Health behaviours and mental and physical health status in older adults with a history of homelessness: a cross-sectional population-based study in England

Objectives: This study compared (i) levels of engagement in lifestyle risk behaviours and (ii) mental and physical health status in individuals who have previously been homeless to those of individuals who have not. Design: Cross-sectional. Participants: Data were from participants (n=6,931) of the English Longitudinal Study of Ageing. Measures: Participants reported whether they had ever been homeless. We used regression models to analyse associations between homelessness and (i) cigarette smoking, daily alcohol consumption and physical inactivity, adjusting for sociodemographic covariates (age, sex, ethnicity, highest level of education, marital status, and household non-pension wealth), and (ii) self-rated health, limiting long-standing illness, depressive symptoms, life satisfaction, quality of life and loneliness, adjusting for sociodemographics and health behaviours. Results: 104 participants (1.5%) reported having been homeless. Individuals who had been homeless were significantly more likely to be physically inactive (OR=1.62, 95% CI 1.44 to 2.52), report fair/bad/very bad self-rated health (OR=1.75, 95% CI 1.07 to 2.86), have a limiting long-standing illness (OR=2.66, 95% CI 1.65 to 4.30) and be depressed (OR=3.06, 95% CI 1.85 to 5.05), and scored lower on measures of life satisfaction (17.34 vs. 19.96, p<0.001) and quality of life (39.02 vs. 41.21, p=0.013). Rates of smoking (20.2% vs. 15.4%, p=0.436), daily drinking (27.6% vs. 22.8%, p=0.385), and loneliness (27.1% vs. 21.0%, p=0.080) were also elevated. Conclusions: Those who were once homeless have poorer mental and physical health outcomes and are more likely to be physically inactive. Interventions to improve their health and quality of life are required.