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Homelessness is one thing I have been fortunate to avoid so far in my life. I have had little to do with homeless people until recently, other than walking past them in shop doorways and seeing them when they have been often admitted acutely, with various ailments, under my care in the past (especially in the middle of winter). Most have been keen to get out of hospital as fast as possible and I have often thought, after talking with them, how lucky I was—and thought to myself, after listening to what has happened to them, “there but through the grace of God go I”.

More recently I have been forced to re-examine the issues that homeless people are living with and society’s reactions to them, after a group of homeless men and women moved onto a section I own in central Christchurch. For over 9 months the local council and police did a good job providing support for these people and were tolerant of their presence. These homeless people developed a garden and had pet ducks, however, had no toilet facilities or running water. While they generally kept to themselves and lived in a sort of symbiotic relationship with the community, at times they partied and upset some local residents. As a result, eventually a few residents complained about this group to the Council and to the media. They were noticed, and the inevitable rules and regulations of society took over.

This meant that these homeless people had to move off the previously unused, vacant section, and back into areas such as shopping streets, doorways and the local parks, where none of the council requirements that forced them away were going to be met. What did surprise me was how intolerant a few well-off people are to the homeless, and the way the media tried to distort the story and continued to support urban myths about the homeless.

There is increasing literature about homelessness in New Zealand and some key points are worth reflecting on.

View Figures 1–4.

Homelessness is common and increasing. The 2018 Census identified 102,123 people as severely housing deprived, which is nearly 2.2% of the population. This figure includes people living in “Uninhabitable housing”, a statistic measured for the first time in the 2018 Census. If one excludes the “Uninhabitable housing” category, 41,724 people (or nearly 0.9% of the population) were identified as severely housing deprived. Compared with 2013, the rate of severe housing deprivation in 2018 had increased by 0.9% per 10,000 people, an increase of about 4,400 people.[[1]]

There is considerable geographical variation in homelessness within New Zealand. The highest rates of severe housing deprivation were found in Northland, Gisborne and Auckland; the lowest in Canterbury, Taranaki and Southland.[[1]]

Māori and young people are most affected groups (see Figures 3 and 4).

The average life expectancy of those chronically homeless is significantly reduced. One study found the average life span of a homeless person was shorter by approximately 17.5 years than that recorded for the general population. The average age at death of a homeless male was 56.27 years old (SD 10.38), and 52.00 years old (SD 9.85) for a homeless female. Other studies have found greater impact, with one suggesting the life expectancy of a chronically homeless male is 48 years.[[6]]

There are high rates of mental illness and substance abuse amongst the homeless. Epidemiological studies have consistently found that at least 25–30% of homeless persons have a severe mental illness such as schizophrenia and substance abuse. At the same time, the deleterious effects of homelessness on mental health have been established by research going back decades. There is a bi-directional relationship between mental ill health and homelessness.[[7]]

For many homeless, this is a temporary distressing issue; however, there is a small percentage of homeless people for whom this is a long-term issue. Many homeless are Māori and Pasifika peoples, and people with mental illness and substance abuse issues that are made worse by homelessness. The impact of homelessness on life expectancy is significant. Managing homelessness by moving people on as misbehaving youths is not the answer. After these recent severe storms there may be an increase in homelessness in the regions, despite whatever initial support is put in place. Though in this post-COVID lockdown period, society appears to have become less tolerant and considerate. Compassion, and tolerance are required, and the understanding that no one wants to be homeless—and that while it is as much a medical issue as it is social, it should not be considered criminal.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Acknowledgements

Correspondence

Frank Frizelle: Editor in Chief NZMJ; Professor of Surgery; Clinical Director of General Surgery; Department of Surgery, University of Otago Christchurch, New Zealand.

Correspondence Email

E: Frank.Frizelle@cdhb.health.nz

Competing Interests

Frank Frizelle is the Editor-in-Chief at the New Zealand Medical Journal.

