Lifetime prevalence of homelessness in housed people aged 55–79 years in England: its childhood correlates and association with mortality over 10 years of follow-up

P. Demakakos*, D. Lewer, S. E. Jackson, A. C. Hayward

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Objectives: Since 2010, the number of homeless people in the UK has increased, and homelessness in its different types has become a major public health problem. Housed older people with past experience of homelessness are an understudied population that can provide valuable insight into this problem. For this reason, we examined the lifetime prevalence of homelessness and its associations with childhood adversity and mortality in a national sample of older people. Study design: This is a longitudinal cohort study. Methods: We studied 6649 housed individuals aged 55–79 years in 2007 from the English Longitudinal Study of Ageing (ELSA). We used logistic regression to model the association between adverse childhood experiences (ACE) and lifetime experience of homelessness (ever been homeless for ≥1 months) and Cox proportional hazards regression to model the prospective association between lifetime experience of homelessness and mortality. Results: We identified 107 participants with lifetime experience of homelessness. We found a strong graded association between the number of ACE and lifetime experience of homelessness; participants with two ACE had 5.35 (95% confidence interval [CI]: 3.17–9.05) times greater odds of having experienced homelessness than those reporting none. Most ACE were individually associated with lifetime homelessness, but fewer remained so in the mutually adjusted model. Participants with lifetime experience of homelessness had 1.55 (95% CI: 1.01–2.37) times greater risk of mortality over a 10-year follow-up and after adjustment for covariates. Conclusions: Exposure to childhood adversity is associated with increased risk of experiencing homelessness. Older housed people with past experience of homelessness are at increased risk of mortality.

Original languageEnglish
Pages (from-to)131-138
Number of pages8
JournalPublic Health
Volume182
DOIs
Publication statusPublished - May 2020
Externally publishedYes

Bibliographical note

Funding Information:
The English Longitudinal Study of Ageing is supported by the National Institute on Aging (Grants 2R01AG7644 and 2R01AG017644-01A1 ) and a consortium of the UK government departments coordinated by the Economic and Social Research Council . The National Institute on Aging and the consortium of the UK government departments had no role in the design and conduct of this study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. Professor Hayward is a National Institute for Health Research (NIHR) Senior Investigator and codirector of the UK Prevention Research Partnership (UKPRP) – ActEarly: a City Collaboratory approach to early promotion of good health and wellbeing (RC grant reference MR/S037527/ ) that is administered by MRC as part of a multifunder alliance including the Wellcome Trust . The views expressed in this article are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care, or the funders of the UKPRP.

Funding Information:
The English Longitudinal Study of Ageing is supported by the National Institute on Aging (Grants 2R01AG7644 and 2R01AG017644-01A1) and a consortium of the UK government departments coordinated by the Economic and Social Research Council. The National Institute on Aging and the consortium of the UK government departments had no role in the design and conduct of this study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. Professor Hayward is a National Institute for Health Research (NIHR) Senior Investigator and codirector of the UK Prevention Research Partnership (UKPRP) ? ActEarly: a City Collaboratory approach to early promotion of good health and wellbeing (RC grant reference MR/S037527/) that is administered by MRC as part of a multifunder alliance including the Wellcome Trust. The views expressed in this article are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care, or the funders of the UKPRP.

Publisher Copyright:
© 2020 The Authors

Keywords

  • Adverse childhood experiences
  • Ageing
  • Cohort
  • Homelessness
  • Longitudinal
  • Mortality

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