Health of people experiencing homelessness

People experiencing homelessness and those at risk of homelessness are among Australia’s most disadvantaged. Homelessness and housing insecurity can expose people to harsh living conditions and violence and disrupt daily functions like eating and sleeping (Box et al. 2025; Edmed et al. 2025; Larney et al. 2009). These experiences contribute to a range of adverse health outcomes, including (Goode et al. 2018; Gordon et al. 2024; Huang et al. 2022; Vallesi et al. 2021):

• nutritional deficiencies and dental problems
• chronic mental and physical health issues
• disability.

People experiencing homelessness can have limited control over social determinants of health. In addition to challenges securing housing, they may face barriers to employment, maintaining social connections and access to services. Reduced access to healthcare services can make it harder to manage health conditions. Without support to exit homelessness, a cycle of worsening health can develop, increasing the risk of chronic illness and premature death (Gordon et al. 2024; Tuson et al. 2024; Vallesi et al. 2021).

People experiencing homelessness

In 2019, an estimated 1 in 9 (11% or 2.2 million) Australians aged 15 and over had been without a permanent place to live at some time in their lives (ABS 2019), most commonly due to a relationship or family breakdown (48%). Around 75% stayed with friends or relatives, while 34% experienced rough sleeping.

On Census night in 2021, more than 122,000 Australians were estimated to be experiencing homelessness, up from 116,000 (an increase of 5.2%) in 2016. Around 56% were male, 58% were younger than 35 and 20% identified as Aboriginal and/or Torres Strait Islander (First Nations) origin (ABS 2023).

Of people experiencing homelessness in Australia in 2021 (ABS 2023):

• 47,900 (39%) were living in 'severely' crowded dwellings
• 24,300 (20%) were in supported accommodation for the homeless
• 7,600 (6.2%) were living in improvised dwellings, tents or sleeping out (also termed rough sleeping).

Government-funded specialist homelessness services (SHS) across Australia provide support to people who are experiencing or at risk of homelessness. In 2024–25, services supported almost 289,000 clients. Of those, around half (132,500 or 49%) were experiencing homelessness when they first began support (AIHW 2025c).

For further information about the profile of people experiencing homelessness and the support provided by specialist homelessness services, see Homelessness and homelessness services.

The impact of homelessness on health

There is growing research on the impact of homelessness on the health of individuals and the associated costs to the health system.

Meeting basic physical needs such as food, water and a place to sleep can be the most important day-to-day priority for people experiencing homelessness, especially those rough sleeping. Health needs are often not addressed until an emergency arises (Wise and Phillips 2013; Zaretzky and Flatau 2013). While rough sleeping is the least common form of homelessness in Australia (ABS 2023), the long-term impacts of rough sleeping on health are profound due to issues such as poor nutrition, living in harsh environments and high rates of injury (Fazel et al. 2014). For more information, see SHS clients rough sleeping.

Severe overcrowding is the most common form of homelessness in Australia and is associated with unique health impacts. For example, severe overcrowding places stress on the infrastructure of the dwelling, such as food preparation areas, bathrooms, laundry facilities and sewerage systems. It may lead to more rapid transmission of infectious diseases, with subsequent longer-term health impacts, and induce psychological stress (AIHW 2025d; Buckle et al. 2020).

Health outcomes for people experiencing homelessness can be improved through access to appropriate housing combined with targeted wraparound services, such as health or medical, mental health and disability services. While housing alone is not sufficient to improve health outcomes, it is a necessary foundation for creating conditions that enable better health (Kuehnle et al. 2022).

Additionally, there is evidence of health benefits associated with secure housing following a period of insecure housing, including (Carnemolla and Skinner 2021):

• decreased rates of hospitalisation
• reduced transmission of infectious diseases
• improved mental health symptoms
• overall improved wellbeing.

Life expectancy of people experiencing homelessness

Regardless of the form of homelessness, international research on the gap in life expectancy consistently reveals large differences among those who have experienced homelessness compared with those who have not:

• more than 30 years in the United Kingdom and the United States (Maness and Khan 2014; Perry and Craig 2015)
• more than 10 years for people in marginal housing in Canada (Hwang et al. 2009).

Australian studies have found people who had experienced homelessness died an average of 22 to 33 years younger than those who had not (Tuson et al. 2024; Knaus 2024; Zordan et al. 2023). Among clients of Specialist Homelessness Services (SHS) in Australia who died between 2012–23, people with a history of homelessness (median age of death 50–52 years) died around a decade earlier than SHS clients with no history of homelessness (61 years) (AIHW 2025b; see People with a history of SHS support who have died below for more detail).

Research has shown that much of the mortality gap is due to causes which could be effectively treated with appropriate health care (Aldridge et al. 2019; Waugh et al. 2018). In Australia, more than half of deaths (56%) among people who received homelessness services were potentially avoidable (AIHW 2025b; see Potentially avoidable deaths). A study from Scotland found that interactions with health services increased in the years prior to becoming homeless, with a peak in interactions around the time of the first assessment as homeless – particularly for services related to mental health or problematic drug and alcohol use (Waugh et al. 2018). This study suggests that health services could play a role in preventing homelessness by identifying risk factors, and targeted early intervention.

People with a history of SHS support who have died

SHS agencies provide a variety of services to assist people who are experiencing, or at risk of, homelessness, ranging from advice and information to crisis accommodation. Analysis of the NACS linked dataset of people who have received SHS support and have died provides insights into the experiences of housing insecurity and causes of death. 

