Isobel Anderson

HOUSING, HOMELESSNESS AND THE WELFARE STATE IN THE UK

This paper re-examines the role of the state in relation to homelessness in the UK. Taking a long term and macro-level perspective, the paper takes changing levels of poverty and inequality as broad indicators of the effectiveness of differing approaches to welfare, and looks at trends in homelessness across three eras of welfare. The analysis draws on theories of the state and the welfare state to explain differing levels of homelessness and to draw conclusions as to possible future pathways. State intervention in housing in the UK preceded the development of the welfare state, but homelessness intervention lagged behind during a long period of welfare expansion and consolidation. This early period bequeathed a legacy of social democratic policies which had significantly reduced poverty and income inequality, improved housing conditions and introduced legislation to protect households from homelessness. During the Conservative neo-liberal period (1979–97) welfare retrenchment was significant and resulted in real and substantial increases in poverty and inequality. The homelessness crisis resulted in further intervention in homelessness, despite retrenchment in housing. Since 1997, New Labour has claimed to implement a Third Way in social policy. However, this has been limited in its distinctiveness from the Conservative era (rolling out neo-liberalism, rather than rolling back welfare). Nevertheless, state intervention and welfare outcomes can and do change over time and space. Neo-liberalism is neither inevitable nor global, though it is proving to be enduring and widespread. Homelessness levels can be an important and valuable indicator of the most extreme manifestations of inequality and of the differing impact of different welfare regimes.

Housing policy and street homelessness in Britain

Abstract Recent government policies to tackle single homelessness have been expressly concerned to reduce the incidence of rough sleeping, particularly in central London. This paper sets the issue of street homelessness in its policy and legislative context; examines available evidence of the rise in street homelessness in Britain; and presents a critical overview of the Single Homelessness Initiative.

Housing and self-neglect: the responses of health, social care and environmental health agencies.

Substantiated cases of elder self-neglect have been reported to be more common than either elder abuse or neglect. It is a problem that often requires the active involvement of a whole range of health, social, housing, police and voluntary agencies. The ways in which these various agencies respond to self-neglect and how they interact with one another is not known. This research explored the ways in which different health and social care organizations respond to the problems associated with self-neglect. Research methods involved qualitative in-depth interviews with housing, healthcare, environmental health and social workers and a sample of their clients who were described as living in self-neglecting circumstances. This study revealed a lack of joint working across the relevant professions in relation to self-neglect. Better co-ordinated intervention could improve effectiveness and help make available resources go further. The study also suggests a need for a preventative approach to self-neglect, although further work would be required to develop indicators for early intervention.

Re-conceptualising Approaches to Meeting the Health Needs of Homeless People

The experience of homelessness not only affects physical health, but can also constrain access to required health care. In a number of European countries, national strategies to tackle homelessness have sought to deliver integrated solutions across housing, health and other social policy areas. This article examines approaches to meeting the health care needs of homeless people in relation to such strategies, drawing upon recent research in Norway and Scotland. The article presents a comparative analysis of approaches to service provision in relation to welfare models and the concepts of universal and specialist provision. The analysis suggests a cross-national shift in the conceptualisation of appropriate responses to the health care needs of those who experience homelessness. The provision of some specialist health services, while reflecting a selective model of welfare, need not be solely interpreted as conflicting with a more universal model of ensuring access to mainstream services. Rather, the challenge is to recognise the need for a process approach which supports an effective transition from the (sometimes necessary) use of specialist services for this group, towards (the ideal of) full integration into mainstream health care.

Housing and Health

Housing, health and well-being have always been inextricably linked. Shelter is a basic life necessity and adequate, affordable housing, in a secure neighbourhood, is commonly taken to be a fundamental prerequisite for healthy and happy living. Arguably, the broad principle that adequate housing is essential to public health offers as strong a case for positive state intervention in the housing system as do housing-specific objectives. Similarly, the varied input of the housing profession into providing and managing housing, and to supporting the well-being of tenants and residents, contributes in no small measure to public health outcomes as well as housing outcomes. Consequently, an understanding of the operation of the housing system and contribution of the housing profession will be essential to any comprehensive analysis of public health.

The Health of Homeless Women

Chapter 7 examines the health of homeless women, which is an under-researched topic in most European countries. It presents an overview of the available European research evidence on the health of homeless women and the factors that influence homeless women’s access to health services in different national health care and welfare systems. Although the knowledge base is patchy, thus limiting the extent to which comparisons can be made between countries, there is considerable evidence of relatively poor health among homeless women. Furthermore, the effectiveness with which the health care needs of homeless women are met depends, to a large degree, on enabling factors such as the nature and accessibility of national health care services. The chapter concludes that there is considerable scope for further research within and across European countries in order to better establish how women’s homelessness affects their health and how homeless women experience health care services across Europe.

Policies to Address Homelessness: Rights-Based Approaches

while homelessness has always existed in varying degrees across the globe, the late twentieth and early twenty-first centuries saw important progress in policy and rights-based responses to homelessness at national and international levels. This article considers two recent examples of rights-based responses to homelessness in Europe, with reference to the wider international context of the right to housing as a human right. It concludes that rights-based approaches can be effective, but that nation states should seek to convey both legal and social housing rights in order to best prevent and respond to homelessness.

Challenges for Housing Policy in Cuba: Case Studies from Havana

Abstract Housing remains one of the most severe and politically sensitive social issues facing the Cuban nation. While Cuba maintained its reputation for high standards in education and public health through the difficult years of the Special Period, meeting the housing needs of the population proved much more challenging. This paper begins with an overview of revolutionary Cuba’s housing system and achievements up to the 1990s and documents some of the challenges of the subsequent economic crisis. Its main thrust, however, is on research on housing strategies and initiatives in the post-2000 period, mainly focused on the capital city, Havana. The research identifies changing approaches to housing policy in response to the broader national and international economic climate. The evidence confirms the significance of structures for the governance of housing within the state apparatus; the important role of professional analysts and practitioners in innovative practice; and the importance of community participation in achieving new solutions to housing problems. Improvements through initiatives such as the regeneration of Old Havana and collaboration with international NGOs present valuable models but have been limited in quantity and geographical scope, relative to the scale of need.