1) Amore K, Viggers H, Chapman PH. Severe housing deprivation in Aotearoa New Zealand 2018. 2021 Jun update. Available from: https://www.hud.govt.nz/assets/Uploads/Documents/Severe-Housing-Deprivation-2018-Estimate-Report.pdf

2) OECD Affordable Housing Database [Internet]. Organisation for Economic Co-operation and Development. Available from: https://www.oecd.org/housing/data/affordable-housing-database/.

3) The People’s Project [Internet]. 2023. Available from: https://www.thepeoplesproject.org.nz/homelessness/.

4) Statista [Internet]. Statista Research Department; 2023. Available from: https://www.statista.com/statistics/1028946/new-zealand-homeless-population-in-auckland-by-age-group/.

5) Statista [Internet]. Statista Research Department; 2023. Available from: https://www.statista.com/statistics/1028989/new-zealand-homeless-population-in-auckland-by-ethnicity/.

6) Romaszko J, Cymes I, Dragańska E, Kuchta R, Glińska-Lewczuk K. Mortality among the homeless: Causes and meteorological relationships. PLoS One. 2017 Dec 21;12(12):e0189938. doi: 10.1371/journal.pone.0189938. PMID: 29267330; PMCID: PMC5739436.

7) Padgett DK. Homelessness, housing instability and mental health. BJPsych Bulletin. 2020;44(5):197-201, doi:10.1192/bjb.2020.49

For the PDF of this article,
contact nzmj@nzma.org.nz

View Article PDF

Homelessness is one thing I have been fortunate to avoid so far in my life. I have had little to do with homeless people until recently, other than walking past them in shop doorways and seeing them when they have been often admitted acutely, with various ailments, under my care in the past (especially in the middle of winter). Most have been keen to get out of hospital as fast as possible and I have often thought, after talking with them, how lucky I was—and thought to myself, after listening to what has happened to them, “there but through the grace of God go I”.

More recently I have been forced to re-examine the issues that homeless people are living with and society’s reactions to them, after a group of homeless men and women moved onto a section I own in central Christchurch. For over 9 months the local council and police did a good job providing support for these people and were tolerant of their presence. These homeless people developed a garden and had pet ducks, however, had no toilet facilities or running water. While they generally kept to themselves and lived in a sort of symbiotic relationship with the community, at times they partied and upset some local residents. As a result, eventually a few residents complained about this group to the Council and to the media. They were noticed, and the inevitable rules and regulations of society took over.

This meant that these homeless people had to move off the previously unused, vacant section, and back into areas such as shopping streets, doorways and the local parks, where none of the council requirements that forced them away were going to be met. What did surprise me was how intolerant a few well-off people are to the homeless, and the way the media tried to distort the story and continued to support urban myths about the homeless.

There is increasing literature about homelessness in New Zealand and some key points are worth reflecting on.

View Figures 1–4.

Homelessness is common and increasing. The 2018 Census identified 102,123 people as severely housing deprived, which is nearly 2.2% of the population. This figure includes people living in “Uninhabitable housing”, a statistic measured for the first time in the 2018 Census. If one excludes the “Uninhabitable housing” category, 41,724 people (or nearly 0.9% of the population) were identified as severely housing deprived. Compared with 2013, the rate of severe housing deprivation in 2018 had increased by 0.9% per 10,000 people, an increase of about 4,400 people.[[1]]

There is considerable geographical variation in homelessness within New Zealand. The highest rates of severe housing deprivation were found in Northland, Gisborne and Auckland; the lowest in Canterbury, Taranaki and Southland.[[1]]

Māori and young people are most affected groups (see Figures 3 and 4).