Throughout 2012–13 to 2022–23, around 43,200 people with a history of SHS support died – around 25,600 males and 17,700 females. Over half (56%) of people with a history of SHS support who died had a recorded history of homelessness. Any experience of rough sleeping (50 years) was associated with a younger median age at death, compared with people who experienced other forms of homelessness (52 years) and those who did not have a recorded experience of homelessness while in contact with SHS agencies (61 years) (AIHW 2025b).

Between 2012–13 to 2022–23, natural causes accounted for between 55% and 76% of deaths among people with a history of SHS support, compared with 92% of non-SHS clients.

In 2022–23, almost 94 years of potential life were lost (PYLL) each day among people who had received SHS support in their last year of life. People with a history of SHS support who died contributed around 15% (121,400) of PYLL nationally in 2022–23 – reflecting the low median age at death (55 years) among the cohort. 

Over half (56%) of deaths among people with a history of SHS support in 2022–23 were potentially avoidable, equating to around 9 potentially avoidable deaths per day, and accounting for around 1 in 8 potentially avoidable deaths nationally. For analysis on causes of death among people who received SHS support, see Underlying cause of death.

People who received SHS support in the last year of life

Around 14,000 people received SHS support in their last year of life between 2012–13 and 2022–23 – around 8,700 males and around 5,300 females. The death rate of SHS clients was up to 1.7 times the rate of non-SHS clients (AIHW 2025a).

Of the 14,000 people who received SHS support in the last year of life:

• almost half (45% or 6,300) deaths were people aged 35–54 years
• around 1 in 8 deaths (12% or 1,700) were people aged 25–34 years
• around 1 in 77 deaths (1.3% or around 180 people) were children aged 0–14 years.

Accidental poisoning and suicide were the most common underlying causes of death among people who received SHS support in their last year of life, accounting for around 1 in 5 deaths each year (Figure 1).

As a proportion of all deaths each year in Australia throughout 2012–13 to 2022–23, people who received SHS support in their last year of life accounted for:

• around 1 in 7 (14–18%) deaths among Australians who died from accidental poisoning
• around 1 in 20 (4.2–6.2%) deaths by suicide
• around 1 in 25 (2.0–4.0%) deaths from land transport accidents.

Self-assessed health

In 2014, around 1 in 4 (26%) people in Australia who had ever experienced homelessness assessed their health as fair or poor, compared with 14% of those who had not experienced homelessness (ABS 2015). These data are limited to people who had experienced homelessness but were living in private dwellings at the time of the survey.

People who had experienced homelessness were also more likely to report having a health condition or disability – particularly a mental health condition or a long-term health condition – with depression, back pain or back problems, anxiety, and asthma the most commonly reported.

Health service needs of SHS clients

In 2024–25, around 1 in 4 (24% or 69,000) SHS clients identified health-related reasons for seeking support (AIHW 2025c). Clients may require assistance for more than one reason. Of the 69,000 SHS clients reporting health‑related reasons:

• 49,100 clients identified mental health issues
• 27,900 clients identified medical issues
• 14,900 clients identified problematic drug or substance use
• 7,700 clients identified problematic alcohol use.

SHS agencies provide various services to clients, from accommodation to more specialised services such as health or medical services. When an SHS agency is unable to provide specialised services, clients can be referred to another agency. Health-related services were among the most commonly referred service types (AIHW 2025c).

In 2024–25, SHS clients needed a range of health-related services:

• around 26,600 clients needed health/medical services
• over 8,000 needed drug/alcohol counselling (Table 1).

Individual clients may have more than one need and SHS data does not describe whether referred clients eventually received the health care needed.

(a) Includes clients who refuse a service.

Source: Specialist Homelessness Services Collection 2024–25, AIHW 2025c

Barriers to accessing health care

In 2014, people with an experience of homelessness in the past 10 years were more likely to report having experienced a barrier to accessing health-care (13%), compared with those without (4.4%) (ABS 2015). Among people unable to obtain health-care when needed, 2 in 5 (40%) identified the cost of service as the main barrier to access. Long waiting times and lack of appointment availability were also reported as common barriers (ABS 2015).

Individual risk factors such as illness and poor health can be a barrier to receiving health-care. For example, mental illness can influence both being able to attend appointments and the effectiveness of health care provided (Davies and Wood 2018). The stigma associated with receiving mental health care, feeling stereotyped or judged can also have an impact.

Physical barriers pose further challenges to people who may be rough sleeping, couch surfing or living in short-term accommodation. Examples include:

• accessibility and cost of public transport to attend appointments
• having no mailing address or phone to receive appointment reminders
• being able to keep medications secure.

Improving health service access

The Australian Government has established the Homelessness Support Program to support improved access to primary care services for people experiencing or at risk of homelessness (Commonwealth of Australia 2023). The program tasks Primary Healthcare Networks with identifying barriers to care, supporting targeted services, and promoting coordination among primary care providers to deliver integrated and effective care (Department of Health and Aged Care 2023).

Access to health-care for people experiencing or at risk of homelessness can be significantly improved through targeted, flexible interventions that address both structural and individual barriers. Key approaches include case management and peer support, community-based and outreach care, service integration and co-location, and digital health tools. Outreach and community-based models are particularly effective, meeting people in familiar, low-threshold environments that build trust and reduce stigma, while an integrated wraparound service approach ensures that complex and overlapping health and social needs are addressed holistically. Combining these strategies – alongside collaboration between health and social services – offers the most promising pathway to equitable, person-centred care for this population (Meda et al. 2025).

Where do I go for more information?

For more information on the health of people experiencing homelessness, see:

• Specialist homelessness services annual report
• Specialist homelessness services: feature analysis
• Housing data dashboard
• Homelessness and housing affordability in Australia
• Australian Bureau of Statistics (ABS) Estimating homelessness: Census, 2021

For more information on this topic, see Homelessness services.