb MD, Locke TF. Suicidality, depression, and alcohol use among adolescents: a review of empirical findings. Int J Adolesc Med Health. 2007;19(1):27–35.
Fekadu A, Hanlon C, Gebre-Eyesus E, et al. Burden of mental disorders and unmet needs among street homeless people in Addis Ababa, Ethiopia. BMC Med. 2014;12:138.
Okamura T, Ito K, Morikawa S, Awata S. Suicidal behavior among homeless people in Japan. Soc Psychiatry Psychiatr Epidemiol. 2014;49(4):573–582.
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