The average life expectancy of those chronically homeless is significantly reduced. One study found the average life span of a homeless person was shorter by approximately 17.5 years than that recorded for the general population. The average age at death of a homeless male was 56.27 years old (SD 10.38), and 52.00 years old (SD 9.85) for a homeless female. Other studies have found greater impact, with one suggesting the life expectancy of a chronically homeless male is 48 years.[[6]]

There are high rates of mental illness and substance abuse amongst the homeless. Epidemiological studies have consistently found that at least 25–30% of homeless persons have a severe mental illness such as schizophrenia and substance abuse. At the same time, the deleterious effects of homelessness on mental health have been established by research going back decades. There is a bi-directional relationship between mental ill health and homelessness.[[7]]

For many homeless, this is a temporary distressing issue; however, there is a small percentage of homeless people for whom this is a long-term issue. Many homeless are Māori and Pasifika peoples, and people with mental illness and substance abuse issues that are made worse by homelessness. The impact of homelessness on life expectancy is significant. Managing homelessness by moving people on as misbehaving youths is not the answer. After these recent severe storms there may be an increase in homelessness in the regions, despite whatever initial support is put in place. Though in this post-COVID lockdown period, society appears to have become less tolerant and considerate. Compassion, and tolerance are required, and the understanding that no one wants to be homeless—and that while it is as much a medical issue as it is social, it should not be considered criminal.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Acknowledgements

Correspondence

Frank Frizelle: Editor in Chief NZMJ; Professor of Surgery; Clinical Director of General Surgery; Department of Surgery, University of Otago Christchurch, New Zealand.

Correspondence Email

E: Frank.Frizelle@cdhb.health.nz

Competing Interests

Frank Frizelle is the Editor-in-Chief at the New Zealand Medical Journal.

1) Amore K, Viggers H, Chapman PH. Severe housing deprivation in Aotearoa New Zealand 2018. 2021 Jun update. Available from: https://www.hud.govt.nz/assets/Uploads/Documents/Severe-Housing-Deprivation-2018-Estimate-Report.pdf

2) OECD Affordable Housing Database [Internet]. Organisation for Economic Co-operation and Development. Available from: https://www.oecd.org/housing/data/affordable-housing-database/.

3) The People’s Project [Internet]. 2023. Available from: https://www.thepeoplesproject.org.nz/homelessness/.

4) Statista [Internet]. Statista Research Department; 2023. Available from: https://www.statista.com/statistics/1028946/new-zealand-homeless-population-in-auckland-by-age-group/.

5) Statista [Internet]. Statista Research Department; 2023. Available from: https://www.statista.com/statistics/1028989/new-zealand-homeless-population-in-auckland-by-ethnicity/.

6) Romaszko J, Cymes I, Dragańska E, Kuchta R, Glińska-Lewczuk K. Mortality among the homeless: Causes and meteorological relationships. PLoS One. 2017 Dec 21;12(12):e0189938. doi: 10.1371/journal.pone.0189938. PMID: 29267330; PMCID: PMC5739436.

7) Padgett DK. Homelessness, housing instability and mental health. BJPsych Bulletin. 2020;44(5):197-201, doi:10.1192/bjb.2020.49

For the PDF of this article,
contact nzmj@nzma.org.nz

View Article PDF

Homelessness is one thing I have been fortunate to avoid so far in my life. I have had little to do with homeless people until recently, other than walking past them in shop doorways and seeing them when they have been often admitted acutely, with various ailments, under my care in the past (especially in the middle of winter). Most have been keen to get out of hospital as fast as possible and I have often thought, after talking with them, how lucky I was—and thought to myself, after listening to what has happened to them, “there but through the grace of God go I”.

More recently I have been forced to re-examine the issues that homeless people are living with and society’s reactions to them, after a group of homeless men and women moved onto a section I own in central Christchurch. For over 9 months the local council and police did a good job providing support for these people and were tolerant of their presence. These homeless people developed a garden and had pet ducks, however, had no toilet facilities or running water. While they generally kept to themselves and lived in a sort of symbiotic relationship with the community, at times they partied and upset some local residents. As a result, eventually a few residents complained about this group to the Council and to the media. They were noticed, and the inevitable rules and regulations of society took over.

This meant that these homeless people had to move off the previously unused, vacant section, and back into areas such as shopping streets, doorways and the local parks, where none of the council requirements that forced them away were going to be met. What did surprise me was how intolerant a few well-off people are to the homeless, and the way the media tried to distort the story and continued to support urban myths about the homeless.

There is increasing literature about homelessness in New Zealand and some key points are worth reflecting on.

