Publications

Guest Article by Irfan Lone, Advisor for Policy & Communications, FEANTSA & CANCERless.EU 

Cancer is one of the greatest causes of death in Europe, but it does not affect everyone equally. Take for example people experiencing homelessness. While cancer adversely affects those who are already vulnerable, many individuals also simultaneously struggle to find shelter and navigate the barriers and challenges of accessing adequate healthcare services. In this article, we look at the struggles faced by those bearing the weight of this dual burden. 

A multi-faceted angle   

Experiencing homelessness pushes people into situations where they may either have irregular addresses or be undocumented and have no address at all. Therefore, those who experience homelessness are frequently excluded from accessing healthcare services, social security, and systems of social justice. This makes it extremely difficult for these individuals to benefit from primary prevention and screenings for many diseases, including for cancer. However, one of the biggest healthcare challenges overall is that such screening and prevention is not sufficiently taking place to begin with [1]. The situation is further complicated by the fact that people experiencing homelessness face prejudice, stigma, nonacceptance, and discrimination on a daily basis.

Further, healthcare and community care providers may have difficulties in ensuring sufficient care and support for individuals experiencing homelessness. For example, frontline health care professionals (HCP) encounter a fundamental challenge in reaching out to those who experience homelessness and require healthcare. This dual burden complicates both the delivery of care by HCPs and the accessibility of healthcare services for individuals experiencing homelessness. Moreover, fragmented health systems add further barriers to achieving comprehensive care for people experiencing homelessness.  

Research insights    

The odds of developing cancer are believed to be two times higher for those who experience homelessness than for those who are adequately housed [2]. Similar insights are put forward by CANCERless.EU, a project which aims to improve access to screening and prevention of cancer among people experiencing homelessness. Initial findings from this project underscore the need to increase availability of information, and access to cancer screening, prevention, treatment and care, across different genders and age groups. 

Advocacy and action amid public health priorities     

Homelessness extends beyond an individual’s health, reaching into societal well-being. The resulting public health consequences include not only personal health challenges, but they also strain communities at the local and national levels. For instance, beyond individual impacts, homelessness exacerbates health, social and economic disparities, affecting social services and community health.

Addressing homelessness is not merely a health concern, it is a multifaceted societal obligation, crucial for fostering equity and enhancing the overall well-being of communities. Consequently, societies and healthcare systems must navigate multiple priorities, allocating resources to tackle this complex issue. For instance, among many health conditions faced by people experiencing homelessness, cancer stands out. The lack of access to preventive screenings among individuals experiencing homelessness often results in delayed diagnosis of various cancers. Consequently, treating diseases becomes extremely challenging, resulting in lower survival rates. This contributes to the fact that, as shown in research by the Cancerless project, the mortality rate of cancer among people experiencing homelessness is more than double that of the general population.

Both homelessness and cancer are expected to rise drastically in the coming decades. It is therefore crucial that policy makers and stakeholders take collective action and ensure that no one has to face the burden of this dual crisis. This calls for the design, implementation, acceleration and evaluation of holistic, equitable and compassionate policy, ensuring that health coverage is not just a luxury for a few, but a basic and universal human right for all. This should be irrespective of the housing situation and should be working towards a long-cherished vision: forging a “Europe for all.”

Interested in CANCERless.eu? Feel free to get in touch with Irfan Lone at irfan.lone@feantsa.org, or read more information on the project on the website: cancerless.eu 

Sources: 

[1] Drescher, N. R., & Oladeru, O. T. (2023). Cancer screening, treatment, and outcomes in persons experiencing homelessness: Shifting the lens to an understudied population. JCO Oncology Practice, 19(3), 103–105.   https://doi.org/10.1200/op.22.00720       

[2] Schiffler T, Jeleff  M, Gil-Salmerón, A, et al. Cancer risk factors and access to cancer prevention services for people experiencing homelessness: a scoping review protocol BMJ Open 2023;13:e074710. doi: 10.1136/bmjopen-2023-074710