View Figures 1–4.

Homelessness is common and increasing. The 2018 Census identified 102,123 people as severely housing deprived, which is nearly 2.2% of the population. This figure includes people living in “Uninhabitable housing”, a statistic measured for the first time in the 2018 Census. If one excludes the “Uninhabitable housing” category, 41,724 people (or nearly 0.9% of the population) were identified as severely housing deprived. Compared with 2013, the rate of severe housing deprivation in 2018 had increased by 0.9% per 10,000 people, an increase of about 4,400 people.[[1]]

There is considerable geographical variation in homelessness within New Zealand. The highest rates of severe housing deprivation were found in Northland, Gisborne and Auckland; the lowest in Canterbury, Taranaki and Southland.[[1]]

Māori and young people are most affected groups (see Figures 3 and 4).

The average life expectancy of those chronically homeless is significantly reduced. One study found the average life span of a homeless person was shorter by approximately 17.5 years than that recorded for the general population. The average age at death of a homeless male was 56.27 years old (SD 10.38), and 52.00 years old (SD 9.85) for a homeless female. Other studies have found greater impact, with one suggesting the life expectancy of a chronically homeless male is 48 years.[[6]]

There are high rates of mental illness and substance abuse amongst the homeless. Epidemiological studies have consistently found that at least 25–30% of homeless persons have a severe mental illness such as schizophrenia and substance abuse. At the same time, the deleterious effects of homelessness on mental health have been established by research going back decades. There is a bi-directional relationship between mental ill health and homelessness.[[7]]

For many homeless, this is a temporary distressing issue; however, there is a small percentage of homeless people for whom this is a long-term issue. Many homeless are Māori and Pasifika peoples, and people with mental illness and substance abuse issues that are made worse by homelessness. The impact of homelessness on life expectancy is significant. Managing homelessness by moving people on as misbehaving youths is not the answer. After these recent severe storms there may be an increase in homelessness in the regions, despite whatever initial support is put in place. Though in this post-COVID lockdown period, society appears to have become less tolerant and considerate. Compassion, and tolerance are required, and the understanding that no one wants to be homeless—and that while it is as much a medical issue as it is social, it should not be considered criminal.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Acknowledgements

Correspondence

Frank Frizelle: Editor in Chief NZMJ; Professor of Surgery; Clinical Director of General Surgery; Department of Surgery, University of Otago Christchurch, New Zealand.

Correspondence Email

E: Frank.Frizelle@cdhb.health.nz

Competing Interests

Frank Frizelle is the Editor-in-Chief at the New Zealand Medical Journal.

1) Amore K, Viggers H, Chapman PH. Severe housing deprivation in Aotearoa New Zealand 2018. 2021 Jun update. Available from: https://www.hud.govt.nz/assets/Uploads/Documents/Severe-Housing-Deprivation-2018-Estimate-Report.pdf

2) OECD Affordable Housing Database [Internet]. Organisation for Economic Co-operation and Development. Available from: https://www.oecd.org/housing/data/affordable-housing-database/.

3) The People’s Project [Internet]. 2023. Available from: https://www.thepeoplesproject.org.nz/homelessness/.

4) Statista [Internet]. Statista Research Department; 2023. Available from: https://www.statista.com/statistics/1028946/new-zealand-homeless-population-in-auckland-by-age-group/.

5) Statista [Internet]. Statista Research Department; 2023. Available from: https://www.statista.com/statistics/1028989/new-zealand-homeless-population-in-auckland-by-ethnicity/.

6) Romaszko J, Cymes I, Dragańska E, Kuchta R, Glińska-Lewczuk K. Mortality among the homeless: Causes and meteorological relationships. PLoS One. 2017 Dec 21;12(12):e0189938. doi: 10.1371/journal.pone.0189938. PMID: 29267330; PMCID: PMC5739436.

7) Padgett DK. Homelessness, housing instability and mental health. BJPsych Bulletin. 2020;44(5):197-201, doi:10.1192/bjb.2020.49

Contact diana@nzma.org.nz
for the PDF of this article

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